Dr Aovana Timmerman, Specialist Endodontist

Role: Specialist Endodontist, Smile Solutions

Qualifications: BDSc (Melb), FRACDS, DCD (Melb), GCertClinTeach, MRACDS (Endo)

Registration: DEN0001022313 — Registered Dentist, Specialist, with Specialist Registration in Endodontics

This is a specialist registration. Only a dentist holding specialist registration in a recognised specialty may use its title under the Health Practitioner Regulation National Law. Verify free on the AHPRA public register at ahpra.gov.au. The other clinicians here holding specialist registration are listed on Dentists and Registered Specialists; the endodontic service page is Specialist Endodontists.

Background

Dr Timmerman graduated with a Bachelor of Dental Science from the University of Melbourne in 2001. After completing her fellowship with the Royal Australasian College of Dental Surgeons (RACDS) in 2010, she continued into specialist training in endodontics, obtaining a Doctorate of Clinical Dentistry in Endodontics, also from the University of Melbourne.

She has been involved in endodontic education since 2011, and was awarded a Graduate Certificate in Clinical Teaching in 2019.

She is currently a clinical demonstrator for the Doctor of Dental Surgery endodontic programme at the University of Melbourne, and examines dentists in the Membership (GDP) programme for the RACDS and the Australian Dental Council.

She has been carrying out endodontic research at the University of Melbourne since 2013, and has published in local and international peer-reviewed journals.

She is a member of the Australian Dental Association, the RACDS, and the IADT — the International Association of Dental Traumatology. With an interest in languages, she is fluent in Mandarin.

Two things in that record are worth drawing out. Examining for the ADC means assessing overseas-trained dentists seeking Australian registration — the gatekeeping function of the profession. And membership of the IADT points to dental trauma, which is the subject below, and the area where knowing what to do in the first ten minutes changes the outcome more than anything a clinician can do later.

Dental trauma: the ten minutes that decide it

A knocked-out permanent tooth is the most time-critical situation in dentistry. The cells on the root surface begin dying within minutes out of the socket, and their survival is what determines whether the tooth can be kept.

If a permanent tooth is knocked out:

Find the tooth. Hold it by the crown — never the root, which carries the cells that matter.
If dirty, rinse briefly in milk or saline. Do not scrub, and do not use water to store it if anything better is at hand — plain water damages those cells osmotically within minutes.
Replant it into the socket immediately, the right way round. Bite gently on a cloth to hold it.
If you cannot replant it, store it in milk. Milk is the best readily available medium. The person's own saliva — held inside their cheek — is second best, if they are conscious and old enough not to swallow it, and saline is next. If you have none of those, use water rather than nothing — the IADT is explicit that "although water is a poor medium, it is better than leaving the tooth to air-dry". The one real absolute is never to let the tooth dry out.
Get to a dentist immediately. See Emergency Dentistry, and What should I do when a tooth is knocked out?

A knocked-out baby tooth is never replanted — doing so can damage the permanent tooth developing above it. See a dentist anyway, the same day. See My child has a knocked out baby tooth: What do I do? and Children's Dental Emergencies.

The other trauma situations, briefly:

A tooth pushed out of position or very loose — do not force it back. It may need repositioning and splinting.
A fractured tooth — find the fragment and keep it in milk. It can often be bonded back on. See Chipped and Cracked Teeth and What should I do if I have a chipped tooth?
A tooth pushed into the socket — leave it; it needs assessment.
A suspected jaw fracture, head injury, loss of consciousness, vomiting or confusion — hospital emergency department, not a dental appointment. What is considered a dental emergency? sets out the dividing line.

And the part that is easy to miss: a tooth that was hit and looks fine still needs review. Trauma can kill the pulp weeks, months or years later, and a tooth that darkens or becomes tender long afterwards is often traced back to an old injury. Traumatised teeth need follow-up over years, not one visit. For the pain that signals it, see Tooth Pain and Ache.

Immature teeth, and why they are treated differently

This is where specialist endodontics diverges most from routine practice.

In a child, a permanent tooth erupts before its root has finished forming. The root continues developing for two to three years afterwards, and the tip stays open. If the pulp dies before that is complete, the root stops growing — leaving a short root with thin walls, which is structurally weak and prone to fracture for the rest of the person's life.

