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Last Updated April 29, 2009 |
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NEWEST ADDITIONS |
US ENDODONTISTS STRONGLY AGAINST THE USE OF SARGENTI PASTE
Since 1991, the America Association of Endodontists (American Dental Association's only recognized root canal specialty board) has held a strong position against the use of Sargenti Paste. The formaldehyde in this root canal material is widely known to cause serious and permament damage to nerves, tissue and bone. We encourage everyone to read this position statement before visiting more of our site. (Link)
POOR TURNOUT AT SARGENTI 2008 CONVENTION
The American Endodontic Society's 2008 Annual convention was attended by a mere dozen or so dentists even though it was held at the same time and place as the well attended American Dental Association annual convention. Nearly all in attendance were AES officers and/or board members. This was witnessed and confirmed by members of the SOS who had long believed that there was little support for the activities of this rogue group of dentists.
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SARGENTI ENDODONTICS - A CULT
The prominent endodontic textbook, Endodontics, by John Ide Ingle, Leif K. Bakland, states, "The Sargenti method has become a cult and, like most cults, is based more on testimonials than on facts." It further states, "[Dr.] Sargenti himself indicated a double standard of endodontic treatment when he publically stated 'If I had endodontic problems myself, and I wished to have an exact endodontic treatment, I would certainly ask Dr. Herbert Schilder to treat me'". Note that Dr. Schlider was an expert on endodontic treatment and did not use Sargenti Paste.
N2 MATERIAL SAFETY DATA SHEET (MSDS)
The MSDS for N2 documents the exact reason that mainstream dentistry is against the use of (para)formaldehyde in root canal sealers. Irreversable harm is possible when it comes in contact with living tissue. It is considered toxic waste and requires disposal as such. What patient would willingly allow a dentist to put this carcinogen in their mouth? Link |
SARGENTI ADVERSE EVENT DATABANK
The American Association of Endodontics (AAE) has initiated a databank to collect adverse reactions from their members when Sargenti Paste formulations (N2, RC2B, RC2B White, RC2W) are used. Any patient injured by the use of these materials should encourage their dentist/endodontist to report their situation to this databank. If they do not or cannot, we encourage the patient to make the contact. Sargenti injuries are under reported as many dentists conceal its use from their patients. Link |
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ABOUT ROOT CANALS
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Before reading about Sargenti Paste, you may want to read about the root canal procedure. For a detailed description, please visit Dr. Spiller's website (scroll dwn). Visit this ADA link for a less detailed description. |
WHY DO DENTISTS USE SARGENTI PASTE? |
 The "disinfecting" property of Sargenti Paste occurs from the fumes off-gassed by the para formaldehyde. This activity deactivates and destroys debris left in an improperly cleaned canal. It makes for cheaper, quicker, sloppier and cheaper root canals. Dentists who use it believe that it causes no damage, even when extruded outside of the tooth and the patient's complaint is immediate. They refuse to accept responsibility for the devastation that it sometimes causes. Knowing that Sargenti type formulations are shunned by all of mainstream dentistry and considered below the standard of care throughout the US, the dentist will often conceal its use and leave it to the injured patient and their treating doctor(s) to hopefully not discover. Problems can even show up months after the procedure and the connection never made. Their is no valid reason to use Sargenti Paste over the widely accepted and used gutta percha.
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ARE YOUR TEETH SAFE? |
No patient is protected from the use of Sargenti Paste. Damages are random. Peanut and formaldehyde allergies beware! You MUST ask your dentist if they use this type of material and say NO. Unfortunately, many Sargenti injured patients were not given the opportunity to make their own choices and now live with permanent life altering health conditions. Don't walk in their shoes. Most dentists would not use this material on their patients. Unfortunately, that is not true for all.
Dr. Stephen Cohen, DDS and one of the authors of the most widely used endodontic textbook, Pathways of the Pulp, writes about the substandard and risky Sargenti Paste and other paraformaldehyde root canal sealers. An excerpt from his acticle -
"It is shocking that in the 21st century there are still some dentists who choose to use a paraformaldehyde containing sealer.
Simply put, there is no circumstance where it would be appropriate to use a paraformaldehyde paste for sealing a root canal. Why would any dentist choose to use this dangerous paste? I don’t know the answer to this question, but I do know that a few of our colleagues court disaster by continuing to use a dangerous paste instead of gutta-percha and sealers that are, according to the Food and Drug Administration, “generally recognized as safe and effective.”" Full Article begins on page 14, paraformaldehyde on page 16. |
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WHAT IS SARGENTI PASTE? |
 The Sargenti Opposition Society (SOS) was created in 2008 to inform the American public and our dental professionals of the continued
use of a dangerous, FDA rejected root canal drug, Sargenti Paste, which contains formaldehyde. Formaldehyde is widely regarded as a carcinogen and it's use in root canals is considered below the standard of acceptable care by the vast majority of the US and international dental communities. This drug is used by a minority number of general dentists who perform root canals. History has shown that Sargenti using dentists often do not tell their patients that the material they are using is considered below the standard of care and toxic and not approved for use in the United States. Injuries are completely random and damage can be life altering.
