The Toxic Tooth: Preface

 

PREFACE

When the New York State Office of Professional Discipline (OPD) began investigating my dental practice in 2005, I realized that there were many dentists who disagreed with me. I had once been where they were, completely immersed in a busy dental practice and totally unaware of the comprehensive and compelling research that exposes the systemic risks of root canal treatments.

At first, I allayed my nagging fears with a naive confidence. Surely these investigators were guided by a sincere concern for the public in general and my patients specifically. Once all the science, the microbiological cultures, the pathology reports, the X-rays, and the nearly miraculous patient outcomes were clearly set before them, their eyes, previously blinded by ignorance, would be opened—even as mine had been many years before. Ultimately the OPD would vindicate me and even embrace my practice of dentistry.

Boy, was I wrong!

I was soon to discover that these investigators, who were supposedly truth-seeking advocates for patient welfare, were no more interested in uncovering the truth than a cop who’s paid to look the other way.

When the decision was made to write this new book, I was not planning to recount the incredibly painful history that started with the OPD’s initial contact. However, friends encouraged me. They felt it would provide a reality check glimpse into the consequence of challenging long-accepted clinical paradigms of the American Dental Association. Plus, and maybe even more importantly, it could help explain the resistance patients will get from their general dentist or endodontist when they question the safety of root canal-treated teeth.

My journey began when a patient told me that his doctor had warned him against root canal therapy.

Before the realities presented in this book invaded my world, I performed dentistry just like the majority of dentists do. Life was good. I enjoyed what I did and I made a decent living from it. I was exactly where I wanted to be in life. I worked 4.5 days per week and made enough money to do just about anything that I wanted to do. I took flying lessons and got my pilot’s license. I bought a house. I bought an aerobatic airplane and flew it three or four times a week. I had a wonderful family and my wife and I were thoroughly enjoying raising our twin girls.

Life was great. I had arrived.

I often ask myself why I rocked the boat when everything was going so well. Frankly, I do not have an answer that provides me much comfort. I suppose I just felt obligated to go in whatever direction the scientific truth led me. At the same time I certainly understand much better the reasons why many other dentists would never even consider such a path.

My journey began when a patient told me that his doctor had warned him against root canal therapy, and that this procedure could initiate a wide range of medical diseases.

I quickly retorted, “That’s ridiculous, whoever said that is completely crazy. You shouldn’t listen to such nonsense!”

It made me angry that someone in the medical field would propagate this absurdity. I felt personally attacked so I began to research the validity of these claims in order to prove to my patient that his physician was wrong.

My quest led me to the works of Weston Price, Edward Rosenow, and Frank Billings, all pioneers in the early research clearly linking dental infections to systemic disease. Although I found their research very interesting, I just “knew” that these writings from the 1920’s were “ancient” and had certainly been disproved with more contemporary research.

Then I went to an International Academy of Oral Medicine and Toxicology meeting where I attended a lecture by Professor Boyd Haley. At that time Dr. Haley was the department chair of chemistry at The University of Kentucky. He spoke about the toxicity that he found in all root canal- treated teeth and the detrimental inhibition of key bodily enzymes that had been demonstrated by testing the toxins released from these teeth. I felt like I had been punched in the stomach. Could this be true?

I searched in vain for any scientific studies that refuted the research of Price, Rosenow, Billings, and the evidence presented by Haley. To be fair,

there were a few editorial articles in the Journal of the American Dental Association that were critical of these earlier scientists. However, rather than provide research or data to substantiate the position of the American Dental Association (ADA), these editorials attempted to discredit previous researchers on their experimental techniques. These articles never addressed the huge volume of data that had been independently amassed by these diligent scientists; they completely sidestepped the research demonstrating the risks of the root canal procedure.

What a blow to my professional pride. I didn’t like what I had discovered, but I couldn’t deny the powerful evidence. My patient was right and I was wrong.

Contrary to what I had been taught, I was forced to conclude that root canal treatment was not a benign procedure without systemic health risks. In good conscience, I could no longer practice dentistry as I had learned it. I had to change the focus of my practice.

Many of my patients noticed great improvement in medical conditions that had been plaguing them for years.

I knew that I if I were to best treat patients who were coming to see me, I had to learn a lot more about the intersection of dentistry and medicine. To satisfy this need for knowledge, I read through countless journal articles and consulted a number of medical textbooks.