So the priority in a young traumatised tooth is keeping the pulp alive if at all possible, and where it cannot be, using techniques that either encourage continued root development or seal the open end. This is materially different from adult root canal treatment, and it is one of the clearest reasons for early specialist involvement — often alongside a specialist paediatric dentist. See also Children's Dentistry.

Which is also the strongest argument for mouthguards. A knocked-out upper front tooth at age ten commits a family to decades of replacement restorations, because an implant cannot be placed until facial growth is complete. See Sports Mouthguards, Should I wear a mouthguard while playing sports? and Should my child wear a mouthguard?

What a specialist endodontist does

All dentists are trained to perform root canal treatment, and many do so routinely and well. A specialist has completed a three-year full-time postgraduate qualification on top of a dental degree, restricted to this field, and then holds specialist registration.

Specialist referral matters most for complex canal anatomy, retreatment, difficult diagnosis, resorption, cracked teeth, and trauma. Specialist practice routinely uses operating microscopes and, selectively, CBCT imaging — selectively because CBCT carries a higher radiation dose than an ordinary dental radiograph and should be justified case by case; see How safe are dental x-rays.

The distinction is set out at greater length in Endodontist vs Dentist for Root Canal: Why It Makes a Difference, Why is the microscope so crucial in endodontic treatment by a specialist? and Why would I need to see a dental specialist?

How to judge whether root canal treatment was done well

A fair question, and there are objective markers:

Was a rubber dam used? It is a basic standard of care for root canal treatment, not an optional extra.
Were radiographs taken during and after, and were you shown them?
Was the final restoration planned and quoted from the start? A root-filled back tooth usually needs cuspal coverage, and treatment left under a temporary filling is likely to fail — because the tooth breaks, not because the root filling was poor.
Was the diagnosis explained — which tooth, and on what evidence?
Was follow-up arranged? Healing is assessed by comparing radiographs over months to years, not from a single image.

And one myth worth retiring: ‘focal infection' claims. The idea that root-filled teeth cause systemic disease and should be extracted to treat it has been examined repeatedly and is not supported by evidence. Extracting sound root-filled teeth on that basis causes harm.

Common questions

Do I need a referral to see an endodontist, and what does a referral actually do?

Ring and ask, because practices differ — but do not assume a referral is a formality you can skip. The useful thing to understand is what it carries, because that is what makes the appointment work.

A referral is a question, not a transfer. It should name the tooth, say what the referring dentist found and when, what has already been tried, and what they want answered — a diagnosis, a treatment, or an opinion on whether the tooth is worth keeping. It should arrive with the radiographs, which is the part that saves you time and, sometimes, a repeated exposure. Without it, the first appointment starts from nothing.

Your general dentist does not stop being your dentist. A specialist stage is usually one defined piece of work: the endodontic treatment happens here, the tooth then goes back for the final restoration, and the person who has watched that tooth for years keeps the overall picture. Ask explicitly who is doing which part and in what order, because a root-filled back tooth left under a temporary filling is the single most common way good endodontic work is lost.

If you have no dentist and the tooth is hurting now, that is a different situation — see Emergency Dentistry and ring 13 13 96. And if you would like a referral and have not been offered one, asking for one is entirely normal and does not offend anybody.

What do all the letters after her name mean — and which one makes her a specialist?

None of them. That is the answer patients find most surprising, and it is worth understanding because it applies everywhere.

Academic and college qualifications are awarded by universities and colleges. Specialist registration is granted by the Dental Board of Australia and appears on the AHPRA register — here, as Registered Dentist, Specialist, with Specialist Registration in Endodontics, under DEN0001022313. A degree, a fellowship, a doctorate or a professorship is evidence a board may consider; it is not the registration, and it never confers the title by itself.

Taking the letters on this page in turn, as the practice publishes them: BDSc (Melb) is the primary dental degree, from the University of Melbourne in 2001. FRACDS is fellowship of the Royal Australasian College of Dental Surgeons, completed in 2010. DCD (Melb) is the Doctorate of Clinical Dentistry in Endodontics — the specialist training programme itself. GCertClinTeach is the Graduate Certificate in Clinical Teaching awarded in 2019, a teaching qualification rather than a clinical one. MRACDS (Endo) is a membership of the same College in the endodontic stream.

