Once again, the American dental community has had the wool pulled over its eyes with Dr. Shahrokh Shabahang and colleagues’ January JADA cover story, "State of the Art and Science of Endodontics." This article portrays endodontics as a far more complex treatment than it is, discouraging general dentists from getting involved and rather subliminally encouraging them to send their root canal patients to the offices of endodontic specialists.
First of all, Dr. Shabahang correctly discovers that endodontic disease is mostly of a microbial nature. Swiss dental research scientist Dr. Angelo Sargenti reported this to the Dallas ADA Annual Meeting back in 1958—almost 50 years ago. His report also introduced a simple sealer that he and other dental scientists of the day—Drs. Ingles and Orban—developed. This featured an endodontic treatment that was virtually painless, could be performed in just one visit and had an almost perfect success rate. What’s more, it took the hocus-pocus out of endodontics with its simplicity, and could be easily performed by general dentists.
No wonder this treatment spread like wildfire throughout the country. Thousands of once-condemned teeth were "saved" in the human arch. The magic sealer Dr. Sargenti promoted was basically 70 percent zinc oxide eugenol, with the addition of 4 percent formaldehyde and several other ingredients for opacity. Contrary to what some incorrectly believe, at 4 percent, formaldehyde is a safe and powerful sterilizing agent (toxicity is a matter of dosage), so it destroys virtually all the microbes in the entire root canal system.
Dr. Shabahang addresses the importance of properly cleansing and shaping what amounts to merely the central canal(s). Absolutely. But that alone will not sterilize the canal system, not even with irrigation using the suggested caustic sodium hypochlorite. One of the biggest features in Dr. Sargenti’s sealer is that formaldehyde is a "gas," and it penetrates all the interstitial and lateral canals, virtually sterilizing the entire structure.
It was Dr. Sargenti who also introduced mechanical instrumentation for the process of cleansing the canal spaces. He also brought about single-visit endodontics, and discouraged the use of cultures. So why, in all of the 158 references in the article, is there not one mention of Dr. Sargenti? He published more than 10 books and many articles about this technique.
I’ll tell you why. When the endodontic specialty group realized how popular Sargenti’s treatment had become among general dentists, they realized their specialty was in jeopardy. So they set out to discredit Dr. Sargenti personally and to attack the inclusion of formaldehyde in his formula. They even published a position paper based on junk science (implanting formaldehyde plugs in a rat’s neck) and attempted to demonstrate that the formaldehyde isotopes traveled to a patient’s brain, kidneys, spleen and other organs, putting these patients in dire straits.
Dr. Jeffrey Brent, past president of the American Toxicology Association and an expert on formaldehyde, tells us this is impossible. The isotopes might travel around the body, but not as formaldehyde. He reports that formaldehyde is broken down in the body within 90 seconds, and the isotopes might travel, but not as CHOH. As a matter of fact, he states that the human liver manufactures "gobs" of formaldehyde every hour.
Another attack is the insinuation that many people are injured from this procedure. Nowhere in the scientific literature is there one instance of anyone being harmed from this treatment. Not one.
One of the leading endodontic lecturers on the circuit continues to exhibit an unnamed, undated radiograph of the entire mandibular canal "filled" with some sort of material that he alludes is Sargenti paste (a misnomer). This is a gross overstatement.
But has the endodontic specialty group withdrawn its innuendos and half-truths? No. Rather they continue to perpetuate this lie. And today’s generation comes by the falsehoods honestly. That’s what they are taught in school. Only endodontists teach endodontics in dental schools, and so the lie perpetuates. Their attacks are purely and simply a travesty of deceit and deception. Tell a lie often enough, and it soon becomes gospel.
So your "State of the Art and Science of Endodontics" is hardly current truth. Fortunately for the American public, there are thousands of Sargenti followers still treating their patients with simplified endodontics, the Sargenti way. We do it simply, safely, and with virtually no discomfort and a 99 percent success rate. Our patients can’t believe they’ve had dreaded "root canal" treatment.
