When you smile or open your mouth, the part of the tooth that everyone sees, is called the crown. This is the white colored surface that is made of enamel, the hardest substance in the human body.
It acts as a protection to the soft and vulnerable tissues within.
Should the enamel be damaged, bacteria, liquids and food stuffs can come into contact with the delicate inner tooth structure. This softer area is called the pulp.
If this happens, the result can be infection within the root(s) that are essential to keeping the tooth healthy and in place within the jaw.
The body’s reaction is to try and protect and heal this tissue, but it is not possible and you will normally suffer with pain and discomfort as a result. If the infection is left untreated it can lead to more serious health issues.
A treatment process called Root Canal Treatment/Therapy, RCT for short.
RCT is an option for dentists to save the tooth, with the intention of avoiding alternative options, which includes extraction.
This treatment may also be referred to as endodontic treatment. Some dentists choose to specialise in treatments of the pulp, and they are called endodontists.
This article explains all you need to know about RCT, covering commonly asked questions such as what is involved, how long will it take, what does it cost and more.
What is root canal treatment?
Root canal treatment/therapy is the name given to a procedure that involves removing decay and infection that exists inside centre and roots of the teeth (the pulp and root canal system).
Sometimes referred to as root filling, the pulp (blood vessels and nerves) inside of the tooth is removed and then the tooth filled to preserve it.
RCT is a means by which the natural tooth can be saved.
In the eyes of the professionals, there is no better solution than the natural tooth and taking this approach allows for it to be retained and avoids the need for extraction and dentures.
Any tooth that has had RCT is more fragile than a regular natural tooth. For the best chances of success, as part of the treatment procedure the tooth will usually be capped, with an artificial crown to protect it from the stress it has to endure.
Why would I need root canal treatment ?
A root canal treatment is necessary to stop the spread of decay and infection from the tooth into the surrounding bone and tissues, but the process also saves the natural tooth.
Trauma, fractures, faulty crowns and fillings can all contribute to damage to the tooth enamel, but decay (caries) is the primary cause.
Twice daily brushing and interdental cleaning are vital to reduce the chances of decay occurring.
A large number fail to take these preventative steps and decay makes its way through the enamel and the soft inner core of the tooth is then damaged.
Whilst every case is different, if you see a dentist for a regular checkup, the decay can be dealt with, before it makes its way to the sensitive inner tooth structure and an RCT in needed.
Nothing acts or looks as good as a natural tooth, so it is best to keep them if possible.
Initially decay occurs only in the outermost surface of the tooth – the enamel.
If this simple decay is left, it progresses through the tooth, towards the centre of the tooth, where the pulp is. This will cause the nerves in the pulp to react.
The most common symptoms and complaints of those who then need RCT are:
- Sensitivity when eating or drinking, often hot or cold foods
- Pain when biting down
- A loose tooth
- When your tooth has got/darker / discoloured
Failing to take note of these warning signs can lead to the spread of the decay and make the situation worse.
Once the infection gets to a certain stage, you will no longer feel the pain or discomfort. This is not a good thing. This means the infection has damaged the nerves within the tooth to such an extent they not longer function correctly.
Failing to treat the spreading infection or a dead nerve may eventually lead to an abscess.
An abscess is an inflamed area in which pus collects and can cause swelling of the tissues around the tooth.
Within a short space of time you can expect:
- Pain when biting or chewing returning
- Swollen gums around the tooth
- Swelling to your face
- Pus draining from the tooth or gum
- Change in colour of the tooth (gets darker)
Unlike the skin on your body, the pulp inside the tooth cannot heal itself.
Over the counter pain medication might well appear to reduce the pain or get rid of it entirely, but it is ultimately just masking the problem that needs dealing with.
Ultimately you need to remove the source of the infection -- the tooth decay!
Going to the dentist might not be high up on your priority list, but it should be if you experience such symptoms.
If you think going to the doctor or dentist for antibiotics is the solution, sadly you are wrong.
Antibiotics are not effective in treating root canal infections, because usually there is no longer a blood supply entering the pulp space to reach the bacteria and deliver the antibiotic.
Do I need a root canal treatment?
Whether you need the treatment or not will be up to your dentist to decide.
Once you have booked into see them, they will make an assessment.
You will be asked about the symptoms, the pain you are suffering and your medical history.
Expect at this time to receive an oral examination, so the dentist can see what is going on within the mouth.