What the Board requires on top of all that is worth knowing: an applicant for specialist registration must have completed a minimum of two years of general dental practice, and must meet every requirement for general registration as a dentist. Specialist registration is not a shortcut around general practice — it is built on it.

The practical rule: if you want to know whether someone is a specialist, do not read the letters. Look up the registration. It is free and it takes a minute.

Will a root canal actually work, and how long will the tooth last?

Well, on the published evidence — and the reason teeth are eventually lost is usually not the root filling.

A long-term study of primary root canal treatment followed 598 teeth in 312 patients for a mean of 21 years. It found overall success of 87.8% at tooth level (95% CI 84% to 90%) and 80.8% at patient level (95% CI 75% to 86%). Survival — the tooth still being there — was 85.5% at tooth level (95% CI 81% to 88%). Looked at cumulatively, treatment success was 93% at 10 years, 85% at 20, and 81% at both 30 and 37 years (Long-term tooth survival and success following primary root canal treatment, PMC).

Read the failure side carefully, because it changes what you should do next. Among the teeth that were eventually extracted in that study, the largest single cause was vertical root fracture — 33.3% of extractions — followed by progression of periodontal disease. In other words, root-filled teeth are mostly lost to the tooth breaking and to gum disease, not to the root canal treatment failing on its own terms.

Two things follow, and they are the whole of the practical advice. First, the final restoration is not an optional afterthought — it is the thing standing between a successful root filling and a vertical fracture, and it should be planned and quoted from the start rather than decided later. Second, the gum health around that tooth keeps mattering for the next twenty years; see Dental Cleans & Hygienists and what is periodontal disease?.

Numbers from a study population are not a prediction about your tooth. Ask what makes your case easier or harder than average — that is a question a clinician can answer specifically, and the answer is more useful than any published percentage.

Why does specialist treatment cost more, and what am I paying for?

Time, training and equipment — and it is worth being clear that none of those is a promise of a better outcome in your particular case.

The structural reasons are straightforward. Specialist training is three years of full-time postgraduate study on top of a dental degree and at least two years in general practice. Specialist endodontic practice uses an operating microscope as a matter of routine and, selectively, CBCT imaging. And the cases that get referred are, by definition, the ones that take longer: complex anatomy, retreatment of work that did not settle, difficult diagnosis, resorption, cracks and trauma.

On the numbers, the ADA's fee survey gives the only independent picture available, and it is about specialists generally rather than endodontics in particular. It found that a fifth (20%) of specialists charged an hourly rate, with the mean hourly rate rising from $662 in 2020 to $921 in 2022, and the median from $600 to $800. It also records wide variation — between $450 and $1,500 per hour in 2022. That spread is the useful part: there is no single specialist rate, which is why a written quote for your case beats any published figure. Australia has no national dental fee schedule, and a submission to the Commonwealth Parliament on dental fees puts the consequence plainly — “there are no consumer guidelines to ascertain the reasonableness of dental fees charged”.

What to ask for before you agree to anything: a written, itemised quote with item numbers covering both the endodontic treatment and the final restoration; who is doing each part; how many appointments; and what happens, and what it costs, if the tooth does not settle. Understanding your treatment sets out what a plan should contain, and the price guide publishes fee ranges. The comparison that usually matters is not specialist against general dentist — it is keeping the tooth against losing it, because an extraction is rarely the end of the spending.

Practical details

Dr Timmerman's registration and specialty can be verified free on the AHPRA public register at ahpra.gov.au. For consultation or referral, call 13 13 96.

Smile Solutions, Level 1, 220 Collins Street, Manchester Unity Building, Melbourne VIC 3000. Phone 13 13 96, or theteam@smilesolutions.com.au. Monday–Friday 8.00am–6.00pm, Saturday 8.30am–1.30pm, Sunday by appointment. Location and directions, or contact us.

This page records qualifications and career history as published by the practice. General information only; it does not replace advice from your treating practitioner. Outcomes vary between individuals, and all treatment carries risks. In a medical emergency call 000.

Smile Solutions trades under ABN 28 193 514 103.