Discover the transformative world of biologic dentistry with Dr. Sonia Chopra, a board-certified endodontist whose personal journey from misdiagnosis to advocacy provides a powerful perspective on holistic dental care. We unravel the prevalent misconceptions surrounding root canals, emphasizing their role as a viable option for tooth pain management while stressing the importance of preserving natural teeth. This episode illuminates the significance of accurate diagnosis and informed consent, providing clarity for patients seeking to make informed decisions that align with their personal health values.
Explore the cutting-edge advancements revolutionizing root canal treatments today. With Dr. Chopra's expertise, we dive into the technologies reshaping the field, such as the GentleWave system and laser therapy, which enhance treatment precision and efficacy. These tools, combined with innovative imaging techniques, help address even the most complex cases, leading to faster healing and improved patient outcomes. We highlight the necessity of understanding each "tooth story" and selecting providers who are equipped with the latest technological capabilities to transform your dental experience.
We conclude with a deeper look into biological endodontics and the broader health implications of proper root canal diagnosis. Dr. Chopra shares real-life case studies that underscore the body's incredible resilience and healing capacity. By integrating advanced techniques and natural remedies, we aim to align dental practices with the body's natural healing processes. This episode encourages both patients and professionals to continuously seek knowledge and stay informed about the latest developments in endodontics, emphasizing a thoughtful and comprehensive approach to dental care. Join us for an enlightening conversation that promises to shift your perspective on root canal therapy.
Check out Dr. Chopra's website here: https://drsoniachopra.com/
Follow her on Instagram: https://www.instagram.com/drsoniachopra/
Check out her course: https://drsoniachopra.com/endodontic-patient-course/
To learn more about holistic dentistry, check out Dr. Carver's website:
http://carverfamilydentistry.com
To contact Dr. Carver directly, email her at drcarver@carverfamilydentistry.com
Want to talk with someone at Dr. Carver's office? Call her practice: 413-663-7372
Reverse Gum Disease In 6 Weeks! With Dr. Rachaele Carver Online Course!
Learn more about here: https://reversegumdiseaseinsixweeks.info/optinpage
Disclaimer: This podcast is for educational purposes only. Information discussed is not intended for diagnosis, curing, or prevention of any disease and is not intended to replace advice given by a licensed healthcare practitioner. Before using any products mentioned or attempting methods discussed, please speak with a licensed healthcare provider. This podcast disclaims responsibility from any possible adverse reactions associated with products or methods discussed. Opinions from guests are their own, and this podcast does not condone or endorse opinions made by guests. We do not provide guarantees about the guests' qualifications or credibility. This podcast and its guests may have direct or indirect financial interests associated with products mentioned.
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Episode Transcript
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Dr. Carver (00:00):
Hello everybody, welcome back to another episode
of the Root of the Matter.
I am your host, dr RachelCarver, and I'm very excited to
have the conversation today withDr Sonia Chopra, who is a
board-certified endodontist.
So you know many of you arelistening to this podcast
because you're interested inbiologic dentistry, how it
connects to the rest of the body, and there is a subset of
(00:22):
biologic or holistic dentistswho think root canals are all
bad and there's no place in thebody for them.
And if you've been listening tothe podcast, you know that I
have a different take on thatand I really believe in the
bio-individuality of each person, and so it's really important
when we're considering treatmentthat we look at all different
avenues and that patients aregiven a choice.
(00:43):
So I don't ever want mythoughts or ideas to persuade
somebody to do something thatmaybe isn't fit with their
values.
So we always, you know, talkabout all the different options,
and Dr Schroeper is here toexplain a little bit more about
canal kind of, why they maybehave a bad rap and what a
properly done root canal withthe right technology can really
(01:06):
do.
So a little bit more aboutSonia she has been not just an
author and an entrepreneur.
Her website is fabulous with somany resources.
So she is a woman after my ownheart and I love it and I'm
excited for this conversation.
So thank you for being todayand welcome, thank you so much
for having me.
Dr. Chopra (01:28):
This is truly an honor to be able to connect with
the biological dentist whoactually still sees that there's
space for the root canal at thetables.
I feel like you are just myfavorite person right now.
Thank you.
Dr. Carver (01:40):
So it's really kind of fabulous.
So maybe just give us a littlebit about your story, how you
got to become an endodontist andyeah, again, my mom was so
adamant about me having a fullcomplement of teeth going to
(02:06):
college.
Dr. Chopra (02:07):
That the summer after I graduated high school,
she was like all right, I'mgoing to close up all these gaps
in my mouth.
And soon after a lot of thatdental work, I started to
develop a toothache.
And because I just had dentalwork done, everyone assumed that
the toothache was related tothat dental work.
And so this is what kind ofstarted this kind of path to a
(02:29):
misdiagnosis.
I had this toothache, nobodycould diagnose it and in fact,
now that I look back, I'm likethey didn't really know how to
diagnose.
Now that I am where I am in mycareer, I look back and like
whoa, they didn't do any of thisstuff and they decided to
extract a tooth on me and Istill.
(02:51):
They extracted the tooth, Istill had my toothache.
They extracted the wrong toothbecause their diagnosis was
wrong and now I'm without nineteeth.
So I have had everything done inmy mouth.
I've had an extraction now.
I've had root canals, I've hadbraces, I've had gingival grafts
, I have crowns, bridges, likeyou name it, and implants.
(03:13):
I have four implants nowbecause of this kind of debacle
and it was so incrediblyimpactful on me because it was
like a nine month journey ofpain and so tooth pain to me.
I've had three children too.
Now I have three children andI've had a massive toothache,
and the toothache wins thebattle of the worst pain I've
(03:37):
ever experienced in my entirelife, and so I have this
compassion for people who areexperiencing it, and I think
that event in my life is whatcatapulted me to become an
endodontist or a tooth saver,tooth healer and somebody who
really gets people out of painquickly when it comes to their
(03:57):
mouth and safely.
Yeah, yeah, it's great.
Dr. Carver (04:03):
And it's.
You know.
It's amazing, your story, tothink about all that because in
listening to your I don't knowif it was in the TEDx talk I was
listening to or something elsewhere even the oral surgeon,
before he took out that tooth,he said he kind of had, and I
was hoping, while you weretelling this story that you were
going to say he said nope, youknow what?
This, it's not this tooth andI'm not going to do it.
You know, but unfortunately hedid, and you know that's that's
(04:25):
the issue.
Like, sometimes, when you havetooth pain, you have two options
.
Now, right, have the root canal, have the tooth extracted.
But once a tooth, that's it,it's gone forever.
Right, that is an irreversibleproblem, right?
Whereas a root canal, we cansave the tooth right and maybe
down the line it has to beextracted.
But in the meantime, again,let's look at that person, look
at their, their life, let's lookat their overall, let's see,
(04:47):
you know, is this going to be agood, viable option for this
patient?
Like you know, it's thepatient's decision.
We, you know, I'm giving theminformed consent.
You know, here's what it is.
I mean, the extraction ispretty, you know it.
Most of us know that the toothis not just this mechanical, you
know body part that is supposedto chew food.
It's a living organ and it'sconnected to, you know, the
(05:10):
jawbone.
It is connected to our stomach.
You know there is all sorts ofthings that the reason why we
need teeth.
So, again, just pulling it out,we lose a lot of that
connection to the nervous systemand proprioception and a bunch
of the posture right.
We know a lot of thatconnection to the nervous system
and proprioception and a bunchof the posture right.
We know a lot of the way ourteeth come together effect.
(05:31):
You know it can be a relativelysimple procedure, but what are
the consequences?
And that's I really wanted tohave this conversation today.
Patients can really understandyou know these different options
and you know what it meansbecause I love what you said in
all in on your website rightthat the body has an amazing
ability to heal itself.
If we can remove those tucksand the infections, the body can
(05:52):
regenerate and that's whatpeople, a lot of times people
don't appreciate.
Dr. Chopra (05:54):
We are regenerative beings.
We can heal from a cut right.
If you knock out a tooth, yourbody can re-accept it and
regenerate it back.
When we have a tooth infectionand we see bone loss around the
tooth, we can regenerate thatbecause there's already these
systems in our body that arethere, ready to protect us.
(06:15):
And so that's why I loveendodontics, because when you
see what can heal, what can work, what can regenerate, it is so
powerful and that's really themissing piece.
I love what you said.
Like I am the same way, like Ipractice, when a patient comes
to me even though they werealready prescribed, like a root
canal, I give them that optionAgain, like you can do the root
(06:38):
canal and you can extract it.
And I think there's so muchvalue that we should really
remember about our teeth.
Our teeth should not be meantto be disposable.
They are given to us for areason they give us nourishment,
they give us hydration, theygive us breath, they give us
confidence, they give usattraction.
Dr. Carver (06:59):
They give us so much and I think the more we
start to value our teeth, thebetter we're going to be
Absolutely so.
Maybe for those of us who don'treally understand what a root
canal is, what is?
Every tooth has a root canalsystem, right, but when you have
(07:21):
a procedure that we typicallycall a root canal, what are we
doing?
Why?
Dr. Chopra (07:23):
do we do a root canal treatment.
So typically what's happeningis there's a bacterial infection
.
So I would say the most commonscenario is somebody gets a
cavity.
That cavity has the opportunityto get deep and then the
bacteria finds its way into thenerve or the pulp and starts
creating either pain andinfection.
(07:43):
Sometimes that infection ispainless, it doesn't even have
to be painful.
So that's one of the reasonswhy I'm a proponent of imaging
digital imaging that keeps theradiation low so that we can
identify these areas ofinfection.
But once that happens, that pulpis irreversibly damaged.
And that's when you have twooptions either the root canal or
(08:04):
an extraction.
And then it becomes a personalchoice Do you want to save this
tooth or do you want to take itout?
And if something is savable, Iwould always try to just show
people why it's worth saving.
Because when you take out atooth, there are repercussions
Other teeth start to shift, youget super eruption, you get like
(08:26):
your tongue starts to spreadout.
There's just a lot of thingsthat can happen as a result of
taking out one tooth.
Your whole neuromuscularjunction here can be affected
and again, like you said, yourposture.
It all shifts.
It's all connected.
So what we do in root canaltherapy, you have to follow two
cardinal rules, and this isanother problem, because many
(08:48):
root canals are done violatingthese rules.
You've got to find all thecanals in a tooth and you've got
to get to the very end of theseroots and these canals,
otherwise you're simply leavingbacteria inside the teeth.
And when you think about howwe're taught how to do a root
canal in dental school, we havefour years of education.
(09:09):
I personally only had atwo-week crash course on how to
do a root canal and I only hadto perform four of them in order
to graduate and be able to justdo it freely on people.
I didn't really feel that goodabout that.
So I went ahead and did aspecialty because I knew it's
what I enjoyed, because it'swhat got me out of pain and what
(09:30):
saved my life.
But I knew that I wasn't goodenough after I graduated dental
school, and nowadays therequirements are actually like
two or sometimes it's fourcanals, and sometimes you can
find four canals in one tooth.
So the requirements to graduateare very low, and so that is
what creates this problem of weneed to really be clear on the
(09:52):
difference between a good rootcanal and a bad root canal.
And it's not that I think thatthese dentists are ill
intentioned.
They're not trying to hurtanybody.
They just don't know what theydon't know and they're doing
their best with the resourcesthat they were given.
So when we do root canal,you've got to clean out all
those canals and get to the endof every canal, and so you
(10:12):
disinfect the tooth and nowadaysthere's so much fun technology
that helps us do our job evenbetter and get better patient
outcomes and then, once that'sall cleaned out, you seal it up
outcomes.
And then, once that's allcleaned out, you seal it up and
then you can see and watch theregeneration of what is going to
happen.
And I have some imaging that Ican show you so you can actually
(10:33):
see what happens in thesepatients.
Dr. Carver (10:37):
Yeah, and again, this is important, judgene, I
had the exact same situation.
I graduated 21 years ago.
We had to do, you know, oneanterior tooth, I think, and one
posterior molar, with multiplecanals, right.
So one single canal tooth andone end.
You know that this is a verythere's a reason why we have
specialists who just do rootcanals, because sometimes maybe
in a front tooth, the canal isnice and big, it's very easy to
(10:59):
see.
