Assesment & Referral

Case Difficulty Assessment and Referral tool for Root Canal treatment.

This innovative software was devoloped at the QMUL and is now piloted exclusively by  Billis Endodontics for its first release.


I am delighted to be able to offer a referral service for endodontic treatments in South East England (London, Surrey, Sussex, Kent).
My aim is to provide high quality root canal treatment in an efficient manner, using the latest techniques and equipment. I enjoy the challenge of treating nervous patients and changing their often unfavourable opinion of root canal treatment.

Once I have received your referral, you will be invited to attend an initial consultation appointment. Following this you will receive a customised treatment plan, so you will always know exactly the treatment you require and how much it will cost. Treatment options may vary depending on your clinical need and personal preference.

 ESE Certified MemberMembership can be verified here.

Meet George Billis

BDS, MSc (Endodontics)

FGDP(UK) Mentoring in Dentistry


Clinical Lecturer (QMUL)

GDC Reg. No: 78959

Specialist in Endodontics

George is a registered specialist in Endodontics with the General Dental Council (GDC) and the European Society of Endodontology (ESE). He qualified from the University of Athens, School of Dentistry in 1991 and later gained the Diploma in Implants-Biomaterials, a qualification in “Mentoring in Dentistry” from the Faculty of General Dental Practice (FGDP UK) and an MSc in Endodontics from Queen Mary, University of London (QMUL).
He has been working mainly in private practices and served the NHS England, accepting referrals for Complex Endodontic Cases. Since 2009 has been providing Endodontic treatment at the Royal London Dental Teaching Hospital and he is a Clinical Lecturer at The Bart’s and the London School of Medicine and Dentistry, Queen Mary University of London, where he teaches Endodontics to undergraduate and postgraduate students.
Over the years he has developed a special interest in surgical endodontics and guided tissue regeneration, which has become his main field of practice and research.

Patient Testimonials

Dentist Testimonials

Information for Dentists

I hope you will regard me as part of your team and will contact me for your referrals and to discuss cases, and I can offer you help and advice on Endodontics. My aim is to offer your patients endodontic treatment, carried out in a relaxed environment using the latest techniques and equipment and returning them to you pain-free, confident and happy with the quality of treatment they have received. Your patient will only be offered treatment for which they have been specifically referred, with no other involvement with the practice where the treatment will be carried out.
The services I can offer include:

  • Emergencies involving pain/ ‘HOT’ pulps or Dental trauma
  • Apexification of immature teeth
  • Initial root canal treatments and re-treatments
  • Complex cases with unusual root canal anatomy
  • Complications due to sclerosed or blocked canals, missing or extra canals
  • Removal of posts, silver points and fractured instruments
  • Repair of perforations
  • Treatment/ advice on resorption cases
  • Endodontic surgery

During their consultation patients will be fully informed of the procedure, cost and number of visits. Most treatments are completed in a single visit but badly infected or complex cases may require a second visit. The treatments are carried out using high magnification (Global operating microscope and/or Loupes), tooth isolation (rubber dam) and a variety of modern endodontic equipment and techniques. On completion of the endodontic treatment patients will be returned back to your care for a definitive restoration and routine dental treatment.
Patients and referring dentists will be able to contact me should any queries arise before, during or after an endodontic case is undertaken.


Information for Patients

My aim is to provide high quality root canal treatment in an efficient manner, using the latest techniques and equipment. I enjoy the challenge of treating nervous patients and changing their often unfavourable opinion of root canal treatment.
If you require endodontic (root canal) treatment or advice, your dentist will make a referral. You may also contact me direct or one of the dental practices where I carry out treatment. 

It is important that you find it easy to contact me at any time with queries, fully understand the procedure and the stages of the treatment, as well as the associated costs (all discussed during your consultation) and feel comfortable throughout the treatment.
Your registration and regular dental care will stay with your own dentist.
At the Billis Endodontics clinic you will only receive advice and treatment relating to the root canal treatment for which you have been referred. We will send you and your dentist the details of any treatment you receive at Billis Endodontics.

