Quack Watch: Keeping Your Patients Informed
Well today I come before you to talk about “Quack Watch”. Actually, I want you to make special note of Quackwatch because it’s a website (www.quackwatch.org). It’s going to be useful when you listen to this blog then go to Quackwatch and you’ll get a rebuttal to what I’m going to tell you happened.
Here’s what has been happening and I’m getting quite a few calls now from dentists around the country, but specifically this time in Southern California. I guess we didn’t get the connotation as being the “Left Coast” for nothing. But, to put into context what the concern is, there has been recently many patients presenting for endodontic care at various professional offices and the patient is armed with either a handout from a website or a little book or, in some way, literature that supports that they shouldn’t have a root canal but yet they’ve been referred for a root canal.
The person I want to speak about really is a fellow who’s been known as Dr. Mercola. Dr. Mercola apparently has had quite a bit of multimedia success. Certainly, he’s been touted as one of the healers because if you go to his website you can find out that he is an author on the New York Times Best Selling List, he’s a game-changer in ultimate wellness according to the Huffington Post, and I read here, in this little printout I have in front of me, that he’s also been a guest for Time Magazine, LA Times, CNN, Fox News, ABC, Today Show, and the CBS Washington Unplugged with Sharyl Attkisson.
Now, what you need to understand about this guy, right off the bat, is… Let me get your blood pressure up because I’m probably just talking to dentists… The article starts off with 97% of terminal cancer patients previously had a root canal. Well, let’s talk about this a little bit more. In this story, Dr. Mercola goes on to say that root canal’ed and filled teeth harbor bacteria that morph into very toxic forms, and then they migrate to other tissues or organs in the body and they cause serious medical conditions, including diseases of the heart, kidneys, bone and brain, not to mention the colon. So, you can see how dangerous endodontics always is and has been, seen by him, because he’s attributing many of these medical maladies to endodontics.
He goes on to say that the procedure is done 41,000 times each day in the United States alone and that makes up for about 25 million canals treated every year. He’s saying that the problem is that root canal teeth are “dead” teeth, and he has “dead” in quotes. Well, this is a complete fabrication because anybody that’s even been remotely involved in dentistry, even as a casual observer, would know that any “dead” tooth would be exfoliated and rejected by your own immune system. So, those of us in the know, meaning all dentists, we realize that an endodontic tooth is a vital tooth because the body perceives it as vital because there is a PDL attachment, a suspensatory ligament, that slings the tooth from the cementum to the surrounding bone. So, the tooth is vital, interpreted as an integral member of the arch, and it can function in complete health.
Really, the problem is that he is referring back to Weston Price’s work and, for some of you, that probably rings a bell because Weston Price was a dentist who had a lot to say about endodontics. Many of you heard about the work of Hal Huggins in Colorado. He’s only lost his license, served time, I believe, in prison, and he was the one who wanted to take amalgams out of everybody’s head because he wanted to save their lives because of amalgam toxicity. Never mind the literature… Never mind thousands of papers showing the efficacy of amalgam used successfully across the world on hundreds of millions of patients, on billions of teeth. And, rarely has anybody been able to link any kind of untoward effects back to amalgam, but there’s been efforts.
Well, back to Weston Price and Hal Huggins… Probably the one that I remember the most out of these guys is a guy named George Meinig. Let me explain what happened in my practice probably 15 years ago, but it was about the middle 90s, and I recall perfectly many people started being referred in and they would come in with a little book. It was called Root Canal Cover-Up (what they never told you). Meinig is a dentist and he practices in a little town about 30 miles south and east of Santa Barbara, called Ojai. It’s an eclectic community. It’s filled with artists and wonderful little shops. There’s quite a little health group up there where you can work on wellness… and this is all good. I’m not knocking that at all, but Meinig lives in this little community. He wrote this book, and people were bringing the book in saying, “Dr. Ruddle, I was referred for endodontics but I’m afraid”. Or, “I don’t think we should do the root canal because this is what they said”.
Let me just explain a little bit of the errors I made and then how I learned to remedy the problem and turn it around. So, when these people would come in and show me the literature, we would begin to discuss it. I would then try to defend endodontics to this patient. I tried that for several weeks and many of the patients went ahead and had treatment, and some decided not to have treatment, but I found out… my staff found out… they pointed out to me that I was spending a lot of time needlessly talking to patients trying to be defensive to protect our profession. That was the first thing that happened.
The second thing that happened is they would come in and they would show me the literature and I would listen, but less intently, but honestly I would listen. Then finally when they were all done talking, I would say, “Well, you were referred in for a root canal. How would you like me to proceed?” Let them make the call.
Finally, I realized even that was problematic, and it moved me to a third phase in my life regarding quackery. I finally would say to the patient:
“You know something, you make a very good point. Based on your observations, based on your experience, and based on what you’re reading and who you’re listening to you, for you, endodontics probably isn’t appropriate. So, what I’d like you to do is think about what we’ve talked about and if you should want to proceed with care, go ahead and give me a call and we’ll know how to schedule you.”
Then, the patients would oftentimes start arguing with me that they didn’t want to think it over… They actually wanted a root canal.
