Endodontics plays a critical role in maintaining good oral health by not only eliminating infection and pain, but also by preserving our natural teeth. A key responsibility of any endodontist is to reassure patients who are concerned about the safety of endodontic treatment that their overall well-being is a top priority.
The American Association of Endodontists website (www.aae.org) is one of the best places for anxious patients to obtain comprehensive information on the safety and efficacy of endodontics and root canal treatment. While plenty of good information is available online from the AAE and other reliable resources, patients sometimes arrive at the dental office with misinformation.
Misguided Research in the Early 1900s
This has occurred with the long-dispelled “focal infection theory” in endodontics, introduced in the early 1900s. In the 1920s, Dr. Weston A. Price presented research suggesting that bacteria trapped in dentinal tubules during root canal treatment could “leak” and cause almost any type of degenerative systemic disease (eg, arthritis, diseases of the kidney, heart, nervous, gastrointestinal, endocrine and other systems). This was before modern medicine, and at the time, doctors did not understand the causes of such disease.
Dr. Price advocated tooth extraction—the least conservative dental procedure—over endodontic treatment. This theory resulted in a frightening era of tooth extraction both for treatment of systemic disease and as a prophylactic measure against future illness. Dr. Price’s research techniques were criticized at the time they were published, and by the early 1930s, a number of well-designed studies using more modern research techniques discredited his findings.
Endodontic Treatment Reaffirmed
Decades of research have contradicted Dr. Price’s findings since then. In 1951, the Journal of the American Dental Association published a special edition reviewing the scientific literature and shifted the standard of practice back to endodontic treatment for teeth with non-vital pulp in instances where the tooth could be saved. The JADA reviewed Dr. Price’s research techniques from the 1920s and noted that they lacked many aspects of modern scientific research, including the absence of proper control groups and the induction of excessive doses of bacteria.
Recent Endodontic Research
More recent research continues to support the safety of dental treatment as it relates to overall systemic health. In 2007, the American Heart Association updated its guidelines on the prevention of infective endocarditis, drastically curbing the indications for pre-medication for dental procedures and excluding endodontic treatment from dental procedures requiring premedication. In April 2012, the AHA found no scientific evidence linking periodontal disease and heart disease, concluding that heart disease and periodontal disease often coincidentally occur in the same person due to common risk factors of smoking, age, and diabetes mellitus.
Decades of research contradict the early beliefs of “focal infection” proponents. That is, there is no valid, scientific evidence linking endodontically treated teeth and systemic disease. Rather, problems can arise if an infected tooth is left untreated. Some patients still hear about this long-dispelled theory.
Contact Your Philadelphia Endodontist
By referring you to our office, your dentist has shown their concern that you receive the finest endodontic care possible. Our goal is to provide unsurpassed quality in a compassionate environment of professionalism and clinical excellence. We hope to exceed your expectations. If you have any questions or if you would like to schedule an appointment with Dr. Rhome, we encourage you to contact us today. We look forward to helping you.