INFO FOR PATIENTS | Justin Barnes, Specialist in Endodontics

Thank you for taking time to read this information for patients.

Justin looks forward to meeting you.

Patient Information Leaflet

REFERRAL PROCESS

Stage 1: Referral made

Your dentist may decide that you need specialist endodontic care and offer to refer you to Justin Barnes, Specialist in Endodontics.
Your dentist should inform you about the referral process and give you a Patient Information Leaflet.

Stage 2: Forms

Once the referral has been received and approved, you will be contacted and asked to complete forms about you, your medical history, and your dental history.
Justin will then analyse the forms usually within seven days, but it may take longer.

Stage 3: Consultation

If there is sufficient information, Justin will compose and send you a consultation report (fee £50).
If there is insufficient information, Justin may ask for additional information or ask that you attend a face-to-face consultation (fee £150).

Stage 4: Decision-making

It is advisable that you carefully consider the information before making a decision on how you want to proceed.

Stage 5: Treatment with Justin

If you decide to proceed with treatment with Justin, a treatment appointment will then be scheduled.
Justin aims to complete most cases in one 60-90-minute appointment.
Treatment is carried out under local anaesthetic; Justin does not offer any form of sedation.
Every effort will be made to offer you the soonest available appointment. The current waiting time between a consultation and treatment is around one-to-two weeks; however, this could change at short notice depending on the number of referrals and patients engaging in the referral process.
In a small number of cases, it can take multiple appointments and several months for endodontic treatment to be completed from the point you are referred.

Stage 6: Care with your general dentist

After treatment with Justin, you may require additional treatment with your dentist.
It is important that you continue to attend your dentist for general dental care.

Stage 7: Review

After treatment, a review is usually advisable.
The review may be carried out with Justin or your general dentist.

Please notify us in advance if English is not your first language or if you have any other communication and/or accessibility needs.

CANCELLATION POLICY

If you cannot attend, or need to amend/change your appointment, please notify the clinic as soon as possible giving at least two full weekdays' notice so the appointment can be offered to another patient. For example:

If you need to cancel/amend an appointment scheduled on a Monday, please notify the clinic before 17:00 on the preceding Wednesday.
If you need to cancel/amend an appointment scheduled on a Tuesday, please notify the clinic before 17:00 on the preceding Thursday.
If you need to cancel/amend an appointment scheduled on a Wednesday, please notify the clinic before 17:00 on the preceding Friday.
If you need to cancel/amend an appointment scheduled on a Thursday, please notify the clinic before 17:00 on the preceding Monday.
If you need to cancel/amend an appointment scheduled on a Friday, please notify the clinic before 17:00 on the preceding Tuesday.
If you need to cancel/amend an appointment scheduled on a Saturday, please notify the clinic before 17:00 on the preceding Wednesday.

Patients will be charged £50 per 30 minutes of appointment time if they:

Do not attend their appointment.
Arrive late and the appointment has to be rescheduled.
Give less than two full weekdays' notice to cancel or amend an appointment.

This charge must be prepaid before the clinic will schedule another appointment. If the charge is not paid, Justin may discharge the patient back to the referring dentist, and no further appointments will be offered.

This policy is necessary to ensure that patients attend their appointments, other waiting patients are not disadvantaged, and Justin's waiting time is kept to a minimum. Failing to attend, arriving late for, or giving insufficient notice to amend an appointment can result in a wasted appointment for another patient.

FEES AND PAYMENT

Please refer to FEES page.

FREQUENTLY ASKED QUESTIONS

WHAT IS ENDODONTICS?

Endodontics is the branch of dentistry concerned with the prevention, diagnosis, and treatment of diseases and injuries of the tooth root, and the tissues inside and surrounding the roots.

Endodontic treatment is a dental procedure usually performed when:

The nerves and blood vessels inside of the tooth root(s) (known as the "pulp") are dying, dead or have doubtful health.
There is an infection inside the tooth root(s).
There is infection-related inflammation of the tissues around the tooth root(s).

The above may have occurred due to tooth decay, dental trauma, or stress cracks in teeth.

Examples of endodontic treatment include:

Pulp protection procedures.
Root canal treatment.
Root canal retreatment.
Surgical endodontics (e.g. apical surgery).

WHAT IS THE AIM OF ENDODONTIC TREATMENT?

To CONTROL infection inside of a tooth, and thus allow the tissues around the tooth to heal and/or stay healthy so that the tooth can be retained.

WHAT DOES ROOT CANAL TREATMENT INVOLVE?

Root canal treatment involves cleaning the infected "tunnels" (known as 'root canals') inside of the tooth, and then sealing the space left with a root filling to prevent reinfection.

The procedure involves:

Administration of local anaesthetic.
Placement of a protective sheet (known as the 'rubber dam' or 'dental dam') around the tooth.
Removal of all or part of the existing restorative material in the tooth.
Shaping and cleaning the root canal(s) with fine sterile dental instruments and cleaning solutions.
Filling the cleaned root canal(s). The root filling material is usually a rubbery material called gutta-percha.
Taking small dental x-ray image(s).
Filling the hole in the tooth with a semi-permanent or definitive core filling.