But oftentimes those posterior,those back teeth molars have
curvature of the roots or allsorts of funky anatomy.
And again, why imaging is socrucial and you leave just one
little bit of bacteria behindand you know can potentially
cause persistent infection.
And this is what we see and whya lot of biological people say
(11:21):
you know, root canal is just sobad If it's not cleaned out
properly.
You'd lose that.
And that's the part, like ifyou aren't doing these all day,
every day and you don't reallyunderstand how.
And that's what we seeoftentimes on x-rays, like the
fill material is short, soyou've let the last couple
millimeters of the root wherethe bacteria you know didn't get
fully clean, and you know thisis where problems with the lab
(11:43):
right and they find all sorts ofweird bugs and bacteria.
Maybe talk to us a little bitabout the technology.
Dr. Chopra (11:49):
So, yeah, let's talk about a properly done root
canal.
I think that's key.
I love to talk in tooth stories, okay, because I believe every
tooth has a story and you needto figure out what's happening
in that particular tooth.
So here is a tooth and it's hada previous root canal.
You can see that this whitematerial inside the tooth is the
(12:13):
evidence that there's been aroot canal.
Now, again, we want to followall the cardinal rules when
we're doing root canal therapy.
So I can see already that thisroot canal end adherometer
counts in our world.
Okay.
So if you're a patient andyou're trying to figure out
what's happening in my toothstory, this is how you can
evaluate it.
Okay, now we are using 3D conebeam technology to really
(12:39):
understand the internal anatomyof our teeth.
Actually, I take this before Ieven start treatment now,
because it's helped me so muchin being able to understand the
tooth in front of me andunderstand that tooth story.
So you can see that there's rootcanal filling material in three
of these canals, but there's afourth canal that wasn't even
treated.
(12:59):
So both of the cardinal ruleshave been violated in this root
canal.
It's not that root canals don'twork, it's that this root canal
is not going to work.
And it's not even like byindividual.
This root canal wouldn't workin any individual.
Does that make sense?
So you can see, here's thecanal.
And if this root canal is 10years old, that tells me this
(13:23):
infection is 10 years oldbecause there's still original
bacteria from 10 years ago thatwas never treated.
And when bacteria has time tofester in these teeth it has
impact.
So you can see the border ofthe sinus here has been eroded.
You can see the sinus mucousmembrane is completely inflamed.
(13:43):
So this patient was evencomplaining about having
breathing problems, sinusproblems.
And again, you can appreciate,here the border of the sinus is
completely eroded by this toothinfection.
I redid the root canal.
I made sure that I got to thevery end.
This little, what we call asealer puff is totally fine, and
(14:03):
so then it's important tofollow up.
Now, one of the secrets abouthow we heal is that bone and
healing after root canalactually takes a lot of time,
and I find that some dentistsdon't even understand this, and
so they jump the gun.
They take an x-ray maybe amonth later and they're like
that's not healing.
It takes time, and so I do aone-year follow-up because bone
(14:27):
is so slow to regenerate, andlook at what happened one year
later.
Do you see that there was nobone here for the sinus floor at
the original time and that allthat inflammation in the sinus?
Look at how beautifully, oneyear later, that floor of the
sinus has restored itself.
The bone regenerated.
Now this is only one year, sowe still have some bone that
(14:49):
needs to regenerate.
That is fine.
But look at this that sinusmucous membrane has now fully
decreased its inflammation andthis patient is not only saving
their tooth, regenerating theirbone, but they're also breathing
better.
That's incredible.
Yeah, it's very dramatic forany of those not only saving
their tooth regenerating theirbone, but they're also breathing
better.
Dr. Carver (15:10):
That's incredible, yeah, that's, it's very dramatic
for any of those listening.
The massive amount ofinflammation in the sinus is
gone, and so that's and we talkabout that all the time.
In my opinion, a lot of diseaseis from toxins and infections,
and if you can remove those, thebody will heal.
And that sometimes is thechallenge.
Where is the infection?
What is the toxin?
And so again in the root canal.
Dr. Chopra (15:31):
Why root canals get the bad rap is because they're
not properly disinfected and soyou can see here that that other
canal, that fourth canal, wastreated.
Here you can really see thatbone reconstituted and that
inflammation gone.
And then again here you couldreally see that bone
reconstituted and thatinflammation gone.
And then again here one, two,three canals that were treated
originally.
But there was one, two, three,four canals actually in this
(15:54):
tooth.
So if you're a patient, you'vebeen told that you have a root
canal that's gone bad.
Do you understand your wholetooth story and has it really
been done with proper methods?
So I will say that I did thisone with the gentle wave, and
the gentle wave looks.
You don't just what it does is,it doesn't just go linearly, it
(16:16):
also gets these connections.
So this is where again, wherepeople used to pick on us that
oh, root canals still harborbacteria, because we couldn't
get these connections and theselittle fins.
But now we can because thegentle wave allows us to
irrigate and disinfect better.
It uses sound waves to actuallymove the disinfection solution
(16:38):
through the tooth in theseanastomoses and these connection
points, and that's reallychanging the game for the
patients and their outcomes andit's allowing them to have
decreased postoperative painafter their procedure and
actually heal a lot faster.
So we're seeing better outcomes, but even faster than before.
Dr. Carver (17:00):
Yeah, and this is what I'm often talking to my
patients about.
One of the complications isbecause there are the main
canals, which are obvious, right, but then there's all the
channels, right, and then again,like you see how sometimes the
canals come together and youknow, in previous, when we were
just using hand files, there wasreally no way to get into all
those little aspects and evenwith our syringe and trying to
(17:22):
flush it with bleach, theyweren't necessarily getting into
all of them.
So the gentle wave is kind oflike an ultrasonic type of
machine where it's amazing, whenyou just put that in water you
can really see how it's justflushing and getting through all
of those little canals andyou're able to get your
disinfectant into those lastlittle areas Right.
Dr. Chopra (17:42):
So if you really want the ideal root canal, you
will utilize somebody you willpick your provider based on.
Like their technology.
For example, those canals canbe really hard to see, so I'm
always using a 3D micro not a 3D, but a microscope to really
elevate my magnification insidethe tooth.
It allows me to keep my openinginto the tooth really small and
(18:05):
be very conservative, but stillbe able to visualize all those
canals.
So I need my microscope, I needmy 3D comb beam so I can
understand the tooth storybefore I go in, and then I need
my gentle wave to really cleanand so that 3D imaging is my GPS
, essentially through the tooth.
(18:26):
I utilize it through my wholeprocedure and then it allows me
to understand how to utilize mygentle wave, because I'm going
to use that differently on everycase.
And then I'm also now using alaser during my treatment so
that, like for me, this is whatI call the modern day root canal
and we're seeing this type ofbone regeneration over and over
(18:48):
again.
Dr. Carver (18:51):
I was going to ask about the laser.
Just a couple episodes ago wehad a periodontist on who.
She's regenerating crazy withthe laser.
Like this, light technology andlaser therapy is amazingly
healing for the body.
In the last root canal I did, Isaid the last one I'm going to
do, I had my laser.
So I was like you know, I waslike I've got, I've got.
You know, he didn't want to goto the specialist.
All right, you know.
(19:11):
Hey, you know, and it's workedout well.
Um, yeah, laser is phenomenalthat way.
You know, in and of itself itcan be antimicrobial, but the
healing part, I think of late isreally, you know, it's funny.
We have a local endodontistwho's fabulous and she makes the
tiniest access holes and Ithink, same thing.
She has all the technology andI think how on earth can be seen
and it's almost.
(19:31):
I was like I think I have towrite her an email.
I love and appreciate how small, because the smaller the access
, the stronger their tooth is.
Right.
A lot of endodontists were likeget the biggest hole possible
so you can see everything, butthat compromises tooth structure
.
Um, but you know, I love howsmall the access is, but, man, I
have the hardest time trying toget that little tape out when I
want to seal that.
It's amazing.
(19:54):
So tell us what is your thingyon the laser?
How does that async work in aroot canal system?
Dr. Chopra (20:00):
I mean, I love it.
I do think the gentle wave andthe laser are two different
animals, but I do think there isa synergy between the two.
But I do think there is asynergy between the two.
So what I love to do in thebeginning, before I even start
moving things around in thetooth because every time you
take an instrument down you arepushing things a little closer
to the exit I like to run mylaser right away and already
(20:25):
when I do that, I call it thelaser sandwich technique.
It's Dr Chopra's laser sandwichtechnique.
I run my laser first, before Istart moving anything around.
Why?
Because what is that doing?
From the beginning of theappointment?
It is reducing the bacteria inthere from the get go.
So before I start movinganything, before I start
(20:46):
cleaning, pushing things againstwalls, beyond walls, whatever,
I'm already reducing thatbacterial load, I'm already
supporting the immune system ofthat person and then I'm going
to start cleaning things,opening things up to allow my
gentle wave to work, and thatgentle wave is going to get in
there and it's going to make theconnections.
When we do a traditional rootcanal, we're just using a hand
(21:09):
syringe, but what happens withthat hand syringe is that
bubbles are formed and whenthose bubbles go in the tooth
they actually prevent theirrigation solution, the
disinfection solution, fromgoing deep in the tooth.
So the first thing that thegentle wave does, that the laser
can't okay, is it degasses thesolution.
It's actually a closed system.
(21:30):
You create this platform aroundthe tooth and there's a special
handpiece that goes on andworks in this closed system.
So the first thing it does isit pulls out all the air, so all
those bubbles that arepreventing that penetration of
the disinfection solution.
It goes away and then the soundwaves start to work and it
pumps the solution through thetooth and you get that
(21:52):
connection and you even get apenetration of the dentinal
tubules, which is what manybiological dentists have
criticized us, that we can'tclean that.
So now we can, and so I'll dothe gentle wave in the middle
and then I probably have alittle bit more cleaning to do,
like sometimes I don't.
(22:12):
If I can just do the gentlewaveand then be done, that would be
great, and then I will alwaysend with the laser.
But as I'm doing myinstrumentation, I'm using my
laser to activate my solution topull things out of the tooth,
so I do an immediate decrease ofthe bacterial load to pull
things out of the tooth.
So I do an immediate decreaseof the bacterial load, I get
clean, I use my laser throughoutthe procedure, I do the gentle
(22:33):
wave at the end, get that reallygood flush through the tooth
and then I'll give it one finallittle laser.
So I'll sandwich it all that inbetween my laser and my
patients are loving it.
I no longer have to give likehefty pain meds.
I rarely have to giveantibiotics, so I'm already like
preventing gut disruption,which is incredible.
(22:57):
Okay, you're going to need alittle Advil Tylenol, because
the reality is I'm working onyou.
You're going to have a littleinflammation, a little soreness.
If I were to dig under yourfingernail for an hour and a
half it would be sore.
So that makes sense.
So your body's just goingthrough wound healing.
Wound healing is just bringingin those immune cells to heal it
.
That influx of cells makessoreness.
(23:18):
So you are going to have aperiod of time where you're sore
.
But the gentle wave decreasesthat.
I even think the laserdecreases that.
We even use the laser forphotomodulation after.
So we're using red lighttherapy to heal the periapical
tissues afterwards.
So it's a process, but I onlylean on over-the-counter
(23:39):
medications.
Now Maybe if somebody has ahard time healing, I have to
give them a steroid.
But I don't give narcoticsanymore and I try to keep my
antibiotic usage to a minimumBecause, if you think about it,
the root canal is the antibioticand everything that comes after
that is inflammatory pain.
So that's why Advil will workbetter than Tylenol, because
(24:02):
it's an anti-inflammatory, andthat's why, if they do need more
support, a steroid is going tobe really helpful and you don't
have to think that it's aninfected pain.
It's an inflammatory pain andyou just have to get through it,
just like you would if you gotin an accident and you're sore
from that Same thing Again, likeyou said right, we're digging
(24:22):
that bacteria deeper down intothose pockets.
Dr. Carver (24:25):
Right, we're decontaminating.
And now all of my hygienistshave been trained with the laser
, so they're going around doingthat decontamination.
You know, there's all these inthe in the medical world.
