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Should Your Child Get That Root Canal?

STORY AT-A-GLANCE If your dentist tells you that you or your child needs a root canal, think carefully before accepting.

Should Your Child Get That Root Canal?

A root canal, also known as a pulpotomy, is a procedure to remove infiamed or infected pulp from your tooth. The empty root is then cleaned out and filled with a rubber-like material. A crown or filling is then placed on the tooth, which remains in your mouth.

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It's a risky, invasive procedure that leaves a dead tooth in your body, setting the stage for both acute and chronic infection, which may circulate throughout your body undetected, leading to disease. Among children, in particular, there's little research on how this procedure affects baby teeth — and at least one settlement suggests oftentimes root canals in children are unnecessary.

Dentists Face $750,000 Settlement Over Baby Root Canals

Thirteen dental clinics operated by pediatric dentist Barry L. Jacobson and his company, HQRC Management Services, were accused of performing and billing Medicaid for medically unnecessary baby root canals — or root canals performed on “baby” primary teeth. The allegations came following a joint investigation between the Attorney General's Medicaid Fraud Control Unit (MFCU), and the United States Attorney's Ofice for the District of New Jersey. Jacobson and HQRC, which is now operating under the name PDS Management Solutions, have pediatric dental practices in New York, New Jersey and Vermont. The investigation was prompted by a 2017 whistleblower lawsuit filed by a former employee, who stated that not only did staff perform unnecessary procedures, but, according to Undark, “were pressured to increase the number of patients and procedures in order to meet a $180,000-per-month revenue goal.” Jacobson and HQRC agreed to a $753,457 settlement following the investigation, with $313,783 going toward Medicaid damages. In addition to billing errors submitted on claims to Medicaid between 2011 and 2014, the Attorney General's Medicaid Fraud Control Unit (MFCU) found “in some instances between 2011 and 2018, afiliated dentists performed and billed Medicaid for therapeutic pulpotomies not supported by the medical records maintained at the respective dental practices.” U.S. Attorney Philip Sellinger said in a news release:

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“It is unconscionable that medical professionals were willing to performunnecessary dental procedures on children simply to make money. Recoveringtheir ill-gotten gains only begins to undo this damage. Working with AttorneyGeneral James and our partners in the New York Attorney General's Ofice, wewant to make it clear that this behavior is intolerable.”

Cash Incentives and Lack of Science Drive Pediatric Dentistry

Commonly recommended dental procedures aren't always the tried-and-true panaceas they seem to be. Many also lack scientific evidence to back them up. Even the dogma that it's necessary to visit a dentist every six months appears to have materialized virtually out of thin air. “Scholars have traced its origins to a few potential sources, including a toothpaste advertisement from the 1930s and an illustrated pamphlet from 1849 that follows the travails of a man with a severe toothache,” The Atlantic reported. “Today, an increasing number of dentists acknowledge that adults with good oral hygiene need to see a dentist only once every 12 to 16 months.” The profession's longstanding support for toxic mercury fillings and fiuoride are evidence enough of its archaic practices. But even Jane Gillette, a dentist afiliated with the American Dental Association's Center for Evidence-Based Dentistry, told The Atlantic:

“We are isolated from the larger health-care system. So when evidence-basedpolicies are being made, dentistry is often left out of the equation. We're kind ofbehind the times, but increasingly we are trying to move the needle forward.”

Confiicts of interest further pollute the already low-quality evidence surrounding many pediatric dental procedures. According to Undark:

“Review articles, which evaluate a body of research on a particular subject,conclude that findings regarding pediatric dentistry have low certainty. For onething, much of the relevant research that does exist has a high risk of bias,
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according to Shaun Sellars, a general dentist in Suffolk in the United Kingdom,because it is paid for by players in the industry, such as manufacturers of dentalmaterials.Dentists ‘don't do a lot of practice-based research either,' said Sellars, who isalso the ethics columnist for the British Dental Journal. ‘There's the fundingissue there,' he added. ‘Because dentists, if they're not hands in mouth, they'renot making money.'”

Large Payouts for Interventions Instead of Prevention

Adding to the problem, prevention of dental issues is often overlooked in favor of invasive interventions, which are incentivized by Medicaid. That said, Medicaid offers low reimbursement rates, so dentists who see a lot of Medicaid patients — whose practices tend to be located in high-poverty areas — may try to make money by performing many procedures, some of which may not be necessary. Undark reported:

“An analysis of California's Medicaid program in 2012 indicated that about 8percent of dentists reviewed that provided Medicaid services to children metcertain thresholds for questionable billing. The average general dentistperforms root canals on 5 percent of pediatric patients. In the sample reviewed,the threshold of questionable billing was 18 percent, which about 2 percent ofthe Medicaid dentists exceeded.A 2022 analysis of dentists found that about 33 percent treat at least oneMedicaid patient. Those that do may also be tempted by the offers of privateequity firms, which can lead to big payouts, but might also encourage practicesto prioritize profits over evidence-based care. (Firms often don't pay penalties incases of fraud.)A 2013 report prepared by a U.S. Senate committee noted that corporate-managed “clinics tend to focus on low-income children eligible for Medicaid.
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However, these clinics have been cited for conducting unnecessarytreatments.”"

