Position Papers

Our Position

The IABDM holds that a root canal-treated tooth is not a sterile tooth. The treatment removes the pulp, but the root canal system is a complex, branching network of tubules that cannot be fully instrumented or sealed by any known technique. Tissue and bacteria can remain in the spaces that instruments and irrigants do not reach.

We do not say that every root canal must be extracted. We say that a root canal should never be treated as a routine, consequence-free procedure, and that the patient deserves a full explanation of what remains in the tooth and what the alternatives are.

What This Means In Practice

Biological dentists approach a compromised tooth by first asking whether it can be saved without a root canal, and whether the tooth needs to be saved at all. Where a root canal is the chosen path, the academy expects it to be performed to the highest attainable standard of cleaning, disinfection, and sealing, with proper isolation.

• Evaluate the whole patient, not just the tooth, before deciding on treatment.
• Consider whether the tooth can be retained with a less invasive approach.
• If a root canal is performed, use magnification, thorough irrigation, and a proper seal.
• Discuss extraction and replacement honestly as a genuine option, not a last resort.
• Never treat a root canal as a finished problem, re-evaluation matters.

Why We Hold This Position

The academy's position rests on the anatomy of the root canal system and on decades of clinical observation by biological practitioners who have seen patients improve after a chronically infected tooth was addressed. It is a position about informed consent and about taking the tooth-body connection seriously, not a blanket prohibition.