During that time, many of the patients that I saw had migrated through a series of doctors without resolution of their medical conditions. Although I was in no way qualified to treat their wide variety of ailments, I wanted to know as much as I could about all aspects of medicine. I was convinced that the disconnect between dentistry and medicine was arbitrary, and was potentially harmful to patients. These disciplines needed to be integrated, and I wanted to work hand-in-hand with my patients’ physicians, knowing that my work could help improve their overall health.

It was not long before all of my time was devoted to treating acute and chronic oral infections. Many of my patients noticed great improvement in

medical conditions that had been plaguing them for years, and my practice grew simply by word of mouth.

It would soon become clear that scientific validity and positive patient outcomes were irrelevant to them.

I did not treat everyone who came to see me. In fact, I turned away the majority of those who wanted surgery because they simply did not need it or they had unrealistic expectations about the outcome.

Never did I treat patients’ medical conditions or even suggest that their medical conditions were caused by a root canal-treated tooth or cavitation. I simply told them that I would surgically remove the dead and infected bone. If the tissue biopsies and microbiology cultures indicated that they needed additional antibiotic therapy, I would continue to treat them, but usually only after consulting with their physicians.

At times patients needed no further treatment. At other times the tissue biopsy and microbiological cultures revealed infection and inflammation with some highly pathogenic, antibiotic-resistant microorganisms. Some of these were resolved with an oral course of an antibiotic while a few others required longer term, intravenous antibiotic therapy.

While my extraction fees were higher than those of most dentists, my pre- op consultation and extraction procedure was far more extensive. Often treatment included surgical tooth removal, biopsy and culture of all surgical sites, removal of the dead or diseased tissue in the bone around the residual tooth socket (debridement), and placement of antibiotic-impregnated graft material. These procedures were far more involved and time-consuming than traditional extractions. So even though I charged more for the treatment, my net income was about half what I made when I was practicing all phases of dentistry. Contrary to the claims of some of my critics, it was never about the money.

As my oral infection treatment protocol became well known, I began to do a weekly radio show on Healthy Talk Radio with host Deborah Ray. I enjoyed speaking about various dental topics, and I was astounded by the wide range of dental experiences of the listeners who called into the show.

It was at that time that I decided to write a book on the systemic effects of oral infections, mainly because I wanted a reference for my patients who wanted to learn more about this subject.

I asked Dr. Tom Levy if he would be interested in writing the book with me. I had met him a few years earlier and was very impressed by his knowledge and understanding of this topic. Thankfully, he said yes and The Roots of Disease was completed and published in 2002.

The popularity of the radio show and the book greatly expanded my public exposure and made me a prime target for attack by the dental boards. Any individual who speaks up and questions the belief system of an organization should expect that organization to retaliate. And although I had known of other dentists who were targeted by the dental board for practicing similarly, I naively felt secure. After all, I had a very detailed informed consent form, and I never talked anyone into a procedure. In fact, I talked more people out of treatment than I actually treated. I had pathology reports and microbiological cultures confirming infection in all the teeth and surrounding bone that I removed, and I had the science to back up all of my treatment decisions.

However, as admitted to me by the OPD attorney, none of this was of interest to the dental board. It would soon become clear that scientific validity and positive patient outcomes were irrelevant to them. They had a completely different agenda.

The New York State Dental Board began an investigation regarding the extraction of two root canal-treated teeth in one of my former patients. They requested a copy of my patient’s chart and all X-rays. I was a little concerned but I knew that my treatment was correct, and I felt confident that after review of the data it would be very clear that there was no basis for any disciplinary action.

A short time later, to my surprise, I received a letter from the OPD charging me with two counts of gross misconduct. The first was for the “negligent extraction” of two root canal-treated teeth, and the other accused me of an ethics violation. The dental board claimed that the statement on my website: “I changed the focus of my practice after learning of some of the dangers in dental procedures,” implied a claim of superiority over other dentists. By their interpretation, this was a direct violation of the code of ethics.

The penalty for these violations: Revocation of my license!

They were determined to revoke my license for extracting two infected root canal-treated teeth. One tooth had previously undergone an apicoectomy, which is a procedure done after an earlier root canal treatment has failed. The other tooth had a vertical fracture. Pathology from both these surgical sites confirmed infection of both teeth as well as chronic osteomyelitis of the surrounding bone. Microbiological cultures showed multiple species of bacteria from the infected jawbone. The facts of the case were so clear-cut that even a non-dentist could have seen that my treatment was 100% appropriate and in the best health interests of the patient.

