Dental Clinique

40 Balham High Road

Balham, London SW12 9AQ

 

Telephone: 0208 675 7307

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Specialist Endodontics

 

Meet our Specialist

Our Specialist empathises with patients and understands the apprehensions one can experience prior to root canal treatment. He prides himself in taking time to explain procedures and helping patients to have a pleasant visit at Dental Clinique

 

Edward Brady

Specialist in Endodontics
BChD MJDF MClin Dent MEndo RCSEd

GDC No. 74436

Edward qualified at Leeds Dental School in 1998. Since qualifying he has worked in hospital and practice in the UK and Australia. He completed his specialist training with distinction in Endodontics at Guy's Hospital in 2012. He was also awarded Membership in Endodontics (MEndo) by the Royal College of Surgeons, Edinburgh.


Edward has contributed chapters to a textbook of Endodontics and currently teaches specialist trainees at King's College Hospital. He is a member of the Royal College of Surgeons of Edinburgh and the British Endodontic Society.

Edwards accepts referrals in:
Root canal treatments
Surgical Endodontics

 

 

Welcome to our Specialist Endodontist Page

Endodontics is a branch of dentistry recognised by the General Dental Council and British Dental Association involving treatment of the pulp (tooth nerve), nerve canals (root canal) and surrounding tissues of the tooth.

Endondontic Treatment

Dental Clinique has been offering a specialist Endodontic service for patients and referring dentists since 2001. We recognise that Endodontic treatment is very specialised. It requires an extreme high level of skill using specialist equipment to reduce failure rates.

Many dentists refer all Root canal cases to specialists. If required, patients can ask their Dentists to refer you to a specialist.

Endodontic treatment can be performed by a general dentist or may require the expertise of an Endodontist—a dentist who only specialises in performing these procedures.

Having qualified as a General Dentist, an endodontist must also complete an additional two to five years of advanced or specialist training. Only after this training and acceptance onto the General Dental Council Specialist Register (http://www.gdc-uk.org/Membersofpublic/Lookforaspecialist/Pages/default.aspx) can a dentist call themselves an Endodontic Specialist. Regrettably the numbers are very few in the UK.

Root canal treatment is a skilled and time-consuming procedure and most courses of treatment will involve two or more visits.

Life Benefits

  • Preservation of remaining healthy tooth structure.

  • Prevention of infection spreading any further.

  • Restoration of tooth to its natural look and feel.

Why is Endodontic treatment required?

Endodontic (or root canal) treatment has been recommended as a procedure for your tooth in an attempt to prevent the tooth’s premature loss. Treatment is required when the living tissue inside the tooth (called the pulp) becomes inflamed or infected. The pulp contains the nerves and blood supply to the tooth and may become damaged by deep decay, trauma or cracks in the tooth structure. The treatment allows the surrounding tissues to heal and the natural tooth to be retained in form and function. 

What does the treatment involve?

Endodontic treatment involves the removal of the inflamed or infected tissue inside the tooth and the sealing of the root canals to prevent future infection. The tooth is isolated with a rubber sheet (called rubber dam) to prevent the tooth becoming infected with bacteria from the mouth.  An opening is prepared in the biting surface of the tooth to access the root canals. The canals are cleaned and shaped using fine metal instruments.  A disinfectant is used to wash out pulp tissue and kill bacteria. The root canals are then sealed using a root filling material.

Does root canal treatment hurt?

Root canal treatment is carried out under local anaesthesia and is normally a painless procedure. Although patients are frequently fearful of having treatment, the tooth is fully anaesthetised prior to treatment and the treatment should not feel any different from having a normal filling.

How long does treatment take?

Root canal treatment is a complex, time-consuming procedure. Treatment is usually carried out over one or two visits. Each visit takes approximately 90 minutes to 2 hours. If your case is especially complicated, your treatment may take longer; this is something that will be discussed with you.

What are the alternatives to endodontic treatment?

 The alternatives to the proposed treatment are to have:no treatment. If no treatment is carried out, there is a risk of infection, pain and/or loss of the tooth; orthe tooth extracted. If the tooth is extracted, then you may elect to have some form of artificial replacement tooth provided. This could be a removable denture, fixed bridge or an implant.

What are the possible complications?

In most cases, endodontic treatment is a highly successful procedure for postponing the loss of teeth that would otherwise be extracted. However, as with all dental procedures, not all teeth will respond as favourably to the treatment as one would wish. Risks or complications, although quite rare, may still occur. The main risks are outlined and explained overleaf. A Specialist in Endodontics is trained to identify and minimise the risks associated with endodontic treatment.