WHAT DOES ROOT CANAL RETREATMENT INVOLVE?

Root canal retreatment involves re-cleaning infected root canal(s), and then re-sealing the space left with a new root filling. The processes are similar to root canal treatment (see above); however, it can sometimes be more challenging to perform.

WHAT DOES APICAL SURGERY INVOLVE?

Apical surgery is a minor surgical procedure which involves cleaning and filling the tips of the root(s).

The procedure involves:

Administration of local anaesthetic.
Cutting and lifting of the gum.
Removal of the tip of the root.
Cleaning and filling of the new tip of the root.
Taking small dental x-ray image(s).
Replacement of the gum being held in place with dissolvable stitches.

WHAT IS THE SUCCESS RATE OF ENDODONTIC TREATMENT?

Traditionally, success means your tooth should be symptom-free and without evidence of infection after completing endodontic treatment. The probability of endodontic treatment being successful is usually high but treatment cannot be guaranteed to be effective. Sometimes endodontic treatment has been completed to a satisfactory standard but it is ineffective. There is a risk of persistent infection which may then require further dental treatment, including further endodontic treatment or removal of the tooth (known as 'extraction'). It should be remembered that endodontic treatment aims to control infection, and it is not currently possible to make the inside of a tooth completely free from bacteria or other microbes.

WHAT ARE THE ALTERNATIVES TO ENDODONTIC TREATMENT?

It is important that you take time to carefully consider all options available for your tooth, including the associated pros, cons, risks, likely prognoses and financial costs. The alternatives to endodontic treatment may include:

No treatment, which is not advisable as there is a risk of acute infection with pain and swelling; OR
Removal of the tooth (known as 'extraction'). It may be possible to restore the resulting space with a dental implant, fixed bridge or removable denture, subject to further assessment.

HOW MANY APPOINTMENTS ARE REQUIRED FOR TREATMENT?

Usually one 60-90-minute appointment. In a small number of cases, it can take multiple appointments.

WHY IS THE APPOINTMENT SO LONG?

The root canals may be complex, e.g. narrow, curved or blocked. It is important to take time to thoroughly clean and seal the inside of the tooth.

WHAT CAN I EXPECT DURING TREATMENT?

There are unwarranted horror stories about endodontic treatment. Most patients do not experience any pain during treatment with local anaesthetic. Justin wants the experience to be as pleasant as possible, and patients frequently report that the experience was not as bad as they had expected. Justin will explain what he is doing during treatment and he will let you know in advance if you are likely to feel vibrations or hear noises. Justin uses a stretchy sheet (known as the 'dental dam') during root canal treatment and retreatment. This sheet is secured around the tooth to ensure optimal cleaning of the root canals and provide patient comfort as it protects the throat. Justin uses an operating microscope to significantly improve vision within the tooth.

HOW CAN I RELAX DURING TREATMENT?

You are welcome to bring your own headphones and listen to music. A rubbery prop can be placed between your upper and lower teeth to help your mouth stay open. Sometimes patients catch up on some sleep and take a nap.

WHAT CAN I EXPECT AFTER TREATMENT?

After treatment, most patients experience mild discomfort/pain due to the work carried out. This discomfort/pain may last for several days. It may be necessary to take pain killers, and avoid chewing directly on the treated tooth for a few days.

A small number of patients experience:

Soreness in their jaw muscles due to keeping their mouth open during treatment. This soreness may last for several days. It may be necessary to eat softer foods to allow the jaw muscles time to recover.
A bruise on their face. It may take around two weeks for the bruise to disappear.
Severe pain and/or facial swelling due to a spreading infection. This pain and/or swelling may take many days to settle, and may unfortunately disrupt daily activities. It is therefore advisable that treatment is not schedule within two weeks of an important event or travelling/flying. It may be necessary to seek emergency dental care with Justin, your general dentist or an emergency dental clinic which may involve taking stronger pain killers and possibly antibiotics.

WHAT FURTHER DENTAL CARE IS RECOMMENDED?

You will remain under the care of your general dentist during and after treatment with Justin.

You may require additional dental treatment with your general dentist. This may involve:

Aesthetic dentistry (e.g. dental whitening of the tooth).
Protective cap (e.g. onlay or crown) to minimise the risk of the tooth cracking/splitting.
Replacement of an existing crown.
A bite guard for a tooth/clenching grinding habit.

Your general dentist will be able to give you further details, including the type, timing and cost of additional dental treatment. Please discuss this with your general dentist before embarking upon treatment with Justin.

It is advisable that the tooth and surrounding tissues are reviewed to assess the outcome and determine whether treatment has been effective or ineffective. The review is usually carried out at least one year following the completion of treatment. Sometimes sooner or several reviews are necessary. The review appointment usually involves a clinical examination and taking a small x-ray image. The review appointment may be carried out by your general dentist or Justin.

It is imperative that you:

Keep your teeth and gums clean and healthy.
Eat a healthy diet with a low frequency intake of sugary substances.
Attend your general dentist for regular check-ups and general dental care of your teeth, gums and mouth.