Profile
Professor Shanon Patel
MSc, MClinDent, MRD, PhD, FDS, FHEA
Making teeth great again
Shanon practices at Dawood & Tanner, a well established multi-disciplinary dental practice in central London. Patients are referred to him at the practice for treatment focused on saving teeth.
He is also a Consultant at Guy’s & St Thomas’ Hospital NHS trust and teaches at King’s College London (KCL)-the largest dental school in Europe. He has published over 100 papers in peer reviewed journals. The impact of his research and clinical excellence has resulted in Shanon being invited as a keynote speaker at over 120 international meetings spanning 5 continents.
Shanon has been saving and making teeth great again by carrying out root canal treatment for over 20 years.
Shanon is recognised internationally for his high impact research on root resorption, treatment outcomes and 3D Cone Beam Computed Tomography (CBCT) imaging. This is reflected in him being lead author of 4 European Society of Endodontology position statements (CBCT 2014, 2019 & External Cervical Resorption 2018, Root Resorption 2023) which are used by dentists in Europe and beyond for guidance on the managing complex root canal problems.
If you have not fallen asleep yet, then please do scroll down....
Treatments
Shanon carries out all aspects of root canal (Endodontic) treatment using the latest materials and techniques, including, when appropriate laser activated disinfection. A CBCT scan is taken prior to embarking on any treatment-this is done in-house, thus expediting treatment.
He works closely with referring dentists, and in more complex cases (multiple dental problems), he teams up with specialists/consultants in Periodontics, Orthodontics, Prosthodontics, ENT, Oral & Maxillofacial surgery and/or Paediatric dentistry to ensure that patients get the best outcome in the minimum number of appointments.
Read on to see the types of treatments Shanon been regularly carrying out for over 20 years........
Managing dental trauma
Research shows that 25% and 33% of children and adults, respectively, have experienced dental trauma. Shanon is well versed in managing both children and adults who have sustained dental trauma, including patients who have already been treated elsewhere.
Working alongside in-house dental specialists means that when appropriate, an efficient, multi-disciplinary approach to treatment can be adopted; for example, gently repositioning displaced teeth with orthodontic treatment or determining when to replace a tooth with a dental implant. This approach will will also minimise the number of appointments required.
Root Canal Treatment
The aim of root canal (endodontic) treatment, regardless of the nature of treatment is to keep/maintain teeth healthy and functional. Your own natural tooth is the best dental implant!
The objective of root canal treatment is to remove the inflamed and/or infected nerve tissue from within the root(s) of the tooth, and then disinfect and sealing the root canal(s), thus returning the tooth back to health again.
In some instances, where a tooth has already been root treated then re-root canal treatment may indicated. This entails carefully removing the filling or crown, and the retrieving the existing root canal fillings to allow the entire root canal system to be adequately disinfected and sealed.
Root canal treatment takes place in two phases; initially the tooth is stripped down, the root canals are located, disinfected using bleach and shaped with very flexible files after which the disinfected root canals are then sealed with a root filling material after which the top part of the tooth is restored with a permanent tooth coloured bonded filling.
Periapical Microsurgery
The aim of periapical microsurgery is to return your tooth to health and functional.
In some cases, the gum overlying the tip of the infected root is reflected back to allow the tip of the root to be assessed and removed, after which a bioceramic filling will be placed in the remaining exposed root. The gum is then secured in place with a few tiny stitches which are removed 4-5 days later. Treatment is carried out under local anaesthetic, and in certain cases supplemented with intravenous sedation.
There is a good body of clinical research that confirms that this treatment option when carried out by endodontists has a very high success (95%) rate.
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Patient testimonial
Being a dentist myself, I can say with confidence that Shanon is the best that you can get. I suffered trauma to my front teeth which left me needing a root treatment, all my colleagues recommended Shanon. I now understand why…..he treated me with such patience, confidence and kindness-I trust him completely. Thank you so much for helping me and for being so detailed and thorough in your explanations.
