Dr Gregory Tilley, Specialist Endodontist

Role: Specialist endodontist

Qualifications: BDSc, University of Melbourne; LDS (Victoria), 1972; FRACDS (Fellow, Royal Australasian College of Dental Surgeons); MRACDS (Endodontics)

Registration: Registered dentist with specialist registration in endodontics, DEN0001386081

Specialist registration can be verified on the AHPRA register of practitioners at ahpra.gov.au. Endodontics is one of the thirteen dental specialties recognised by the Dental Board of Australia, and the title “endodontist” is protected. The specialty page is Specialist Endodontists; the other specialists here are listed on Dentists and Registered Specialists and under Specialist Care.

What ‘specialist registration' means, in the Board's own words

The Dental Board of Australia states that “there are 13 dental specialties in Australia which are approved by the Australian Health Workforce Ministerial Council”. Endodontics is one of them. The list is closed: a description that is not on it — however impressive — is not a specialty.

The specialist qualification alone is not enough. The Board's specialist registration standard requires an applicant to have “completed a minimum of two years general dental practice” — which “may be achieved by experience outside Australia, subject to assessment and approval by the Board” — and to have “met all other requirements for general registration as a dentist”. The Board adds that “all dentists who wish to apply for specialist registration must have general registration and be on the Register of practitioners under the division of dentists”. A specialist is therefore a registered dentist with a specialty recorded against the registration, not a separate kind of practitioner.

And you can check it yourself, for nothing. Ahpra “publishes an online register of all dental practitioners that provides the profession and the public with up-to-date information about a dental practitioner's registration status”, and that register “also includes details of the specialty or specialties for dentists who hold specialist registration”. Search the name at ahpra.gov.au and read the profession and specialty fields. That record, not this page, is the authority.

(Source for this section: Dental Board of Australia, Specialist Registration and FAQ: Specialist registration — dentalboard.gov.au.)

Background

Dr Gregory Tilley trained in Melbourne, taking his Bachelor of Dental Science at the University of Melbourne followed by his Licentiate of Dental Surgery (Victoria) in 1972. He is a Fellow of the Royal Australasian College of Dental Surgeons and holds the College's Membership in Endodontics.

He practised as a general dentist until 1979, and has practised as a specialist endodontist in Tasmania and Victoria since then — more than four decades in the field. His current work concentrates on the management of complex cases — see Complex Dentistry.

As an honorary Senior Fellow in the Faculty of Medicine, Dentistry and Health Sciences at the University of Melbourne, he has supervised and mentored endodontic specialists in training for over twenty years.

He has lectured in every Australian state and overseas, and has chaired sessions and presented at international conferences in the United States and across Asia. He consults on an international committee concerned with the development of endodontic instruments and materials, and has run introductory and advanced hands-on workshops for dentists moving from hand instrumentation to rotary endodontic techniques. On the instruments themselves, see The risk of broken files during root canal treatment and Our Technology.

He is a past president of the Australian Dental Association (Victorian branch), and a member of the American Association of Endodontists, the Australian Society of Endodontology and the Australian & New Zealand Academy of Endodontists.

What an endodontist is

An endodontist is a dental specialist in the tissue inside the tooth — the dental pulp — and the tissues immediately around the root tip. In practice that means root canal treatment and everything adjacent to it. See Endodontist vs Dentist for Root Canal: Why It Makes a Difference and Why would I need to see a dental specialist?

The specialist pathway is:

1. A dental degree.
2. General practice experience — the Board's standard requires a minimum of two years.
3. Three years of full-time postgraduate specialist training in endodontics.
4. Application to the Dental Board of Australia for specialist registration.

