DENTAL PROTOCOL: For the safe and proper removal of a root-canaled teeth

Submitted on March 17, 2019 by DA

Abscessed root canal tooth research findings by dental patient after a root canaled tooth was diagnosed on Mar 08.19 as abscessed, followed by consultations and a panoramic x-ray on Mar 18.19.

Interview with Dr. Joseph Mercola and George E. Meinig excerpt that led me to a PROTOCOL for removal of a root canaled tooth, copied and pasted below.

Mercola: If extraction proves necessary for anyone reading this, do you want to summarize what’s special about the extraction technique?

George Meinig: Just pulling the tooth is not enough when removal proves necessary. Dr. Price found bacteria in the tissues and bone just adjacent to the tooth’s root. So, we now recommend slow-speed drilling with a burr, to remove one millimeter of the entire bony tooth socket. The purpose is to remove the periodontal ligament (which is always infected with toxins produced by streptococcus bacteria living in the dentin tubules) and the first millimeter of bone that lines the socket (which is usually infected).

There’s a whole protocol involved, including irrigating with sterile saline to assure removal of contaminated bone chips, and treating the socket to stimulate and encourage infection-free healing. I describe the procedure in detail, step by step, in my book

KEY ELEMENTS from the book and their page numbers

Taken from:

Test former extraction sites for possible cavitations [185]

The only known successful treatment of cavitations is surgical removal [185]

Good bone must be removed to eliminate all that is infected [186]

To avoid nerve injury requires great skill [186]

Remove periodontal ligament and one millimeter of bony socket to prevent cavitation areas from forming [186]

Cavitations a.k.a. holes in the bone, alveolar cavitation pathosis, alveolar osteo pathosis, neuralgia inducing cavitational osteo necrosis or NICO [186]

To avoid cavitation formation requires a simple procedure immediately after a tooth is removed. In as much as evidence points to accumulation of bacteria and their toxins in the periodontal membrane, and the first millimeter of bony socket, it is advocated that these tissues be removed to prevent formation of cavitations and their neuralgic complications [187]

The following PROTOCOL is not only preventative of future trouble, it also promotes better possibility of recovery from any degenerative process due to root canal infection [187]

Proper surgical elimination of chronically infected teeth i.e. root canal and jaw osteomyelytic lesions do eradicate chronic diseases [187]

Infections in teeth are often accompanied by bacterial infection in the periodontal ligament and first millimeter of the tooth’s boney socket, which can lead to cavitation infections [188]

A high percentage of people suffer pain and illness due to the presence of cavitations in jaw bones [188]

Clinical and histopathologic features of NICO more closely resemble ischemic/avascular/aseptic osteonecrosis of the femoral head, corticosteroid induced osteonecrosis or osteonecrosis in caisson’s [tunnel digger’s or deep-sea diver’s] disease than a true osteomyelitis, although secondary odontogenic infection often adds an osteomyelitis overtone to the presentation. This similarity to ischemic osteonecrosis is so strong as to lend considerable credence to the theory that NICO results from poor vascular circulation of the jaws, but the etiology is as yet unproven and the relationship of NICO to etiology is facial neuralgias remains controversial [189]

Any alveolar site may be affected but the third molar areas are most frequently involved. One third of patients have more than a single quadrant involved, and 10% have lesion in all four quadrants, not necessarily at the same time [189]

The typical case of NICO is not visible on panographic radiographs, magnetic resonance imaging, computed axial tomography, and all forms of radioisotope bone scans, except technetium-99 scans [190]

Simple periapical radiographs appear to be the most sensitive imaging technique, and considerable diagnostic experience is required because changes are quite subtle and may mimic a number of other entities. This disease has been called the ‘invisible osteomyelitis’. When visible NICO usually presents as a poorly demarcated, non-expansible radiolucency, often with irregular vertical remnants of lamia dura associated with old extraction sites in the region [190]

Nerves are infrequently found, but typically demonstrate a loss of myelin without a subsequent loss of the nerve fiber itself therefore leaving an ‘uninsulated’ nerve in the area [190]

Antibodies to peripheral myelin, usually not present in humans, have been found in NICO patients [190]

The abnormal intra bony tissues usually must be surgically removed via decortication and curettage [191]

Because many of these infections are traceable to root filled teeth, finding one-third cavitations effect more than one quadrant of the jaws, and 10% occur in all four quadrants is also important [191]

PROTOCOL pages 193 and 194

After the tooth has been removed, slow speed drilling with a number 8 round burr is used to remove one millimeter of the entire bony socket, including the apex area. The purpose of this procedure is to remove the periodontal ligament and the first millimeter of bone, as they are usually infected with bacteria and the toxins that live in the dentin tubules. The periodontal ligament is always infected, and most of the time so is the adjacent bone likewise diseased

While this procedure is being done, irrigate the socket with sterile saline via a Monojet 412, 12 cc syringe with a curved plastic tip. 2 to 3 syringes may be required. The purpose of this flushing action is to remover contaminated bone that is cut. In cutting the bone not only are toxins removed, but the bone is perturbated. This perturbation of the bone stimulates a change from osteocytes to osteoblasts cells. The blast cells are the ones that generate new bone formation

After the socket has been cut, it should be filled with a non-vasoconstrictor local anesthetic. Allow the liquid local anesthetic to set for about 30 seconds

Suction should be applied gently to the socket area so that the majority of the anesthetic is removed, but there is still substantial coating of the anesthetic over the bony interior. This further perturbs bone cells to encourage osteoblastic action and bone healing

When this protocol is followed the tooth socket usually heals much more rapidly with less bleeding and pain.

SUMMARY pages 194 to 196

CONCLUSIONS pages 198 and 198

It is essential to effectively sterilize the bacteria which invade dentin tubules

Tooth infections concern the nature of dentin tubules and how harmless bacteria, which reside in our moths, can become so virulent as to cause serious and eve fatal degenerative diseases

Bacteria trapped in tiny dentin tubules have polymorphic characteristics. They have the ability to change, adapt, mutate, become smaller and more virulent, and their toxins to become more toxic

SUMMARY pages 198 to 200

Ill health conditions usually progressively disappeared after a dental infection was removed

Dental infections reduced the body’s normal alkaline reserve in the blood of both patients and animals i.e. they produced acidosis

The presence of dental infections increases the uric acid of the blood

Low ionic calcium individuals tend to heal slowly and have a marked tendency to develop secondary infections of sockets following extractions whereas individuals with high ionic calcium almost invariably experience rapid repair and seldom develop secondary infections

Those who experience so-called ‘dry socket’ and suffer its painful course are almost always those who, at the time, have a low ionic calcium level of the blood

Dentists can learn to save teeth by taking them out. 

Prepared by DM