~Dr. E
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Mother's testimonial
Our 10 year old daughter knocked out her two front teeth after a fall on a wooden floor. Thankfully Professor Patel skilfully saved the teeth - avoiding root canal in the process. The teeth were then expertly rebuilt identical to the originals. Our daughter now has her teeth and confidence restored.
~Ms. F
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10 year old patient's testimonial
Professor Patel helped me get back my confidence when it was knocked👍🏼👏🏼
~Daughter of Ms. F
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Referring dentist testimonial
I’ve been referring my patients to Shanon 15 years now. Why? There’s all the obvious things. Yes, he’s got an amazing reputation among his peers. Yes, I know my patients will receive the best treatment. But, above all he is very experienced, caring and thoughtful.
~Dr. Kassardjian, Specialist Prosthodontist, Pond Square Dental Practice, Highgate, London.
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Patient testimonial
I was really dreading the treatment, but it didn’t take long to realise that I was in good hands. It was evident to me that Professor Patel holds himself to a very high standard, he and Naomi work together as a very efficient and professional team. They prioritised my comfort throughout the process and offered generous explanation whenever I had questions
~Mr. O
Clinical research
Shanon has been involved in some of the most cutting-edge clinical research in his specialty; predominantly focusing on 3D CBCT technology, improving treatment outcomes and the management of root resorption.
Shanon has carried out novel research which has been shown to improve the diagnosis and management of root canal (endodontic) problems.
As well as carrying out his own research, he has supervised over 70 Masters and PhD students at KCL. He has also been invited to supervise Masters and PhD research at several leading academic units in Europe and the USA.
The impact of Shanon’s clinical research in his specialty has led to 3 of his papers being amongst the 50 most cited papers (from over 9500 published) in the last 60 years in the International Endodontic Journal.
Education
Shanon has been privileged to teach in the Endodontic postgraduate unit at KCL since 2002 where he is involved in the training of next generation of specialists in Endodontics and Restorative dentistry. In recognition of his contribution to education and the impact of his clinical research Shanon is also an Honorary Professor at KCL.
Shanon has co-authored 4 textbooks which have been translated into 5 languages.
In collaboration with the British Dental Association, Shanon together with Dr Simon Harvey (Consultant Maxillofacial Radiologist) runs the hugely successful CBCT masterclass-now in its seventh year.
Upcoming Lectures
2022
British Dental Association CBCT masterclass, 7th Jan 2022, London, UK.
American Association of Endodontics, 27-30 April 2022, Arizona, USA.
European Society of Endodontology, 7-10 Sept 2022, Budapest, HUNGARY.
14th Encontro Internacional, 29-30 Sept 2022, São Paulo, BRAZIL.
International Federation of Endodontic Association, 7-12 Nov 2020, Santiago, CHILE.
Portuguese Dental Association, 17-19 Nov, Lisbon, PORTUGAL
Congreso Nacional de Endodoncia, 24-26 Nov 2022, Lima, PERU.
2023
Malaysian International Dental Exhibition & Conference, 4-6 August, Kuala Lumpa, MALAYASIA.
European Society of Endodontology, 6-9 Sept 2023, Helsinki, Finland.
Czech Endodontic Society, 15-16 September, Prague, CZECH REPUBLIC.
Société de Médecine Dentaire, 12-14 October, Brussels, BELGIUM.
Gemeinschaftstagung Zahnerhaltung, 23-25 November, Munich, GERMANY.
Swiss Society of Endodontology, 19-20 January, Lusanne, SWITZERLAND.
Panhellenic Endodontics Symposium, 24-25 February, Thessaloniki, GREECE.
Danish Dental Association, 12-13 April, Copenhagen, DENMARK.