The Sargenti Opposition Society wants you to know the right questions to ask so that you do not become a victim. The questions that we, the founders of the SOS, did not know to ask. That question is "Are you putting anything with formaldehyde in any form (powder or liquid) into my mouth?" Since a frequent response from dental professionals has been "I didn't think anyone used that stuff anymore" or "that is only used in 3rd world countries", the Sargenti Opposition Society and its members have alerted every state dental board to the fact that this material is still in use and that patients continue to be harmed. We have alerted the FDA, ADA and the official root canal regulation board in America, the American Association of Endodontics (AAE). This site is intended to inform both the general public and dental professionals. Feel free to send us any questions.
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Sargenti Paste is a material that is used to fill the canals that are created during a root canal procedure. This material is permanently sealed within the tooth. Sargenti paste always contains paraformaldehyde and sometimes contains lead and mercury. Paraformaldehyde is a powder form of formaldehyde and is highly toxic and causes severe and irreversible damage to tissues, nerves, and bones that it contacts. When mixed with liquid eugenol and then enclosed in the tooth, the formaldehyde emits gasses that permeate what is inside and sometimes outside of the tooth. If the paste is extruded out the bottom of the tooth (called an overfill) or seeps out of the porous structure of the tooth, it can cause severe and devastating results, many times becoming permanent life-altering conditions and can be fatal.
Sargenti Paste contains peanut oil, which, along with formaldehyde can cause an allergic person to go into anaphylatic shock. If you can die from anaphylactic shock (and you can), you can die from a Sargenti root canal. Not all dentists ask their patients about peanut allergies.
Many independent studies, including this one, demonstrate that anyone with an overfill of Sargenti Paste should seek immediate surgical removal. The formaldehyde continues to "disinfect" for 7-10 days, as reported by even the proponents. This "disinfecting" action means that the formaldehyde is continuing to permeate and destroy the tissue, nerve and/or bone that it has come in contact with.
Sargenti Paste is known by many names - Sargenti Cement, N-2, N-2 Normal, N-2 Medical, N-2 Universal, N-2 Apical, RC-2B, RC-2W, One Step Endodontic White, TCM and Endodilato. There are many formulations but all contain approximately 6.5% paraformaldehyde. Some contain lead and mercury. The Material Science Data Sheet (MSDS) for the powder portion of the N2 formulation which does not contain lead and mercury can be found at this link. A review of this information clearly demonstrates why it is NOT a safe material to be used in the practice of dentistry. The powder version containing lead and mercury, according to the FDA, should NOT be made or sold anywhere within the US. Unfortunately, that is not the reality of today. The MSDS for the liquid component can be found at this link.
ADA ENDODONTIC SPECIALTY BOARD
SAYS NO! |
The American Association of Endodontics (AAE) has a strong position paper stating NOT to use this material. The AAE is an administrative board that sets the standards for endodontic care in the U.S. They are the only endodontic board recognized by the American Dental Association. |
BE WARY OF SARGENTI ROOT CANALS! |
An excellent article, written by Dr. Stephen Barrett, of quackwatch.com provides a history of Sargenti Paste and the US dental and regulatory organizations. Click here. |
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ARE YOUR PETS SAFE? |
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| ARE OUR TROOPS SAFE? |
 Confirmed by the current (2008) Chief of Dental at the Veterans Administration, Sargenti Paste is not FDA approved and has never been used in a VA medical center. This article from 1975, documents such position. Thankfully, we keep our veterans out of harm's way while in the dental chair. |
ALL US DENTAL SCHOOLS SAY NO! |
Not one single accredited dental school in the US teaches to use Sargenti Paste. Instead, they teach that it is below the standard of care and have done so for decades. Dentists who use it claim that their instructors were biased because Sargenti using dentists are taking business away from the endodontics so they ignored what was taught. The truth is that dental schools have both general dentists and endodontists on their faculty and there is no big monetary conspiracy. The fact is that Sargenti Paste is recognized as the toxic material that it is. |
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WHAT INJURIES CAN RESULT? |
 A Huntsville/Madison, Alabama patient suffers permanent 24/7 numbness and burning pain in the chin/lips/gums after an overfill of Sargenti Paste (RC-2B) into the Inferior Alveolar Nerve (IAN) canal which runs under the bottom back molars (see diagram). The first xray, on the left, shows tooth #18 before the root canal procedure. Note that there is no material under the circled tooth. The xray below this on the left, shows the tooth after the root canal. There is a significant amount of paste outside the bottom of the tooth and inside the IAN canal. This overfill, approximately 6-7 mm is considered, by all standards, a gross overfill. The dentist, upon overfilling the root canal with Sargenti paste into the underlying inferior alveolar nerve canal, should have told the patient that the Sargenti paste overfill penetrated the nerve canal. An immediate referral to an oral surgeon to remove the overfill with microsurgery at a surgical center or hospital would likely have stopped the spread of Sargenti Paste's toxic chemical effects along the nerve pathways. Instead, the dentists concealed that the toxic Sargenti paste inside the nerve canal was the cause of the patient's feeling numbness and burning pain in the lip, chin and gums. The dentist blamed local anesthetic (novacaine) injections as the cause. Consequently, microsurgical removal of Sargenti paste was delayed until it was too late to make a difference. Thus constant numbness and disabling burning pain persist to this day and will remain so for life. The Alabama Dental Board disciplined these dentists and the patient filed a dental malpractice lawsuit that was settled out of court. If you would like to contact this patient, please email info@sargentipaste.org.
