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Rahul Goria
Dipti Mehta
Patient Testimonials

"Many thanks to all in the team for making my recent root canal treatment such a stress-free experience with each stage of treatment being clearly explained by Mr Goria in terms easy to understand. All members of his team from receptionist to nurse made me feel welcome and relaxed as soon as I arrived and throughout each visit. A friendly and professional practice I would certainly recommend." M.H.

"Receiving treatment from Mr Goria and the team at The Chequers has been a very reassuring experience: Professional, highly competent, clean, kindly and excellent at explaining every aspect of the procedure. I have felt myself, intuitively, to be in the most trustworthy and decent of hands. I would recommend The Chequers to anyone requiring root canal treatment. With thanks, R.G." 

"Root canal is not something to look forward to, but if anyone can minimise worry and discomfort, it is Rahul. His professionalism makes one feel completely safe and at ease. I shall be forever grateful. His advice about anaesthesia was equally useful....and saved me a great deal of money!" S.Z.

"I had experienced tooth pain for 3 months and was advised I would need root canal treatment. I was recommended to The Chequers Endodontic Practice by my dentist. I received fantastic reassurance during the whole procedure, and Rahul explained in detail each part of the procedure and what to expect. I received total reassurance and instantly felt relief from pain. All very professional and would never worry about having root canal treatment here again." S.S.

"Thank you so much for the expert care and attention I have received at The Chequers Endodontic Practice. I am impressed by the friendliness and patience shown by everyone I came into contact with and by Mr Goria's expertise in dealing with such an involved tooth problem. He always took the utmost care to make sure I was comfortable and in no pain. Many thanks, R.T.

What is an Endodontist and what do they do?

The word 'Endodontic'' comes from the Greek "endo" meaning inside and "odont" meaning tooth.  Endodontic therapy, therefore, involves treatment of the soft tissue inside the tooth called the 'pulp'. This is a very complex, unique piece of tissue from which the tooth develops.  Root canal treatment  becomes necessary when this piece of tissue is irreversibly damaged - this usually occurs following dental decay or trauma.

All dentists are trained in diagnosis and endodontic therapy, however some dental problems can be especially difficult to diagnose due to the complexity of the nervous system. Treatment of some teeth can also be difficult due to the complexity of the root canal anatomy.

In the UK, in addition to five years at dental school, endodontists receive further formal advanced education and training before they are accepted on to the Endodontic Specialist Register by the General Dental Council. They study root canal anatomy, treatment techniques and procedures in greater depth, for diagnosis and treatment of more difficult cases. They use their special training and experience in treating these difficult cases, such as teeth with narrow or blocked canals, or unusual anatomyans because they limit their practices to endodontics, they treat these types of problems every day.

For this reason, many dentists choose to refer their patients to specialist endodontists who use advanced technology, such as operating microscopes, ultrasonics and digital imaging, to perform these special services.

What is Root Canal Treatment?

Retaining your natural tooth should always be your first choice. 

From the outside, a tooth looks like a hard, solid substance, but this diagram shows that a tooth is really a complex system of various  tissues.

Root canal treatment is necessary when the soft 'pulp' of the tooth becomes infected by bacteria. The toxins from the bacteria then seep out though the ends of the roots and affect the  tissues around the tip of the roots. This can sometimes occur without pain in which case your own dentist may have noticed a change in the appearance  on an x-ray. The aim of Root Canal Treatment is to remove  bacteria from the root canals so that the surrounding tissues can heal. 

Once we have the necessary information from your own dentist and the endodontist has  seen it we can then book you an appointment. At the appointment the endodontist will discuss your chief complaint and complete a history of the tooth pain before taking digital x-rays of your teeth. Your symptoms will be evaluated prior to testing the tooth in question along with adjacent teeth. After the tests are complete, a diagnosis will be given to determine the best treatment care and prognosis. Possible post-treatment decisions, such as a crown on the treated tooth, will be addressed.

Your endodontist will make you aware of the benefits, options and risks involved in order for you to understand how endodontic treatment is a way of saving your tooth.

If you decide to receive treatment, the procedure may start immediately. Before treatment begins, you will receive local anaesthesia to numb any sensations you may feel during the procedure. In the vast majority of cases for various reasons treatment is carried out over two visits and an antibacterial paste will be  sealed inside  your tooth between appointments.

You will be provided with post-operation instructions and what to expect over the next few days.