Fees
| Consultation | £140 (excluding X rays & 3D scans) |
| Dental X rays | £35 each |
| 3D cone beam CT scan | £160 |
| Root canal treatment (incisor/canine) | from £1,530* |
| Root canal treatment (molar) | from £1,670* |
| Re-root canal treatment (any tooth) | from £1,850* |
| Periapical microsurgery | £1,545-£2,150 |
| Review (follow up) | £95 (excluding X rays & 3D scans) |
*A permanent bonded foundation (filling) to seal and restore the integrity of the top part of the tooth will be placed immediately after root canal treatment has been completed (unless your dentist as specifically has requested a provisional restoration), the fee for this is included in the above fees. This foundation/filling will be definitive, and when indicated will be used as a foundation to support a subsequent onlay/crown-this will reduce the number of visits and/or expedite any further treatment required with your dentist.
In more complex cases the root canal treatment fee may be higher (for example removing existing broken instruments or repair existing perforations)- you will be quoted prior to commencing treatment if this is the case.
If a post (£450-£650) and/or a provisional plastic crown (£450-£700) is required then there will be an additional fee. All fees will be confirmed before commencement of treatment.
Your treatment
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How do I know if I need root canal treatment?
You may have, or have had a throbbing pain and/or lingering sensitivity to hot and/or cold, discomfort when chewing or even a swelling around the tooth. You may experienced unbelievably severe pain.
However, in some cases a tooth may not have any obvious symptoms, i.e, you may not be aware of any issues. In these cases, it is typically your dentist who detects that you have a (potential) root canal infection. -
What causes teeth to require root canal treatment?
Usually dental decay, hairline cracks, leaking fillings or dental trauma may result in a tooth needing a root canal treatment.
Patient often ask why they need a root canal treatment when they are so diligent with there tooth brushing and flossing, as well as seeing the hygienist on a very frequent basis. The reason is that we use our teeth everyday of the week, so in a lot of cases it is simply down to everyday wear and tear which has probably been exacerbated by intermittent tooth grinding - so teeth require maintenance!
If you are in you are in your mid-40s, and your molar tooth needs a root canal treatment - it means that after nearly 40 years of regular use your tooth requires some TLC to keep in going.
Sometimes existing root canal treatments have a persistent and/or new infection resulting in pain and/or an abscess. In these cases a revision of the existing treatment, i.e. re-root canal treatment may be indicated.
You will be assessed, and a low dose, high resolution Cone Beam CT (3D) scan taken, after which a diagnosis and potential treatment options will be discussed.
The majority of treatments are carried out efficiently in one visit of 90 minutes or less duration-this is down to good team work between my fantastic assistant, Naomi and I, as well as the fact that I have over 20 years’ experience in managing a endodontic problems.
Occasionally, further appointments may be required, this typically when the first appointment was an unscheduled emergency visit and/or the tooth is very infected.
Treatment is carried out with local anaesthetic, and the tooth is then isolated with a non-latex sheet, (dental dam) to prevent contamination of the tooth with saliva (which contains bacteria), and also to make you comfortable-it is not uncommon for patients to fall asleep during the course of treatment (partly due to my boring chit chat). -
How successful is treatment?
The reported survival rate for a (re-) root treated is over 94%, i.e. the failure rate is less than 6% over 4 years-these figures are based on recent research that I has been involved in at KCL.
The longevity of root treated teeth is similar, and in some cases better than dental implants. The number of appointments required to root treat and restore a tooth with a crown, from starting to finishing all the treatment are far fewer than for dental implant placement and crown placement. Also, the cost of the root canal treatment option is lower than the dental implant option.
However, as with any medical procedure, success can never be guaranteed no matter how straightforward the treatment is to perform. This is because healing is ultimately dependent on the response of the individual patient to the treatment carried out.
In over 25 years of treating patients I do on occasion see patients where my treatment has failed years, or even decades later. In my experience this is usually due to an undetected, existing or a new microscopic crack which has developed in the tooth usually due to everyday wear and tear, which can be exacerbated due to subconscious tooth grinding during the day and/or night. -
Is every tooth treatable?
In some instances, treatment may not be viable, typically, if the tooth has a significant crack and/or insufficient sound remaining tooth structure to retain a filling or crown. If the tooth has already had a previous root canal treatment, revision of this treatment is may not be possible. -
Why do I need a 3D (cone beam CT) scan?