Like you can't have a cleaningso many months after heart or
after this or that, and I'mthinking but now we're letting
up.
That person is a periodontalpatient and we're letting that
build up.
And you know, yes, maybe atraditional dentist, that's not
(24:45):
great, but those of us who areusing these antimicrobial like I
think that's more importantbecause we know oral bacteria
contributes to heart disease andon and on.
So I think that's me.
Like you, you know I do a lot ofextractions and between the
laser and the ozone I use PRF.
There's I don't remember thelast time I gave an opiate
either or had somebody come backfor you know, you know dry
(25:06):
socket or anything like that.
And actually I give Arnicaright after, before the numbness
where it's.
Often I have them take homesome Arnica to use for five days
and that even reduces the needfor sometimes the ibuprofen.
And so we tell them hey, that's, you know, use that.
I found the little Arnicapellet been amazing for for
post-op and it was funny I saw apatient after an extraction and
(25:27):
she was.
She was like, oh, there's like asharp thing.
And I was like, oh, maybethere's a bone fragment, cause
sometimes that happens, and Iwas looking in that and both my
assistant heal as well, and thenshe was like, oh no, no, that
wasn't done by you and by youknow somebody else.
I was like, aha, it's like youknow so that, like with all the
(25:50):
kind of natural stuff and stuffthat we're giving to enhance the
body's, you know, ability toheal itself, so, like you just
see the difference.
Um, yeah, you know, when we'redoing these kind of things to
support the body's healing right, that photobiomodulation is so
key to just stimulating, um, youknow, the body's ability to
heal yeah, I feel is it fair tosay that I'm a biological
endodontist, like I would say.
(26:12):
I feel like I am.
Dr. Chopra (26:13):
Yeah, even though the biological community might
come after me for saying that,but like I really do feel, like
I understand the biology, like Iunderstand the time it takes to
heal, to see the evidence, justlike really thinking about
things in a strategic way that'sgoing to support the patient
and their recovery.
Dr. Carver (26:33):
Well, you know, I teach at the biological dental
college, the American Collegefor Integrative Medicine and
Dentistry, just same as you.
Right, you guys have the sametechnology and do the stuff, and
we teach our biologic studentsabout a properly done root canal
, so that there is such a thing.
Dr. Chopra (26:52):
Yeah, oh, I would love to be a part of that.
What fun, that would be great.
Dr. Carver (26:56):
Yeah, it's exciting .
I'm really excited that we'redoing this episode because,
again, I do want people tounderstand that it's not all bad
.
But unfortunately, like yousaid, we can do two root canals
and then we can go into practiceand start doing them.
I did them for a long timeuntil I was like you know what?
I don't feel like I have theright expertise.
I don't want to contribute to alot of poorly done root canals.
(27:18):
Again will abscess and willcreate systemic effects and I'm
like I'm going to stick to mylane.
Dr. Chopra (27:23):
They really are technique sensitive and I think
patients need to understand that, because I do think patients
feel like their dentist shoulddo everything.
And there's really a zone ofgenius, like I was telling you
earlier.
If you asked me to do yourfront four veneers, you wouldn't
look pretty.
I would not make, even thoughI'm a dentist, those veneers
(27:45):
would not look very prettybecause my zone of genius is
really the root canal.
I do root canals for the past16 years eight to 10 times a day
and even my first three yearsin practice I didn't really know
it.
It took me those three yearsafter a residency of doing 250
root canals beyond the two fourthat I did in dental school
(28:05):
right, and then the 250 and thenthree years of eight times a
day.
I finally learned the nuancesthat I understand now and I
think that's what patients needto understand.
And even I would say not allendodontists are created equal.
There's some endodontists thatI know that don't use a
(28:25):
microscope, that don't have conebeam 3D technology in their
practice.
They would never invest in agentle wave.
So I think, as a lay person,understanding what's available
and making your choice based onthat.
On the flip side, there aresome general dentists who
actually do really good rootcanals especially.
I have a lot of dentists that Itrain.
(28:46):
I can honestly say I would letthem do my root canal because
they just get it.
They understand the wholeconcept.
I think understanding whichprovider you choose is also just
as important.
Dr. Carver (29:02):
And what do you say to?
So I often tell me I'll take a3D x-ray and a look at the tip
of a tooth right and let's saythe root canal was done maybe a
decade ago and you still seelike a little shadow, maybe a
little radial lucency.
How would you determine like,is that an active problem, does
it need to be redone or is itjust scar tissue?
(29:23):
Is there any way to really know?
I think if it's.
Dr. Chopra (29:28):
I think scars are small and I think some things
that dentists actually watch andwait are actually active
infections.
So I I it's funny because thisyear I have seen a few of my
patients from like pre 2018 comeback to me.
And I say pre 2018 becausethat's the year that I got my
(29:50):
gentle wave and I didn't havethe resources, I didn't have the
technology.
The technology simply didn'texist for me to use it.
And they came.
I did.
I followed the rules.
I followed that cardinal ruleof root canal therapy of finding
every canal, getting to the endof every canal.
It was actually a redo of aroot canal that didn't follow
(30:10):
the rules.
I followed them like, oh, itshould work, and then it came
back to me.
It was a 2015 root canal.
It came back to me in 2023.
And even though the patientwasn't in pain, that dark shadow
was still there.
That dark shadow should haveresolved itself in a year or two
.
And so to me, that tells meokay, my root canal didn't work,
but can I redo this now that Ihave new resources?
(30:34):
And so understanding thetimeframe or how that root canal
was done originally isimportant.
So anything of mine thatdoesn't work and it was done
pre-general wave era.
I'm going to offer anopportunity before extraction
that if you want me to do thisagain with new resources, new
(30:55):
technology, I'm happy to do it.
I also respect the decision of Idon't want to do this treatment
again and if you want toextract it, that's okay.
But I'm seeing the ones thatI'm redoing are healing now.
I've only had three or fourthis year and over, like the
last 16 years, and so, like eventraditional root canals, they
(31:19):
still work.
But I want people to startthinking like okay, just because
the first one didn't work, wecan redo it and it doesn't have
to be something.
That's a symptomatic thing.
I think scar tissue is reallysmall and if there's a sleepy
lesion, a sleepy infection, andit's tiny, I may not necessarily
(31:41):
hunt after it, but I feel likeif it's of a good size and it's
sleepy, it's not making noiseI'm going to consider that still
active infection.
Dr. Carver (31:51):
Yeah, and that's good to know Because as a
general dentist, when I'mlooking at these things I'm like
I don't really have symptomsbut I want it to look better.
And then as a biologist, I'malways thinking what part of the
body is that connected to?
Are they having any, maybesymptoms?
Do you?
You know, what is yourinterpretation of how kind of
are connected to the rest of thebody and the gut health?
(32:11):
Do you ever see situationswhere, like an infected, a lot
of, like the infected firstmolar and people and you know
breast health issues, becausesupposedly that's on that same
meridian?
Have you seen any connectionswith systemic health and
infected teeth?
Dr. Chopra (32:26):
I haven't from a breast perspective, but I mean
I've definitely seen it withmore adjacent tissues like
sinuses, headaches, people justfeeling like malaise, like just
because they have this thing inthe background.
I actually just had a patientwho I did a redo of her root
canal and I could see there wassome sinus connection.
But she was like I'm so plannedfor this surgery over here.
(32:50):
I'm like whoa, hold on, givethis a month to heal before you
go for that surgery, because youmay be okay.
So she's coming back to see mein a month to see how her
symptoms are doing and if shereally needs surgery or if it
was just this tooth having animpact.
Now I will say that I don't seeroot canal infections jumping
(33:11):
from tooth to tooth, and so I dofeel like there is a protective
mechanism.
The way our bodies createalmost assist is a protective
mechanism because it'sencapsulating that infection so
it doesn't spread anywhere else.
I feel like there is someconfusion between periodontitis
and endodontic infections.
(33:31):
Does that make sense?
Yeah, and so I think thereneeds to be some clarity there.
I think what we're seeing inthe research is that it's more
perio connection than endodonticinfection, connection than
endodontic infection.
(33:51):
And I you know people say theysee connections all the time
between root canal infectionsand breast cancer, but I haven't
been able to find that article.
Dr. Carver (33:57):
The way I'd explain it to my patients is if there
is, if the immune system has abunch of energy trying to deal
with the infection in the toothright, there's less energy along
that pathway to clean up theother cancer cells that are
being made right.
So, again, it's not a necessarycause, it's the fact that the
resources are being used up.
So when we do a well done rootcanal, we get rid of the
(34:19):
infection right.
Then the energy persists in therest of the body.
And to your point about sayingimaging is so important right
because, as you stated there.
To your point about sayingimaging is so important, right
Because, as you stated there,sometimes are abscessed teeth
and patients have no pills,nothing.
I'm like whoa, like this is.
It's so close to the and weknow there's so much research
coming out with oral infectionsand dementia and I just we've
(34:40):
got to have.
Dr. Chopra (34:41):
I want to show you another tooth story That'll blow
your mind.
It'll blow your mind.
Dr. Carver (34:50):
I really geek out about it and I can't help it.
Dr. Chopra (34:51):
Yeah, that's what we're here for.
Love it.
Here we have a few teeth andthis giant dark shadow.
So a dark shadow is what people, dentists, find, and that's a
sign that your body is giving usthat there's infection, okay,
and it's huge, like in 3D thoseof you are listening.
Dr. Carver (35:09):
Yeah, In the regular x-ray it looks like it's
three teeth are in this big.
Dr. Chopra (35:13):
And this is the 3D image.
So you can see the differencebetween 2D and 3D and the
clarity that you get with 3D.
It's like a no brainer.
But look at it.
In this section, this entireright part of the maxilla has
been eaten away.
This dark shadow is all boneloss.
Okay, look, a lot of dentistswould get nervous that there's a
(35:33):
loss of cortical plate here,and I'm here to say it doesn't
have to be so nerve wracking.
So I did the root canal becauseI did proper testing and I
found that only this tooth wasthe issue, even though it looked
like three teeth were the issue, because, again, you can't just
treat the radiograph, you haveto do the testing and marry the
(35:55):
two.
And this was the only tooththat didn't respond to cold, so
it was actually a dead nerve.
So bacteria got into this toothat some point and I did the
root canal and I got thebacteria out, and then I have to
start following up.
Now.
This was a massive infectionlike almost the whole maxilla on
(36:15):
the right side, and the patientdidn't have any pain.
That's crazy, okay, and so itwas hard for them to even
believe that they neededtreatment.
They were like refusingtreatment.
But you can see a year laterthat they needed treatment.
They were like refusingtreatment.
But you can see, a year later,this bone is coming back.
You can see it's coming back.
That buckle plate hasregenerated.
(36:36):
Obviously, it's not going to bedone healing in a year, it's
going to take time, but you cansee that regeneration of that
bone happening and I thinkthat's wild.
Dr. Carver (36:49):
Yeah, that's significant.
Dr. Chopra (36:50):
You can have an infection this big and not even
know it.
Dr. Carver (36:54):
I know, I see it all the time and it just is
amazing to me, because the bodyis just an amazing thing.
It's always trying to help usand heal us, but sometimes it
needs a little help For sure.
Tell me a little bit.
You know you talked about coldtesting.
What is your?
You know a tooth.
You know how do you know thatit needs a root canal?
Dr. Chopra (37:11):
Yeah.
So I will say it's a commonthing I do is I listen, because
I'm listening to too few.
There's like six or sevendescriptions of a story that a
patient will tell me and I willknow it to be of a root canal
issue, Because sometimes I getsent somebody and it's not a
root canal issue.
Maybe it's a bite issue, Maybeit's actually perio, or maybe
(37:33):
they just had some recent dentalwork, or maybe it is truly
sinus and they just got througha sickness.
So it's very important that I'mlistening.
So listening is number one.
Number two is I start withimaging and I start to see, I
start to match what they'retelling me to their imaging and
then I do testing.
(37:53):
I do, I'll make sure I probethem, I'll make sure I
understand their percussion.
So I'll tap on their teeth,because teeth that are upset
have three main symptoms pain tohot, pain to cold, pain to
biting.