Dr. M. Anthony Pogrel, DDS, MD published research in January 2007 in the Journal of the American Dental Association which shows that root canal overfills into the nerve canal if microsurgically removed within 72 hours completely reversed the nerve numbness and/or pain. Both doctor and patient should not delay surgical removal of Sargenti overfills into the canal. A patient should seek the help of an Oral Surgeon, not general dentist, for removal. Cone Beam 3D dental x-rays provide proof positive if Sargenti paste entry into the nerve canal is the cause of post-operative numbness or burning pain after a root canal.
 The CT scan to the right is that of a New Jersey patient who suffers from chronic osteomyelitis (bone infection). This scan was taken early into the patient's treatment. The yellow arrow points to the initial bone loss after an overfill of RC-2W. This patient's infection has been uncontrollable for 8+ years and has eaten away the jawbone and floor of the sinuses, requiring rebuilding from other parts of the patient's body. The second scan to the right (below) shows some of the pins (inside the red box) that are now present in the patient's jaw after many, many surgeries to attempt to correct and stop the damage. This patient's medical bills are in excess of $600,000 and climbing. Her dentist never disclosed that he had used Sargenti paste. For five years she was searching for the answer to her problems. She did not know the truth about what was used for her root canals.A dental malpractice case was brought against this dentist and was settled out of court. If you would like to contact this patient, please email info@sargentipaste.org
This New Jersey patient's case is similar to the most horrendous reported case of Sargenti damage which occurred in 1984 (Link). The story of this patient was part of aPrimeTime Live show that aired on February 8, 1990. 60 Minutes has also done a story on the perils of Sargenti Paste at least a decade ago. It is time to realert the public to help them stay out of harm's way.
Injuries from Sargenti Paste and other paraformaldehyde materials can include chronic sinus infections, temporary or permanent numbness and burning nerve pain, serious chronic bone infections, and even anaphylactic shock. Many formulations of Sargenti Paste include peanut oil, which can also send an allergic person into anaphylactic shock. Neither of the above mentioned patients were asked if they were allergic to peanuts before, during, or after their root canals. It is also believed that the toxins in Sargenti Paste can travel throughout the body and affect distant organs. Many believe that the formaldehyde in this material is a carcinogen. Damage can be a life changing disaster. And, it is random. These two patients had nothing unique about their dental care that warranted deviating from the standard of care material, gutta percha. They simply chose the wrong dentists and did not know the right questions to ask. None of the dentists involved in these two patient's care divulged that Sargenti Paste was used until confronted.
The public must know what these patients had to learn the very hard way. No one should have to walk in their shoes, not even them.
ASK - "ARE YOU PUTTING ANYTHING WITH FORMALDEHYDE IN MY MOUTH?" Say NO!
WHAT ARE (OR AREN'T) OUR REGULATORY BOARDS DOING ABOUT THIS? |
Pointing at each other for accountability! The ADA and AAE point to the FDA. The FDA points to the State Pharmacy Boards. The State Pharmacy Boards point to the State Dental Boards. The State Dental Boards point to the FDA and ADA. NO ONE is accepting responsibility for enforcement of the sale and use of this unapproved and dangerous material. Any action that is taken is only in response to a patient complaint AFTER the damage is done. THIS MUST CHANGE!The SOS has been in contact with all regulatory boards that are involved with this issue. Unfortunately, for the public, these boards have implemented a reactive form of enforcement. Only when a patient is injured, discovers it is Sargenti, and then reports it, is anything done. Then they only act upon the dentist that is involved with that particular injury. The next patient in that same dental chair is NOT protected. Our regulatory boards must become proactive in their enforcement and stop patients from being harmed instead of waiting until after they are harmed. There is not much that can be done for the injured patient once the damage from Sargenti Paste is done.In 1996, the FDA confiscated and destroyed Sargenti Paste as toxic waste. They have recently confirmed that their position has not changed. What has changed, is the dysfunction of the FDA and the failure of their mandate to protect the public. On their own website, is a troubling article "A Troubling Trend", about the lack of FDA enforcement of compounded drugs. Sargenti Paste is a compounded drug. Enforcement is lacking.
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Injured patients should file an adverse event report with the FDA.
Absent
reports from the public, the FDA will not realize the extent
of the dangers
of Sargent Paste. Click here to file report. Also ask
your doctor to file a
report on your behalf. Since reports are
voluntary over 90% of adverse events go unreported.
and ask if your pet is ever in need of a root canal.