The following is an email I received from a parent concerning her daughter who had been told she needed a root canal. Her letter and my response are below:
Hi…My 17 year old daughter has been told she needs a root canal (don’t believe in them). The tooth in question is the last molar in the back (it’s very sensitive). I am wondering about remineralizing with fermented cod liver oil, diotomaceous earth..etc.
Do you think it might work? Could you give me a balllpark figure for a crown? Do you have any other suggestions?
Great question. Homeopathics and topical applications of re-mineralizing agents are useful in the beginning when damage is superficial and remain in the enamel, and sometimes when it has reached the dentin. It does not sound like this is the case in your daughter’s circumstance.
I understand the reluctance to submit to a tooth removal or root canal. However, there are times when it is absolutely necessary. Putting off care may involve pain and the need for antibiotics that could have been avoided.
A tooth which becomes invaded by bacteria goes through a number of stages which are roughly as follows: surface demineralization of the enamel -> full thickness enamel demineralization -> infection of the dentin –> infection of the pulp (blood, lymph, nerve).
Infection of the dentin is the grayest area, and when most teeth are diagnosed for tooth decay requiring fillings. As the infection travels deeper into the tooth, tissue destruction is often massive and quietly painless, perhaps reacting only to sugar or mildly to cold.
Along with infection progression is fewer treatment options. If your daughter has cold sensitivity which immediately subsides when the cold is removed, conservative removal of the dead tooth tissue, ozone, and temporization during which the tooth heals is a real option.
Sensitivity most commonly occurs only in the very last stages. At this point, however, when the tooth becomes horribly reactive to cold (or hot), or hurts spontaneously (with no stimulus at all), there is nothing one can but but remove the tooth or treat with root canal therapy.
Whether or not to have root canal therapy (RCT) is a personal choice. I don’t believe that either extractions or RCTs are inherently evil. Both should diligently be avoided by prevention of the infection in the first place, but when the pulp becomes involved, as I said before, one procedure or the other needs to occur. If the tooth is mostly intact (has plenty of tooth structure), if the decay is very accessible (not below the gum-line), if the tooth has just begun to have symptoms, and if the patient is healthy (one might also look along the acupuncture meridians), then a RCT may be an option.
If a RCT is chosen, go to an endodontist. With a microscope they can access the pulp conservatively and clean canals as meticulously as possible. Preferably also have ozone gas placed in the canals to kill off more bacteria than disinfecting fluid alone and stimulate healing. A crown or onlay is often recommended to extend the life of the tooth structure.
If any of those “ifs” are absent, then tooth removal (extraction) and placement of traditional bridge-work, a removable “flipper”, or implant are options depending on the clinical presentation. Biocompatible materials are available for nearly all possible clinical options. Both titanium(metal) and zirconia(ceramic) implants are available and have longer track records with every year. Both implant types are finally covered with a crown that serves as the tooth replacement.
Homeopathics have a place in promoting healing, reducing pain, and improving lymphatic drainage. Excellent nutrition is crucial to all healing scenarios. If antibiotics are taken, the gut flora will need to be re-established, and enzymes are useful to extract the most nutrition from the diet.
Costs vary a lot especially by practitioner, material, and procedure. Expect to pay about $2500 for a molar RCT with at least 3 canals, about $1300 for a crown, $400 for an extraction, and $3500 for an implant. It will likely cost $2500-4500 for a bridge and $1000 for a removable partial.
Hope this helps.