You may wonder how that relates to root canals. Well … did you know that if all of the dead nerve tissue inside the root canal of the tooth is not removed, then there is dead stuff left inside your tooth? The tooth is formed in such a way that it resembles a trunk of a tree with a few branches that is contained within a cylinder. The trunk of the tree is what is often called the “root canal” and the branches of the tree are the “accessory canals.” Dentists are pretty good at removing all of the dead or dying nerve tissue within the trunk ( the “root canal”), but it is very difficult to perhaps impossible to clean out the microscopic nerve fibers that are extending out from the trunk as the branches of a tree (these are the “accessory canals”). When a root canal treatment is performed, the trunk is removed while the branches are left, so a person who had a “root canal” procedure completed usually does not feel any pain from those dead nerve fibers that are in the branches.

However, the immune system is not easily fooled. The fact that we cannot see the accessory canals does not mean the immune system is blind to them. The immune system is created to protect us from bad things, and it does kick into high gear and start fighting any source of infection.

If a small splinter on a finger is infected, we will feel the pain when we touch the area, because the nerves in our skin are fully intact; if however a small accessory canal is infected, we may not feel the discomfort because while doing a root canal, we have removed the nerve which would have allowed us to feel the discomfort. We have ultimately paralyzed the tooth and expect everything to be okay. This is like saying that an infected splinter cannot harm a person who happens to have a paralyzed finger. Just because a person does not feel pain does not mean that all is well.

There is a procedure that helps to remove the dead nerve tissues that are in the accessory canals, and that procedure is called “Photon Induced Photoacoustic Streaming” or “PIPS” which uses a laser and vibration inside the tooth during a root canal procedure and this procedure appears to remove the dead nerve tissue from the accessory canals that have previously been impossible to clean. I do not know if it removes all of the dead nerve tissue, but it is definitely a better alternative to conventional root canal treatments. The brand name that we know of that use PIPS is the “GentleWave” procedure by Sonendo.