The scope covers:

• Root canal treatment, including anatomically difficult and calcified canals. See Everything you need to know about root canal treatment and Root canal treatment: who and what is involved?
• Retreatment of root canals that have failed
• Surgical endodontics — apicoectomy (root-end surgery) where a conventional approach cannot resolve the problem. Magnification is central to this: Why is the microscope so crucial in endodontic treatment by a specialist?
• Diagnosis of dental pain, including pain that has proved difficult to localise. See What are the causes of toothache and what are their symptoms? and I have a toothache, what could be the cause?
• Management of dental trauma — knocked-out, displaced and fractured teeth. See Emergency Dentistry
• Internal bleaching of discoloured root-filled teeth — related to, but not the same as, teeth whitening; see I want to whiten my teeth but one of my front teeth has a porcelain crown. What are my options?
• Assessment of cracked teeth and decisions about whether a tooth can be saved. See Why does a cracked tooth hurt so much? and How will my cracked tooth be treated?

Where infection has already spread beyond the root, see What is a tooth abscess? Should I have it treated? If so, how? and Can a dental abscess affect your general health?

What the scope does not include

An endodontist does not place implants, do orthodontics, treat gum disease surgically, or perform jaw surgery. An endodontist will usually not place the final crown either — the root canal is completed and the patient returns to their general dentist or a prosthodontist for the restoration. A root-filled back tooth generally needs a cusp-covering restoration, and leaving it in a temporary filling is a common cause of later fracture. See Dental Crowns and What do I do if a temporary filling comes out?

Root canal treatment: what it actually is

A root canal treatment removes infected or irreversibly inflamed pulp tissue from inside the tooth, disinfects and shapes the canal system, and fills it to prevent reinfection. It is done to keep a tooth that would otherwise have to be extracted.

What is true about it:

• It is performed under local anaesthetic and is usually comfortable. The reputation of root canal treatment for pain is largely inherited from the condition that leads to it — an acutely inflamed or abscessed tooth hurts a great deal before treatment, and treatment is what relieves that. See Dental Phobia: How do you give a virtually pain-free injection? and, if the prospect is the obstacle, Dental Anxiety.
• It often takes more than one visit, particularly where there is infection.
• Success rates are high but not universal. Published outcome studies commonly report success in the region of 85–95% for initial treatment, lower for retreatment, and lower again where there is an existing lesion at the root tip. Individual outcomes depend on the anatomy of the tooth, the extent of infection, and how well the tooth is restored afterwards.
• A treated tooth can still fail — through reinfection, a missed canal, root fracture, or new decay under the restoration.

What the published long-term data show

It is worth being specific, because ‘high success rates' is the kind of phrase that can mean anything. A long-term retrospective study of 598 endodontically treated teeth in 312 patients, published in PMC, reported that “the overall success rates of ETT were 87.8% (95% CI: 84 to 90%) and 80.8% (95% CI: 75 to 86%) at the tooth and patient levels, respectively”.

Those are two different questions and the gap between them matters. The tooth-level figure answers ‘did this tooth do well'. The patient-level figure answers ‘did everything done for this person do well', and it is always the lower number, because a patient with several treated teeth only has to have one problem to fall out of the success column.

On survival — the tooth still being in the mouth and functioning, whether or not it is textbook-perfect on a radiograph — the same study found that “at 10 and 20 years post treatment, the probability of survival for an ETT was 97% and 81%, respectively”.

What made the difference, in that data set, is the genuinely useful part, and most of it is not about the root canal at all:

• A pre-operative lesion at the root tip roughly doubled the odds of the tooth eventually being extracted (OR 1.87; 95% CI 1.07–3.28) — which is the argument for not waiting until a tooth is abscessed.
• A cast metal post was associated with higher odds of extraction (OR 2.14; 95% CI 1.14–4.01), while a fibre post was protective (OR 0.47; 95% CI 0.24–0.91). How the tooth is rebuilt is part of the endodontic prognosis, not a separate matter.
• Healthy gums around the tooth (probing depths of 5 mm or less) were protective (OR 0.68; 95% CI 0.54–0.86) — see What Is Gum Disease? and Dental Cleans and Hygienists.
• Wearing a night guard was protective (OR 0.34; 95% CI 0.13–0.86), which is consistent with grinding forces being a real threat to a root-filled tooth. See TMD and Teeth Grinding and What kind of mouth guard should I use?

