Root Canals, Cavitations & Focal Infections

In the 1920s, a dentist named Weston A. Price conducted an experiment that modern dentistry has spent a century trying to forget. He extracted infected teeth from patients with heart disease, kidney disease, and arthritis — then implanted fragments of those teeth beneath the skin of rabbits. The rabbits developed the same diseases the patients had. Heart disease from heart disease patients. Kidney disease from kidney disease patients. When Price implanted healthy teeth, the rabbits remained well.

Price’s research, spanning 25 years and resulting in over 1,100 pages of published findings, proposed a radical idea: that dead teeth could harbor chronic infections that seeded disease throughout the body. He called it the focal infection theory. Mainstream dentistry declared the idea dead and buried sometime around the 1950s. But like many things buried prematurely, it keeps surfacing.

The Anatomy of a Root Canal

To understand the controversy, you need to understand the tooth. A living tooth is not solid — it contains a pulp chamber housing nerves, blood vessels, and lymphatic tissue. Radiating outward from the main canal are lateral canals, accessory canals, and approximately three miles of dentinal tubules per tooth — microscopic tunnels that permeate the dentin like capillaries through tissue.

When a tooth’s pulp becomes irreversibly infected or necrotic, conventional dentistry performs a root canal: the pulp is removed, the main canal is shaped, cleaned, and filled with gutta-percha and sealer, and the tooth is capped with a crown. The tooth remains in the jaw — structurally present but biologically dead.

The stated goal is complete sterilization of the canal system. The problem is that complete sterilization is anatomically impossible. The main canal can be cleaned and filled. But the three miles of dentinal tubules, the lateral canals branching off at unpredictable angles, the apical delta where the root tip ramifies into dozens of tiny channels — these cannot be reached by files, irrigants, or sealers. They remain inhabited.

What Lives Inside Root-Canaled Teeth

Research by Robert Kulacz, DDS, and Thomas Levy, MD, JD — documented in their book The Toxic Tooth — describes the microbial reality inside root-canaled teeth. Without blood supply, the interior becomes an anaerobic environment. The bacteria that thrived aerobically in the living tooth adapt or are replaced by strict anaerobes — organisms that produce some of the most toxic metabolic byproducts in microbiology.

These include:

• Thioethers (thioether mercaptans): Sulfur-containing compounds produced by anaerobic bacteria. Extremely toxic to mitochondrial function and capable of disrupting enzyme systems throughout the body. Measurable in blood samples and via the OroTox test.
• Mercaptans: Another class of sulfur compounds produced by anaerobic metabolism. Even in minute quantities, these substances are cytotoxic.
• Hydrogen sulfide: A metabolic poison that inhibits cytochrome c oxidase — the same enzyme complex targeted by cyanide.
• Lipopolysaccharides (LPS/endotoxin): Shed from gram-negative bacterial cell walls, these molecules trigger potent inflammatory cascades via Toll-like receptor 4 (TLR4) activation.

Hal Huggins, DDS, had root-canaled teeth extracted and sent to laboratories for culture. Over 99% yielded pathogenic bacteria, despite having been deemed “successful” by radiographic standards. The most common species identified included Prevotella intermedia, Fusobacterium nucleatum, Peptostreptococcus, and various Streptococcus species.

The tooth, sealed from the immune system by the root canal filling, becomes a sanctuary — bacteria proliferate without interference from white blood cells, antibodies, or blood-borne antibiotics.

Cavitations: The Hidden Jaw Lesion

A cavitation — formally termed NICO (Neuralgia-Inducing Cavitational Osteonecrosis) or ischemic osteonecrosis of the jawbone — is a hollow or necrotic area within the jawbone, most commonly at the site of a previous tooth extraction, particularly wisdom teeth.

Cavitations form when:

1. A tooth is extracted but the periodontal ligament is not completely removed from the socket
2. The socket heals over on the surface but fails to fill with healthy bone internally
3. The remaining ligament tissue and trapped blood supply degenerate, creating a pocket of necrotic bone, anaerobic bacteria, and inflammatory mediators
4. The overlying bone and gum appear normal on visual inspection and even standard 2D X-rays

The interior of a cavitation is biologically similar to the interior of a root-canaled tooth — an anaerobic environment producing thioethers, mercaptans, and endotoxin. Jerry Bouquot, DDS, a maxillofacial pathologist, documented ischemic osteonecrosis in jawbone specimens and found that it was far more common than previously recognized. His research showed that up to 77% of extracted wisdom tooth sites had some degree of cavitational pathology.

