Root canal therapy is an alternative to dental implants. It offers many benefits because it preserves your natural tooth material. Although the tooth is dead, it still interacts with your jawbone as only a natural tooth can, which means that it can perform better in some situations. It might even last longer than dental implants on average. And if the treated tooth fails, it can be replaced with a dental implant, while a failed implant might not be able to be replaced by another.
But root canal therapy does have disadvantages, including the risk that it might spread disease through the body.
Mausoleums of Gold
It’s worth noting that for decades root canal therapy was in disfavor among a large segment of the medical community because of the sepsis theory. As one critic put it in 1910, in a root canal restorations were, “built in, on, and around diseased teeth which form a veritable mausoleum of gold over a mass of sepsis to which there is no parallel in the whole realm of medicine.” Instead of root canals, dentists were persuaded to just pull teeth that had been compromised, which is why people in the first half of the 20th century tended to have a lot of teeth pulled. (Well, that and toothbrushing didn’t really become common until after WWII.)
Although there are still people who advocate the sepsis hypothesis, it’s been discredited. But that doesn’t mean that there isn’t still potential for infection related to root canal therapy. Just how much risk is still uncertain, although it’s likely small.
Bacteria in Infected Teeth
But there are still bacteria in infected teeth. When you have a root canal, some of this bacteria can be released into the body. This bacteria can then travel through the body and cause infections elsewhere, including your heart, leading to a risk of heart infection known as infective endocarditis, which can be dangerous, even fatal.
Does this mean that you should avoid root canals? No. Here’s why.
Managing Infection Risk with Root Canals
First, it’s important to note that all dental procedures have a risk of spreading oral bacteria into your bloodstream and your body. In fact, research suggests that the primary release of oral bacteria into the blood comes as a result of daily toothbrushing. Although an extraction or root canal can cause the release of more bacteria at once, it’s this daily expose that contributes the most bacteria over time. Our body can generally eliminate bacteremia within 15 minutes, whether it’s caused by root canals, extractions, or toothbrushing, so it’s most important to try to improve your overall oral health, not avoid root canals.
Most guidelines aren’t recommending the use of preventive antibiotics before a root canal procedure. Instead, these are only recommended for people who are at an elevated risk of heart infection, including those with:
- Prosthetic heart valves
- Heart valves repaired with prosthetic materials
- Prior history of infective endocarditis
- Congenital heart defects
Studies have even shown that people with artificial joints don’t have to worry about antibiotics before dental procedures.
It’s important to be aware of risks, but it’s not a reason to avoid root canals. This is a viable treatment that should be considered if you have a tooth that can benefit.