The following may be inherent or potential risks related to the proposed treatment:

  • swelling, pain, numbness and/or a tingling sensation in the gum and in some parts of the mouth;

  • adverse reactions to injections. These are rare, but can result in jaw muscle soreness and stiffness;

  • damage to existing restorations. Access to the root canal may involve removing or cutting through existing restorations, crowns or bridges. These restorations may need to be repaired or replaced after treatment;

  • discolouration of teeth after root canal treatment. The teeth may become dark and may require additional cosmetic treatment, such as bleaching;

  • treatment failure is always a possibility. The anatomy of the root canal system is often very complex, particularly in molar teeth. Root canals are frequently very fine, curved or even blocked, which may result in problems locating the canals or cleaning them fully and to the end of the roots; and

  • complications such as perforations (i.e. holes made through the end or side of the root of the tooth), extrusion of dental materials through the apices of the roots and/or instrument breakage. Such complications may result in a decreased success rate. However, in the majority of cases, patients do not experience any long-term problems with the tooth.

Will the tooth be painful after root canal treatment?

It is normal to experience pain for a few days following root canal treatment. Painkillers (for example, ibuprofen and/or paracetamol) are usually sufficient to control any pain.  However, in particularly infected teeth, some patients experience more severe pain or even swelling after treatment, which is normally helped with a course of antibiotics. Teeth are frequently tender on biting for a few days. Occasionally, this can take several months to settle. If you are given painkillers or antibiotics, you should follow the instructions regarding the dose and you should not drive or operate equipment if indicated. If you are a female who is taking contraceptive pills, it is possible that you could become pregnant while taking an antibiotic. Consequently, an alternative form of contraception may be appropriate while taking antibiotics, and for a short time thereafter.

What other treatment is required after endodontic treatment?

After endodontic treatment has been completed, the treated tooth will become brittle and vulnerable to fracture and infection by bacteria in the mouth.  Prompt restoration is necessary to avoid this. This will involve either a filling, crown or onlay. The final restoration is as important to the survival of the tooth as the root filling itself. In the majority of cases, the tooth should be restored as soon as possible. However, if the tooth has a questionable prognosis, further treatment with a crown or an onlay may need to be delayed until satisfactory signs of healing have been observed. The post-endodontic restoration is a separate procedure and is charged separately. It is your responsibility to see your dentist for final restoration of the tooth.

 
 
 

Endodontic Therapy: Our Charges explained

We have produced this guide so you know what is included in the fees for the procedure and where other fees might be warranted. We have produced very transparent fees guide for your care.

(Please note although Specialist charges often range from £650-£2000. We use the latest technology, materials and standards associated with specialist care. The time we allocate is not reduced. We have used sound business practices and reduced margins to be able to offer such competitive prices. In order to maintain the above, we have a strict non-attendance policy)

What are our charges?*Updated January 2018

 The alternatives to the proposed treatment are to have:

no treatment. If no treatment is carried out, there is a risk of infection, pain and/or loss of the tooth; or the tooth extracted. If the tooth is extracted, then you may elect to have some form of artificial replacement tooth provided. This could be a removable denture, fixed bridge or an implant.

Endodontic Treatment

Incisors and Canines -Upper and Lower front teeth - £620.00
Side teeth-Upper and Lower Pre-Molars- £ 640.00
Back chewing teeth- Upper and Lower Molars- £ 680.00

Endodontic Re-Treatment

As per above PLUS £120.00

Endodontic Micro-surgery (apicectomy)

 

Use of MTA (mineral tri-aggregate)

Additional fee of £15.00 is made

What is included?

We include all treatment, materials, x-rays, temporary filling and reports. There are no additional taxes or hidden fees. 


Our fee includes

Endodontic Treatment, Re-Treatment and Microsurgery (Root Canal)
The fee for each individual tooth includes:

1. All radiographs-the initial diagnostic radiographs, working and measurement radiographs and those of the completed root canal verification of treatment.
2. Isolation- using Rubber Dam
3. Local anaesthesia- to “numb” the tooth
4. Treatment as required-Access into the tooth, Removal of the nerve tissue, Cleaning and shaping of the canals, Irrigation of the canals with medicated solutions, Placement of medicated dressings where needed, Filling the canals with root canal filling materials
5. Temporary restoration-in the access opening between appointments and at completion.
6. Reports- to referring Dentist


What is not included?

The fee does NOT cover:

1. Prescription medication- if a prescription is issued that must be filled at a pharmacy
2. Final restoration- placed by your Dentist, which is always a separate fee 

The final restoration is placed by the referring dentist. The restoration you will need after the root canal is completed will depend on which tooth is being treated and on how much natural tooth remains and how strong it appears. Your dentist should have informed you of the probable restoration you will need and its cost, before the root canal is started. Again, this fee is separate from the root canal fees. 

How do I pay?

A deposit is required to secure the appointment. The balance is payable on the day of treatment.

Deposit-       £150.00 deposit is payable upon booking the appointment
Payments-   We accept most Debit cards , Credit cards and Cash. 
Cheques-    We NO longer accept personal cheques


What additional costs can I expect to pay?

The charges are for specialist Root canal therapy only.
 In addition, your usual dentist will make their standard charges to restore the tooth.
The usual restorative procedures after Root canal therapy are one or more of the following:
Placement of the final restoration (filling). This replaces the Temporary filling placed.
If there is a lot of tooth loss, a metal core or fiber glass post retained core is placed
For most, but not all teeth a crown is placed to prevent the weakened tooth from fracturing. This is essential for long term use.