At your first consultation, the history of your problems will be discussed. A clinical and radiographic examination, based on the referral, will be carried out. At this stage, we will fully explain the treatment proposed, and we will provide you with a written treatment plan outlining costs and the number of proposed appointments.
Following the consultation, an appointment will be arranged for you and the endodontic treatment will be carried out in accordance to European Society of Endodontology Guidelines.
The referring dentists will be kept informed of their patients’ progress and a discharge letter and a copy of the final radiograph will be sent upon completion of the treatment. The patient will also receive a copy of this.
No other treatment, other than that for which the patient has been referred, will be undertaken.
Referrals may be made by downloading our referral form and send it to: Billis Endodontics, Gateway Dental, 73 Station Road, Burgess Hill, West Sussex RH15 9DY.
Or fill our secured online form.
Also, you can contact me directly by e-mail:

Endodontic treatment can often be performed in one or two visits and involves the following steps:


  • Step 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.
  • Step 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
  • Step 3
After the space is 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. In most cases, a temporary filling is placed to close the opening. The temporary filling will be removed by your dentist before the tooth is restored.
  • Step 4

After the final visit with your endodontist, you must return to your dentist to have a crown or other restoration placed on the tooth to protect and restore it to full function.

  • Step 5

If the tooth lacks sufficient structure to hold the restoration in place, your dentist or endodontist may place a post inside the tooth. Ask your dentist or endodontist for more details about the specific restoration planned for your tooth.

With proper care, even teeth that have had root canal treatment can last a lifetime. But sometimes, a tooth that has been treated doesn’t heal properly and can become painful or diseased months or even years after treatment. If your tooth failed to heal or develops new problems, you have a second chance. An additional procedure may be able to support healing and save your tooth.

Why do I need another endodontic procedure?

As occasionally happens with any dental or medical procedure, a tooth may not heal as expected after initial treatment for a variety of reasons:

  • 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 jeopardize 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.


What will happen during retreatment?

First, the endodontist will discuss your treatment options. If you and your endodontist choose retreatment, the endodontist will reopen your tooth to gain access to the root canal filling material. In many cases, complex restorative materials—crown, post and core material—must be disassembled and removed to permit access to the root canals.

After removing the canal filling, the endodontist can clean the canals and carefully examine the inside of your tooth using magnification and illumination, searching for any additional canals or unusual anatomy that requires treatment.

After cleaning the canals, the endodontist will fill and seal the canals and place a temporary filling in the tooth. If the canals are unusually narrow or blocked, your endodontist may recommend endodontic surgery. This surgery involves making an incision to allow the other end of the root to be sealed.

After your endodontist completes retreatment, you will need to return to your dentist as soon as possible to have a new crown or other restoration placed on the tooth to protect and restore it to its full function.


Is retreatment the best choice for me?

Whenever possible, it is best to save your natural tooth. Retreated teeth can function well for years, even for a lifetime.
Advances in technology are constantly changing the way root canal treatment is performed, so your endodontist may use new techniques that were not available when you had your first procedure. Your endodontist may be able to resolve your problem with retreatment. As with any dental or medical procedure, there are no guarantees. Your endodontist will discuss your options and the chances of success before beginning retreatment.

How much will the procedure cost?

The cost varies depending on how complicated the procedure will be. The procedure will probably be more complex than your first root canal treatment, because your restoration and filling material may need to be removed to accomplish the new procedure. In addition, your endodontist may need to spend extra time searching for unusual canal anatomy. Therefore, you can generally expect retreatment to cost more than the initial endodontic treatment.
While dental insurance may cover part or all of the cost for retreatment, some policies limit coverage to a single procedure on a tooth in a given period of time. Check with your employer or insurance company prior to retreatment to be sure of your coverage.

What are the alternatives to retreatment?

If nonsurgical retreatment is not an option, then endodontic surgery should be considered. This surgery involves making an incision to allow access to the tip of the root. Endodontic surgery may also be recommended in conjunction with retreatment or as an alternative. Your endodontist will discuss your options and recommend appropriate treatment.

What are the alternatives to endodontic retreatment and/or endodontic surgery?

The only other alternative is extraction of the tooth. The extracted tooth must then be replaced with an implant, bridge or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting. Because these options require extensive surgery or dental procedures on adjacent healthy teeth, they can be far more costly and time consuming than retreatment and restoration of the natural tooth. No matter how effective tooth replacements are—nothing is as good as your own natural tooth. You’ve already made an investment in saving your tooth. The payoff for choosing retreatment could be a healthy, functioning natural tooth for many years to come.

Why would I need endodontic surgery?

  • Surgery can help save your tooth in a variety of situations.
  • Surgery may be used in diagnosis. If you have persistent symptoms but no problems appear on your x-ray, your tooth may have a tiny fracture or canal that could not be detected during nonsurgical treatment. In such a case, surgery allows your endodontist to examine the entire root of your tooth, find the problem, and provide treatment.
  • Sometimes calcium deposits make a canal too narrow for the instruments used in nonsurgical root canal treatment to reach the end of the root. If your tooth has this “calcification,” your endodontist may perform endodontic surgery to clean and seal the remainder of the canal.
  • Usually, a tooth that has undergone a root canal can last the rest of your life and never need further endodontic treatment. However, in a few cases, a tooth may not heal or become infected. A tooth may become painful or diseased months or even years after successful treatment. If this is true for you, surgery may help save your tooth.
  • Surgery may also be performed to treat damaged root surfaces or surrounding bone.