It's either one, two or allthree of these at the same time.
(38:15):
Of that diagnostic testing I'llmarry it with my imaging and
also with my listening to theirtooth story and then from there
I come up with a properdiagnosis.
And because of my past I'm alittle sensitive to this and I
am very keen on a properdiagnosis.
I will not prescribe a rootcanal just to anyone who walks
(38:38):
through my door.
Okay, I will understand them asan individual.
Like maybe they have a highcarries rate right and they're
like keep getting decay in thisone spot, Maybe it is better
that they transition into animplant.
So I am actually always lookingat the patient holistically and
seeing, okay for this patient,what is the right treatment plan
(39:02):
.
But it's always based on thediagnosis, and getting that
diagnosis for me is the mostimportant thing.
Dr. Carver (39:10):
Absolutely it is, and so I find sometimes when
with the cold testing that'swhat I have, and sometimes I
always try to start with what Iassume to be a normal tooth
maybe you know a front tooth Alot of people don't do that and
we say, okay, this is what itshould feel like.
Right, you should feel cold.
As soon as I remove it itshould dissipate.
But sometimes you have thepatient maybe you know an older
patient who the nerves haveretreated a little, who never
(39:32):
feel and you've done thepercussion and you know, but Old
doesn't really, you know, as ageneral dentist.
That's why I get you know, Iget to be like well, we're going
to have a specialist.
And something interesting somepeople when they have reversible
colitis, they generally arelike it's here, right, and
they're like describing an areawhen that tooth has abscess or
(39:53):
irreversible.
They can pinpoint the toothspecifically.
So it's when you're in thatreversible phase where sometimes
the diagnosis is a littletricky.
Dr. Chopra (40:01):
So I teach dentists how to do better root canals,
but a huge part of what I teachis diagnosis and what I've
learned is that people don'treally do their testing.
But the key, the beautifuloutcome of doing the testing
almost every single time youmeet a new patient is that you
(40:23):
understand better what's withinnormal and maybe has the
opportunity to heal with justtime because they had a recent
crown done and what's not normaland what's root canal worthy
and what's not root canal worthy.
Like you start to see thosenuances.
And again, that is a musclethat I've had to exercise and
I've had to work out and now Ican be like I'm going to pause
(40:46):
Instead of treating this person.
I'm going to pause and maybethere's an opportunity for it to
heal on its own.
Or maybe there's an opportunityfor that pain localization that
you talk about, because toothpain will 100% of the time,
localize Okay, and what thatmeans is the patient can put
their finger on it and say, doc,that's the only tooth that
(41:08):
hurts and then you starttreatment on the right tooth,
which is what I wish my doctorsdid First.
I wish they did the testing.
Nobody did the cold testing andthey sprayed air with a syringe
, but that went on multipleteeth and so they didn't do the
testing.
Nobody did the cold testing andthey sprayed air with a syringe
, but that went on multipleteeth and so they didn't do
localized testing, they justsprayed air and asked me first
of all it wasn't cold enough,and then it was too generalized
(41:31):
that you didn't know where itcame from.
So when my cold test doesn'twork for me, I'm looking at
other things like percussion, orI'm even looking at my comb
beam to see is there anincipient radiolucency?
That's starting to begin,because you start to see what
other tests are going to supportyou when your traditional tests
(41:52):
don't, and I do think thattakes time and exercise.
Dr. Carver (41:59):
And, let's say, you have that kind of in that, that
murky, reversible, irreversiblestate.
Are there any modalities?
I, for one, love to use ozone,because when I'm thinking of
pain in my thoughts it's alwaysokay.
The energy is not flowing forsome reason right.
Is it an infection?
Is it a scar?
Like?
How do we get more energy tothe tooth so it can maybe heal
itself?
Are there any modalities thatyou energy to the tooth so it
(42:20):
can maybe heal itself?
Are there any modalities thatyou're aware of or that you
maybe use to see if you can help?
I?
Dr. Chopra (42:26):
use time, because I think by the time somebody's
referred to me they're past thatpoint, right?
Yes, and it's my job to be thegatekeeper of root canal land.
Okay, like I have said no to somany people and they've come
back and said I feel better,right, so I do what I call the
two week check.
If I cannot figure it out inthat first appointment with a
(42:49):
patient, I bring them back intwo weeks.
And the reason why is becausemost of the time the patient
doesn't understand their owntrue story and so they can't
describe it to me.
So that listing piece is offfor me.
Because what are they doing?
They're avoiding, they're notusing that side, so they don't
actually know what hurts.
What hurts Hot, cold or biting,I don't know.
(43:09):
I've been avoiding it All.
Right, I'm going to send youhome and I have an idea of where
I think this may be coming from, or if it's even a root canal
problem.
And because, again, thediagnosis for me is number one
before I start throwingtreatment at it.
And because I don't know, isthat treatment needs to be ozone
?
I actually don't use ozone inmy practice.
Everything that you've seenfrom a healing perspective has
(43:31):
not had ozone on it.
So I know when it comes to aroot canal you don't necessarily
need that, but you do general.
So you probably do need thatand I think that there's so much
stuff that can happen at thegeneral level, the general
dentist level, before thereferral is made.
That's where I think we couldbe a team right.
(43:52):
But once they get to my chairand I still don't know what the
problem is, their symptomshaven't really localized too
much.
It could have just been likecracked tooth syndrome and they
just need a crown.
So I will do all my testing.
It doesn't add up, I'll pause,I won't treat, I'll say let's.
I'm going to send you home fortwo weeks.
I want you to pay attention, Iwant you to actually chew things
(44:15):
hard things, crunchy things,soft things, hot things, cold
things and see what sets it up.
And I want you to take record.
And then I want you to comeback and I want to retest.
I would say eight times out of10, the patient's pain goes away
because maybe they wereclenching or grinding or maybe
they did have a cold and it wassomehow impacting their teeth
Like.
Two weeks is a good enough timefor things to just go away
(44:39):
naturally, to recover from somedentistry to do a lot of things,
and so I love that.
Time can be a beautifulmedicine, and so that's
typically my approach and Idon't charge the patient again
for that second show, like Iwant to make sure that's
inclusive of that oneconsultation.
My goal is that we just get theanswer that we need.
Dr. Carver (45:04):
I think that's so valuable, right?
Because in your own experienceit was like oh, it's painful,
it's this too, let's just diveright in, right.
But I think you're right, thegeneralist.
That's why I have that sameapproach.
Okay, I can't exactly tellwhere it is, so I throw all
sorts of fun things at them,busy like all of us.
Dr. Chopra (45:22):
We're pretty sure it needs a root and I think just
throwing out antibiotics is thewrong move.
I actually don't want to giveantibiotics because I want, if
there is a problem, I want it tosurface.
I don't want the patient totake pain meds on the day of
testing, because all of thisstuff can mask the problem.
And so, again, I think some ofour treatments are palliative
(45:44):
and supportive.
That would work.
But I also think that trying tobe drug-free is also important,
because then it allows me toreally make an accurate
diagnosis, so much of that stuffcan mask.
Dr. Carver (45:59):
Absolutely yeah, and that's a really important
point too.
So what about cracks?
So sometimes a cracked toothcan cause you talked about decay
being one reason we need rootcanals but other times it's a
crack that hits the nerve andthat causes death of the nerve
too.
But I know sometimes a crack istoo much.
So how do you know if a crackis too deep and the root canal
is not going to work and it hasto have extraction?
Dr. Chopra (46:21):
You actually have to go inside the tooth and
visualize it with the microscope.
I never diagnose a crackedtooth.
Let's align on our vocabularybecause for me cracked tooth is
something that is within thecrown, versus a vertical root
fracture which extends to theroot and that's not restorable.
I think there are many crackedteeth out there that can be
(46:44):
saved and once you do the rootcanal and the crown now some of
them don't even need the rootcanal, they just need the crown
and they'll get better becauseit's a true reversible pulpitis.
But I even see some cracksextending down into the root
that are not completely cracked.
That I think we can save.
And maybe it's not a lifelongsave, but maybe it's four or
(47:05):
five years and then implanttechnology has advanced for
another four or five years andthe implant you get in the
future is better than theimplant you get today.
So I will always have thatconversation with the patient
about what they want to do.
Some patients are like, nope,just take it out, and I can
respect that.
I will.
If I'm really weary about atooth that doesn't have any life
(47:25):
in it, I will remove it.
But I will not make thatdecision until I've actually
visualized it with my microscopeand gone inside, Because you
will make so many assumptions ifyou just do it on imaging alone
.
Dr. Carver (47:40):
And a lot of times you're not imaging, doesn't?
Dr. Chopra (47:43):
show us cracks.
Dr. Carver (47:44):
Even on 3Ds, you can't.
There's some techniques, butit's more challenging.
You really have to go by.
Like you said, a microscope isreally the goal if you want to
see a crack there.
So yeah, that's awesome.
Anything else you think that'simportant for us to know about a
properly done root canal andwhy it is a viable option.
Dr. Chopra (48:02):
They're safe, they're effective, they give
beautiful outcomes, they'reincredibly regenerative and
there is purpose to our teeth.
So give teeth a chance is allI'm going to say.
Dr. Carver (48:17):
And again I so value you coming on because this
is an important topic thatcomes up a lot and there are a
lot of myths surrounding it andnot every root canal is the same
, and you've elucidated for us.
The amount of education that weget really varies.
No one is really getting enoughin dental school and so I know
the first couple of years out ofschool all of my CE was about
(48:39):
endo and trying to understandhow to, how to do it better.
You know I I got some of thenewer technology like
immediately, um.
But then it got to the pointwhere I was like you know, my
expertise is avenues.
I'm going to let the realspecialists cause, you know, if
I'm doing, you know, two a month, you know that's not, you know,
versus somebody who's doing twoin an hour.
I mean that's a big differenceand this is so important If we
(49:05):
are striving to maintain teethand maintain health.
We want it done in the most, youknow, beneficial, you know,
appropriate way.
So, and again, I'm so fortunateto have Dr Sarah Martinelli in
our area who uses all thesegrapes, and she does such a
wonderful job for me.
So just a shout out to her.
But thank you, I know you're inCharlotte, if somebody wanted
(49:26):
to get some more informationabout your website.
It's amazing.
There's so many resources,especially for dentists too.
There's so much training, andall this talks.
How do we connect with you ifwe have any questions?
Dr. Chopra (49:37):
Yeah, my website is a great place to start.
That's drsoniatropracom.
That's Sonia with an I.
I know I trained a lot ofdentists, but I will say a lot
of patients have found me and sonow there's a lot of new
patient resources out there.
I just launched an onlinecourse for patients called Tooth
Wisdom.
A little play on words there,but it's really a great guide to
(49:58):
understanding your own oralhealth and being a great patient
advocate.
And I would say, hang out onInstagram the most, and that's
at Dr Sonia Chopra as well.
Dr. Carver (50:09):
And we will link to that in the show notes.
So, thank you so much for yourtime on this Friday to chat with
us and educate all of us.
And yes, thank you.
I really appreciate all yourtime and I wish you the best in
all your endeavors.
I love that you're educatingbecause, like me, we're just
trying to spread this awareness,make everyone aware of the
options.
Right, it's really importantthat you choose the best option
(50:30):
for you.
Dr. Chopra (50:30):
I appreciate you.
Thanks everybody.
I appreciate you so much forhaving an open mind.
Dr. Carver (50:35):
Thank you, oh of course, I think science is
constantly evolving and if wecan't have an open mind, we're
not really helping our patients,we're not really helping
ourselves, we're not helping ourpatients.
Things that I knew and thoughtwere true five years ago now is
more evidence.
Some of them.
We change and I think that'sreally important and some of the
reason why I think healthcareis really stuck where it is now
(50:55):
it's become more disease careLike we really.
We might still think the earthwas flat right If we didn't
challenge these ideas, and that,to me, is the definition of
science.
And, as health practitioners, Ithink it's so valuable.
There's so much informationcoming out all the time that
it's important to keep learningand keep understanding, keep
having these conversations,trying to have community with
(51:16):
all of us, because we're not, noone can do everything alone.
