A root canal saved one of my patients.
Another told me it ruined their health.
That contrast—so common, so extreme—is exactly why people feel stuck.
If you’ve ever had a root canal and wondered whether it was a mistake, or you’re facing the decision and don’t know who to trust, this email is for you.
This one procedure brings up more fear, doubt, and debate than almost anything else in dentistry.
Let’s look at what’s actually true, what’s often missing, and what I want you to know before saying yes—or no.
First, what is a root canal, really?
I like to call a root canal a “mummified tooth.” When bacteria reach the pulp—the soft inner core of your tooth—it can’t recover. That tissue dies. It becomes a breeding ground for infection, which can spread to your bone, bloodstream, or even your brain in rare cases.
A root canal removes the dead and infected tissue, disinfects the canal, and seals it to keep bacteria out. The goal is simple: keep the natural tooth without letting infection take hold elsewhere.
When done properly, it’s effective. A 2022 CBCT study showed root canals had an 86% success rate at 10 years. That doesn’t mean they’re perfect—but it’s a far cry from the horror stories floating around online.
So why are people so scared?
Documentaries like Root Cause have shaped the conversation. You’ve probably seen claims that root canals cause fatigue, cancer, and autoimmune disease.
Here’s why that narrative doesn’t hold up:
- The documentary is based entirely on personal stories, not clinical data.
- Most of the featured cases involved poor technique—no rubber dam, no 3D imaging, poor sealant materials.
- There’s no health context provided—no CRP tracking, no follow-up scans, nothing to show whether the root canal was truly the cause of someone’s symptoms.
Can a bad root canal cause problems? Yes.
Is that the same as saying all root canals are dangerous? Absolutely not.
Here’s how I think about it:
The best root canal is the one you never need.
The second best is one done with precision—and monitored over time.
Let’s talk about avoiding root canals in the first place.
Tooth decay doesn’t happen overnight.
It starts as demineralization—minerals leaving your enamel faster than they’re replaced.
When you catch it early, you can reverse it.
That means your best defense against needing a root canal is strengthening your enamel, supporting saliva flow, and keeping the oral microbiome in balance.
Here’s what I look for in prevention:
- Magnesium: This one gets overlooked constantly. It’s essential for calcium regulation and enamel formation. If you’re low, your teeth are more vulnerable to decay. Many people are deficient without realizing it—especially if they’re stressed, sweating often, or not eating many greens. (Link to the one I take and recommend to 99% of patients.)
- Saliva support: Xylitol nasal spray, mouth breathing correction, and remineralizing toothpaste (link to the one I use) all help. Dry mouth is one of the fastest ways to tip toward decay.
- Diet: Less sugar, yes—but also more fat-soluble vitamins (A, D, K2). These support dentin formation and immune defense inside the tooth (link to my supplements on Amazon)
- Xylitol gum: Chew it after all starchy meals. It’s not just about saliva stimulation. Daily xylitol use actually shifts the oral bacteria toward less cavity-causing strains. In long-term studies, kids who chewed it daily needed fewer fillings years later, even after they stopped. That’s how powerful it is. (Link to my favorite xylitol gum.)
Oral hygiene that’s actually effective: That means brushing, flossing, tongue scraping, and not killing off the good bacteria with alcohol mouthwash. - Catch decay early: Ask your dentist about early-stage lesions. Most cavities don’t hurt until they’re deep. Don’t wait for pain. If you want a dentist who looks for early warning signs (not just drill-and-fill), check out my Functional Dentist Directory.
We’ll go deeper on this in a future newsletter. But for now, just know this: Avoiding a root canal is possible. And it doesn’t require perfection—just consistency with a few key habits.
Still, sometimes prevention isn’t enough.
Whether it’s from trauma, missed decay, or genetics, sometimes the nerve dies.
So, how do you know if you actually need one?
When the pulp is inflamed beyond repair, you’ll often feel:
- Throbbing pain that wakes you up
- Lingering heat sensitivity, especially to hot drinks
- Spontaneous pain, even at rest
- Pressure pain when chewing or tapping (that unmistakable “thunk”)
Your dentist should perform thermal testing, percussion (tap) testing, and most importantly—a CBCT scan. Standard X-rays won’t show the full picture.
If you do need one, here’s what to ask:
- Will a rubber dam be used to isolate the tooth?
- Will you take a CBCT before and after the procedure?
- What material will be used to seal the canal?
- Will a molar receive a crown afterward?
- Do you use a surgical microscope to locate all canals? (Most failed root canals miss small accessory canals. A microscope isn’t optional—it’s how your endodontist sees what they’re actually cleaning.)
- Choose a specialist who does root canals all day, every day. You want an endodontist—not a general dentist. Repetition builds skill, and in root canals, precision is everything.
These aren’t “bonus” questions. They’re essential. A root canal without this level of care is far more likely to fail.
After the procedure, don’t just move on and forget about it.
- Schedule a CBCT every 3 to 5 years to monitor the area
- Track your C-reactive protein (CRP) annually as a marker of inflammation
- Watch for symptoms like brain fog, chronic fatigue, or sinus pressure that doesn’t respond to typical treatment
Sometimes a root canal needs to be retreated.
Occasionally, extraction and implant is the better long-term choice.
But these are conversations to have with a provider who understands both your oral health and your whole-body health.
And what if you already have a root canal and feel fine?
You probably don’t need to do anything.
If the tooth feels solid, your CRP is normal, and your scans are clear—leave it alone.
You wouldn’t remove your appendix just because someone else had a bad outcome.
Same logic applies here.
Have you had a good experience with a root canal—or a difficult one?
Are you still unsure about a decision you made years ago?
Reply and let me know. I read every message, and your stories help shape what I write each week.
If you know someone who’s feeling anxious about a root canal, forward this along. A little clarity goes a long way.
Next Monday—should I unpack more of the research on root canals, or move on to something new you’re curious about?
Talk soon,
Mark
P.S. Thank you for making it to the end of this email. I know your inbox is full, and I don’t take your time or trust lightly. These newsletters are my way of giving you the guidance I wish everyone got in the dental chair. Your questions, stories, and replies mean a lot—and they make this better.
For further reading on root canals…
Podcast Episode #38: Should my child get a root canal?