(Source: PMC, Long-term tooth survival and success following primary root canal treatment.) These are figures from one cohort, not a promise: no study predicts an individual tooth, and the sensible use of them is to ask what your own prognostic factors are before treatment starts.

The realistic alternative to root canal treatment is extraction, followed by a decision about whether and how to replace the tooth (implant, bridge, denture, or leaving the space) — see What are the replacement options for missing teeth? and Bridges, implants, or dentures for replacing missing teeth? A dentist who presents both options with their costs and consequences is giving proper advice; keeping a natural tooth is usually preferable where it is restorable, but not in every case. See Understanding Your Treatment and, if you want another view, Second Opinions and Corrective Dentistry.

Dental trauma

A knocked-out permanent tooth is a genuine emergency. Handle it by the crown, not the root; if it is dirty, rinse it briefly in milk or saline, not water or disinfectant; and if possible reinsert it into the socket immediately. If reinsertion is not possible, keep it in milk or in the person's own saliva and get to a dentist urgently. The prognosis falls sharply with time out of the socket, and dry storage is the worst case. Do not attempt to reimplant a baby tooth.

See What should I do when a tooth is knocked out?, My child has a knocked out baby tooth: What do I do?, Children's Dental Emergencies and What is considered a dental emergency? The best prevention is a properly made mouthguard: Sports Mouthguards. The Australian Dental Association's position is that “the most effective protection against oral damage is a custom fitted mouthguard, where precision fit and quality materials offer maximum comfort & injury prevention”, while over-the-counter guards “provide better protection than no mouthguard” (ADA, mouthguards policy).

Registration

The Dental Board of Australia registers dentists, dental specialists, dental hygienists, dental therapists, oral health therapists and dental prosthetists. Specialist registration is a distinct category and appears on the public register alongside the specialty held.

Registration is renewed annually, subject to standards covering recency of practice, continuing professional development, professional indemnity insurance, criminal history and English language skills. Conditions, undertakings and reprimands appear on the register.

Each standard has a published date of effect: Scope of practice, 1 July 2020 — which “requires dental practitioners to practise within the scope of their education, training, and competence at all times”; Continuing professional development, 1 December 2015; Recency of practice, 1 December 2015; Professional indemnity insurance arrangements, 1 July 2016; English language skills, 18 March 2025; Criminal history, 15 July 2026; and the Specialist registration standard, 1 July 2010, with the current list of recognised specialties, related specialist titles and definitions in effect from 1 October 2017. (Source: Dental Board of Australia, Registration standards — dentalboard.gov.au.)

Common questions

My toothache stopped on its own. Does that mean it has got better?

Not necessarily, and this is the single most important thing on this page.

The Australian Journal of General Practice describes the sequence plainly: decay reaches the pulp, “pulpitis results in pain that is poorly localised”, and then — “when pulp necrosis finally occurs, there is no pain”. The nerve has died. The pain stops because there is nothing left to hurt, not because anything has healed. The same paper notes that when an acute abscess later develops, “a severe well-localised pain develops”, and that “by this time, all patients have had intermittent episodes of pain as a warning that something is wrong”.

The practical consequences:

• A tooth that hurt badly and then went quiet should be examined, not celebrated. It is often the best moment to treat it — at that stage the same source says the abscess “is easily treated by extraction or root filling”.
• Antibiotics alone do not fix it. The same paper states it without hedging: “antibiotic treatment without dental treatment to remove the cause always fails”, and “if treated with antibiotics alone, the infection will not resolve and will become progressively worse”. Antibiotics are a medical decision for a medical or dental practitioner; the point here is only that they are not a substitute for treating the tooth.
• Some signs mean now, not next week. Swelling spreading under the jaw or into the neck, difficulty opening the mouth, difficulty swallowing or breathing, or feeling generally unwell with a fever are signs that infection is spreading along the tissue spaces of the neck. That is a hospital emergency, not a dental appointment.

(Source: Bayetto, Cheng & Goss, “Dental abscess: A potential cause of death and morbidity”, Australian Journal of General Practice, September 2020.) See Emergency Dentistry and What is considered a dental emergency?