It's important that we talk toour specialists, we meet with
them, and it's okay to havedisagreements, you know, but
again, if we ultimately aretrying to do the best for the,
you know, that's where we havecommon ground and I think that's
really valuable for all of us.
So awesome.
Thanks again for listeningeverybody.
Hope you enjoyed this episode.
(51:36):
Please check out Dr Sun'si'swebsite and we'll see you on the
next episode.
Everyone, have a great day.
Hello, I'm Dr Rachel Carver, aboard-certified naturopathic
biologic dentist and a certifiedhealth coach.
Did you know that over 80% ofthe US population has some form
of gum disease?
(51:57):
Many of us don't even know thatwe have this source of chronic
infection and inflammation inour mouth that's been linked to
serious consequences like heartdisease, diabetes, stroke,
dementia, colon cancer, kidneydisease, even pregnancy
complications.
Would you like to learn how toreverse and prevent these
chronic, debilitating conditionswithout spending a lot of time
(52:17):
and money at the dentist?
Join me for my six-week coursewhere I will teach you the root
cause of disease.
You'll learn how to be your ownbest doctor.
Are you ready to get started?
Let's go.
Hello everybody, welcome back to another episode
of the Root of the Matter.
I am your host, dr RachelCarver, and I'm very excited to
have the conversation today withDr Sonia Chopra, who is a
board-certified endodontist.
So you know many of you arelistening to this podcast
because you're interested inbiologic dentistry, how it
connects to the rest of the body, and there is a subset of
(00:22):
biologic or holistic dentistswho think root canals are all
bad and there's no place in thebody for them.
And if you've been listening tothe podcast, you know that I
have a different take on thatand I really believe in the
bio-individuality of each person, and so it's really important
when we're considering treatmentthat we look at all different
avenues and that patients aregiven a choice.
(00:43):
So I don't ever want mythoughts or ideas to persuade
somebody to do something thatmaybe isn't fit with their
values.
So we always, you know, talkabout all the different options,
and Dr Schroeper is here toexplain a little bit more about
canal kind of, why they maybehave a bad rap and what a
properly done root canal withthe right technology can really
(01:06):
do.
So a little bit more aboutSonia she has been not just an
author and an entrepreneur.
Her website is fabulous with somany resources.
So she is a woman after my ownheart and I love it and I'm
excited for this conversation.
So thank you for being todayand welcome, thank you so much
for having me.
Dr. Chopra (01:28):
This is truly an honor to be able to connect with
the biological dentist whoactually still sees that there's
space for the root canal at thetables.
I feel like you are just myfavorite person right now.
Thank you.
Dr. Carver (01:40):
So it's really kind of fabulous.
So maybe just give us a littlebit about your story, how you
got to become an endodontist andyeah, again, my mom was so
adamant about me having a fullcomplement of teeth going to
(02:06):
college.
Dr. Chopra (02:07):
That the summer after I graduated high school,
she was like all right, I'mgoing to close up all these gaps
in my mouth.
And soon after a lot of thatdental work, I started to
develop a toothache.
And because I just had dentalwork done, everyone assumed that
the toothache was related tothat dental work.
And so this is what kind ofstarted this kind of path to a
(02:29):
misdiagnosis.
I had this toothache, nobodycould diagnose it and in fact,
now that I look back, I'm likethey didn't really know how to
diagnose.
Now that I am where I am in mycareer, I look back and like
whoa, they didn't do any of thisstuff and they decided to
extract a tooth on me and Istill.
(02:51):
They extracted the tooth, Istill had my toothache.
They extracted the wrong toothbecause their diagnosis was
wrong and now I'm without nineteeth.
So I have had everything done inmy mouth.
I've had an extraction now.
I've had root canals, I've hadbraces, I've had gingival grafts
, I have crowns, bridges, likeyou name it, and implants.
(03:13):
I have four implants nowbecause of this kind of debacle
and it was so incrediblyimpactful on me because it was
like a nine month journey ofpain and so tooth pain to me.
I've had three children too.
Now I have three children andI've had a massive toothache,
and the toothache wins thebattle of the worst pain I've
(03:37):
ever experienced in my entirelife, and so I have this
compassion for people who areexperiencing it, and I think
that event in my life is whatcatapulted me to become an
endodontist or a tooth saver,tooth healer and somebody who
really gets people out of painquickly when it comes to their
(03:57):
mouth and safely.
Yeah, yeah, it's great.
Dr. Carver (04:03):
And it's.
You know.
It's amazing, your story, tothink about all that because in
listening to your I don't knowif it was in the TEDx talk I was
listening to or something elsewhere even the oral surgeon,
before he took out that tooth,he said he kind of had, and I
was hoping, while you weretelling this story that you were
going to say he said nope, youknow what?
This, it's not this tooth andI'm not going to do it.
You know, but unfortunately hedid, and you know that's that's
(04:25):
the issue.
Like, sometimes, when you havetooth pain, you have two options
.
Now, right, have the root canal, have the tooth extracted.
But once a tooth, that's it,it's gone forever.
Right, that is an irreversibleproblem, right?
Whereas a root canal, we cansave the tooth right and maybe
down the line it has to beextracted.
But in the meantime, again,let's look at that person, look
at their, their life, let's lookat their overall, let's see,
(04:47):
you know, is this going to be agood, viable option for this
patient?
Like you know, it's thepatient's decision.
We, you know, I'm giving theminformed consent.
You know, here's what it is.
I mean, the extraction ispretty, you know it.
Most of us know that the toothis not just this mechanical, you
know body part that is supposedto chew food.
It's a living organ and it'sconnected to, you know, the
(05:10):
jawbone.
It is connected to our stomach.
You know there is all sorts ofthings that the reason why we
need teeth.
So, again, just pulling it out,we lose a lot of that
connection to the nervous systemand proprioception and a bunch
of the posture right.
We know a lot of thatconnection to the nervous system
and proprioception and a bunchof the posture right.
We know a lot of the way ourteeth come together effect.
(05:31):
You know it can be a relativelysimple procedure, but what are
the consequences?
And that's I really wanted tohave this conversation today.
Patients can really understandyou know these different options
and you know what it meansbecause I love what you said in
all in on your website rightthat the body has an amazing
ability to heal itself.
If we can remove those tucksand the infections, the body can
(05:52):
regenerate and that's whatpeople, a lot of times people
don't appreciate.
Dr. Chopra (05:54):
We are regenerative beings.
We can heal from a cut right.
If you knock out a tooth, yourbody can re-accept it and
regenerate it back.
When we have a tooth infectionand we see bone loss around the
tooth, we can regenerate thatbecause there's already these
systems in our body that arethere, ready to protect us.
(06:15):
And so that's why I loveendodontics, because when you
see what can heal, what can work, what can regenerate, it is so
powerful and that's really themissing piece.
I love what you said.
Like I am the same way, like Ipractice, when a patient comes
to me even though they werealready prescribed, like a root
canal, I give them that optionAgain, like you can do the root
(06:38):
canal and you can extract it.
And I think there's so muchvalue that we should really
remember about our teeth.
Our teeth should not be meantto be disposable.
They are given to us for areason they give us nourishment,
they give us hydration, theygive us breath, they give us
confidence, they give usattraction.
Dr. Carver (06:59):
They give us so much and I think the more we
start to value our teeth, thebetter we're going to be
Absolutely so.
Maybe for those of us who don'treally understand what a root
canal is, what is?
Every tooth has a root canalsystem, right, but when you have
(07:21):
a procedure that we typicallycall a root canal, what are we
doing?
Why?
Dr. Chopra (07:23):
do we do a root canal treatment.
So typically what's happeningis there's a bacterial infection
.
So I would say the most commonscenario is somebody gets a
cavity.
That cavity has the opportunityto get deep and then the
bacteria finds its way into thenerve or the pulp and starts
creating either pain andinfection.
(07:43):
Sometimes that infection ispainless, it doesn't even have
to be painful.
So that's one of the reasonswhy I'm a proponent of imaging
digital imaging that keeps theradiation low so that we can
identify these areas ofinfection.
But once that happens, that pulpis irreversibly damaged.
And that's when you have twooptions either the root canal or
(08:04):
an extraction.
And then it becomes a personalchoice Do you want to save this
tooth or do you want to take itout?
And if something is savable, Iwould always try to just show
people why it's worth saving.
Because when you take out atooth, there are repercussions
Other teeth start to shift, youget super eruption, you get like
(08:26):
your tongue starts to spreadout.
There's just a lot of thingsthat can happen as a result of
taking out one tooth.
Your whole neuromuscularjunction here can be affected
and again, like you said, yourposture.
It all shifts.
It's all connected.
So what we do in root canaltherapy, you have to follow two
cardinal rules, and this isanother problem, because many
(08:48):
root canals are done violatingthese rules.
You've got to find all thecanals in a tooth and you've got
to get to the very end of theseroots and these canals,
otherwise you're simply leavingbacteria inside the teeth.
And when you think about howwe're taught how to do a root
canal in dental school, we havefour years of education.
(09:09):
I personally only had atwo-week crash course on how to
do a root canal and I only hadto perform four of them in order
to graduate and be able to justdo it freely on people.
I didn't really feel that goodabout that.
So I went ahead and did aspecialty because I knew it's
what I enjoyed, because it'swhat got me out of pain and what
(09:30):
saved my life.
But I knew that I wasn't goodenough after I graduated dental
school, and nowadays therequirements are actually like
two or sometimes it's fourcanals, and sometimes you can
find four canals in one tooth.
So the requirements to graduateare very low, and so that is
what creates this problem of weneed to really be clear on the
(09:52):
difference between a good rootcanal and a bad root canal.
And it's not that I think thatthese dentists are ill
intentioned.
They're not trying to hurtanybody.
They just don't know what theydon't know and they're doing
their best with the resourcesthat they were given.
So when we do root canal,you've got to clean out all
those canals and get to the endof every canal, and so you
(10:12):
disinfect the tooth and nowadaysthere's so much fun technology
that helps us do our job evenbetter and get better patient
outcomes and then, once that'sall cleaned out, you seal it up
outcomes.
And then, once that's allcleaned out, you seal it up and
then you can see and watch theregeneration of what is going to
happen.
And I have some imaging that Ican show you so you can actually
(10:33):
see what happens in thesepatients.
Dr. Carver (10:37):
Yeah, and again, this is important, judgene, I
had the exact same situation.
I graduated 21 years ago.
We had to do, you know, oneanterior tooth, I think, and one
posterior molar, with multiplecanals, right.
So one single canal tooth andone end.
You know that this is a verythere's a reason why we have
specialists who just do rootcanals, because sometimes maybe
in a front tooth, the canal isnice and big, it's very easy to
(10:59):
see.
But oftentimes those posterior,those back teeth molars have
curvature of the roots or allsorts of funky anatomy.
And again, why imaging is socrucial and you leave just one
little bit of bacteria behindand you know can potentially
cause persistent infection.
And this is what we see and whya lot of biological people say
(11:21):
you know, root canal is just sobad If it's not cleaned out
properly.
You'd lose that.
And that's the part, like ifyou aren't doing these all day,
every day and you don't reallyunderstand how.
And that's what we seeoftentimes on x-rays, like the
fill material is short, soyou've let the last couple
millimeters of the root wherethe bacteria you know didn't get
fully clean, and you know thisis where problems with the lab
(11:43):
right and they find all sorts ofweird bugs and bacteria.
Maybe talk to us a little bitabout the technology.
Dr. Chopra (11:49):
So, yeah, let's talk about a properly done root
canal.
I think that's key.
I love to talk in tooth stories, okay, because I believe every
tooth has a story and you needto figure out what's happening
in that particular tooth.
So here is a tooth and it's hada previous root canal.
You can see that this whitematerial inside the tooth is the
(12:13):
evidence that there's been aroot canal.
Now, again, we want to followall the cardinal rules when
we're doing root canal therapy.
So I can see already that thisroot canal end adherometer
counts in our world.
Okay.
So if you're a patient andyou're trying to figure out
what's happening in my toothstory, this is how you can
evaluate it.
Okay, now we are using 3D conebeam technology to really
(12:39):
understand the internal anatomyof our teeth.
