Dr. Larry Hoffman has long had two aspirations. One was whimsical: to be a foot taller (he is 5’11”) and to play professional basketball. The second was a serious professional challenge for the young dentist: to find a way to save teeth where severe decay had reached down into the roots.
Over the past seven years, since he was an intern at Philadelphia’s Albert Einstein Medical Center, Dr. Hoffman, 31, has quietly perfected a revolutionary root canal salvage technique. This spring he felt confident enough of its success in treating one of the most common dental problems to report it in a professional journal.
As an intern, Dr. Hoffman was frequently called upon to pull teeth so rotten that conventional root-canal work, in which the decay is gingerly drilled and filed out, would have been futile or impossible. “At the time when Dr. Christiaan Barnard transplanted the first heart,” Hoffman recalls, “it bothered me that we had developed a method of transplanting one of the most complex organs of the body but could not remove, repair and replant a simple tooth.”
Actual transplants of donor teeth up to now have proved impossible largely because of the structural differences of jawbones. Replanting of teeth in the same mouth has had only limited success because the roots die quickly outside the mouth. Dr. Hoffman theorized that roots would remain alive longer if their delicate surface membranes were kept moist in a solution called a nutrient, which closely resembles the body’s chemical balance, and if the tooth were quickly replanted. He began experimenting on teeth so decayed they would have been extracted.
After pulling a tooth, Hoffman holds it in a nutrient-saturated pad and removes decay from the inner tooth and root canals with a drill and minute wire files. He fills the cavity and canals with a neutral cement and then quickly replants the tooth in the patient’s jaw. The entire procedure requires less than 10 minutes.
Although the tooth’s nerve is destroyed by the operation, Hoffman discovered that the roots become firmly reattached to the jawbone. His unusual root-canal operation costs less than half the cost of alternative treatment, which involves implanting steel pins in the jaw and capping them with artificial teeth. Furthermore his procedure can be done right in his Chicago office.
Because there is always a possibility that replanted teeth will not “take,” Hoffman uses replants only when all conventional methods fail—such as drilling teeth while still in the mouth.
Not surprisingly, as news of Hoffman’s experiment spreads, patients from all over the world are calling for appointments. Not wanting to restrict his general dental practice to transplants, Hoffman began limiting the number of new patients he would see. “If I wanted to make a lot of money off this I surely could. But life’s too short. All I need is enough money to buy a nice house and to put my kids through college, and lots of time to myself. When it’s 5 p.m. I’m out the door.”
Wednesday is Hoffman’s day off. Leaving his split-level house in suburban Highland Park, Ill., he customarily heads for a round of golf and follows it with a brisk game of tennis (he was once an all-city player). In the afternoon he coaches a Little League Softball team, and in the evenings he plays shortstop on an adult team. For a nightcap, usually around midnight, he challenges a neighbor to a pressure-packed game of one-on-one basketball on his lighted driveway court. “I tell you, once I leave that office dentistry is far removed from my life. I plan to keep it that way. You know,” he says with a wistful gaze in his eyes, “I really should have been Kareem Abdul-Jabbar.”