Fact-check: Posts misrepresent root canal treatments risks

Root canal treatment involves removal of infected or injured tissue from inside a tooth.

In Summary

• A root canal treatment involves the removal of infected or injured tissue from inside a tooth. 

• The procedure is often recommended to treat a deep cavity or a cracked, fractured or damaged tooth.

Screenshot of a Facebook post taken on January 10, 2022
Screenshot of a Facebook post taken on January 10, 2022
Image: AFP

Social media posts claim that root canal treatment is dangerous to the immune system. This is false; dental experts say the procedure -- which leaves a treated tooth in place, allowing a patient to maintain their natural smile and avoid costly implants -- is not linked to systemic disease, and can eliminate the cause of pain or swelling in the mouth.

"Dentists are the only physicians that believe you can get away with leaving dead tissue in the body. One root canal tooth can shut down 63% of your immune system," says a January 8, 2022 Facebook post.

The image is sourced to the Instagram account @PlantRomance, based in Winnipeg, Canada. It has been reposted on the site here and here, and on Facebook here, here and here.

A root canal treatment involves the removal of infected or injured tissue from inside a tooth. The procedure is often recommended to treat a deep cavity or a cracked, fractured or damaged tooth.

Garry Myers, director of the advanced education program in endodontics at Virginia Commonwealth University, said the posts incorrectly refer to the tooth treated with a root canal as dead tissue. 

"When we do a root canal, what we're actually removing is the dead or diseased tissue that's inside the tooth," he said, explaining that the procedure is often performed by endodontists -- dentists who have received additional, specialized training. 

Myers said the first objective of a root canal is to remove diseased tissue. Then the tooth is disinfected and filled with a substance called Gutta-percha to prevent the treated area from becoming recontaminated with bacteria.

One Facebook post suggested asking for Biocalex to be used in the procedure, but Myers said that substance is not recommended because it can expand when it hardens, placing potential strain on the tooth that could lead to cracks or fractures.

"People have looked for an alternative or a different filling material that worked as well as Gutta-percha or better, and nothing has been found to date, yet, that's superior to it," he said.

Myers also addressed the claim that the root canal can harm the immune system.  A "root canal treatment won't have an adverse effect on the immune system," he said, emphasizing that "there's nothing that has been proven to directly link root canal treatment with any kind of systemic diseases." 

Myers said that many myths about the procedure can be traced back to research produced in the 1920s by Canadian dentist Weston Price, who warned that a root canal could lead to systemic issues. The American Association of Endodontists (AAE) explains on its website that decades of subsequent research has shown Price's study to be inaccurate.

In a statement sent by email to AFP, AAE said: "The science supporting root canal treatment dates back to 1951 when a Journal of the American Dental Association literature review found that previous questions raised in a single study were unfounded because it had lacked many fundamental practices of modern scientific research, including proper control groups. Since then, science has consistently and repeatedly supported the safety of root canal treatment."

The Canadian Dental Association (CDA) also said that misinformation about the root canal procedure regularly circulates online.

"False claims about root canal treatment is harmful because it creates undue fear, or confusion among patients and their families which can lead to delays in seeking treatment and result in the loss of otherwise treatable teeth," said Zelda Burt, head of communications for the CDA.

According to a joint statement from the CDA and the Canadian Academy of Endodontics, the procedure seeks to preserve the tooth, both "to prevent your other teeth from drifting out of line and causing jaw problems" and to avoid "having to replace it with an artificial tooth." 

Keith Krell, former president of the American Board of Endodontics, also said patients benefit when the tooth is preserved. "If you extract the tooth, you eliminate the ligament. With an implant you can lose bone support. It can basically interfere with the way you bite and chew. The preservation of the natural tooth is really the preferential treatment. It's actually the most economical if you can preserve the natural tooth."

This was echoed in an emailed statement from the American Dental Association (ADA): "Endodontic treatment is often the best option for a patient with an infected tooth, allowing the person to keep their tooth, continue to eat normally, and maintain their natural smile."

The ADA said, about 25 million root canals are preformed safely and effectively in the United States each year.

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