Root Canal Specialist: When do you need to see an Endodontist? Are they worth the extra cost?

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When you need to see a root canal specialist, what do they do different to dentists and how much do they charge for treatments.

What is a root canal specialist?

A root canal specialist, or Endodontist, is a dentist who specialises in performing complex procedures such as root canal treatments. 

These specialists receive additional training, experience, and qualifications in this specific field, making them the go-to experts for patients with challenging cases.

If your dentist encounters difficulties while performing your root canal, or if your case is particularly complex, they may refer you to a root canal specialist for further treatment. 

Endodontists have a deep understanding of the internal structures of teeth, and use highly specialised equipment, allowing them to perform procedures with precision and accuracy.

Overall, a root canal specialist may play a crucial role in helping you maintain your oral health by saving damaged teeth. By seeking the expertise of a specialist, patients can ensure that they receive the best possible care for their specific dental needs.

What is the difference between a dentist and root canal specialist (Endodontist)?

A general dentist is qualified to perform a variety of dental treatments. They carry out routine examinations, to diagnose and treat common dental problems such as gum disease and dental decay. However, there may be certain situations where they are unable to complete a treatment due to complexity or severity.

In such cases, patients may benefit from seeing a specialist. For instance, periodontists are specialists who focus on treating advanced gum disease, while specialist oral surgeons are experts in removing difficult teeth. 

If you require a root canal procedure that is complex, or have a problem with a root canal treated tooth, you may need to see a root canal specialist.

Endodontists have carried out hundreds of root canals on patients and practised on extracted teeth in order to hone their skills. This experience helps them achieve the best outcomes.

How does a dentist know if a root canal treatment will need a specialist?

Root canal treatment is needed if the pulp tissue inside a tooth has become infected. 

Root canal specialist
When is a root canal treatment needed?

To determine how difficult the procedure will be, and whether it will need to be referred to a specialist, the dentist will take a history of your problem. They will also take an x-ray, which will help the dentist see the roots of your tooth and the extent of the infection.

There are a number of factors the dentist will consider before they decide whether a referral would be beneficial for you:

The position of the tooth: Teeth further back are harder to fix. If a wisdom tooth is infected, the dentist may suggest extraction rather than root canal treatment. 

The number of canals: The more canals a tooth has, the more difficult it is to disinfect.

Visibility of canals: On most teeth, the root canals are visible on the x-ray image. When they can’t be seen on the radiograph, they may be more difficult to find and navigate. 

Shape of the canals: Curved root canals are more difficult to negotiate, compared to straight ones. 

Previous failed root canal: If a tooth already has a root filling and has become infected again, the treatment is more complex. The previous root filling material needs to be removed before the tooth can be disinfected.

Long standing infections: Chronic infections are difficult to shift as they are well established. 

Post Crowns: Some teeth have posts in them to help support crowns. Posts need to be removed before root canal treatment can be carried out. Endodontists are trained to remove posts. 

Root formation: If a child has a bad knock to a permanent front tooth, the nerve may die off. If the root has not fully formed yet, the teeth have wide open root canals. They will need to have specialist treatment as the canals are more difficult to seal.

What do root canal specialists do differently?

Most Endodontists do not carry out routine dentistry. They only carry out treatments related to root canal problems.

They spend at least three years completing formal training in order to carry out complex root canal procedures. Therefore they are highly skilled in their field.

They invest in specialised equipment to help them with the treatment. They use dental microscopes to see down inside the tooth and clean out complex anatomy. They also have access to CBCT scanners which can create a 3D image of your tooth.

When should I see a root canal specialist?

If you have an infected tooth, you can have your root canal treatment completed by a general dentist, or a root canal specialist. You may choose to see a root canal specialist because you want to ensure the best outcome and are willing to pay more for this.

Your root canal treatment is more likely be successful and last longer if completed by an endodontist. 

However, there are occasions where you may need to see a root canal specialist, or example if your dentist is struggling to complete the treatment.