Actually, I take this before Ieven start treatment now,
because it's helped me so muchin being able to understand the
tooth in front of me andunderstand that tooth story.
So you can see that there's rootcanal filling material in three
of these canals, but there's afourth canal that wasn't even
treated.
(12:59):
So both of the cardinal ruleshave been violated in this root
canal.
It's not that root canals don'twork, it's that this root canal
is not going to work.
And it's not even like byindividual.
This root canal wouldn't workin any individual.
Does that make sense?
So you can see, here's thecanal.
And if this root canal is 10years old, that tells me this
(13:23):
infection is 10 years oldbecause there's still original
bacteria from 10 years ago thatwas never treated.
And when bacteria has time tofester in these teeth it has
impact.
So you can see the border ofthe sinus here has been eroded.
You can see the sinus mucousmembrane is completely inflamed.
(13:43):
So this patient was evencomplaining about having
breathing problems, sinusproblems.
And again, you can appreciate,here the border of the sinus is
completely eroded by this toothinfection.
I redid the root canal.
I made sure that I got to thevery end.
This little, what we call asealer puff is totally fine, and
(14:03):
so then it's important tofollow up.
Now, one of the secrets abouthow we heal is that bone and
healing after root canalactually takes a lot of time,
and I find that some dentistsdon't even understand this, and
so they jump the gun.
They take an x-ray maybe amonth later and they're like
that's not healing.
It takes time, and so I do aone-year follow-up because bone
(14:27):
is so slow to regenerate, andlook at what happened one year
later.
Do you see that there was nobone here for the sinus floor at
the original time and that allthat inflammation in the sinus?
Look at how beautifully, oneyear later, that floor of the
sinus has restored itself.
The bone regenerated.
Now this is only one year, sowe still have some bone that
(14:49):
needs to regenerate.
That is fine.
But look at this that sinusmucous membrane has now fully
decreased its inflammation andthis patient is not only saving
their tooth, regenerating theirbone, but they're also breathing
better.
That's incredible.
Yeah, it's very dramatic forany of those not only saving
their tooth regenerating theirbone, but they're also breathing
better.
Dr. Carver (15:10):
That's incredible, yeah, that's, it's very dramatic
for any of those listening.
The massive amount ofinflammation in the sinus is
gone, and so that's and we talkabout that all the time.
In my opinion, a lot of diseaseis from toxins and infections,
and if you can remove those, thebody will heal.
And that sometimes is thechallenge.
Where is the infection?
What is the toxin?
And so again in the root canal.
Dr. Chopra (15:31):
Why root canals get the bad rap is because they're
not properly disinfected and soyou can see here that that other
canal, that fourth canal, wastreated.
Here you can really see thatbone reconstituted and that
inflammation gone.
And then again here you couldreally see that bone
reconstituted and thatinflammation gone.
And then again here one, two,three canals that were treated
originally.
But there was one, two, three,four canals actually in this
(15:54):
tooth.
So if you're a patient, you'vebeen told that you have a root
canal that's gone bad.
Do you understand your wholetooth story and has it really
been done with proper methods?
So I will say that I did thisone with the gentle wave, and
the gentle wave looks.
You don't just what it does is,it doesn't just go linearly, it
(16:16):
also gets these connections.
So this is where again, wherepeople used to pick on us that
oh, root canals still harborbacteria, because we couldn't
get these connections and theselittle fins.
But now we can because thegentle wave allows us to
irrigate and disinfect better.
It uses sound waves to actuallymove the disinfection solution
(16:38):
through the tooth in theseanastomoses and these connection
points, and that's reallychanging the game for the
patients and their outcomes andit's allowing them to have
decreased postoperative painafter their procedure and
actually heal a lot faster.
So we're seeing better outcomes, but even faster than before.
Dr. Carver (17:00):
Yeah, and this is what I'm often talking to my
patients about.
One of the complications isbecause there are the main
canals, which are obvious, right, but then there's all the
channels, right, and then again,like you see how sometimes the
canals come together and youknow, in previous, when we were
just using hand files, there wasreally no way to get into all
those little aspects and evenwith our syringe and trying to
(17:22):
flush it with bleach, theyweren't necessarily getting into
all of them.
So the gentle wave is kind oflike an ultrasonic type of
machine where it's amazing, whenyou just put that in water you
can really see how it's justflushing and getting through all
of those little canals andyou're able to get your
disinfectant into those lastlittle areas Right.
Dr. Chopra (17:42):
So if you really want the ideal root canal, you
will utilize somebody you willpick your provider based on.
Like their technology.
For example, those canals canbe really hard to see, so I'm
always using a 3D micro not a 3D, but a microscope to really
elevate my magnification insidethe tooth.
It allows me to keep my openinginto the tooth really small and
(18:05):
be very conservative, but stillbe able to visualize all those
canals.
So I need my microscope, I needmy 3D comb beam so I can
understand the tooth storybefore I go in, and then I need
my gentle wave to really cleanand so that 3D imaging is my GPS
, essentially through the tooth.
(18:26):
I utilize it through my wholeprocedure and then it allows me
to understand how to utilize mygentle wave, because I'm going
to use that differently on everycase.
And then I'm also now using alaser during my treatment so
that, like for me, this is whatI call the modern day root canal
and we're seeing this type ofbone regeneration over and over
(18:48):
again.
Dr. Carver (18:51):
I was going to ask about the laser.
Just a couple episodes ago wehad a periodontist on who.
She's regenerating crazy withthe laser.
Like this, light technology andlaser therapy is amazingly
healing for the body.
In the last root canal I did, Isaid the last one I'm going to
do, I had my laser.
So I was like you know, I waslike I've got, I've got.
You know, he didn't want to goto the specialist.
All right, you know.
(19:11):
Hey, you know, and it's workedout well.
Um, yeah, laser is phenomenalthat way.
You know, in and of itself itcan be antimicrobial, but the
healing part, I think of late isreally, you know, it's funny.
We have a local endodontistwho's fabulous and she makes the
tiniest access holes and Ithink, same thing.
She has all the technology andI think how on earth can be seen
and it's almost.
(19:31):
I was like I think I have towrite her an email.
I love and appreciate how small, because the smaller the access
, the stronger their tooth is.
Right.
A lot of endodontists were likeget the biggest hole possible
so you can see everything, butthat compromises tooth structure
.
Um, but you know, I love howsmall the access is, but, man, I
have the hardest time trying toget that little tape out when I
want to seal that.
It's amazing.
(19:54):
So tell us what is your thingyon the laser?
How does that async work in aroot canal system?
Dr. Chopra (20:00):
I mean, I love it.
I do think the gentle wave andthe laser are two different
animals, but I do think there isa synergy between the two.
But I do think there is asynergy between the two.
So what I love to do in thebeginning, before I even start
moving things around in thetooth because every time you
take an instrument down you arepushing things a little closer
to the exit I like to run mylaser right away and already
(20:25):
when I do that, I call it thelaser sandwich technique.
It's Dr Chopra's laser sandwichtechnique.
I run my laser first, before Istart moving anything around.
Why?
Because what is that doing?
From the beginning of theappointment?
It is reducing the bacteria inthere from the get go.
So before I start movinganything, before I start
(20:46):
cleaning, pushing things againstwalls, beyond walls, whatever,
I'm already reducing thatbacterial load, I'm already
supporting the immune system ofthat person and then I'm going
to start cleaning things,opening things up to allow my
gentle wave to work, and thatgentle wave is going to get in
there and it's going to make theconnections.
When we do a traditional rootcanal, we're just using a hand
(21:09):
syringe, but what happens withthat hand syringe is that
bubbles are formed and whenthose bubbles go in the tooth
they actually prevent theirrigation solution, the
disinfection solution, fromgoing deep in the tooth.
So the first thing that thegentle wave does, that the laser
can't okay, is it degasses thesolution.
It's actually a closed system.
(21:30):
You create this platform aroundthe tooth and there's a special
handpiece that goes on andworks in this closed system.
So the first thing it does isit pulls out all the air, so all
those bubbles that arepreventing that penetration of
the disinfection solution.
It goes away and then the soundwaves start to work and it
pumps the solution through thetooth and you get that
(21:52):
connection and you even get apenetration of the dentinal
tubules, which is what manybiological dentists have
criticized us, that we can'tclean that.
So now we can, and so I'll dothe gentle wave in the middle
and then I probably have alittle bit more cleaning to do,
like sometimes I don't.
(22:12):
If I can just do the gentlewaveand then be done, that would be
great, and then I will alwaysend with the laser.
But as I'm doing myinstrumentation, I'm using my
laser to activate my solution topull things out of the tooth,
so I do an immediate decrease ofthe bacterial load to pull
things out of the tooth.
So I do an immediate decreaseof the bacterial load, I get
clean, I use my laser throughoutthe procedure, I do the gentle
(22:33):
wave at the end, get that reallygood flush through the tooth
and then I'll give it one finallittle laser.
So I'll sandwich it all that inbetween my laser and my
patients are loving it.
I no longer have to give likehefty pain meds.
I rarely have to giveantibiotics, so I'm already like
preventing gut disruption,which is incredible.
(22:57):
Okay, you're going to need alittle Advil Tylenol, because
the reality is I'm working onyou.
You're going to have a littleinflammation, a little soreness.
If I were to dig under yourfingernail for an hour and a
half it would be sore.
So that makes sense.
So your body's just goingthrough wound healing.
Wound healing is just bringingin those immune cells to heal it
.
That influx of cells makessoreness.
(23:18):
So you are going to have aperiod of time where you're sore
.
But the gentle wave decreasesthat.
I even think the laserdecreases that.
We even use the laser forphotomodulation after.
So we're using red lighttherapy to heal the periapical
tissues afterwards.
So it's a process, but I onlylean on over-the-counter
(23:39):
medications.
Now Maybe if somebody has ahard time healing, I have to
give them a steroid.
But I don't give narcoticsanymore and I try to keep my
antibiotic usage to a minimumBecause, if you think about it,
the root canal is the antibioticand everything that comes after
that is inflammatory pain.
So that's why Advil will workbetter than Tylenol, because
(24:02):
it's an anti-inflammatory, andthat's why, if they do need more
support, a steroid is going tobe really helpful and you don't
have to think that it's aninfected pain.
It's an inflammatory pain andyou just have to get through it,
just like you would if you gotin an accident and you're sore
from that Same thing Again, likeyou said right, we're digging
(24:22):
that bacteria deeper down intothose pockets.
Dr. Carver (24:25):
Right, we're decontaminating.
And now all of my hygienistshave been trained with the laser
, so they're going around doingthat decontamination.
You know, there's all these inthe in the medical world.
Like you can't have a cleaningso many months after heart or
after this or that, and I'mthinking but now we're letting
up.
That person is a periodontalpatient and we're letting that
build up.
And you know, yes, maybe atraditional dentist, that's not
(24:45):
great, but those of us who areusing these antimicrobial like I
think that's more importantbecause we know oral bacteria
contributes to heart disease andon and on.
So I think that's me.
Like you, you know I do a lot ofextractions and between the
laser and the ozone I use PRF.
There's I don't remember thelast time I gave an opiate
either or had somebody come backfor you know, you know dry
(25:06):
socket or anything like that.
And actually I give Arnicaright after, before the numbness
where it's.
Often I have them take homesome Arnica to use for five days
and that even reduces the needfor sometimes the ibuprofen.
And so we tell them hey, that's, you know, use that.
I found the little Arnicapellet been amazing for for
post-op and it was funny I saw apatient after an extraction and
(25:27):
she was.
She was like, oh, there's like asharp thing.
And I was like, oh, maybethere's a bone fragment, cause
sometimes that happens, and Iwas looking in that and both my
assistant heal as well, and thenshe was like, oh no, no, that
wasn't done by you and by youknow somebody else.
I was like, aha, it's like youknow so that, like with all the
(25:50):
kind of natural stuff and stuffthat we're giving to enhance the
body's, you know, ability toheal itself, so, like you just
see the difference.
Um, yeah, you know, when we'redoing these kind of things to
support the body's healing right, that photobiomodulation is so
key to just stimulating, um, youknow, the body's ability to
heal yeah, I feel is it fair tosay that I'm a biological
endodontist, like I would say.