It is interesting to note that a patient can choose to have either a root canal procedure or an extraction when seeing a dentist for an infected tooth. If the patient chooses to have an extraction instead of a root canal procedure there is absolutely no professional misconduct. However, a patient cannot change his or her mind after the root canal procedure is completed. Any dentist who extracts the treated tooth can be brought up on charges of misconduct.

This is absurd. It would be misconduct if a dentist talked a person into having a root canal-treated tooth extracted that the patient wanted to keep. However, that was absolutely not the case in my situation. The patient specifically sought me out for the sole purpose of having me extract two root canal-treated teeth that showed X-ray evidence of pathology. The patient even sent me letters after the extractions praising me for what I was doing.

Immediately, I consulted my malpractice insurance carrier to obtain coverage for my legal defense, and they stated that these charges were not covered by my policy. I was on my own.

Even so, I was still confident that once I presented all the data to the OPD, the charges would be dropped. Yes, I had spoken out against one of the most lucrative procedures in dentistry, and it was not hard to imagine why the dental board was motivated to discredit me and remove me from practice. But I still had hope that the attorneys at the OPD would be able to objectively see that I had done nothing wrong.

I contacted the OPD prosecuting attorney assigned to my case, and we began discussions about how the OPD would proceed. I sent him numerous

scientific references supporting my treatment approaches. Many of my patients wrote letters on my behalf to the dental board.

After review, he said that the board had not reversed its initial decision and that the OPD was intent on full prosecution. I was sickened and disheartened as I began to realize the hopelessness of my predicament.

Some time later he called and asked me to schedule an informal settlement conference. This was to be a simple meeting where the defendant meets with the OPD representatives to discuss the penalty. He asked me what my available days were to schedule this. I told him that the only time that I could not make this meeting was on Tuesday mornings.

A short time later he called me and told me that the informal settlement conference was scheduled for a Tuesday morning. I reminded him that Tuesday was the only time that I told him I could not attend. Several days later I called him back and told him that I rearranged my schedule and that I could now attend that Tuesday morning meeting.

That was no longer an option. He told me that my slot was “taken.” I asked to be rescheduled for the next available time but he told me that this would “not be possible.” He said that since I initially stated that I was not able to attend the assigned conference my slot was given away and that no other appointments would be assigned. It had already been decided: the revocation of my license would be the penalty.

There was never even a pretense of fair play in this process. It was clear that their singular plan was to strip me of my license. And since a license to practice a profession is considered a privilege and not a right—even though obtaining such a license involves a lifetime of hard work and sacrifice— there are no guarantees of due process, a fair trial, or “innocent until proven guilty.” The Dental Board and the OPD are not bound by the same rules as the American legal system.

I wanted to know exactly who was behind this attack on me so I filed a Freedom of Information Act (FOIA) request about my case to see exactly how the case against me was put together and who was making these decisions that would have such a profound impact on my life.

The request was denied. Apparently, the New York State Board of Regents has exempted itself from the Freedom of Information Act and does not have to release anything. They can operate in complete secrecy and for whatever reasons they deem appropriate.

At that point I decided to contact my U.S. Senator, Hillary Clinton. I called her office and explained my whole story to a staff member. I sent the same documentation to her office that I sent to the dental board. Senator Clinton felt that the charges against me warranted further discussion so she wrote a letter to the OPD asking for another review of my case. Unfortunately, her letter did not even slow down the prosecution.

Shortly after, the OPD attorney called and told me that my case was going to be reviewed by three separate dentists across New York State. I requested permission to speak to these dentists. Once again, my request was denied.

Several weeks later the attorney called again. He told me that the three new dentists who reviewed my case all came to the same conclusion—that these two teeth should not have been extracted, a truly absurd conclusion based upon the pathology and microbiology reports from the surgical sites.

So I asked him, ”Where are these three dentists located?” He told me that one was in New York City, one was in Long Island, and one was in the northwest region of the state.

“Alright then, if these dentists are so far apart how were they able to so quickly review the X-rays and all the data that I sent you?” I asked.

“Forget about justice. This has nothing to do with justice... They have an agenda.”

“They didn’t,” he responded.

“What? They didn’t? They didn’t even review the X-rays and they came to the same conclusion as the dental board? Who is the one really guilty of misconduct here? Is this justice?”

He knew that he had just said something that he should not have revealed to me. “Look, you’re a smart guy,” he said. “Forget about the truth. Forget about justice. This has nothing to do with justice. It has nothing to do with this patient. They have an agenda.”

Suddenly, the true motives of the OPD were clear: they just wanted to silence me for good. I never had a chance.