If a dentist cannot find canals or if they are blocked, the tooth cannot be fully disinfected and you may continue to have symptoms. You will need to be referred to a root canal specialist in order to complete the treatment.

Root canal specialist
When do you need to see a root canal specialist?

A root canal specialist can fix things when they go wrong

A root canal treatment is a complicated process and there are some risks involved. An endodontist may be required to resolve these issues.

Broken files

The small thin files the dentist uses to clean and shape the canals can break inside your tooth. If this happens, you may need to be referred to a root canal specialist to remove the file and complete the treatment.

Broken file needs to be removed by root canal specialist
Broken file in a tooth might need a root canal specialist


Where canals are difficult to find, there is a higher risk of a dentist accidentally creating a small hole (perforation) at the base of the pulp cavity. If this happens you will need a referral to an endodontist to repair it, and have the root canal treatment completed. 

What treatments are offered by Endodontists?

Complex root canal treatments

As covered in detail above, the most common treatments performed are complex root canal treatments. This includes teeth with difficult anatomy, extra roots, and teeth with persistent infection. Complex root treatments may take more visits than a straight forward treatment (Read more on How long does a root canal take?)

Re-Root Canal Treatments 

If a tooth that has previously had root canal treatment becomes painful, it could mean it has become reinfected, and treatment has failed. Endodontists can perform re-root canal treatment, where the previous root filling is removed, before disinfecting the tooth again. 

Often any fillings, crowns and posts will have to be removed before treatment, and will need replacing as an extra cost.

Root canal specialist
When is a re-root canal treatment needed?


When a root canal treatment (or re-root treatment) has been completed to a high standard but the infection has still not resolved, an endodontist may suggest an apicectomy.

Apicectomy is a minor dental surgery, where the end (or apex) of the root is accessed and cleaned directly. A small incision is made, to raise a flap of gum to access the root. The infection is then cleaned, the end of the root cut off and sealed. This should lead to a resolution of your tooth infection. 

Help with diagnosis

If your dentist is struggling to find exactly where your pain is coming from, they may refer you to a root canal specialist for a second opinion. After thorough assessment, if diagnosis is unclear, they may also take a CBCT Scan.

How many specialists are there in the UK?

There are around 300 root canal specialists in the UK, compared to 29,000 general dentists. Finding one close to you was not always easy, but My Private Dentist can now help you with this. You need to check the box which says ‘GDC Registered Specialist’ when completing your search.

There are also some dentists who have ‘special interest’ in Endodontics. They have qualifications such as Diplomas and Masters, but are not registered specialists. Many of them are also competent in helping you with complex root canal work.

How much does a root canal specialist charge for treatment?

A specialist will charge between £550 and £850 for root canal treatment. (Read more about Root Canal Cost)

Can I see a root canal specialist on the NHS?

If you’re having NHS treatment, you may be able to see a root canal specialist on the NHS. 

If your root canal treatment is complex, or if your dentist has had problems with your treatment, you can be referred to a dental hospital to see a specialist endodontist.

In reality, few referrals are accepted by dental hospitals. They have long waiting lists and strict case selection criteria. The tooth needs to be considered ‘strategically important’ in the maintenance of your overall dental health. 

Children who have had trauma to front teeth which need root treatment will also be referred.

Is a root canal specialist included on my dental plan?

Often specialist treatment is not covered on a dental plan. The plans include routine dentistry, but if your case is complex and needs referral, you may need to cover the cost of this yourself. It is best to check with your dental practice to see what exactly is covered on your dental plan. 

What are the success rates of root canal treatments?

8 or 9 out of 10 root treated teeth will survive another 10 years [1]. Root canal specialists have a higher rate of success than general dentists in equivalent cases.

What should I do now?

If you want to have your root canals treatment completed by a root canal specialist, find one on My Private Dentist today.

Picture of Dr Jarri Amini

Dr Jarri Amini

BDS (Honours) London 2012. Jarri has worked as a General Dentist in West Yorkshire for over 10 years. He firmly believes that educating patients about their oral health is one of the most impactful aspects of his job. He has worked on the NHS and in Private Practice.

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