Do I need my own dentist to refer me, and how quickly can I be seen?

You do not need a referral. Dental care in Australia is not inside the Medicare referral system that governs medical specialist appointments, so you can make the appointment yourself — and if you are in pain, do that rather than waiting for paperwork.

A referral still carries real value when there is time for one, because of its contents rather than any permission it confers. A useful referral names the tooth, states the specific question (“can this be retreated or should it be extracted?” rather than “please assess”), and travels with the radiographs already taken.

Ask that the images be sent. That is not tidiness: the radiology literature holds that “strict and individualized justification should determine the prescription of each radiograph”, and that a justified radiograph “should make a substantial contribution to distinguishing between treatment options”. Repeating an image that already exists and still answers the question does not meet that test — though a different view, or a newer one where the situation has changed, often does, and you are entitled to ask which applies. For scale, the International Atomic Energy Agency gives typical effective doses of 1–8 μSv for an intraoral radiograph and 4–30 μSv for a panoramic examination, noting that intraoral doses are “usually less than one day of natural background radiation”. See How safe are dental x-rays.

Is a specialist worth the extra cost for a root canal?

Here is what we can tell you, and here is what we cannot.

What we cannot tell you is the comparison you actually want. Whether a specialist achieves a better outcome than a general dentist on the same tooth is not a question the independent sources available to us answer. Figures comparing the two circulate widely and we have not been able to source them to any regulator, professional body or systematic review, so they are not repeated here. If you see such a comparison quoted anywhere, ask where it comes from.

What we can tell you is the fee picture. The Australian Dental Association's Dental Fees Survey 2022 found that “a fifth (20%) of specialists charged an hourly rate, and the mean hourly rate has increased significantly, from $662 in 2020, to $921 in 2022”, with a median of “$800 from $600 in 2020” and “wide variation in hourly rates in 2022, ranging between $450 and $1,500 per hour”. Those figures rest on 284 self-identified specialists, and the ADA itself says “survey results for specialists should be interpreted with considerable caution”. (Source: ADA.)

What is reasonable to say without any comparison at all is that specialist practice is narrower. An endodontist does this work and little else, sees the difficult and the failed cases, and has the equipment and time allocation built around them. That is the argument, and it is an argument about case selection and volume rather than a claim about anyone's results.

The sensible way to use it is by case: a straightforward front tooth is routine general dentistry; a calcified canal, a retreatment, a tooth that has already failed once, or pain nobody has been able to localise are the situations where the referral usually earns its fee. Ask what makes your tooth one or the other. See the Price Guide and Understanding Your Treatment.

How do I know a practitioner's training is still current?

Through the registration standards rather than through the biography, and it is worth knowing what those do and do not guarantee.

Every registered dental practitioner in Australia renews annually and must meet the Board's Continuing professional development registration standard (in effect 1 December 2015) and its Recency of practice registration standard (also 1 December 2015) — the latter being the separate requirement to have practised recently enough to remain competent. Practitioners must also hold professional indemnity insurance under the standard in effect from 1 July 2016. None of these is optional: they are conditions of remaining on the register, not achievements.

What the register will not show you is the detail. It does not publish how many CPD hours a practitioner completed, what courses they were, how many procedures of any kind they perform, or any outcome or patient-experience measure. No Australian body publishes that data for individual dental practitioners, so there is nothing to look up and no ranking to consult. What the register does show — current registration, specialty held, and any conditions, undertakings or reprimands — is checked in a minute at ahpra.gov.au and is still the most useful minute you can spend.

Practical details

Dr Tilley's specialist registration can be verified on the AHPRA public register. Endodontic treatment is usually accessed by referral from a general dentist, though a direct appointment can be made. See Contact Us. The full clinical team is on Our Team.

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.

This page records qualifications and career history as published by the practice. General information only — it is not a diagnosis, a treatment plan or a promise of any particular clinical outcome. Practitioner availability changes; confirm when booking.

Smile Solutions trades under ABN 28 193 514 103.