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Endo Questions for the RWE Faculty:

In this area, users are encouraged to ask questions from the RWE Faculty regarding Endodontics in General and the EndoSequence Technique.

Endo Questions for the RWE Faculty:: Endo vs Coronary desease

Missing

Joined: September 2014

Rank: Rookie

Posts: 2

#1
Hello Dr. Nasseh and Happy New Year,

I would like to hear your opinion on the the video below https://youtu.be/OxJsTKL_laY.


Thank you,

Alex Paraschiv
Allen_ali_nasseh

Joined: August 2013

Rank: Faculty General

Posts: 259

#2
In reply to Alexandru Paraschiv Dobriceanu This is a great question and I really should make a video about it. This kind of non-sense is on the rise and we will have to deal with it more frequently in the internet age, where the quality of information can not be verified by independent sources. 
I did leave a comment on the video. We just have to give it a thumbs down. 
Now, about the substance of the problem I can tell you that this cardiologist is very misinformed about root canal therapy and oral bacteria. He says the bacteria found in a coronary clot is the same found in root canals and periodontal disease. Well, that bacteria is also the same bacteria found in the oral cavity everywhere. It's not some foreign bacteria that found its way there! So, what's next, removing our whole mouth? 
Lastly, he offers a solution to remove the tooth instead of RCT. By that theory edentulous people should not have coronary disease or heart attacks. Well, in fact, edentulous people have a higher rate of heart attacks compared to their dentate counterparts. 
Also, in general, edentulous people have a higher mortality rate than people with teeth! See here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903522/

People like this guy who are either intentionally or unintentionally misinformed do a great disservice to people. 
Of course, there are also very poor root canals out there. After all, this is a skill based procedure and I believe if one can not do it right they should either refer the patient or pull the tooth. Just attempting to do a root canal does not constitutes root canal  therapy. 
Thanks for bring up this important topic and sorry for the late reply!  :) Al.
Missing

Joined: September 2014

Rank: Rookie

Posts: 2

#3
What makes me wonder is why a lot of people pay so much attention to others' job. I haven't heard of a dentist questioning the  surgical quality of a stent placed by a cardiologist. The fact the patient signs a "book" of informed consent about complications and accidents that can occur doesn't make a cardiologist better in any way.
I won't start now to document what's the success rate and survival rate of any kind of procedure in medicine.
I have so much to read and learn in Endodontics that I feel one life isn't enough.

I agree with you, Dr Nasseh, 99% but I think that we have to give a chance even to a poor root canal before being too judgy. I have seen some cases done by some specialists where the results were not ideal.
They did the best in those situations. Like all of us. 

Thank you very much for your "late" answer. I bet you are bussier than most of us managing so much information.

Allen_ali_nasseh

Joined: August 2013

Rank: Faculty General

Posts: 259

#4
In reply to Alexandru Paraschiv Dobriceanu You're right. It's not easy to judge. But if basic principles of finding all canals and removing their content through negotiating to the apex can not be achievable predictably, then I'm not sure whether going through the motions of attempting a root canal will do the patient and the profession a service in the long run. There are too many cases of missed MB2 associated with Chronic maxillary sinusitis. And this poor quality management feeds these wholistic quacks' "I told you so!" approach to root canal therapy.

So, we need to be more vigilant to protect the procedure by making sure that people understand their own capability and only attempt cases that they can be successful in. This doesn't mean only endodontists should do root canals. But any dentist doing this should know its biological goals, rather than trying to a achieve a radiographic look. 
   Therefore, yes, it's not easy to judge, but we all need to judge our own limits before we can be great clinicians. For example, I don't do implants in the Esthetic zone because I don't think I'm adequately experienced in that specific area to do an equally good job as my periodontist friends. So, I refer to them! It doesn't make me a bad dentist, but someone who is in touch with his strengths and is aware of his weaknesses. Knowing our own capability, and focusing on our strengths while working to improve our weaknesses is the hallmark of excellence.  Cheers!