Physiology 101

Before I dive into the root canal controversy, let’s talk about how your teeth are supposed to work.

There are four layers to your tooth, listed from outer to inner: enamel (hardest and most mineralized), dentin (a protective, also mineralized layer), pulp (containing blood vessels and nerves), and cementum (covering the roots—also mineralized).

Just like any other part of your body, teeth are living tissues and they have the ability to regenerate and heal themselves. All they need is 1) adequate building blocks, and 2) removal of any obstacle(s) to cure.

In the case of teeth, the building blocks are primarily the minerals calcium and phosphorus, as well as Vitamin D (which helps to absorb calcium from the gut). They also need a healthy oral microbiome: just like in your gut and everywhere else in your body, good bacteria act as sentinels to protect you against both pathogenic bad bacteria, and against opportunists. (Opportunists are bacteria that already exist in a given space in your body, and they’re fine as long as their numbers stay small. But if they overgrow, look out.)

One way you can end up with an imbalance in the oral microbiome, for instance, is to eat a lot of sugar and white carbs—the very same culprits that create an imbalance in the gut. This is why a poor diet, low in the minerals needed to keep up the enamel and high in the foods for the opportunistic bacteria, can cause cavities. The reverse is also true: according to the work of 1918 dentist Dr May Mellanby and 1900s dentist Dr Weston Price, cavities can also be healed by providing the body with the nutrients it lacks.

Dental Procedures

But let’s say you get a filling instead. (No judgment—I certainly got my fair share of these before I knew any better!) The whole mercury filling controversy aside, the filling itself is obviously not regenerative tissue anymore. It can get cracked or damaged, requiring further work, such as a crown, a root canal (killing the nerve and the blood vessels inside the pulp of the tooth while leaving the outer shell intact), or an extraction.

The Root Canal

The root canal procedure hollows out the canal containing the pulp, cutting off blood and therefore oxygen from the rest of the tooth. But of course, just as you have capillaries filtering blood into the tiniest crevices of your tissues, tubules run from the pulp into the rest of the tooth as well. And keep in mind, you’ve got between 1000 to 10,000 bacteria living on and in each tooth—some of which are healthy normal flora, but some of which are opportunists which can cause infection (cavities and abscesses) when left unchecked by your immune system. Cut off the blood supply, as you do in a root canal, and your immune system can’t keep these bacteria in check anymore.

The original concern with root canals also comes from the work of Dr Weston Price, who suspected that leaving a piece of dead tissue in the body may be at the root of other systemic illnesses. (Makes sense, right? If you develop gangrene in a limb, you amputate it to avoid sepsis.) While his work has been largely discredited by the traditional medical establishment, the connection between the mouth and the rest of the body is well established, and the correlation between periodontal disease and heart disease is strongest of all. This is the reason why prophylactic (preventative) antibiotics are typically given after dental work: to make sure the bacteria in your mouth don’t make it into the rest of your body.

Yet the American Dental Association still holds that root canals—leaving dead tissue in your mouth, a breeding ground for unchecked anaerobic bacteria with easy access to the rest of your body—are perfectly safe.

The Upshot

I haven’t been able to find unbiased references on either side of the issue on this one, so I can’t make a definite recommendation—beyond this:

  • Take care of your teeth by eating a nutrient rich diet, and cut out the sugar. Prevent cavities in the first place if you possibly can.
  • Maintain a healthy microbiome: eat fermented foods, take your probiotics, and if you have active periodontal disease I’d also recommend a chewable probiotic containing strains of beneficial flora for your mouth.
  • Brush and floss. (Obviously.)

Also, given the reasoning above, while many people have root canals and suffer no apparent ill effects from them, I have to wonder whether there might be some truth to the sources claiming a connection between chronic illness and root canals—particularly given the clear connection between periodontal disease and systemic illness. 

For that reason, if you have had a root canal and have a recalcitrant systemic illness as well, or if you’ve been told you need a root canal, I highly recommend consulting a biological or holistic dentist in your area to see if you might be a candidate for alternative therapies.

Our bodies, after all, are designed to heal themselves. We just have to give them the optimal conditions to do so.