An X-ray may also be needed to give another view of what is happening below the gumline and inside the tooth.
Based on all of this information, the dentist will determine if root canal treatment is necessary and suitable for you.
Some cases may be borderline whether an RCT is required or not. For example, the infection may be close to the pulp and when it is removed the nerve may be irritated. Sometimes the nerve is able to settle down by itself with time. Sometimes the filling has been left too late, and and RCT is needed.
In some instances, if the infection has passed into the bone surrounding the tooth or the remaining tooth structure is not strong enough to support the root filling or crown that will be placed over it, extraction might be the only option.
However, this is not an option dentists like to take. Keeping the tooth in place, even if there is no longer and living tissue inside is better than removing it, so they will offer RCT if they feel they can save the tooth.
You can decide though, it is your mouth and teeth and you are the one paying for the dental care. It might however be reckless to not take the professional’s recommendation.
Our guide on tooth extraction goes into much greater detail but what you need to be aware of is that removing a tooth poses new issues.
If a tooth is extracted extra pressure is put on the surrounding teeth. It can affect how you eat and speak, not to mention your confidence with a potential gap in your smile.
Do you want to have to consider or deal with movement of the teeth, issues speaking and eating?
Dentures are the primary solution. There are pros and cons to these, but one of the biggest might be the costs.
Nothing is better than your natural tooth, so dentists will always try to save the tooth and opting for root canal treatment is usually best.
The tooth structure
Enamel and pulp are just 2 words that have been used already to describe root canal treatment, but nothing helps picture and understand something like an image.
The following graphic is a representation of what a tooth would look like on the inside, if you were to cut it open.
It is not a solid lump of enamel, inside it is a complex network of tissues, nerves and blood vessels.
On the top is the crown, made of enamel, this is the white top side of the tooth that is exposed to everything in our mouths and is the hardest structure in the body. It is this that we protect and help stop being exposed to decay when we brush and floss our teeth.
Below this sits the neck of the tooth which runs down the crown, down into the gum.
The remaining part of the tooth, that is normally twice as long as the crown, is the root which anchors the tooth into the jawbone.
Inside each root are the canals. Each root can have 1 or more canals, although it’s often the larger rear teeth that have multiple canals per tooth root.
There are essentially 3 layers to the tooth -- enamel, dentine (or dentin), and the pulp.
The first layer is the hard enamel.
The 2nd layer is called dentin. This is a softer, more porous material, that makes up the majority of the tooth.
The 3rd layer is the pulp chamber which is much softer and is the network of nerves and blood vessels that run through the roots and into the jawbone. It is the enamel and dentin that protect this pulp.
Enamel is broken down by what dentists call ‘dental caries’ or to you and I, decay.
In other words, poor oral hygiene and maintenance is what allows for the enamel to be broken down by bacteria. Had it be correctly removed, the decay would not exist.
Only a tiny hole need be made in the enamel to allow for the dentin and pulp that sits below, to be put at risk.
Bacteria can very quickly set into the soft dental pulp and spread through to the root(s) of the tooth.
Root canal treatment removes the pulp from the internal tooth structure and involves filling the tooth to give it strength to remain seated in the jaw.
How many roots and canals does each tooth have?
The number of roots a tooth has differs.
Normally it will be 1, 2 or 3 although some have 4.
As a general rule, the greater the pressure the tooth has to endure, the more roots it has to keep it in place.
As such, the molars at the back of the both have the most roots.
The images below shows the position and name of teeth, whilst the table lists how many roots each tooth normally has.
|Tooth||Number of Roots|
|Uppers (Top Jaw)|
|Third molar (wisdom teeth)||3|
|Lowers (Bottom Jaw)|
|Third molar (wisdom teeth)||2|
The amount of time taken for treatment obviously depends on which tooth requires root canal treatment. Those with more roots will have more canals and thus need more treatment to properly clean out the infected material.
Endodontist -- Root canal specialists
A general dentist is capable of carrying out routine root canal treatments.
However, dentists can and do choose to specialise in certain areas of dentistry.
An endodontist, is a dentist who has carried out extra study and practice in the treatment of disease and injury to the tooth root, dental pulp and surrounding tissue.
Depending on your dentist or dental office, they may refer you to a an endodontist. Many dental offices have an endodontist within their staff.
