Can a dental infection cause a massive heart attack?

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woman in dental chair(NaturalHealth365) For literally hundreds of years now, the idea that one or more focal infections in the body could seed, initiate, and promote virtually all chronic degenerative diseases has been hotly debated in the medical and dental communities, often with much more passion and hyperbole than with science.

This “debate” continues today, and nothing encapsulates this focal infection link between the mouth and the body better than the root canal-treated tooth. And while the root canal-treated tooth is certainly not the only significant source of dental infection and toxicity, it is easily the most devastating one – as you will soon see.

What is the goal of a root canal procedure?

The “success” of a root canal-treated tooth for a given individual depends on the goal of the root canal procedure. If the goal of a root canal procedure is to retain a pain-free natural tooth for both esthetic and chewing function, then the root canal procedure is frequently successful.

Considered in strictly a dental/mechanical context, few procedures in dentistry are so beneficial. Typically very painful and grossly infected teeth are restored to a mechanically sound state, free of obvious infection and any significant symptoms. Without the root canal procedure, the only real option, in modern dentistry, for most such teeth is extraction – an option that most dentists and patients want to avoid at all costs.

However, when the health of the rest of the body is the paramount consideration, few, if any procedures in dentistry or medicine, can undermine good health and shorten longevity as effectively as root canal-treated teeth. Both the dentist and the patient should fully realize the potential negative impact of having a root canal procedure in order to make the best and most informed decision for a treatment plan.

The true nature of a root canal procedure revealed

The only way to make an informed decision on whether to have a root canal treatment on a painful, infected tooth is to understand fully the nature of the procedure, as well as to be familiar with an increasing volume of scientific literature directly examining its clinical and pathological impact throughout the body. The “old issue” of the root canal-treated tooth being the classic example of a focal infection causing dramatic pathology throughout the body now has very strong, new support in the dental and medical literature.

With rare exception, the root canal procedure is performed to relieve acute or chronic pain resulting from an inflamed and infected pulp and root tip. The procedure itself then involves removing the pulp tissue with all the associated nerves, blood vessels, and connective tissue, widening and shaping the root canal space, followed by the insertion of a filling material into the hollow canal space. Also, identifiable abscesses at the root tip are drained as part of the procedure.

The literature now clearly demonstrates that while the root canal procedure might acutely remove most, if not all of the infected pulp tissue, it simply never sterilizes it. Residual bacteria will always remain in the accessory canals, dentinal tubules, or remnants of pulp tissue.

This really should not come as a surprise, as the physical matrix (pulp) on which the immune system depends to gain access to the infection inside the tooth has been removed. The microscopic dentinal tubules then harbor whatever pathogens were present indefinitely, typically producing a steady supply of enormously potent toxins that result whenever oral aerobic organisms remain trapped in an anaerobic environment, like the inside of the tooth.

And to make matters worse, the venous and lymphatic drainage at the base of the root canal-treated tooth remain intact, meaning that every time the individual chews on such a tooth, pathogens and toxins are injected directly into the circulation, just as a hypodermic needle might inject its contents directly into the vein.

Scientific research that remains unseen by most dental patients

Recent studies have been compelling in establishing the link between root canal-treated teeth and coronary heart disease, and the totality of the studies make it hard to avoid the clear-cut conclusion that root canal-treated teeth are one of the primary contributors to the cause and progression of heart disease in many individuals. Even the Journal of the American Dental Association, in 2009, reported that individuals with root canal-treated teeth had more coronary heart disease than those without root canal-treated teeth.

Apical periodontitis, an advanced form of gum disease that share the same pathogen profiles as are seen in root canal-treated teeth, has been found to seed those same pathogens directly into the coronary arterial wall, directly into the atherosclerotic plaque, and directly into the clots that acutely form to cause coronary artery obstruction and heart attack. Also, studies have now demonstrated the significant role that toxins from those same pathogens play in the evolution of atherosclerosis leading to heart attack.

Would you bet your health on the mindset of conventional dentistry?

It does not appear that any amount of data will convince the vast majority of conventionally-trained dentists, performing root canal procedures on a regular basis, that this procedure is one of the primary reasons for a patient eventually sustaining a heart attack – even years later. However, the data is what the data is.

Examine it, try to find a dentist who is at least open to discussing these issues, and make as informed a decision as possible before proceeding with a root canal procedure, if you feel it must be done. The root canal procedure is not the only “option” for an infected, painful tooth, and you need to be fully aware of all of these options. You need to save your health, and your life, as well as your smile.

About the author: Thomas E. Levy, MD, JD is a board-certified internist and cardiologist. He is also bar-certified for the practice of law. He has written extensively on the importance of eliminating toxins while bolstering antioxidant defenses in the body, with particular focus on vitamin C. His website is  His latest book, The Toxic Tooth: How a root canal could be making you sick, co-authored with Robert Kulacz, DDS, is now available at

1.  Haraszthy et al. (2000) Identification of periodontal pathogens in atheromatous plaques. Journal of Periodontology 71:1554-1560. PMID: 11063387
2.  Mattila et al. (2005) Dental infections and cardiovascular disease: a review. Journal of Periodontology 76:2085-2088. PMID: 16277580
3.  Caplan et al. (2006) Lesions of endodontic origin and risk of coronary artery disease. Journal of Dental Research 85:996-1000. PMID: 17062738
4.  Caplan et al. (2009) The relationship between self-reported history of endodontic therapy and coronary artery disease in the Atherosclerosis Risk in Communities Study. Journal of the American Dental Association 140:1004-1012. PMID: 19654253
5.  Willershausen et al. (2014) Association between chronic periodontal and apical inflammation and acute myocardial infarction. Odontology 102:297-302. PMID: 23604464
6.  Ott et al. (2006) Detection of diverse bacterial signatures in atherosclerotic lesions of patients with coronary artery disease. Circulation 113:929-937. PMID: 16490835 Pessi et al. (2013) Bacterial signatures in thrombus aspirates of patients with myocardial infarction. Circulation 127:1219-1228. PMID: 23418311

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  • Cory Kratz

    There is evidence that a large percentage of heart disease begins with an infection, which starts an inflammatory response in the coronary arteries of the heart.

    This is the reason that drugs don’t work they mask symptoms, and also block the body from responding to both the infection and inflammation. Often the first sign of an infection is a heart attack.

    A healthy mouth is the first line of defense against heart disease.

  • s edwin

    what are the alternatives ?

  • pam r

    I had 2 root canal teeth pulled just to get them out of my mouth. Turns our they were both infected did not show any problem on an x-ray and I had no bad symptoms.
    Only after pulling I saw that they were both infected. Dentist said that was normal most infections do not show up on an x-ray.

  • Glen Cooper

    One of the worst offenders is high fructose corn syrup. People have had abscess form within 48 hours of consuming large amounts. This is easy to do as it found in candy bars, ice cream, cookies and cakes, sports drinks and soda.

    Anyone who is not in really good health could have this happen for a number of reasons. Many people have bacteria in their mouth ready to feed on any sweet. At the same their mouth is depleted of key trace minerals which are needed for healthy teeth and gums.

  • Claudia

    I would really like to know where to find information on what to do if you have symptoms of peri apical infection in a non- root canal treated tooth. I have a surgically damaged maxillary sinus that has led to tooth symptoms for many years. X-rays show nothing, but I’m confident there is infection due to periodic inflammation. I have had irregular heartbeat for many years as well, I’m concerned and do not have a functional MD or biologic dentist within 300 miles.