Connections to Systemic Disease

The focal infection theory — that chronic dental infections can drive or contribute to systemic disease — has resurfaced with increasing scientific support:

Cardiovascular Disease: Josef Issels, MD, a German oncologist, observed that a significant percentage of his cancer patients had root-canaled teeth or jawbone pathology on the same meridian as their tumor. While his work was primarily clinical observation, the mechanism is consistent with what we now understand about chronic low-grade infection, endotoxemia, and endothelial dysfunction driving atherosclerosis.

Autoimmune Disease: Chronic immune stimulation from bacterial toxins leaking from root-canaled teeth or cavitations can drive molecular mimicry, epitope spreading, and loss of self-tolerance. Clinicians in biological dentistry consistently report improvement in autoimmune markers after extraction of root-canaled teeth and cavitation surgery — though controlled trials remain limited.

Cancer: George Meinig, DDS (a founding member of the American Association of Endodontists who later became a critic of root canal therapy) documented cases of cancer remission following extraction of root-canaled teeth in Root Canal Cover-Up. The proposed mechanism involves chronic immune suppression, mitochondrial toxicity from thioethers, and disruption of the body’s terrain — the metabolic and immune environment that determines whether cancerous cells are controlled or proliferate.

Chronic Fatigue and Neurological Conditions: Thioethers and mercaptans from dental focal infections are potent mitochondrial poisons. Patients with unexplained fatigue, brain fog, neuropathy, or treatment-resistant chronic conditions sometimes experience dramatic improvement after addressing dental focal infections.

Diagnostic Tools

Standard dental X-rays (periapical radiographs) are notoriously poor at detecting cavitations and subtle root canal pathology. The bone loss must exceed 30-50% before it becomes visible on 2D imaging. Advanced diagnostics include:

3D Cone Beam CT (CBCT): Provides three-dimensional imaging of the jawbone at far higher resolution than standard dental X-rays. Can reveal radiolucencies (areas of bone loss), periapical pathology around root-canaled teeth, and cavitational lesions not visible on 2D imaging. This is the minimum standard for assessment.

CaviTAU Ultrasound: A relatively new technology that uses through-transmission alveolar ultrasonography (TAU) to assess bone density in the jaw. Unlike CBCT, it involves no radiation. It generates a color-coded map of jaw bone density, revealing areas of fatty degeneration, inflammation, and cavitation. Increasingly available in biological dental practices.

Thermography: Digital infrared thermal imaging can detect inflammatory “hot spots” in the jaw and face that correlate with dental pathology. Non-invasive and radiation-free, though less specific than CBCT or CaviTAU.

Applied Kinesiology and Autonomic Response Testing: Some biological practitioners use muscle testing to assess whether specific teeth are causing systemic stress. While these methods lack conventional validation, experienced practitioners report useful clinical correlation, particularly when used to guide rather than replace objective imaging.

The Meridian Tooth Chart: TCM Connections

Traditional Chinese Medicine (TCM) has long recognized energetic connections between teeth and organ systems through the acupuncture meridian network. The meridian tooth chart maps each tooth to specific organs, glands, vertebrae, and tissues:

• Upper and lower incisors: Kidney, bladder meridian — connected to kidneys, bladder, reproductive organs, ears, sinuses
• Canines (cuspids): Liver, gallbladder meridian — connected to liver, gallbladder, eyes, hip joints
• Premolars (bicuspids): Lung, large intestine meridian — connected to lungs, colon, shoulders, immune system
• Upper molars: Stomach, spleen meridian — connected to stomach, spleen, pancreas, breast, thyroid
• Lower molars: Lung, large intestine meridian (first molars) and heart, small intestine meridian (second and third molars)
• Wisdom teeth: Heart, small intestine meridian — connected to heart, small intestine, central nervous system

Biological dentists frequently observe that patients with pathology in a specific tooth have corresponding organ or system dysfunction along the same meridian. A root-canaled lower molar on the heart meridian in a patient with unexplained cardiac symptoms is not a coincidence to dismiss — it is a pattern to investigate.