Cases that a normal dentist may refer you for specialist treatment include: re-treatment of teeth that have already had RCT, teeth with curved or very long roots, adult teeth in children which have not yet finished growing.
As specialists, they have the extra expertise, clinical skill, equipment to give the best success rates. If you feel you want to seek the opinion of a specialist, rather than a general dentist, you can use the American Dental Associations find a dentist tool or search the listed professionals on the American Association of Edndodontists database.
The root canal procedure
The exact procedure differs from patient to patient and from one dental office to another.
However, the 4 or 5 stages explained below give a good overview of what you can expect if you are about to or are expecting to have root canal treatment.
In most instances, before these stages take place, you will have had a routine or emergency appointment with your general dentist who will have confirmed the need for RCT.
They 4 stages are:
- Opening the tooth
- Cleaning the tooth
- Root filling
Depending on the particular case, there is a 5th step that might be necessary, to place a crown on the tooth.
In most instances, during the initial consultation that confirmed that root canal treatment was necessary an x-ray will have been taken to help understand the extent of the decay and what treatment, from a dental professionals perspective is required.
Before commuting to RCT, you should have all the positives and negatives to the treatment explained as well as the costs, so you are fully aware of what to expect.
Should you have any outstanding questions, make sure these are answered to your satisfaction, before letting the surgical process get underway.
RCT gets rid of infected tissues within the tooth, so the working environment, tools included need to be sterile to ensure the filling and treatment as a whole is successful.
The dentist will first inject the area around the problem tooth with local anaesthetic. This will numb the area and should mean you cannot feel anything other than maybe a bit of tugging and pushing. You will know the dental team are doing something, but you won’t know what.
Throughout the procedure you are awake and able to hear what is going on. Although some dentists may allow music to be played to ensure you are comfortable and at ease.
What is known as a dental dam (cofferdam) is put place around the tooth. It gives the dentist a safe area to work. This rubber dam prevents chemicals and small instruments going into your mouth, and also prevents bacteria from your saliva getting into the clean tooth.
They can work knowing their tools will not come into contact with any other surface in your mouth, debris from the treatment cannot be swallowed or choked upon.
The dam looks quite dramatic when in place, but the American Association for Endodontists value the importance it plays.
Opening the tooth/accessing the root canal
Technically a hole already exists in the tooth already, this is why you need the treatment.
However, using specialist drills, a larger hole will be made through which the dentist can access the pulp chambers inside the tooth teeth that contain the infected tissue.
On larger teeth such as molars, this hole is usually placed in the top of the tooth. With smaller teeth, like those at the front of the mouth, the hole is drilled at the back of the tooth.
With clear access gained, it will be at this point the dentist will begin removing what is left of the pulp.
The dentist will likely making use of the best lighting and microscopes available to give themselves a magnified and clearer view of what they are working with which in turn allows them to complete the treatment more successfully.
The canals that need to be cleaned out are not just hollow tubes that run in a straight line from the top to the bottom of the tooth. They are narrow and often curve. This makes the job more difficult and time consuming for the dentist to do properly.
Specialist files will be used to help enlarge the canals to give them a regular shape for filling and to allow for reach into the depth of the root to clear out the infected tissue.
This part of the treatment may take several hours to complete. The front incisor and canine teeth usually have a single root containing one root canal, but premolars and back molar teeth (chewing teeth) have two or three roots, each containing either one or two root canals. The more roots a tooth has, the longer the treatment will take to complete.
As soon as all the obvious pulp has been removed, the dentist will use a combination of liquids and products to thoroughly clean out the internal structure of the tooth.
Bacteria and their waste products are removed in two ways. One way they are removed is by physically getting rid of them, using small specialist files. The second technique is chemical removal using special solutions to kill the bacteria in the canals.
The inside of the tooth needs to be super clean to allow for a really effective filling to be placed and give you the best chance of success.
Cleaning the internal chambers of the tooth gets rid of the bacteria and infection.
In some cases, or when treatment cannot be completed in a single appointment, medication will be placed into the canals and a temporary filling placed.
If this is applicable, a temporary filling will be placed and you will be expected to return within a week for the treatment to be completed.
The medication will kill off the remaining bacteria, before syringes are used to push cleaning solutions into the canals, before being sucked back out and repeated several times. The canals are then dried with paper points or suction tips to complete the process ready for filling.
With a clean and dry interior tooth surface, the restorative stages of the treatment can begin.