I could not afford to go back into practice, and I could not afford to pursue my legal “rights.”

What the attorney did not know was that I had tape-recorded many of my phone conversations with him. I was not about to let his shocking disclosure go unchallenged. I called the Chancellor for the New York State Board of Regents. I got voice mail when I called and described my situation. I proceeded to state that the State Dental Board and the OPD were both corrupt, and reiterated what the OPD attorney told me about the board’s agenda. I said that I had this on tape and proceeded to play a portion of a previously recorded conversation with the OPD attorney as proof that I did record my conversations with him.

The next day I received a call from the attorney. He said that the board wanted to drop all charges against me if I would simply plead “guilty” to a records violation. A records violation was only a slap on the wrist but it would still allow them to protect themselves from future legal action for filing malicious prosecution.

I didn’t want to accept this plea bargain, but after speaking with an attorney who handles many board actions, he advised me to take it. He said that if I had that actual recording we could pursue it. But since I did not, it would take five years and a quarter of a million dollars in legal fees; I would win, but they would find some other way to get me. So I reluctantly took the plea. In July 2006 I signed the plea agreement.

At the time it seemed like a fairly innocuous settlement. But because of this “minor” records violation, insurers immediately labeled me as “high risk” and I was denied malpractice coverage. To obtain malpractice insurance I had to go to the New York State high-risk pool. My malpractice premium, which was originally about $8,000 per year and typical for a practice performing predominately oral surgery, jumped to nearly $80,000 per year.

The OPD and its attorney had out-maneuvered me. I could not afford to go back into practice, and I could not afford to pursue my legal “rights.”

The stress of this year-long process nearly killed me, and having my career ripped away so easily and so unjustly was enough to drive me crazy

as well. I knew that if I went back to practice the dental board would eventually come after me again. Their victory was devastating. The idea of going through this process a second time was unthinkable. I was through with dentistry. All the years of education and building a practice and suddenly it was over. I cannot describe in words the visceral feelings that I experienced confronting this reality. I could not sleep. I could not eat. I felt so alone. What would I do? I would have to change careers. Even if I still wanted to practice dentistry, a massive malpractice premium had put that possibility out of reach.

So, as difficult as it was to accept, I decided to explore other career options. But that possibility was quickly swept off the table as well.

Because of my position on root canal treatment, the QuackWatch website wrote an article about me and posted it on the Internet. QuackWatch is a site that claims to expose fraudulent medical practices and beliefs. Some of the things that they do are good. However, in my opinion, some of its actions are simply designed to silence anyone who speaks out against mainstream medical or dental ideology.

What’s more, a link to this article was on page one of Google when anyone would do a search of my name. That, along with the OPD records violation, was the first thing that people saw when they Googled my name. The impact on my reputation and my future was devastating.

I tried to apply for other jobs but never made it to the interview phase. Once, when a prospective employer Googled my name and saw the QuackWatch article and the OPD action, I was immediately rejected.

How would I ever get a job?

An attorney friend of mine said, ”Why don’t you change your name? Just change your name.”

That idea sounded crazy at first but after thinking about it, it started to make more sense. So in 2008 I changed my name to Cole Sommers in the hope of starting fresh.

I am persuaded that an honest review of the scientific research vindicates my position.

Shortly after I changed my name, QuackWatch found out and posted it on

their website. The link to the article again appeared as the first listing on page one of a Google search for “Cole Sommers.” The OPD also tied my new name with my records violation on their website. Now all searchers were immediately exposed to this maligning information when searching my new name on Google. The article about me on QuackWatch has finally been removed, but the OPD listing still appears on page one of a search on my name.

Even though this incredible injustice has made me angry and bitter, I harbor no ill will against my fellow dentists. I wish them no harm. But I am convinced that the health of millions is in the balance, and I am persuaded that an honest review of the scientific research vindicates my position. If the truth inconveniences dentists and changes the way dentistry is practiced around the world, then so be it. But the health and welfare of patients have to be the primary concerns.

I also understand that agencies and associations that protect the dental/endodontic industry will throw unmitigated and unrelenting force against any suggestion that root canal treatment can cause or contribute to systemic disease. Hundreds of billions of dollars are at stake—and not just for dentists, but also for the agencies/associations that represent them. If the truth about root canal treatment reaches the masses, the insurance industry could be hit with a financial tsunami as well.

“Look, you are going after the wrong guy. I feel 100% better than I did before.”