So, I saved a lot of chairtime by just agreeing with them and saying, for you, probably endodontics isn’t the appropriate procedure. By turning it around on them, I got through a lot of the unnecessary discussions, chairtime, and the defensive position that many dentists feel up against.
That was 15 years ago… So now, back to the current, when a recent dear friend – when his receptionist, his wife – called our office and talked to my daughter, there was quite a long discussion about some patients that they’d seen in a very sophisticated, upscale community in Southern California. Because Dr. Mercola has a big presence in Southern California, a lot of his patients are trotting in with, A) all of this nonsense about does endodontics work; and B) “If I do have it done, is it going to cause some kind of a long term medical problem that we just can’t foresee currently in the present?”
I think what I’d like to share with you is don’t get into arguments with these people because these people are health nuts and there’s nothing wrong with being a health nut… It’s just that we have to shepherd our zeal for health and it’s got to be balanced, I think, against common sense and scientific evidence. So, much of the evidence that Mercola quotes is so anecdotal. It is so ridiculous; it doesn’t even meet the scientific smell test.
As examples, he says that he did autopsy of several thousand people that died of all these medical diseases and he found out that it was flabbergasting to realize that many of these people had root canals. I don’t know how you can possibly make a connection between morbidity and a person that had a root canal in their head any more than you can say, “Did they smoke? Did they drive a car? Did they have high blood pressure?” So, that, in and of itself, is ridiculous. I think people died before endodontics and I don’t think post-mortems revealed that there was a massive amount of endodontics in these patients that were deceased. I mean, we found a few people with endodontics in the tombs of the great pharaohs, but it wasn’t a procedure that was done across the board. Yet, from what I can tell, everybody dies at some point and has historically, even before modern endodontics took off around World War II.
The other thing… If you look at the research, especially by Meinig, who quotes Weston – Get the connection? Meinig quotes Weston. Most of the research was done before 1920. Can you imagine how endodontics was performed prior to 1920? No rubber dams, no sodium hypochlorite, no radiographs. In the book that I actually purchased so that I could get a little better handle on what was being disseminated, they show all these cases, meaning radiographic images of cases, that are only have a pulpotomy. Many of them are filled to mid-root. Many of them are filled 3 or 4mm short. There are countless missed canals. There are posts out the sides of roots. My point is… It’s a wonder that any of those cases worked.
So, they’re taking the worst that endodontics has to offer and they’re saying when it’s done like this, it’s dangerous. Well, listen… We can make the connection between one medical issue, an oral, and that is when people come in with mitral valve prolapse syndrome, as an example. We oftentimes pre-medicate them with an antibiotic because we know there’s a transient bacteremia. We know that, in these patients, they might be susceptible. The bacteria that get into the systemic circulation can go through the heart, and they could colonize and become residents, and cause mitral valve prolapse syndrome.
So, yes, we do pre-medicate because we do understand there is a connection between teeth, which are in the mouth, and the whole body, as a whole. Just because you can extract an infected tooth from a rat and take extracts of that abscess and drop it into the eye of a rat and the rat would go blind in 30 days, that is hardly evidence that we should take out all the teeth.
Clearly, virulent microorganisms that are implanted intentionally in some parts of the body can cause a malady, of course, but that’s not endodontics. In fact, if you think about sodium hypochlorite and our shaping that has improved dramatically… Now our shapes hold a significant reservoir of sodium hypochlorite that can potentially penetrate, circulate, and digest tissue in the uninstrumentable portions of the root canal space. Think of how much better of a job we’re doing with active disinfection and all the things I’ve talked about previously on this blog with the EndoActivator; a single example of moving these reagents through all areas of the root canal system.
This is not the kind of endodontics that Dr. Mercola is speaking about. Back to Weston Price and Meinig, this is not the kind of endodontics they’re talking about. In fact, I’ll say this humbly, but even in the book by Meinig, for some reason, he pirated one of my cases and one of my cases shows up in this textbook. In the figure description, he says that if root canals were done like this, he would have no issue with endodontics. But then he goes on to say, regrettably, most endodontic procedures aren’t done like this and that’s why he stands by his assertion that if you need a root canal, you should have your tooth extracted. If you’ve had a root canal, you should have your tooth extracted.
So, let’s meet these patients, not defensively. They’re going to show up in your practice and it’s going to be cyclical. There’s going to be periods of great quietness followed by it seems like everybody’s coming in questioning, “Do endodontic procedures work and should they even be entertained on the general public?” Learn to speak about modern day endodontics. Keep distinguishing modern day science and the abundance of collaborative evidence that has been generated around the world, at countless universities, and compare that research with the research from 1910, 1915 and 1920. Every medical procedure has “grown-up” and become much more predictably successful with concepts, ideas, strategies and technologies that allow us to do a lot more than we could do in the “old” days.
So, in closing, go to Quackwatch (.com) and you’ll hear how various medical people identify people like Mercola, Huggins, Meinig, Price, and you’ll begin to see how foolish their statements are. Then, you might then use this website to refer your patients to so they can also rapidly come up-to-speed and learn how foolish these kinds of comments really are and how they sabotage the potential health and well-being of millions of Americans… not to mention, our international patients as well.
