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Why do I need endodontic treatment?

Endodontics, from the Greek endo (inside) and odon (tooth), it is a discipline of dentistry and deals with the tooth pulp and the tissues surrounding the root of a tooth.

Your tooth consists of two main parts: the crown, which is the part of the tooth above the gum and visible in your mouth; and the roots which are the part of the tooth that lie beneath the gum and are held in the jaw bone by ligaments. Inside each root is a channel that runs the length of the tooth. This channel is the root canal and contains the pulp (nerves, blood vessels, and soft tissue), which is often referred to as the “nerve” of the tooth.

Bacteria associated with decay, very deep restorations, trauma and cracks in teeth may cause irreversible inflammation or infection of the pulp and damage to the surrounding ligament and tissues. At this point it is necessary to remove the damaged and infected pulp tissue and place a root filling which seals the root from top to bottom to induce healing of the surrounding ligament and prevent reinfection of the root canal. This procedure is known as endodontic treatment. Endodontic treatment saves a tooth that would otherwise have to be extracted and prevents the need for more costly bridge or implant replacements. If an infected pulp is not treated it will lead to pain and potentially swelling and abscess formation.

Why have I been referred to a Specialist Endodontist?

Your dentist may undertake endodontic treatment but it is not uncommon for more complicated cases to be referred to an Endodontist. At Clifton Down Dental Practice, Dr Jonathan Cowie is our Specialist Endodontist. He limits his practice solely to endodontics and uses his additional training and experience to treat these difficult cases, such as teeth with narrow or blocked canals, unusual anatomy, retreating root canals where the initial root canal treatment has been unsuccessful or undertaking endodontic surgery.

Jon will undertake root canal treatment using advanced techniques and technology including an operating dental microscope but most importantly, will spend time to talk through your individual treatment options and answer any questions you may have.

What to expect at my first appointment?

Your first appointment will commonly be a consultation appointment. Dr Cowie will aim to understand your concerns and expectations with treatment. He will carry out a clinical examination, radiographs (X-rays) will be taken if needed and treatment options discussed along with relevant costs.

Occasionally, it may be possible to book a treatment appointment without a prior consultation. If this is the case, Dr Cowie will still complete an initial examination with discussion of treatment options at the start of the appointment and will then undertake the root canal treatment as agreed.

Currently, we can expect success rates of over 90% for first time root canal treatments performed by a specialist endodontist. The success rate is reduced to about 80% when an existing root treatment needs redoing if it has failed. The apparent survival rates of root treated teeth and implant supported crowns are similar.

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JONATHAN COWIE - BDS Dip Endo MClinDent (Endo) M Endo RCS (Ed) Jon graduated from the University of Bristol in 2004. After completing vocational training, he worked in Carlisle in General Practice. Jon relocated back to the south-west in 2006 and continued working in General Practice and in 2009 was awarded a Diploma in Endodontic Practice with merit after two years of further postgraduate training at Barts and The London Hospital. Soon after this, he embarked upon four years of formal specialist training in the field of Endodontics at Guy’s Hospital. As part of his specialist training, he was awarded a Master of Clinical Dentistry degree in Endodontics with distinction at Kings College, London whilst also attaining the Membership in Endodontics from the Royal College of Surgeons of Edinburgh. This training enables him to offer a range of treatments to manage complex endodontic (root canal) cases, with an understanding of the complex restorative problems such patients may have. Jon is also a part-time Clinical Instructor for the MSc in Endodontics at King’s College, London. He has published clinical articles and is a reviewer for the International Endodontic Journal. Jon has been accepting endodontic referrals locally for many years and is a General Dental Council registered Specialist in Endodontics.