Although there are many surgical procedures that can be performed to save a tooth, the most common is called apicectomy or root-end resection. When inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure, your endodontist may have to perform an apicectomy.


What is an apicectomy?

In this procedure, the endodontist opens the gum tissue near the tooth to see the underlying bone and to remove any inflamed or infected tissue. The very end of the root is also removed.








A small filling may be placed in the root to seal the end of the root canal, and a few stitches or sutures are placed in the gingiva to help the tissue heal properly.










Over a period of months, the bone heals around the end of the root.



Are there other types of endodontic surgery?

Other surgeries endodontists might perform include dividing a tooth in half, repairing an injured root, or even removing one or more roots. Your endodontist will be happy to discuss the specific type of surgery your tooth requires.
In certain cases, a procedure called intentional replantation may be performed. In this procedure, a tooth is extracted, treated with an endodontic procedure while it is out of the mouth, and then replaced in its socket.
These procedures are designed to help you save your tooth.

Will the procedure hurt?

Local anaesthetics make the procedure comfortable. Of course, you may feel some discomfort or experience slight swelling while the incision heals. This is normal for any surgical procedure.
Your endodontist will recommend appropriate pain medication to alleviate your discomfort. Your endodontist will give you specific postoperative instructions to follow. If you have questions after your procedure, or if you have pain that does not respond to medication, call your endodontist.

Can I drive myself home?

Often you can, but you should ask your endodontist before your appointment so that you can make transportation arrangements if necessary.

When can I return to my normal activities?

Most patients return to work or other routine activities the next day. Your endodontist will be happy to discuss your expected recovery time with you.

How do I know the surgery will be successful?

Your dentist or endodontist is suggesting endodontic surgery because he or she believes it is the best option for saving your own natural tooth. Of course, there are no guarantees with any surgical procedure. Your endodontist will discuss your chances for success so that you can make an informed decision.

What are the alternatives to endodontic surgery?

Often, the only alternative to surgery is extraction of the tooth. The extracted tooth must then be replaced with an implant, bridge, or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting. Because these alternatives require surgery or dental procedures on adjacent healthy teeth, endodontic surgery is usually the most biologic and cost-effective option for maintaining your oral health.
No matter how effective modern artificial tooth replacements are—and they can be very effective—nothing is as good as a natural tooth. You’ve already made an investment in saving your tooth. The pay-off for choosing endodontic surgery could be a healthy, functioning natural tooth for the rest of your life.

Knocked a tooth out?

Don’t panic! Here’s what to do to help save your tooth:

Step 1: Pick the tooth up by the crown only (do not touch the root)

Step 2: Lick the tooth clean if it is dirty, or rinse it in water

Step 3: Stick the tooth back in position (adult teeth only). Never try to re-insert a baby tooth

Step 4: Bite on a handkerchief to hold it in place and go straight to the dentist

If it is not possible to put the tooth back in position, place the tooth in milk and go straight to the dentist (out of hours go to A&E). For more details see poster below:

Broken a tooth?

Tooth fragments can sometimes be stuck back into position. Find the fragment (keep it safe) and go to the dentist to see if it can be glued back into position. Don’t worry if you can’t find the fragment as a tooth-coloured filling can be used to build the tooth up.

Further information :


The following ‘Frequently Asked Questions’ are provided by the British Endodontic Society and can also be viewed at:
You can also visit the American Association of Endodontist website at:

The word ‘Endodontics’ comes from the Greek meaning ‘inside’ (endo) the ‘tooth’ (odons). Endodontic treatment, also known as root canal (treatment), is a treatment of the tooth aimed at clearing infection, as well as preventing the tooth from subsequent infection. This damage may occur for a variety of reasons, for example, dental caries (decay), trauma, or damage resulting from old fillings, crowns etc. The alternative to root canal treatment is often extraction of the tooth.

Sometimes root canal treatment is completed in one appointment but usually two or three visits may be necessary.

With proper restoration and care your tooth it may last a lifetime after root canal treatment. Proper dental care includes regular brushing and flossing, proper diet and periodic dental check-ups.

With the use of modern techniques, root canal therapy typically involves little or no discomfort. Often there is pain before treatment and endodontic therapy provides relief.

Cleaning the root canals may cause some slight tenderness but usually over-the-counter pain killers alleviate the discomfort. If pain persists or if you experience severe pain, call your dentist.