(26:12):
I feel like I am.
Dr. Chopra (26:13):
Yeah, even though the biological community might
come after me for saying that,but like I really do feel, like
I understand the biology, like Iunderstand the time it takes to
heal, to see the evidence, justlike really thinking about
things in a strategic way that'sgoing to support the patient
and their recovery.
Dr. Carver (26:33):
Well, you know, I teach at the biological dental
college, the American Collegefor Integrative Medicine and
Dentistry, just same as you.
Right, you guys have the sametechnology and do the stuff, and
we teach our biologic studentsabout a properly done root canal
, so that there is such a thing.
Dr. Chopra (26:52):
Yeah, oh, I would love to be a part of that.
What fun, that would be great.
Dr. Carver (26:56):
Yeah, it's exciting .
I'm really excited that we'redoing this episode because,
again, I do want people tounderstand that it's not all bad
.
But unfortunately, like yousaid, we can do two root canals
and then we can go into practiceand start doing them.
I did them for a long timeuntil I was like you know what?
I don't feel like I have theright expertise.
I don't want to contribute to alot of poorly done root canals.
(27:18):
Again will abscess and willcreate systemic effects and I'm
like I'm going to stick to mylane.
Dr. Chopra (27:23):
They really are technique sensitive and I think
patients need to understand that, because I do think patients
feel like their dentist shoulddo everything.
And there's really a zone ofgenius, like I was telling you
earlier.
If you asked me to do yourfront four veneers, you wouldn't
look pretty.
I would not make, even thoughI'm a dentist, those veneers
(27:45):
would not look very prettybecause my zone of genius is
really the root canal.
I do root canals for the past16 years eight to 10 times a day
and even my first three yearsin practice I didn't really know
it.
It took me those three yearsafter a residency of doing 250
root canals beyond the two fourthat I did in dental school
(28:05):
right, and then the 250 and thenthree years of eight times a
day.
I finally learned the nuancesthat I understand now and I
think that's what patients needto understand.
And even I would say not allendodontists are created equal.
There's some endodontists thatI know that don't use a
(28:25):
microscope, that don't have conebeam 3D technology in their
practice.
They would never invest in agentle wave.
So I think, as a lay person,understanding what's available
and making your choice based onthat.
On the flip side, there aresome general dentists who
actually do really good rootcanals especially.
I have a lot of dentists that Itrain.
(28:46):
I can honestly say I would letthem do my root canal because
they just get it.
They understand the wholeconcept.
I think understanding whichprovider you choose is also just
as important.
Dr. Carver (29:02):
And what do you say to?
So I often tell me I'll take a3D x-ray and a look at the tip
of a tooth right and let's saythe root canal was done maybe a
decade ago and you still seelike a little shadow, maybe a
little radial lucency.
How would you determine like,is that an active problem, does
it need to be redone or is itjust scar tissue?
(29:23):
Is there any way to really know?
I think if it's.
Dr. Chopra (29:28):
I think scars are small and I think some things
that dentists actually watch andwait are actually active
infections.
So I I it's funny because thisyear I have seen a few of my
patients from like pre 2018 comeback to me.
And I say pre 2018 becausethat's the year that I got my
(29:50):
gentle wave and I didn't havethe resources, I didn't have the
technology.
The technology simply didn'texist for me to use it.
And they came.
I did.
I followed the rules.
I followed that cardinal ruleof root canal therapy of finding
every canal, getting to the endof every canal.
It was actually a redo of aroot canal that didn't follow
(30:10):
the rules.
I followed them like, oh, itshould work, and then it came
back to me.
It was a 2015 root canal.
It came back to me in 2023.
And even though the patientwasn't in pain, that dark shadow
was still there.
That dark shadow should haveresolved itself in a year or two
.
And so to me, that tells meokay, my root canal didn't work,
but can I redo this now that Ihave new resources?
(30:34):
And so understanding thetimeframe or how that root canal
was done originally isimportant.
So anything of mine thatdoesn't work and it was done
pre-general wave era.
I'm going to offer anopportunity before extraction
that if you want me to do thisagain with new resources, new
(30:55):
technology, I'm happy to do it.
I also respect the decision of Idon't want to do this treatment
again and if you want toextract it, that's okay.
But I'm seeing the ones thatI'm redoing are healing now.
I've only had three or fourthis year and over, like the
last 16 years, and so, like eventraditional root canals, they
(31:19):
still work.
But I want people to startthinking like okay, just because
the first one didn't work, wecan redo it and it doesn't have
to be something.
That's a symptomatic thing.
I think scar tissue is reallysmall and if there's a sleepy
lesion, a sleepy infection, andit's tiny, I may not necessarily
(31:41):
hunt after it, but I feel likeif it's of a good size and it's
sleepy, it's not making noiseI'm going to consider that still
active infection.
Dr. Carver (31:51):
Yeah, and that's good to know Because as a
general dentist, when I'mlooking at these things I'm like
I don't really have symptomsbut I want it to look better.
And then as a biologist, I'malways thinking what part of the
body is that connected to?
Are they having any, maybesymptoms?
Do you?
You know, what is yourinterpretation of how kind of
are connected to the rest of thebody and the gut health?
(32:11):
Do you ever see situationswhere, like an infected, a lot
of, like the infected firstmolar and people and you know
breast health issues, becausesupposedly that's on that same
meridian?
Have you seen any connectionswith systemic health and
infected teeth?
Dr. Chopra (32:26):
I haven't from a breast perspective, but I mean
I've definitely seen it withmore adjacent tissues like
sinuses, headaches, people justfeeling like malaise, like just
because they have this thing inthe background.
I actually just had a patientwho I did a redo of her root
canal and I could see there wassome sinus connection.
But she was like I'm so plannedfor this surgery over here.
(32:50):
I'm like whoa, hold on, givethis a month to heal before you
go for that surgery, because youmay be okay.
So she's coming back to see mein a month to see how her
symptoms are doing and if shereally needs surgery or if it
was just this tooth having animpact.
Now I will say that I don't seeroot canal infections jumping
(33:11):
from tooth to tooth, and so I dofeel like there is a protective
mechanism.
The way our bodies createalmost assist is a protective
mechanism because it'sencapsulating that infection so
it doesn't spread anywhere else.
I feel like there is someconfusion between periodontitis
and endodontic infections.
(33:31):
Does that make sense?
Yeah, and so I think thereneeds to be some clarity there.
I think what we're seeing inthe research is that it's more
perio connection than endodonticinfection, connection than
endodontic infection.
(33:51):
And I you know people say theysee connections all the time
between root canal infectionsand breast cancer, but I haven't
been able to find that article.
Dr. Carver (33:57):
The way I'd explain it to my patients is if there
is, if the immune system has abunch of energy trying to deal
with the infection in the toothright, there's less energy along
that pathway to clean up theother cancer cells that are
being made right.
So, again, it's not a necessarycause, it's the fact that the
resources are being used up.
So when we do a well done rootcanal, we get rid of the
(34:19):
infection right.
Then the energy persists in therest of the body.
And to your point about sayingimaging is so important right
because, as you stated there.
To your point about sayingimaging is so important, right
Because, as you stated there,sometimes are abscessed teeth
and patients have no pills,nothing.
I'm like whoa, like this is.
It's so close to the and weknow there's so much research
coming out with oral infectionsand dementia and I just we've
(34:40):
got to have.
Dr. Chopra (34:41):
I want to show you another tooth story That'll blow
your mind.
It'll blow your mind.
Dr. Carver (34:50):
I really geek out about it and I can't help it.
Dr. Chopra (34:51):
Yeah, that's what we're here for.
Love it.
Here we have a few teeth andthis giant dark shadow.
So a dark shadow is what people, dentists, find, and that's a
sign that your body is giving usthat there's infection, okay,
and it's huge, like in 3D thoseof you are listening.
Dr. Carver (35:09):
Yeah, In the regular x-ray it looks like it's
three teeth are in this big.
Dr. Chopra (35:13):
And this is the 3D image.
So you can see the differencebetween 2D and 3D and the
clarity that you get with 3D.
It's like a no brainer.
But look at it.
In this section, this entireright part of the maxilla has
been eaten away.
This dark shadow is all boneloss.
Okay, look, a lot of dentistswould get nervous that there's a
(35:33):
loss of cortical plate here,and I'm here to say it doesn't
have to be so nerve wracking.
So I did the root canal becauseI did proper testing and I
found that only this tooth wasthe issue, even though it looked
like three teeth were the issue, because, again, you can't just
treat the radiograph, you haveto do the testing and marry the
(35:55):
two.
And this was the only tooththat didn't respond to cold, so
it was actually a dead nerve.
So bacteria got into this toothat some point and I did the
root canal and I got thebacteria out, and then I have to
start following up.
Now.
This was a massive infectionlike almost the whole maxilla on
(36:15):
the right side, and the patientdidn't have any pain.
That's crazy, okay, and so itwas hard for them to even
believe that they neededtreatment.
They were like refusingtreatment.
But you can see a year laterthat they needed treatment.
They were like refusingtreatment.
But you can see, a year later,this bone is coming back.
You can see it's coming back.
That buckle plate hasregenerated.
(36:36):
Obviously, it's not going to bedone healing in a year, it's
going to take time, but you cansee that regeneration of that
bone happening and I thinkthat's wild.
Dr. Carver (36:49):
Yeah, that's significant.
Dr. Chopra (36:50):
You can have an infection this big and not even
know it.
Dr. Carver (36:54):
I know, I see it all the time and it just is
amazing to me, because the bodyis just an amazing thing.
It's always trying to help usand heal us, but sometimes it
needs a little help For sure.
Tell me a little bit.
You know you talked about coldtesting.
What is your?
You know a tooth.
You know how do you know thatit needs a root canal?
Dr. Chopra (37:11):
Yeah.
So I will say it's a commonthing I do is I listen, because
I'm listening to too few.
There's like six or sevendescriptions of a story that a
patient will tell me and I willknow it to be of a root canal
issue, Because sometimes I getsent somebody and it's not a
root canal issue.
Maybe it's a bite issue, Maybeit's actually perio, or maybe
(37:33):
they just had some recent dentalwork, or maybe it is truly
sinus and they just got througha sickness.
So it's very important that I'mlistening.
So listening is number one.
Number two is I start withimaging and I start to see, I
start to match what they'retelling me to their imaging and
then I do testing.
(37:53):
I do, I'll make sure I probethem, I'll make sure I
understand their percussion.
So I'll tap on their teeth,because teeth that are upset
have three main symptoms pain tohot, pain to cold, pain to
biting.
It's either one, two or allthree of these at the same time.
(38:15):
Of that diagnostic testing I'llmarry it with my imaging and
also with my listening to theirtooth story and then from there
I come up with a properdiagnosis.
And because of my past I'm alittle sensitive to this and I
am very keen on a properdiagnosis.
I will not prescribe a rootcanal just to anyone who walks
(38:38):
through my door.
Okay, I will understand them asan individual.
Like maybe they have a highcarries rate right and they're
like keep getting decay in thisone spot, Maybe it is better
that they transition into animplant.
So I am actually always lookingat the patient holistically and
seeing, okay for this patient,what is the right treatment plan
(39:02):
.
But it's always based on thediagnosis, and getting that
diagnosis for me is the mostimportant thing.
Dr. Carver (39:10):
Absolutely it is, and so I find sometimes when
with the cold testing that'swhat I have, and sometimes I
always try to start with what Iassume to be a normal tooth
maybe you know a front tooth Alot of people don't do that and
we say, okay, this is what itshould feel like.
Right, you should feel cold.
As soon as I remove it itshould dissipate.
But sometimes you have thepatient maybe you know an older
patient who the nerves haveretreated a little, who never
(39:32):
feel and you've done thepercussion and you know, but Old
doesn't really, you know, as ageneral dentist.
That's why I get you know, Iget to be like well, we're going
to have a specialist.
And something interesting somepeople when they have reversible
colitis, they generally arelike it's here, right, and
they're like describing an areawhen that tooth has abscess or
(39:53):
irreversible.
They can pinpoint the toothspecifically.
So it's when you're in thatreversible phase where sometimes
the diagnosis is a littletricky.