The root filling is now placed.
The canals must be filled to stop bacteria re-growth and keep the tooth in the best possible condition.
The canals are normally filled with a special type of rubber called gutta percha. In the past other techniques have been used, e.g. silver.
The gutta percha is shaped as thin cones. These are dipped in a calcium hydroxide glue (cement) to help seal very small gaps. The extra length of gutta percha are then heated with special implements so that the gutta percha stops at the pulp chamber
A slightly different technique involves melting the gutta percha. The cones soften and shape to fill the canal and care compressed for a complete and strong filling.
Once the roots are filled, a normal filling will be applied to the crown of the tooth, to seal everything closed.
Depending on the planned treatment, it may be necessary before completing the filling that seals the tooth closed, to place 1 or more posts or pins.
These posts can be sealed inside the tooth to give extra strength, or it may extend beyond the remaining crown to give a surface to which an artificial crown can be attached.
Any tooth that has or does undergo RCT will be more fragile than a natural tooth that has not.
The best success with treatment is achieved when a crown or cap as it is also known is placed over the top or the natural tooth.
It adds to the cost, but it gives the extra peace of mind and performance needed to live everyday life confidently.
To help a root treated tooth for as long as possible, I always recommend a crown (or cap) for the tooth to prevent it breaking. Teeth which have had root canal treatment are a lot more brittle and prone to breakage. Having a crown also decreases the risk of bacteria getting around the filling and causing another infection.
Dr Gemma Wheeler -- In-house dentist -- GDC Number: 259369
As there is always a risk that the RCT will not work, placing a crown may be delayed for a few weeks, until the dentist can be assured that all has gone to plan.
For a crown to be placed, some of the tooth and filling will need to be removed with drills to create space for a crown to be made. When ready for the crown to be fitted, a mould of your teeth will be taken to ensure the crown is manufactured to fit precisely.
This may be achieved by biting into a special tray mould, or in the most advanced clinics, oral scanners are used to create detailed computer images, measurements and renderings of the teeth, for a cleaner more high-tech approach.
Crowns are made from:
- Metal or porcelain (or both)
- A ceramic material
- Or powdered glass
You can often chose what material, to get the finish you desire as it will normally be you that is paying for it.
To fit the artificial crown, it will be necessary for the existing natural tooth crown to be shaved down to offer a better fit for the cap and a nice surface area given for cementing it in place. In some instances there may be a post extending from the tooth to attach the crown to.
The following video summaries the written content above.
How long does the RCT procedure take?
There is quite simply no set time period for the treatment.
Generally speaking it is completed within a few hours. As a general guide expect approximately 1 hour per root for a simple tooth.
However, the time taken for will vary from one patient to another.
It will depend on the extent of the infection and which tooth is being treated.
Teeth with fewer roots will normally take less time to treat than those with multiple roots.
Some treatments can be carried out in 1 visit, whilst other treatments may require a 2nd visit.
How long does treatment last?
In an ideal scenario, where all has gone to plan and you look after the tooth once treated, there is no reason why it cannot remain in place for the remainder of your life.
Those with poor brushing routines and those who smoke will be at greatest risk of the treated tooth not lasting this long.
Investing in perfecting your cleaning and giving up smoking are only going to help.
However, personal circumstances and health conditions may affect this and the treatment may need to be completed again or the tooth removed entirely.
According to Dr Shelly the success rate is 85-97%, subject to circumstances.
Failure means that the tooth experiences pain or breaks.
How much does a root canal treatment cost?
Treatment for a root canal in the USA averages at around $1000, for the therapy alone.
However, the price can vary from $300 right through to $2000.
This does not include the cost of any crown you may need.
The crowns can range from $500-3000.
It is therefore possible to be paying up to $5000 to have a root canal treatment completed fully and successfully.
There are many factors that influence the price and the prices offered here are just guidelines as to what it might cost. Your dental office will be able to provide accurate costings after an assessment, which itself will likely have a cost.
Each case is different, but the price will go up, the further back in the mouth the teeth are and the more roots they have.
More roots, means more root canals, which means more work and time, hence the increase in cost.
There may well be other medical factors that will influence the price.
You then have consideration for who it is treating you, their popularity, reputation and where in the country you are.
Costs can be lower in the western states of the USA, than the east side of the country.
