Cryotherapy procedure an alternative to root canal

An interview with Dr. James Bahcall, clinical professor at The University of Illinois - Chicago, College of Dentistry, Department of Endodontics.

Q: What do you do?

A: I am a board certified Endodontist. The American Association of Endodontists state while all endodontists are dentists, less than three percent of dentists are endodontists. Endodontists are specialists because they've completed an additional two or more years of training beyond dental school.

Q: What is Vital Pulp Cryotherapy treatment?

A: Vital Pulp Cryotherapy is a dental procedure that can be an alternative to root canal treatment that we developed at the University of Illinois - College of Dentistry.

This procedure is used when decay is removed from a tooth and there is an exposure of the dental pulp (which is the technical term for a tooth's blood and nerve supply). Sterile ice (the cryotherapy portion of the treatment) is placed on the exposed pulp tissue. The application of sterile ice lowers the temperature of the tooth's blood and nerve supply and this clinically has been shown to reduce post-treatment tooth pain and inflammation. It is important to note that after performing the cryotherapy procedure, a bioactive filling material and a permanent tooth filling are then placed in the tooth.

Q: What is the difference between Vital Pulp Cryotherapy and root canal treatment?

A: Vital Pulp Cryotherapy involves treating a decayed tooth, while maintaining the tooth's blood and nerve supply (Once again this blood and nerve supply of a tooth is called the dental pulp) versus root canal treatment that involves the removal of the entire dental pulp and replacing it with a rubber material called gutta-percha and a dental sealer.

One thing I want to point out and that's today's root canal treatment is extremely safe and effective in saving a patient's tooth. It is performed with local anesthesia and high-tech instruments, which allow for complete patient comfort during the procedure.

Q: What are the medical treatment benefits of cryotherapy?

A: Although the concept of cryotherapy goes back thousands of years to early Egyptian culture, the evidence-base medical literature on the benefits of cryotherapy really began in the early 1960s. This medical literature has shown cryotherapy treatment to:

1. Reduce nerve pain response.

2. Cryotherapy has also shown to reduce hemorrhaging (bleeding) and edema (fluid buildup).

3. Cryotherapy reduces inflammation.

4. Cryotherapy helps reduce a patient's need after a medical procedure for post-op pain medications.

We have observed a significant reduction in a patient's need for pain medication following a vital pulp cryotherapy procedure. Most patients are not even taking Advil or Ibuprofen post treatment.

Q: Will Vital Pulp Cryotherapy replace the need for root canal treatment in the future?

A: Although we have seen very good treatment outcomes from vital pulp cryotherapy on our patients, it is case specific, meaning there are certain pre-treatment requirements that need to be met before this treatment can be performed.

Q: What type of benefit does the patient gain from Vital Pulp Cryotherapy treatment?

A: First, Vital Pulp Cryotherapy will eliminate a patient's tooth pain caused by dental decay. Secondly, a patient's tooth nerve and blood supply is left intact and therefore can maintain it's natural immune mechanism to fight against future inflammation or infection. Lastly, it requires minimum treatment time for this procedure. An example of this is a root canal treatment can take 1-2 hours over 1-2 patient treatment visits. Whereas, Vital Pulp Cryotherapy treatment usually takes around 10-15 minutes after the tooth decay is removed and is completed in 1 treatment visit.

Q: Are you currently doing any clinical studies on Vital Pulp Cryotherapy?

A: Yes. We are doing a joint clinical study with the Department of Dentistry at Montefiore Hospital in New York.