Dr. Chopra (40:01):
So I teach dentists how to do better root canals,
but a huge part of what I teachis diagnosis and what I've
learned is that people don'treally do their testing.
But the key, the beautifuloutcome of doing the testing
almost every single time youmeet a new patient is that you
(40:23):
understand better what's withinnormal and maybe has the
opportunity to heal with justtime because they had a recent
crown done and what's not normaland what's root canal worthy
and what's not root canal worthy.
Like you start to see thosenuances.
And again, that is a musclethat I've had to exercise and
I've had to work out and now Ican be like I'm going to pause
(40:46):
Instead of treating this person.
I'm going to pause and maybethere's an opportunity for it to
heal on its own.
Or maybe there's an opportunityfor that pain localization that
you talk about, because toothpain will 100% of the time,
localize Okay, and what thatmeans is the patient can put
their finger on it and say, doc,that's the only tooth that
(41:08):
hurts and then you starttreatment on the right tooth,
which is what I wish my doctorsdid First.
I wish they did the testing.
Nobody did the cold testing andthey sprayed air with a syringe
, but that went on multipleteeth and so they didn't do the
testing.
Nobody did the cold testing andthey sprayed air with a syringe
, but that went on multipleteeth and so they didn't do
localized testing, they justsprayed air and asked me first
of all it wasn't cold enough,and then it was too generalized
(41:31):
that you didn't know where itcame from.
So when my cold test doesn'twork for me, I'm looking at
other things like percussion, orI'm even looking at my comb
beam to see is there anincipient radiolucency?
That's starting to begin,because you start to see what
other tests are going to supportyou when your traditional tests
(41:52):
don't, and I do think thattakes time and exercise.
Dr. Carver (41:59):
And, let's say, you have that kind of in that, that
murky, reversible, irreversiblestate.
Are there any modalities?
I, for one, love to use ozone,because when I'm thinking of
pain in my thoughts it's alwaysokay.
The energy is not flowing forsome reason right.
Is it an infection?
Is it a scar?
Like?
How do we get more energy tothe tooth so it can maybe heal
itself?
Are there any modalities thatyou energy to the tooth so it
(42:20):
can maybe heal itself?
Are there any modalities thatyou're aware of or that you
maybe use to see if you can help?
I?
Dr. Chopra (42:26):
use time, because I think by the time somebody's
referred to me they're past thatpoint, right?
Yes, and it's my job to be thegatekeeper of root canal land.
Okay, like I have said no to somany people and they've come
back and said I feel better,right, so I do what I call the
two week check.
If I cannot figure it out inthat first appointment with a
(42:49):
patient, I bring them back intwo weeks.
And the reason why is becausemost of the time the patient
doesn't understand their owntrue story and so they can't
describe it to me.
So that listing piece is offfor me.
Because what are they doing?
They're avoiding, they're notusing that side, so they don't
actually know what hurts.
What hurts Hot, cold or biting,I don't know.
(43:09):
I've been avoiding it All.
Right, I'm going to send youhome and I have an idea of where
I think this may be coming from, or if it's even a root canal
problem.
And because, again, thediagnosis for me is number one
before I start throwingtreatment at it.
And because I don't know, isthat treatment needs to be ozone
?
I actually don't use ozone inmy practice.
Everything that you've seenfrom a healing perspective has
(43:31):
not had ozone on it.
So I know when it comes to aroot canal you don't necessarily
need that, but you do general.
So you probably do need thatand I think that there's so much
stuff that can happen at thegeneral level, the general
dentist level, before thereferral is made.
That's where I think we couldbe a team right.
(43:52):
But once they get to my chairand I still don't know what the
problem is, their symptomshaven't really localized too
much.
It could have just been likecracked tooth syndrome and they
just need a crown.
So I will do all my testing.
It doesn't add up, I'll pause,I won't treat, I'll say let's.
I'm going to send you home fortwo weeks.
I want you to pay attention, Iwant you to actually chew things
(44:15):
hard things, crunchy things,soft things, hot things, cold
things and see what sets it up.
And I want you to take record.
And then I want you to comeback and I want to retest.
I would say eight times out of10, the patient's pain goes away
because maybe they wereclenching or grinding or maybe
they did have a cold and it wassomehow impacting their teeth
Like.
Two weeks is a good enough timefor things to just go away
(44:39):
naturally, to recover from somedentistry to do a lot of things,
and so I love that.
Time can be a beautifulmedicine, and so that's
typically my approach and Idon't charge the patient again
for that second show, like Iwant to make sure that's
inclusive of that oneconsultation.
My goal is that we just get theanswer that we need.
Dr. Carver (45:04):
I think that's so valuable, right?
Because in your own experienceit was like oh, it's painful,
it's this too, let's just diveright in, right.
But I think you're right, thegeneralist.
That's why I have that sameapproach.
Okay, I can't exactly tellwhere it is, so I throw all
sorts of fun things at them,busy like all of us.
Dr. Chopra (45:22):
We're pretty sure it needs a root and I think just
throwing out antibiotics is thewrong move.
I actually don't want to giveantibiotics because I want, if
there is a problem, I want it tosurface.
I don't want the patient totake pain meds on the day of
testing, because all of thisstuff can mask the problem.
And so, again, I think some ofour treatments are palliative
(45:44):
and supportive.
That would work.
But I also think that trying tobe drug-free is also important,
because then it allows me toreally make an accurate
diagnosis, so much of that stuffcan mask.
Dr. Carver (45:59):
Absolutely yeah, and that's a really important
point too.
So what about cracks?
So sometimes a cracked toothcan cause you talked about decay
being one reason we need rootcanals but other times it's a
crack that hits the nerve andthat causes death of the nerve
too.
But I know sometimes a crack istoo much.
So how do you know if a crackis too deep and the root canal
is not going to work and it hasto have extraction?
Dr. Chopra (46:21):
You actually have to go inside the tooth and
visualize it with the microscope.
I never diagnose a crackedtooth.
Let's align on our vocabularybecause for me cracked tooth is
something that is within thecrown, versus a vertical root
fracture which extends to theroot and that's not restorable.
I think there are many crackedteeth out there that can be
(46:44):
saved and once you do the rootcanal and the crown now some of
them don't even need the rootcanal, they just need the crown
and they'll get better becauseit's a true reversible pulpitis.
But I even see some cracksextending down into the root
that are not completely cracked.
That I think we can save.
And maybe it's not a lifelongsave, but maybe it's four or
(47:05):
five years and then implanttechnology has advanced for
another four or five years andthe implant you get in the
future is better than theimplant you get today.
So I will always have thatconversation with the patient
about what they want to do.
Some patients are like, nope,just take it out, and I can
respect that.
I will.
If I'm really weary about atooth that doesn't have any life
(47:25):
in it, I will remove it.
But I will not make thatdecision until I've actually
visualized it with my microscopeand gone inside, Because you
will make so many assumptions ifyou just do it on imaging alone
.
Dr. Carver (47:40):
And a lot of times you're not imaging, doesn't?
Dr. Chopra (47:43):
show us cracks.
Dr. Carver (47:44):
Even on 3Ds, you can't.
There's some techniques, butit's more challenging.
You really have to go by.
Like you said, a microscope isreally the goal if you want to
see a crack there.
So yeah, that's awesome.
Anything else you think that'simportant for us to know about a
properly done root canal andwhy it is a viable option.
Dr. Chopra (48:02):
They're safe, they're effective, they give
beautiful outcomes, they'reincredibly regenerative and
there is purpose to our teeth.
So give teeth a chance is allI'm going to say.
Dr. Carver (48:17):
And again I so value you coming on because this
is an important topic thatcomes up a lot and there are a
lot of myths surrounding it andnot every root canal is the same
, and you've elucidated for us.
The amount of education that weget really varies.
No one is really getting enoughin dental school and so I know
the first couple of years out ofschool all of my CE was about
(48:39):
endo and trying to understandhow to, how to do it better.
You know I I got some of thenewer technology like
immediately, um.
But then it got to the pointwhere I was like you know, my
expertise is avenues.
I'm going to let the realspecialists cause, you know, if
I'm doing, you know, two a month, you know that's not, you know,
versus somebody who's doing twoin an hour.
I mean that's a big differenceand this is so important If we
(49:05):
are striving to maintain teethand maintain health.
We want it done in the most, youknow, beneficial, you know,
appropriate way.
So, and again, I'm so fortunateto have Dr Sarah Martinelli in
our area who uses all thesegrapes, and she does such a
wonderful job for me.
So just a shout out to her.
But thank you, I know you're inCharlotte, if somebody wanted
(49:26):
to get some more informationabout your website.
It's amazing.
There's so many resources,especially for dentists too.
There's so much training, andall this talks.
How do we connect with you ifwe have any questions?
Dr. Chopra (49:37):
Yeah, my website is a great place to start.
That's drsoniatropracom.
That's Sonia with an I.
I know I trained a lot ofdentists, but I will say a lot
of patients have found me and sonow there's a lot of new
patient resources out there.
I just launched an onlinecourse for patients called Tooth
Wisdom.
A little play on words there,but it's really a great guide to
(49:58):
understanding your own oralhealth and being a great patient
advocate.
And I would say, hang out onInstagram the most, and that's
at Dr Sonia Chopra as well.
Dr. Carver (50:09):
And we will link to that in the show notes.
So, thank you so much for yourtime on this Friday to chat with
us and educate all of us.
And yes, thank you.
I really appreciate all yourtime and I wish you the best in
all your endeavors.
I love that you're educatingbecause, like me, we're just
trying to spread this awareness,make everyone aware of the
options.
Right, it's really importantthat you choose the best option
(50:30):
for you.
Dr. Chopra (50:30):
I appreciate you.
Thanks everybody.
I appreciate you so much forhaving an open mind.
Dr. Carver (50:35):
Thank you, oh of course, I think science is
constantly evolving and if wecan't have an open mind, we're
not really helping our patients,we're not really helping
ourselves, we're not helping ourpatients.
Things that I knew and thoughtwere true five years ago now is
more evidence.
Some of them.
We change and I think that'sreally important and some of the
reason why I think healthcareis really stuck where it is now
(50:55):
it's become more disease careLike we really.
We might still think the earthwas flat right If we didn't
challenge these ideas, and that,to me, is the definition of
science.
And, as health practitioners, Ithink it's so valuable.
There's so much informationcoming out all the time that
it's important to keep learningand keep understanding, keep
having these conversations,trying to have community with
(51:16):
all of us, because we're not, noone can do everything alone.
It's important that we talk toour specialists, we meet with
them, and it's okay to havedisagreements, you know, but
again, if we ultimately aretrying to do the best for the,
you know, that's where we havecommon ground and I think that's
really valuable for all of us.
So awesome.
Thanks again for listeningeverybody.
Hope you enjoyed this episode.
(51:36):
Please check out Dr Sun'si'swebsite and we'll see you on the
next episode.
Everyone, have a great day.
Hello, I'm Dr Rachel Carver, aboard-certified naturopathic
biologic dentist and a certifiedhealth coach.
Did you know that over 80% ofthe US population has some form
of gum disease?
(51:57):
Many of us don't even know thatwe have this source of chronic
infection and inflammation inour mouth that's been linked to
serious consequences like heartdisease, diabetes, stroke,
dementia, colon cancer, kidneydisease, even pregnancy
complications.
Would you like to learn how toreverse and prevent these
chronic, debilitating conditionswithout spending a lot of time
(52:17):
and money at the dentist?
Join me for my six-week coursewhere I will teach you the root
cause of disease.
You'll learn how to be your ownbest doctor.
Are you ready to get started?
Let's go.
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Have you ever wondered what life might be like if you stopped worrying about being wanted, and focused on understanding what you actually want? That was the question Hope Woodard asked herself after a string of situationships inspired her to take a break from sex and dating. She went "boysober," a personal concept that sparked a global movement among women looking to prioritize themselves over men. Now, Hope is looking to expand the ways we explore our relationship to relationships. Taking a bold, unfiltered look into modern love, romance, and self-discovery, Boysober will dive into messy stories about dating, sex, love, friendship, and breaking generational patterns—all with humor, vulnerability, and a fresh perspective.
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