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Root Canals

Root canal #18

04/07/2006

Question:

I come from a family with a poor dental constitution. A mouthful of heavily-filled teeth had lead to root canal after root canal. These procedures have saved my teeth and my smile. I have even needed root canals on completely intact teeth which have never had a filling or procedure of any kind. One of my daughters needed a root canal on a newly erupted 12-year old molar. It was completely necrotic. The endodontist couldn`t believe it. My parents both lost most of their teeth at young ages. What on earth is wrong with us?

Answer:

Sorry for the delay in answering your question, but I wanted to do a little research on your question.

There are two possible reasons, that I could find, for your family's malady. If you are African-American, sickle cell anemia could be a cause for the teeth needing root canal treatment when there is no clinical pathology. This occurs when the sickled red blood cells lock together in small arteries and clog the artery. This leads to necrosis (death) of the tissue fed by that artery unless it can get oxygen from another blood vessel. In teeth, this has been reported to occur since there is very little collateral circulation going into the root of the tooth. If the main tooth artery is blocked - the tissue inside the tooth dies for no apparent reason. Sickle cell anemia is an inherited disease and can be passed on from generation to generation.

Another possible cause is vitamin D-resistant rickets. This disease affects the tubules of the kidney and prevents the kidney from reabsorbing certain metabolites. Rickets causes hypomineralized bone and is usually due to lack of vitamin D or exposure to sunlight - mostly environmental problems that are easy to remedy. However, vitamin D-resistant Rickets is a hereditary disease and does not resolve with increased doses of vitamin D. The disease does affect the teeth and supporting structures. The teeth have hypocalcified dentin and clefts or defects that run very close to the surface of the tooth. These microscopic defects allow bacteria to enter the tooth and cause death of the pulp (nerve) and abscesses without there being any clinical evidence of pathology (like a cavity).

You should go to your family physician and speak to him/her about the problem and have this looked at and tested for.

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Response by:

John M Nusstein, DDS John M Nusstein, DDS
Associate Professor of Endodontics
College of Dentistry
The Ohio State University