On completion of treatment, a report will be sent back to your own dentist with details of treatment carried out including copies of xrays, the prognosis for the tooth, restorative recommendations and the need for a review  - usually after one year. Be sure to contact your endodontist if you have any questions or concerns regarding your treatment.

What Happens During Endodontic Treatment?

Local anaesthetic is always used in various techniques to achieve adequate anaesthesia. The treatment consists of three or four basic steps, but the number of visits will depend on your particular case. Most treatments take 2 visits; very occasionally 3 appointments are needed; this will all be dependant on the stage of infection/inflammation and degree of treatment difficulty. To us, it's more important to do it  to the best of our ability rather than to meet a specific time criteria.

Endodontic treatment involves the following steps:

1. The endodontist examines and x-rays the tooth, then administers local anaesthetic. After the tooth is numb, the endodontist places a small protective sheet called a “dental dam” over the area to isolate the tooth and keep it clean and free of saliva during the procedure. It's a bit like using drapes around an operation site.

 2. The endodontist makes an opening in the crown of the tooth. Very small instruments are used to clean the pulp from the pulp chamber and root canals and to shape the space for filling. Opening up the canals  ensures that cleaning fluids reach deep into the root dissolving any damaged soft tissue and bacteria.
3. After the space is thoroughly cleaned and shaped, the endodontist fills the root canals with a biocompatible material, usually a rubber-like material called “gutta-percha.” The gutta-percha is placed with an adhesive cement to ensure complete sealing of the root canals.  A hard antibacterial cement is placed  to seal the opening.
4. After the final visit with your endodontist, you may need return to your dentist to have a full or partial crown or other restoration placed on the tooth to protect and restore it to full function. If the tooth lacks sufficient structure to hold the restoration in place, your dentist may place a post inside the tooth. All this will have been discussed with you at the inital consultation but do ask for  the endodontist if you are unsre about  the specific restoration planned for your tooth.
Diagnosis and Treatment of Pain

Oral pain can often be difficult to pinpoint due of the vast network of nerves in the mouth and  the pain of a damaged or diseased tooth often is felt in another tooth and/or in the head, neck, or ear. An endodontist is a specialist in diagnosing and treating this type of pain.

Treatment of Traumatic Injuries

Pulp damage is sometimes caused by a blow to the mouth, and the endodontist specialises in treating these traumatic injuries. For example, a blow to a child's permanent tooth that is not fully developed can cause the root to stop growing. A procedure called apexification stimulates bone to be deposited at the end of the root which makes it possible to then save the tooth through a root canal procedure. An endodontist is specially trained in procedures for replanting teeth that have been knocked out of their sockets.

Sometimes, following trauma, particularly in children,  it may not be necessary to carry out root canal treatment immediately. Every effort  should be made to maintain a healthy pulp to allow the root to mature. Endodontists are trained to test and monitor such cases and know when  to intervene and which treatments to carry out.

Will I need to return to your practice for additional visits?

Once endodontic therapy is completed, your tooth may need to be examined periodically, usually after 12 months.  This allows us to make sure the tissue aroun the tip of the roots has healed or is healing properly.  You will be sent a reminder when we feel it is appropriate to re-evaluate the treated area.   Occasionally complete healing of a large abscess can take longer and  the practice will  reevaluate the tooth, if necessary, for several years.

Retreatment - Why do I need another endodontic procedure?

Occasionally a tooth that has undergone endodontic treatment fails to heal or pain continues despite therapy and may require retreatment; this can occur with any dental or medical procedure. A tooth may not heal as expected after initial treatment for a variety of reasons, but a simple way of explaining this is to say that problems persist either due to certain pathogenic bacteria surviving in the tooth or managing to get back in later. These causes are detailed below:

  • Narrow or curved canals were not treated during the initial procedure.
  • Complicated canal anatomy went undetected in the first procedure.
  • The placement of the crown or other restoration was delayed following the endodontic treatment.
  • The restoration did not prevent salivary contamination to the inside of the tooth.

In other cases, a new problem can jeopardise a tooth that was successfully treated. For example:

  • New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth.
  • A loose, cracked or broken crown or filling can expose the tooth to new infection.
  • A tooth sustains a fracture
7 Chequers Drive
Prestwood, Great Missenden, Bucks HP16 9DU

0044(0)1494 891133
0044(0)1494 868624