Endodontists are dentists who have at least two additional years of advanced specialty training and education in the diagnosis and treatment of difficult dental cases. We specialize in treating the inside of the teeth, with the focus on the pulp and surrounding tissues. My work involves diagnosing patients who are experiencing oral pain or who have sustained an injury to their teeth – a root fracture, chipped tooth, cracked or broken tooth (or multiple teeth) as a result of an accident or some other traumatic event. I also treat abscess or infection, and do root canals, as well as other surgical and non-surgical procedures and repair work. It’s my job to do everything possible to restore a patient’s teeth to a state of health and full functionality.
In essence, I find the cause of my patient’s concern, make a diagnosis, develop a treatment plan by carefully considering the available options, and implement that plan with the best possible treatments in order to solve the problem. Here at Visage, we have advanced technology – such as operating microscopes, digital imaging, and ultrasonics – that enables me to see what’s going on and fix the problem. I’m also focused on preventing disease or breakdown of the teeth over time by educating my patients about what they need to do to secure and maintain healthy, stable teeth.
Many people spend years struggling with dental trauma, infections of their gums, or pain caused by inflamed tissue that has caused damage to a nerve. Endodontists treat what’s inside the tooth, and it’s gratifying to diagnose a problem and to correct it. In consultation with new patients who will clearly benefit from endodontic care, I share with them the evidence-based science behind what I offer. I want them to understand the best that they can be given, and to give them hope that their problems can be corrected.
My experience enables me to offer my patients the best available treatment options and to teach them what they need to do in order to maintain the health of their teeth once their treatment is completed. Many of my patients come to me believing that they’ll never have healthy teeth, but they learn that there are solutions to their problems and they are so happy when they decide to move forward and attain a pain-free, healthier life. It’s necessary because it’s a significant aspect of self-care that we should be aware of throughout our lives.
We stay ahead because we practice what we preach. I think we give the highest quality of care because we’re committed to our patients, committed to our own growth as knowledgeable doctors, and we’re here to make lives better. Many say this, but it’s easy to forget that each patient is a real person with a real concern. If we don’t make that concern our top priority, we can never be more than adequate doctors. Dr. Quereshy and I know that this is our priority: we’re fully engaged and interested in what we do here and our patients feel the excitement. We always give our best and put a lot of thoughtful effort into treatment planning for every patient.
My philosophy corresponds to my ethical stance and is reflected in the way I work – centered on the needs of my patients – on providing them with all of the information they need and options they have in order to make decisions they feel good about. I don’t believe in selling a procedure or service to my patients. We have a multi-focus practice and all of the tools we need at our disposal so that our patients have choices.
It comes down to this: saving your natural tooth is always the first choice because nothing – not even implants or bridges – can truly replace your natural teeth. A dentist may recommend tooth extraction, but it’s in your best interest to seek consultation with an endodontist to see if that tooth can be saved with a root canal or other treatment before losing it. A lost tooth causes shifts in the other teeth and compromises the integrity of the mouth.
Let me explain. When I restore a tooth, it works just like the other healthy teeth in your mouth and the restoration lasts for the rest of your life. It means you can chew properly and it means your mouth looks the way it’s meant to look naturally. Even when a tooth has been severely injured, as an endodontist, I can often save it. We should do everything we can to save our teeth, because it definitely affects our quality of life.
People who avoid going to the dentist or to an endodontic specialist, even when they are in distress, have their reasons. I don’t want to lecture them for delaying: I want to know what those reasons are so that I can intervene, give them the support and information they need, and solve their problem. We specialize in pain-free care and the more I know, the more effectively I can plan to take care of the problem without causing physical or emotional trauma.
First of all, I pursue it openly. I take time to ask a fearful patient, “What are you afraid of?” I really want to know, so I can help them understand what they will experience. I know they’re not going to have pain, but they don’t know this and many have had a difficult time in the dentist office at some point in the near or distant past, so naturally they are apprehensive.
I find out that some of these patients are claustrophobic and concerned about being in a small space with a dentist hovering. Others dislike the noises of the dental equipment. And some individuals have an actual phobia about the dentist’s office and will do anything – including allowing their mouths to deteriorate – rather than face the fact that they need to have work done. Many of these patients are well aware that they could probably save their teeth and improve the quality of their daily lives, but they wait because they’re frightened.
I am able to help fearful patients get comfortable and make the adjustments necessary to calm them down. Patients have their own individual ways of feeling more comfortable and accepting of the care I provide for them. Some want to know exactly what’s going on – moment by moment – and are soothed by information. For these patients, I provide continual feedback about what I’m doing and what will happen next. Others don’t want to know the details – they simply want to be as distracted as possible from the experience of being in the dental chair. They may want to have the TV screen on so they can watch something of interest to them during their procedure or choose to listen to music. Others may request sedation dentistry, which is appropriate in some situations.
