Below are two letters.  The first written by me asking the Australian Society of Endodontology for references to support the statements they were making to the public.  Following is their response.  A glaring admission...

Saturday, 12 April 1997

Dr Ralph Reid
12th Floor TNG Building
141 Queen St
Brisbane 4000
Ph 07-3229-4209

Dear Dr Reid,

I am writing with a request for information which I hope you, as president of the Australian Society of Endodontology (Inc.), will be able to supply. I am a practicing general dentist in Sydney and have a great interest in the area of Endodontics. My queries are in relation to the patient education pamphlet;

“Relax- there is no need to lose your tooth…ENDODONTICS (Root Canal Therapy) can save it for you”.

1) In paragraph 2 it is written “Once the tooth is fully formed the main source of nutrition for the tooth comes from the tissues surrounding the root.”

Could you please supply the references for this statement? Would you also be kind enough to explain to me exactly how the tooth is nourished from its surrounding tissues. Is this via the blood supply, the lymph or by osmosis?

2) In the third paragraph it is written;

“Therefore, a tooth can function normally without its pulp and can be kept indefinitely. After endodontic treatment the tooth is pulpless, but it is NOT a dead tooth.”

Again I would appreciate references to support this statement. By suggesting that the tooth is not dead, one can only assume that it is alive. For this to be so it must have some vascular supply. If I am not mistaken the very procedure of Root Canal Therapy is to remove the blood supply.

3) The statement (7th Paragraph) “During endodontic treatment, the infected or damaged pulp is removed from the inside (i.e. root canal) of your tooth.”

Is it necessary to remove all infected dead pulp tissue from the tooth? If not please supply references which describe the fate and effect of remaining infected tissue.

If so please supply the references which demonstrate that all necrotic and infected tissue can be removed from the tooth.

4) The 8th Paragraph states: “The root canals are then cleaned, sterilised and shaped to a form that can be completely sealed.” Firstly I again request references to support this statement. Next would you be kind enough to explain to me;

a- the procedure and medication recommended by the society which does sterilise a tooth.

b - how is sterility of the tooth determined? Is it necessary to take a swab of the tooth for culturing. If so should this be aerobic or anaerobic.

c - if anaerobic testing is required could you please inform me of the correct procedures.

d - please supply references which demonstrate the complete sealing of a root canal.

5) Paragraph 11 talks of the sedative dressings and temporary fillings which are used to settle the tooth “and destroy any remaining bacteria” . References supporting this statement would be appreciated. Would you also list for me the medicaments which are currently recommended to achive this outcome.

I appreciate that you may not be the author of this pamphlet and that this is indeed quite a large request. I believe though, that if I am to pass this pamphlet on to my patients, I would like to be in a position to be able to verify each of these statements by published, peer reviewed scientific papers.

If you are unable to furnish the answers to this request I would appreciate it if you could point me to the author of this paper. I thank you in advance for your response.

Yours sincerely

Robert Gammal
_____________________________

Reply from the Australian Society of Endodontology (Inc.)

Dear Dr Gammal

Thank you for your original letter of the 12th April. The request was handed on to our committee which handles educational matters. I have just returned from three weeks away, hence the delay in replying.

The committee made the following recommendations which are passed on for your information:

. the pamphlet was written by a committee of specialist endodontists as a public service to dentist's patients.

. the pamphlet was then circulated to all specialist endodontists in Australia for their comment, additions, etc before final printing.

. the material was based on the committee members' general knowledge of endodontics and not on specific references.

. the statements are universally accepted by endodontists worldwide and by the dental profession in general.

· there are no controversial issues raised in the pamphlets (this was intentionally avoided by the committee).

· NO specific references were used to write the pamphlets.   ANY text book on endodontics could be used to justify the statements made in the pamphlets.

I hope this information is of some help in showing where the pamphlets have come from.

Yours sincerely,

Ralph J Reid President, ASK Inc.

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