The expense of an endodontic procedure varies depending on how severe the problem is and the type of tooth. Molars with two or three canals are more difficult to treat and the fee will therefore be more. Endodontic treatment is usually more economical in the long term than any other alternative treatment.

The alternative to endodontic treatment is extraction of the tooth. Loss of a tooth could create a functional problem such as chewing or an aesthetic problem. Restoring the lost tooth may involve the provision of a prosthetic replacement such as a denture, bridge or a dental implant the costs of which are variable.

Occasionally a tooth cannot be saved. Endodontic treatment can be performed only if the root canals are accessible and can be adequately cleaned and sealed. The tooth must also have sufficient bone support. We only carry out treatment where we can give a good long term outlook.

Endodontic treatment can have success rate of up to 90% in general if carried out to a good standard allowing the tooth to remain in function. Problems can occur if the tooth develops decay or the restoration on the tooth fails, or on occasions despite good care the tooth may not heal as expected. Further endodontic treatment or surgery may be carried out if appropriate. A tooth that develops a crack can also be a cause of failure and may result in loss of the tooth.

Your tooth should be examined at an interval after treatment to make sure that it has properly healed.

If you have questions before or after your treatment, your dentist will be happy to talk to you.

Teeth that have had endodontic (root canal) treatment can last as long as natural teeth, however, in some cases the treatment can fail or symptoms can persist. This may happen shortly after the treatment has been performed or even years following the treatment. In these cases it may be possible to carry out the treatment again, a procedure called endodontic retreatment

Endodontic treatment can fail for a number of reasons: It was not possible to treat narrow or curved canals well enough or the canals were not fully cleaned during the initial procedure. The tooth may have additional complicated anatomy that was not found on the initial treatment. The final restoration was not placed quickly enough or the final restoration leaked due to a poor fit, fracture or recurrent decay around it
Retreatment is usually more complicated than initial root canal treatment as the tooth is normally fully restored with a permanent restoration. This can range from a simple restoration to a full coverage restoration such as a crown or as part of a bridge. In addition to this a post may have been placed inside the root prior to a final restoration being placed. This creates difficulty as access to the root canals is more difficult. Additionally the canals will have been filled with root filling material and hence this has to be removed before they can be instrumented and cleaned again. All of these obstructions make the process more complicated.

All dentists can carry out endodontic treatment but many prefer not to carry out retreatment procedures as this can be more challenging and may require additional equipment that may not be readily available.
Your dentist may opt to refer you to another practitioner who either has greater experience and training in the procedure or to a dedicated specialist endodontist for the procedure. A specialist endodontist is a practitioner who is registered and approved by the General Dental Council to carry out all forms of endodontic treatment. The endodontist will have more additional dental equipment that may facilitate the procedure.

The endodontist will discuss with you the treatment options for your tooth. The endodontic procedure will be explained to you as well as the costs for the treatment.
If you decide on retreatment the endodontist will gain access to the root canals of the tooth to remove the root filling and clean the canals again prior to refilling the canals. In many cases the restoration on the tooth will have to be removed, including complex restorations such as crowns and posts to allow the procedure to be carried out.
Retreated teeth can function for many years if the reasons for the initial failure can be overcome. Advances in technology have allowed retreatment to be carried out on complicate problems but like most medical and dental procedures difficulties can prevent some teeth from responding to the treatment. The endodontist can advise on the likely success of the procedure and difficulties prior to the procedure.
The cost of the retreatment is usually dependent on how complex the procedure might be but would normally cost more than the original root canal treatment.
Usually the alternatives would be removal of the tooth or endodontic surgery. Removal of the tooth would then leave a space that may or may not be acceptable functionally or aesthetically and perhaps would require a prosthetic replacement tooth in the form of a denture, bridge or implant. Endodontic surgery involves lifting the gum or gingival tissue after a small incision to allow access to the root tip that is the cause of the persistent problem. This root tip can then be treated and sealed. Endodontic surgery would allow the existing restoration to be retained, however retreating the canals is usually the first and best option. Your endodontist can advise on the particular options for your problem.


You refer by:

Secured Online form 

Email – 

Send Endodontic Referral Form to: 

Billis Endodontics, Gateway Dental, 73 Station Road, Burgess Hill, West Sussex RH15 9DY. 

Telephone or Text on 07826396852

Gateway Dental

01444 232188

Case Difficulty Assessment tool for Root Canal treatment.

This innovative software was devoloped at the QMUL and is now piloted exclusively by  Billis Endodontics for its first release.

Contact Us

Online Referral Form