Your Teeth Are Linked to Your Entire Body

If you have a diseased tooth, it can quickly affect your entire body. In the Netfiix documentary "Root Cause," you can watch first-hand accounts of people suffering from chronic anxiety, fatigue, nausea, dizziness and insomnia, which was ultimately traced back to a root canal. In the film, Dr. Gerald H. Smith explains that your teeth are made up of the same tissue as your sympathetic and parasympathetic nerve tissue, so it's important to realize that your teeth are part of your biology and cannot be separated from it. Any toxins originating in your mouth will be transported via your lymphatic system through your thyroid, thymus, heart and the rest of your body. The pulp of your tooth is also closely interconnected with your lymph system and autonomic system — more so than any other organ, according to Dr. Thomas Rau, medical director of the Paracelsus Academy in Switzerland, who's also in the film. Your teeth are also energetically connected to and will affect your meridians, used in Traditional Chinese Medicine. Dr. Thomas Levy, a board-certified cardiologist and author of “ Hidden Epidemic: Silent Oral Infections Cause Most Heart Attacks and Breast Cancers ,” explains that while root canals may relieve pain caused by an infected or abscessed tooth, it doesn't eliminate infection:

“The problem is, once that pulp is infected, the tooth is dead. They say, well, ifyou feel pain, it can't be dead. But you're not feeling pain from the core of thetooth, you're feeling pain from the connective tissue around the tooth, from theinfection that goes down into the root of the tooth. Just because there's paindoes not rule out that the tooth is technically dead.With a root canal, you've effectively taxidermized the tooth. You basically justput the tooth in a state of technical preservation, not infection elimination …Believe me, there's a ton of literature that shows how toxic these teeth are, howclosely they correlate with coronary artery disease and cancers everywhere elsethrough the body. So, it's always a nasty scenario to have a chronically infectedtooth stay in your body.The other thing too is, when you chew on it, what happens? Every time you chewon something that has a big abscess at the root tip, you actually pushpathogens and toxins into the draining venous and lymphatic circulation moreeffectively than if you just gave something intravenously, pushed with a syringe,to disseminate throughout the body.”

Infected Root Canaled Teeth Driving Heart Problems, Cancer

Levy believes an often-overlooked source of heart attacks are infected root canaled teeth. They often lead to abscesses, which are sources of infection that may not cause any pain. Levy convinced a friend that she needed to extract three root canaled teeth. He accompanied her to a 3D cone beam examination. 3D cone beam imaging is a very sophisticated in-depth examination that provides far more information than your average dental X-ray. Adjacent to the three root canaled teeth was another tooth with an abscess so large it protruded into her sinus cavity. Whether you have discernible symptoms of a dental abscess or not, if you have a chronic health condition, your first step would be to get a 3D cone beam exam done. Levy recommends this for children as well, especially if they have cancer.

“If your 5-year-old gets leukemia or a brain tumor or something like that, theyneed to have this test done because kids get abscessed infected teeth too thatare pain-free just like adults,”

he says.

“The other example I like to use too is, when you're an athlete — you're in your20s and in perfect health — it's still a good idea, as part of your baselineexaminations, to get this exam. If you have healthy teeth, great. Then whenyou're 35, 40 years old, you start getting aches and pains, your blood sugargoes up, you're getting a new disease. Then you repeat that test to see ifsomething new has developed.”

Meanwhile, in “Root Cause,” Rau claimed that 97% of the breast cancer patients between the ages of 30 and 70 tested at the Paracelsus Academy were found to have "a root canal or a toxic situation in their teeth." Smith also recounted the story of one of his dental patients who came in with Stage 4 throat cancer. Smith observed the cancer was situated near two root-canaled teeth. He removed the two teeth and treated the extraction site with ozone. The patient was also given some homeopathic remedies and ionic silver to take. In three weeks, the cancer had completely resolved, and the remission was confirmed with blood work, PET scans and visual inspection. "This is the impact of toxic root canaled teeth," Smith said.

What to Consider Before a Root Canal

If you're considering having a root canal, evaluate the data and your personal situation, such as your health risks, before making your decision. I would also suggest considering ozone therapy before getting a root canal or tooth extraction done, particularly on a child. Ozone is directly toxic to infectious material, and it also stimulates your immune system. I was able to prevent a root canal by using about five treatments with ozone therapy. That said, if the pulp tissue has completely died due to infection, nothing, including ozone, will bring the tooth back to life, at which point a root canal or extraction are your only options. If you already have root canals, you can consider getting them removed, but this must be done by a biological dentist familiar with the procedure. After the extraction, the area must be meticulously cleaned and disinfected, and you'll need to allow your jawbone to heal completely. In most cases, this will take at least three months. Once your dentist has confirmed that there's no cavitation — a pocket in the jawbone filled with bacteria — you can proceed with dental replacement. It's also important to recognize that the reason you get cavities and/or infected teeth in the first place is related to your diet, primarily eating too much sugar. Children can often avoid the need for invasive dental procedures by limiting sweets and brushing regularly. Irrigating with hydrogen peroxide can also be very effective, especially if you're an adult with ongoing dental issues. Simply add hydrogen peroxide to your dental irrigator. I put about half a dropperful of 12% food-grade hydrogen peroxide into my Waterpik irrigation water, plus one-eighth teaspoon of unprocessed salt and one-eighth teaspoon of sodium bicarbonate or potassium bicarbonate. The hydrogen peroxide needs to be married with vitamin C for optimal effect, so consider vitamin C supplementation. Manually scraping your tongue is another simple option to remove pathogens and protect your oral health.

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