How could the truth about root canal treatment impact the insurance industry? There are many potential battles. One of these will be over the definition of medical care/coverage and dental care/coverage. A recent experience reveals how this might play out...

About one year after the State Dental Board action against me was over, I received a telephone call from the New Jersey attorney general’s office. An insurance company had filed a complaint against me stating that I was committing insurance fraud. They wanted to come and interview me about a former dental patient whom I had treated and for whom I had submitted a

medical insurance claim. They told me the patient’s name and we scheduled a time to meet.

I called the patient to ask if he knew anything about this and he told me that two investigators from the New Jersey attorney general’s office had come to see him at work and asked a lot of questions about the treatment that I had performed. After a lengthy discussion with the investigators my former patient told them, “Look, you are going after the wrong guy. I feel 100% better than I did before and all my blood work is much better. Why are you going after him?”

Since I no longer had an office, the two investigators came to my home. They sat down, turned on their tape recorder, and we proceeded to review the patient’s chart. We discussed my treatment, which consisted of the extraction of five upper teeth. Each of these teeth had severe infections that extended to the surrounding jawbone and into the floor of the maxillary sinus. Pathology reports showed disease present in the maxillary sinus that had originated in the jawbone surrounding these five teeth.

My treatment included removal of the five teeth, debridement of the infected jawbone, removal of the infected tissue from the sinus, and closure of the opening between the maxillary sinus and the mouth. It was an extensive surgery.

The investigator kept asking questions about the surgical procedure, especially the extraction of the teeth, stating that the extraction of teeth is strictly a dental procedure.

I told him that the extraction of the teeth was the least of this procedure. The most important part was the removal of the infected bone, the removal of the infected tissue within the sinus, and the closure of the opening between the sinus and the mouth. He kept pressing that this was dental and not medical stating that my medical code of operating on the maxillary jawbone was not valid and insisted that this was strictly a dental and not a medical procedure.

Finally, I pulled out the panoramic X-ray and put it on the view box. I pointed out all of the infection within the jawbone and how it extended up into the maxillary sinus. Then I gave him a pencil and asked him to draw a line on the X-ray where dentistry stopped and medicine began.

Of course he couldn’t do it. A week or two later I received a call from the investigator telling me that the case was closed and there was no fraud or

misconduct. I was relieved and felt somewhat vindicated from the ruling (see Appendix G).

As if the dental board action and the New Jersey Attorney General’s investigation were not enough, there were also two lawyers, one in New York and one in California, who placed ads on Craigslist and other Internet sites soliciting patients to sue me. One of them also contacted the hospital where I had surgical privileges in an attempt to have these privileges revoked.

I was even included in a malpractice suit filed against another dentist just because I had previously treated the same patient. But when the person who filed this lawsuit against the other dentist was deposed, she did not even know that I was included in the lawsuit! She went on to say that she was very happy with my treatment and could not understand why I was being sued. This lawyer apparently had included me in his lawsuit without her knowledge.

There could be class action lawsuits akin to those that were launched against the tobacco industry.

Concluding Thoughts

As soon as the link between root canal-treated teeth and medical conditions is appropriately accepted by mainstream medicine, surgical extractions of these teeth, along with expensive restorations, will have to be covered by health insurance, regardless of where dentistry stands on the issue. There could be class action lawsuits akin to those that were launched against the tobacco industry. And malpractice lawsuits against dentists could abound.

Who really cares if the evidence is overwhelming? Does the truth really matter? Maybe I should just shut up and sit down. Part of me wishes I could... but I just can’t.

People often ask me if I would ever go back to practice. My answer is that even if the cost of malpractice insurance was affordable, I could never go back. I also ask them to read the information contained in this book, observe what has already happened to me as a result of the first book, and

then ask themselves what they would do if they were me. The board action against me shattered my faith in the belief that truth always prevails. I have never been under so much stress in my life. It not only negatively affected me personally but it had a severe negative impact on my family. I simply cannot go through that again.

History is full of people who have had their lives trampled and even crushed for trying to speak the truth. Yes, I would like to clear my name. My reputation is very important to me. But, considering the money, forums, and other resources that can be employed against me, there is little hope for that during my lifetime. However, I am confident that truth will eventually prevail and provide complete vindication.

In the meantime, Tom Levy and I hope that we can help motivated readers make informed decisions about their teeth and health by presenting the growing science that confirms the risks of root canal-treated teeth. And if in the process, this “sortie” produces another crack in the false foundations upon which some aspects of modern dentistry rest, that would be welcome.

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