Treatment Options

When dental focal infections are identified, treatment options range from conservative to surgical:

Ozone Injection: Medical-grade ozone (O3) injected into the area around a root-canaled tooth or into a cavitation site. Ozone is a powerful antimicrobial that kills anaerobic bacteria, viruses, and fungi on contact. It also stimulates circulation, immune response, and tissue healing. Some biological dentists use ozone as a first-line treatment for early or mild pathology, or as a bridge for patients who are not ready for extraction.

Extraction with Socket Debridement: For root-canaled teeth or confirmed cavitations, extraction followed by thorough surgical debridement of the socket is the definitive treatment. The procedure involves:

1. Atraumatic extraction of the tooth
2. Complete removal of the periodontal ligament and any granulation tissue
3. Curettage of the bony socket walls to remove necrotic bone
4. Irrigation with ozone water or ozonated saline
5. Assessment of the socket for healthy bleeding bone

PRF (Platelet-Rich Fibrin) Socket Grafting: After extraction and debridement, the socket can be packed with PRF — a concentrated growth factor matrix derived from the patient’s own blood. A small blood draw is centrifuged to produce fibrin clots rich in platelets, growth factors, and white blood cells. PRF dramatically accelerates socket healing, reduces dry socket risk, preserves bone volume, and promotes regeneration of healthy tissue. Many biological dentists consider PRF essential for extraction sites.

Cavitation Surgery: For cavitational lesions in edentulous (toothless) areas, the overlying bone is surgically accessed, the necrotic tissue is removed, and the site is treated with ozone and packed with PRF. Recovery is typically straightforward, though some patients experience a healing crisis as trapped toxins are released.

Finding a Biological or Holistic Dentist

Conventional dentists are not trained to assess or treat focal infections, cavitations, or the systemic implications of root canal therapy. Practitioners who address these issues include:

• IAOMT (International Academy of Oral Medicine and Toxicology): iaomt.org — searchable directory, SMART-certified practitioners
• IABDM (International Academy of Biological Dentistry and Medicine): iabdm.org — directory of biological dentists
• Huggins Applied Healing: Directory of practitioners trained in Hal Huggins’ protocols
• The Holistic Dental Association: holisticdental.org

When selecting a practitioner, ask about CBCT imaging capabilities, SMART protocol certification, ozone therapy availability, PRF use, and experience with cavitation surgery.

Balancing Perspective: When Root Canals May Be Appropriate

Intellectual honesty requires acknowledging complexity. Not every root-canaled tooth causes systemic disease. Many people live with root-canaled teeth and remain healthy — or at least do not develop obviously linked pathology. The decision to extract versus retain a root-canaled tooth should consider:

• Symptoms: Is the patient experiencing unexplained chronic symptoms, autoimmunity, or treatment-resistant conditions?
• Imaging: Does CBCT show periapical pathology or radiolucency around the root-canaled tooth?
• Location: Is the tooth on a meridian that corresponds to the patient’s primary health complaint?
• Overall health: A systemically healthy person with a single well-sealed root canal and no symptoms may reasonably retain the tooth with monitoring
• Alternatives: Extraction creates its own challenges — bone loss, shifting teeth, need for implants or bridges. These are real considerations.
• Patient autonomy: Informed consent means presenting the evidence, the risks of both action and inaction, and letting the patient decide

The functional medicine approach is not “extract all root canals.” It is “assess every root canal as a potential contributor to systemic disease, and make informed decisions based on the individual case.”

The Clinical Takeaway

Teeth are not isolated structures. They are organs — supplied (when alive) by nerves, blood vessels, and lymphatics, embedded in bone, and connected via meridians to the rest of the body. A dead tooth left in the jaw is a dead organ left in the body. No other area of medicine would consider this acceptable practice.

At the same time, the evidence base for focal infection theory, while growing, remains largely observational and clinical rather than consisting of large randomized controlled trials. This does not make it false — it makes it underfunded. The clinical results reported by biological dentists and their patients are too consistent and too dramatic to dismiss.

The mouth is not outside the body. It is inside it. And what festers in silence beneath a porcelain crown may be speaking loudly through symptoms that no one thought to trace back to a tooth.

What if the root of your chronic illness is, quite literally, a root?