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“Root Cause” Netflix Documentary: Let’s Review the Science

Updated: Jul 16, 2019

Spring Hatfield, RDH, January 16, 2019, Today’s RDH

Summarized by: Sara Katz

A newly released Netflix documentary “Root Cause” suggests that root canals are directly associated with systemic issues. The movie discredits RCT (root canal therapy) and expresses that the apex of RCT teeth and previously extracted teeth sites are “cavitations,” and that bacteria present in these cavitations cause inflammation and systemic disease. In reality, these cavitations are neuralgia induced cavitational osteonecrosis (NICO)/fatty degenerative osteonecrosis of the jaw (FDOJ): hollow, dead spaces in jawbones where bone marrow is dying or dead and it is a controversial diagnosis. American Association of Endodontics states that when suspected, no surgical procedure is to be performed, and the patient should be referred to an orofacial pain specialist who will perform and follow up with any treatment. Extractions to prevent this are considered unethical. Two studies were referenced in this article relating NICO/FDOJ and systemic disease. One study hypothesized that permanent increases in RANTES/FGF2 could exacerbate inflammation, but this requires further research. The other study analyzed 7 cytokines and determined that improper wound healing in old extraction sites or RCT might provoke immune modulation that hinders restoration of a disease modified immune system. Both studies involved a small sample size and were written by the same author, suggesting a bias. The documentary made two claims. One was that “97% of patients with breast cancer had a RCT on the same side of the cancer.” Little research supports this claim, and can be compared to saying 100% of patients with cancer drink water. The second claim was that the “#1 cause of heart attack is RCT teeth,” however, untreated abscessed teeth do contribute to CVD risk, although there is not enough evidence to suggest RCT is a contributing factor of CVD.

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