Regular digital dental X rays provide a 2 dimensional image of the tooth and the surrounding bone. Therefore the complex anatomy of the tooth, supporting tissues and jaw bone cannot be truly appreciated-this can have an impact on the management of dental problems.
Cone Beam CT (CBCT) scans provide 3 dimensional images of teeth and the surrounding bone. The radiation dose from the CBCT scanner I use is in the same order of magnitude as a couple of routine dental X rays (about 3 or 4 days background radiation). To put this in perspective, it's important to understand that we are ALL exposed to 'background radiation' from naturally occurring radioactive particles in soil, water and atmosphere (cosmic).
There is compelling evidence confirming that 3D CBCT scans improves the accuracy of diagnosis and treatment of root canal problems. So for me it's a no-brainer, I need to take a CBCT scan to carry out root canal treatment efficiently, confidentially and predictably. -
What are the alternatives to root canal treatment?
You could have the tooth extracted, if you missed the tooth you could have it replaced with an implant retained crown, a fixed bridge or a removable denture. You really need to discuss these options with your dentist before you have the tooth extracted.
I will only consider root treating your tooth if I really do think that it has a good prognosis, I am not going to do just ‘do it’ because I can do it!
If, during the course of treatment is deemed not to be feasible then most patients opt to have the tooth extracted-where appropriate this can be done at the same appointment (while the tooth is still numb), this saving the patient a second appointment.
There is a common misconception that root canal treatment in some way is an inferior or less predictable treatment option compare to dental implants. This simply is not true. The longevity of both treatment options is similar when carried out by experience dentists. So why extract a perfectly good tooth and place an artificial titanium screw in your jaw? Teeth are the best, most biocompatible and elegant dental implants....so if at all possible one should retain them for as long as possible.
If the tooth cannot be saved then dental implants are usually the best treatment option....but it's important to remember that they are not immune from failing. -
Will the treatment hurt?
No! The treatment is usually painless-you will listen to some good music, and/or my extensive repertoire of hilarious jokes.
However, as with most dental procedures it is not uncommon to have a degree of discomfort and possibly swelling for 1-2 weeks after treatment has been completed. This pain is usually resolved with over the counter pain medication. -
Why can’t I just take a course of antibiotics?
Antibiotics do not eliminate the source of inflammation and/or infection within the tooth. The only way to predictably eliminate infection is to carry out root canal treatment or extracting tooth. Repeated doses may ultimately result in a resistance to antibiotics. -
Who performs root canal treatment?
All dentists receive basic training in root canal treatment in dental school. General dentists perform most aspects of dental treatment including root canal treatment. Specialist Endodontists spend a further 3 years in postgraduate education, specialising in root canal treatment. This allows them to manage all types of (complex) root canal problems efficiently.
There is also evidence that the success rates of treatment are higher when carried out by an endodontist, compared to a general dentist. -
Your tooth’s life after root canal treatment
Once I have root treated the tooth it will be permanently sealed with a plastic tooth coloured filling - in some cases, no further treatment is required.
Back (premolar/molar) teeth may require onlays or crowns-these are like lids that cover the biting of the tooth to reduce the likelihood of the tooth fracturing when it is being used, remember, the back teeth do most of the (chewing) work. You will be advised you if this needs to be done after assessing your tooth. This aspect of treatment is relatively straightforward and can be carried out by the dentist who referred you to me.
The tooth in question should be checked (reviewed) after 12 months, perhaps at the same time as a routine check-up with your regular dentist. In some (complex) cases, I may ask you to come back for a review. -
What can affect the likelihood of success?
There is evidence that if you smoke, have existing untreated gum disease or are immunocompromised, for example, you are diabetic then the success rate is reduced slightly. However, the same is true for implant treatment. Therefore, try and get as much mileage from your tooth as possible!
If you clench your teeth together and/or do not get the tooth restored with an only/crown when advised to then you are also more likely to crack the tooth resulting in an extraction.