Additional costs will come from the x-rays, any medication needed and if multiple visits are necessary too.
Dentists and the offices in which they work can typically offer an accurate costing as part of the consultation process and there should be few surprise or unexpected costs.
Dental insurance can certainly help in many cases with the costs.
However, every policy is different and not all companies will cover root canal treatment or the cost of a crown.
You will need to refer to your documentation or speak to your insurance firm to understand what, if anything they will cover.
Some will cover a percentage, anywhere between 50-90% of the cost of root canal therapy, but may not cover the cost of the crown.
Others may payout up to an amount rather than a percentage.
Few, will cover the entire cost of the treatment.
If your insurance pays 50% towards both root canal therapy and crown, your $5000 bill can be reduced to just $2500. That leave a much smaller amount for you to personally pay for.
Some contribution is better than nothing, so do make sure you speak to them and understand the full terms.
Many dental practices will have payment plans that can help spread the cost if necessary.
Overseas treatment for root canals
As we have seen with dental implants, there can be big savings for getting dental work done overseas in countries such as Mexico and Brazil.
Even when factoring in the cost of flights and accommodation the costs can be 50-70% less, but still completed to a very high standard as you would get within the USA.
You will need to make your own assessment as to whether overseas treatment is something you wish to consider.
The complication here is that usually you will want the treatment carried out fairly quickly and this can affect the ease with which you can arrange such overseas treatment.
As there is pain prior to treatment, there will be some post therapy.
Tissues around the tooth will be swollen, inflamed and sensitive.
If you are required to have a 2nd sitting with the dentist to complete the treatment, this may extend for a week or so due to the additional work required.
Eating is possible as soon as the treatment is complete, but you will want to stick to softer foods as the pressure from biting will result in additional sensitivity.
To help manage any pain or sensitivity you can use over the counter painkillers to provide relief.
For most, within 72 hours the side effects of the treatment will have gone and you will be able to return to normal life.
Should you find these are not working or you are concerned, speak to your dentist for more information and guidance on what to do.
Root canal complications and problems
When a surgical procedure, complete with local anaesthetic is being used, there is a chance of risk and in every instance, not everything will go as the dentist or you might plan.
There are little in the way of serious complications or problems that can occur. The worst case outcome for most is that the RCT does not work and the tooth has to be extracted.
Patient health and personal circumstance can affect the risk too, but it is not something to be worried about.
Possible complications and problems include:
- Damage to the root canal or the tissue surrounding the tooth
- Damage to the nerves around the tooth
- A canal not being filled (missed) during the first treatment
- The canal not being properly cleaned and filled (tissue and bacteria remains)
- A fracture in the root
It is quite possible that a week or so after the treatment, if you are not having a cap fitted, that a checkup will be required, just to ensure everything has healed and the treatment has been a success.
You will generally know if it has, because if the pain or symptoms that caused you to fist get the work done have not gone away, it will likely have failed.
Although it is most common for the root canal to fail pretty much straight after the first attempt, it can fail later if preventative care (brushing and flossing) is not followed.
Where it does not work you may be advised to have what is known as re-treatment.
Pros and cons of root canal treatment
There is lots of information on this topic provided within this article. What are the main positives and negatives?
- Saves the natural tooth -- Nothing can replace a natural tooth, RCT save it.
- Gives confidence -- The treatment does away with the pain causing infection and allows you to live life normally once treated.
- Safe -- Used for a long time it is a tried and tested procedure.
- Success rate -- 90% of RCT are successful.
- No gaps -- Extraction is the alternative, that will leave you with a gap in the teeth unless dentures are purchased.
- No denture required -- With the tooth saved no dentures will be required to replace what could otherwise be a missing tooth.
- May not work -- The treatment many not work in all cases, typically 1 in 10.
- Time -- It is a more time consuming procedure than tooth extraction.
- Cost -- It is not cheap to have the treatment and few dental policies will cover the full cost.
- Recovery -- There will be a bit of recovery time, it is a surgical procedure
Preventing further treatment
The best methods to prevent the need for any further treatment to that teeth or others in the mouth is to:
- Maintain good oral hygiene -- Brush twice a day, floss once.
- Not consume too much sugary food
- Give up smoking, if you smoke
- Get regular dental checkups
There are lots of claims and suggestions on the internet and amongst the general population that root canal treatments are dangerous and should be avoided at all costs.