What if I miss my appointment?

Non- attendance charges
 If a patient fails to attend an appointment or cancels within 24 hours, we will retain the deposit of £150.00 as a non- attendance charge.

We accept that certain unexpected circumstances can prevent attendance and we do not wish for you to miss your reserved time. However, in order to keep charges down, we have deliberately not factored in these costs as we feel that it is unfair to pass on non- attendance costs to others. We also feel that missed appointments are unfair to the specialist who could have used the time to treat other patients.
We can help as follows
Reminders- please update your mobile number and e- mail address, We will send you notifications and reminders by text and e-mail.
Waiting List- We operate a standby list and will endeavour to fill the missed appointment. If we are successful we will waive the charge.

Post Treatment Guidance

Your root canal treatment is complete. This sheet will go over some information about what to expect for the next few weeks now that the root canal is completed. Please follow the instructions outlined below, and contact us should any questions or problems arise.


Soreness and pain- It is normal for your tooth to be sore for 2-3 days after treatment. It may even become sorer on the second day. Tenderness to biting can persist for up to two weeks but will gradually get better over time.  Please use painkillers should you require. Ibuprofen is ideal (unless a medical reason stops you from taking this)
Temporary filling- The temporary filling will take about a half an hour to set. With use, the temporary filling may wear down. It is very rare for it to fall out entirely. If the temporary falls out you should contact us, or your general dentist for replacement.


Diet- AVOID Hard foods- (nuts, ice, muesli etc.) until the permanent filling/crown has been placed on the tooth. Again, the tooth is prone to fracture and if you bite down on anything too hard or crunchy you may crack the tooth!
Next Treatment-Your tooth only has a temporary filling. It is critical that you make an appointment with your dentist for placement of the definitive restoration as soon as possible. Your dentist will place a crown, onlay, or filling to seal the root canal filing and help protect the tooth from fracture. Again, avoid chewing on the treated tooth until the restoration is placed. 


Oral care. You may floss and brush your tooth as normal.


FLARE-UPS-Although about 95% of root canals cause very little to no discomfort after the treatment is completed, there are about 5% of cases which can cause significant pain. These are commonly referred to as “flare-ups.”
 They mostly occur on badly infected teeth, teeth that are extremely irritated, or teeth that have a history of prior treatment. The treatment stirs up the infection that is trapped in the bone under the tooth although the tooth is treated.
If you have a flare-up you may experience moderate to severe pain, swelling, bruising, throbbing, and general discomfort, which usually begins a few hours after treatment and may last 2 to 3 days.
Please contact us if you experience any of these symptoms. You may be prescribed antibiotics, stronger pain medication. 

Specialist equipment at Dental Clinique

In addition to the specialist equipment, we use the latest, well-researched materials and techniques for performing root canal treatment. If you have not had endodontic treatment within the last five years, you will be amazed at how easily and painlessly most procedures can be performed.

Operation Microscopes and fire-optic illumination
Digital X-rays-Computerised 
Apex locator
Torque control Motor
Nickel-titanium rotary files
Obturation
MTA


Operating Microscopes and fibre-optic illumination


We utilise special operating microscopes. Magnification and fiber optic illumination are helpful in aiding the specialist to see tiny canals, micro-fractures and details inside your tooth. Secondary canals, which are often missed, can also detected. 

 

Computer Digital X-rays
Digital x-rays enable us to lower the amount of radiation used in exposing radiographs. The x-ray is viewed on a computer monitor enabling better diagnosis capacity and allowing the patient to see their own teeth. In addition, this new technology is friendly to the environment since no chemicals are needed for developing the image.

 

Nickel Titanium Rotary Files


Nickel Titanium has unique features of flexibility, strength and shape memory. This allows n canals that are sharply curved to be accessed, thoroughly cleaned and shaped. Previous stainless-steel instruments had the tendency to break and could not take a curve to follow the shape of the canal; therefore, it was difficult to clean the canal successfully. Using these instruments routinely allows us not only to be more effective but also to work faster. To maintain strict infection control, these instruments are disposed after each patient use.

 

Torque Control Motor-DCM ENDO 3 TCM Endo III


The microprocessor controlled TCM Endo III is a slow-speed, electric torque-control motor capable of achieving faster and easier root canal preparation. Used with a special drill and nickel titanium files, the Speed and maximum torque levels are constantly controlled. The preparation is more comfortable, smoother and quicker.

 

Apex Locator 


This clever instrument uses computerised aided measurements to navigate the length of the Root canal to accurately locate the root end. This allows us to more predictably clean and fill the canals in each root at the correct length.

 

The “System B” and the “Obtura”


When sealing a root canal system, we wish to ensure the fill is accomplished predictably, efficiently and accurately. The Elements Obturation unit incorporates advanced technologies involving software, metallurgy, electronics and design with the best elements of “System B” and a patent-pending motorized extruder. The Elements Obturation unit use “Continuous Wave” of Condensation technique. This technology allows us to introduce warm filler that will adapt to the 3D shape of the root canal system, including small side canals.

 
 
 

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