Simply put, I don’t think patients should have pain in the dentist chair…and all patients who come to see me want to know if they’re going to experience pain during their visit. I know how to prevent pain and that’s always my objective. I give my patients a way to feel calm and secure in a situation they think of as threatening. They need gentle, comfortable care in a peaceful setting. They need to be soothed and to know that their emotional state matters to me. I am clear about conveying this. Many people think that I must hate what I do, because so many people will do anything to avoid coming into a dentist’s office. But I am able to show my patients that they don’t have to be afraid.
The irony here is that many of these patients have been enduring pain for years, with teeth and the surrounding tissue in dire need of restoration. As an endodontist, the dentistry I practice revolves around a quality of life issue. Why? Because losing a tooth detracts from the quality of life. Having nerve pain when you bite into a sandwich or eat a spoonful of ice cream detracts from the pleasure of the experience. Having healthy teeth impacts the way we eat (and what we can eat), how we speak, and of course, how we look. My patients find out that they can have a healthy mouth again without suffering, and it’s a wonderful thing to be able to give this to them.
Running a practice requires careful planning and ours is well designed and highly organized. Dr. Quereshy has his own departments – cosmetic surgery and oral & maxillofacial surgery – and within those departments, highly trained staff that assist and care for his patients. I oversee the department of endodontics, working with staff members who do the same for our endodontic patients. I also oversee the business end of the practice, run staff meetings, and conduct ongoing training sessions for our staff.
We have chosen well, by selecting people to work with us who care about patients the way we do. They’re highly competent and enthusiastic, and it’s obvious to us that having a positive attitude impacts both staff and patients and creates a better work environment. We enjoy mentoring and overseeing the growth of our team members and fostering their careers. I don’t see any staff position as “just a job.” They’re professionals and they each have their own goals and aspirations. We have lively staff meetings, with a lot of discussion and ongoing education. Dr. Quereshy and I talk to our staff about everything we’re doing and why we’re doing what we do. This is who we are and we’ve built our practice around what we believe.
It’s not about using something just because it’s new. The issue here is for doctors to use only what’s safest and most effective and not be swayed by every media mention of something that’s supposed to be the new best thing. We are always learning, evaluating new methods and techniques, and making decisions about what we want for our patients. Just because a procedure or piece of high tech equipment is new doesn’t mean it’s better: it has to be researched, evaluated, and tested. We stay current, do our due diligence, and carefully evaluate the merit of a new piece of technology or surgical technique. If we decide it’s good for our patients, we’ll embrace it; if it’s not, we won’t offer it.
It’s the patients and the process. Patients aren’t coming here for superficial reasons. A patient comes with a problem or concern and it’s my job to ask the right questions, provide a thorough exam and evaluation, and interact openly and honestly so the available options are clearly understood. It’s a “need driven” way of looking at dentistry and medicine. Once I understand the need and investigate the cause of the problem, I can help. I’m a thorough diagnostician and don’t make assumptions without carefully evaluating. For instance, a patient may tell me that she has head and neck pain and it may appear to be a nerve problem that points to the need for a root canal.
But there are numerous reasons why a patient might present with this problem and if it’s in her best interest to be seen by an outside specialist I’m going to make sure to make that recommendation. The only reason to do a root canal is because that’s precisely what’s needed. I love endodontics because it’s a cerebral, investigative branch of specialized dentistry. It suits my analytical mind.
I’m also simultaneously assessing the needs of the patient I’m examining. So while I’m investigating, taking a detailed medical and dental history, and making a diagnosis, I’m also working to help an anxious patient to understand what he or she is experiencing. I am utilizing the best technology, my deep understanding of the human face and neck – the physiology of the patient – and my knowledge of pharmacology. Then I’m bringing all these strands together to make a diagnosis and design the right treatment plan. I’m going down a path that’s evidence based – not guesswork based – and explaining to my patient each step of the way what I’m doing and why. And I’m empowering my patients with knowledge and participation in the process. It is extremely gratifying work.
Dr. Najia Usman is an endodontist specialist, having undergone two additional years of advanced specialty training and education in the diagnosis and treatment of difficult dental cases. Dr. Usman specializes in treating the inside of the teeth, with the focus on the pulp and surrounding tissues. Dr. Usman is a Diplomate of the American Board of Endodontics.
Read more about Cleveland endodontist Dr. Najia Usman.