This is particularly rife amongst those who believe in more natural or holistic approaches to health. wellbeing and medicine. The suggestion if often to avoid surgery.
Some of these claims are based on poor or old information as well as misunderstanding of the treatment process.
The following video gives a little insight into the safety of this procedure, from the point of view of trained endodontists.
There is no alternative treatment, aside from actually removing the tooth.
It is not an option dentists like to take unless absolutely necessary, hence the desire to attempt root canal treatment first.
Decay and infection are quite serious and extraction is the only other option to stop it spreading. Leaving a tooth in, even with a failed RCT will just pose more risk and do more harm than good.
If extraction is chosen or necessary, Most wish to replace the missing tooth, but restoring this involves obtaining an artificial (prosthetic) replacement, such as a denture, bridge or a dental implant. The costs of such can vary considerably.
Opting not to replace the extracted tooth is an option, but this will cause problems with chewing as well as having an impact on your smile and the way your remaining teeth look.
A decaying and infected tooth needs to be treated, be that with extraction or root canal treatment.
Root canal treatment is the best option in the eyes of the professional as it is always better to retain the natural tooth if possible, no denture can simulate what a real tooth offers.
The process will involve some discomfort, but no more than those with infected tooth roots are already suffering.
It comes at a cost, too, but the confidence it brings back to your smile and improving your daily life are worth paying for. Many dental insurances can help, but you will need to consult your policy.
When completed successfully and well managed thereafter, there is no reason why the tooth will not remain in the mouth for a lifetime.
It is a surgery few wish to go through with, but is one that is effective and much better alternative of tooth extraction.
A direct result of decay, regular dental checkups and good daily oral hygiene practices can prevent the need for such treatment.
All being well many questions you may have had have been answered in the contents of the article above.
However, here are some commonly asked questions, complete with answers.
Is a root canal painful?
Local anaesthetic is used to numb the area during the procedure so that you do not feel anything.
The dentist and support staff will be on hand if you feel pain and you will normally be advised to alert them.
Depending on the length of treatment required, extra anesthetic will be used to ensure the area remains numb until the treatment is complete. Most dentists will let you know what is going on at key stages such as this.
And although post treatment there will likely be a bit of discomfort, this will soon ease.
Failing to get the treatment will result in more pain, discomfort and worry than not getting it dealt with at all.
How many appointments are necessary for root canal treatment?
The number of appointments will vary depending on the severity of the decay and infection.
A large proportion are carried out in just 1 sitting.
Most are completed within 2, but a third may well be required, particularly if a crown is being fitted.
Your dentist will often advise in the first consultation if they feel multiple visits will be necessary.
How long will the tooth last following root canal treatment?
Providing good care of the tooth is taken, with regular checkups following the RCT, then it can last a lifetime.
Other factors such as diet and smoking may affect the long term stability and success.
Can all teeth be treated with root canal treatment?
In many cases the answer is yes. However, there are occasions where reluctantly, tooth extraction is the best option.
These instances are where the infection and decay has existed too long for the tooth to be saved, if the canals cannot be properly cleaned and sealed and there must be sufficient bone to support the tooth.
Can the treatment fail?
The circumstances for the failure differ.
It can be possible to reattempt the treatment or it might be necessary to remove the tooth.
What will my tooth look like after treatment?
All being well the tooth will look as it did (or as close as) prior to any decay and treatment.
The idea of the treatment it to retain the natural tooth as nothing looks or performs as well.
It is possible that the tooth will darken, but this is much less common and treatments such as chemical whitening can be completed to match the tooth in with the others in your mouth.
Where is root canal treatment carried out?
The procedure is carried out in your dentists/endodontists office. It does not require admission to hospital.
What is Endodontic Retreatment?
This is the process of providing root canal treatment to teeth that have previously undergone the procedure.
It tends to be a more complicated and longer procedure due to the fillers that have been placed in the teeth during prior treatments.
Your comments and opinions
If you should have any questions, comments or opinions you would like to add to this guide, please do so, by commenting below.
Should you have or be going through the process of implants yourself, why not share some feedback for others to take advantage of.
- Levinsons Textbook for Dental Nurses
- British Endodontic Society
- American Association of Endodontists
- Oral Health Foundation
- Burgess Hill Dental
- Foxhall Dental Practice
- Cygnet Dental Practice
- City Dental
- King Lane Dental Care
- Perfect Profiles