When a tooth becomes painful or infected, patients in Camberley are often presented with a fork in the road: try to save the tooth with a root canal, or take the tooth out and replace it later. Matt Cottam, one of the dentists at Atrium Dental and currently completing a master’s in endodontics, has a clear position on which option deserves the first look.

Coming from a dentist whose practice principal has been placing dental implants for over two decades, his answer carries unusual weight.

“If we can save people’s natural teeth, there’s no good replacement. Even implants are fantastic, and they are a brilliant replacement for a tooth, but they’re not the same as having your natural tooth.” — Matt Cottam

Why a natural tooth is still the gold standard

Modern dentistry has excellent replacement options. Dental implants in particular are a remarkable piece of engineering, and Matt is the first to acknowledge how good they have become. But a natural tooth comes with something no replacement can fully reproduce: a living ligament that suspends it in the jaw, sensory feedback when you chew, and a perfectly fitted root that has spent your whole life integrated with the surrounding bone.

That is why his starting question is always the same: is this tooth saveable? Where the answer is yes, a root canal is almost always the better path.

When a root canal is the right call

Root canal treatment becomes an option when the pulp inside a tooth — the nerve and blood supply — has become inflamed or infected. That might be caused by deep decay, a crack, repeated dental work on the same tooth, or trauma. The classic symptoms are persistent throbbing, sensitivity to hot or cold that lingers, pain on biting, or a tooth that has changed colour.

In these cases, the tooth itself is often perfectly viable. The problem lives inside it, not around it. A root canal removes the damaged tissue, cleans and shapes the canals, and seals the inside of the tooth so it can keep functioning for years to come.

Matt’s interest in this work is partly clinical and partly temperamental. He likes problems that have a clear method and a definable outcome.

“It’s a very logical procedure. You follow the steps and you get a good outcome at the end.” — Matt Cottam

When extraction genuinely is the better option

There are situations where saving a tooth is not realistic. A tooth split below the gum line, a tooth with so much structure lost that no restoration will hold, or a tooth surrounded by severe periodontal disease may all be past the point where root canal treatment would be predictable. In those cases, removing the tooth and planning a replacement is the honest answer.

What Matt resists is jumping straight to extraction simply because it is faster or sounds easier. A root canal preserves the natural root, which keeps the surrounding bone stimulated and the bite intact. Losing a tooth, even a back one, sets off a chain of small changes in the mouth that take more work to put right than most patients expect.

How modern endodontics has changed the maths

The decision between saving and extracting a tooth used to lean more heavily towards extraction simply because root canals were harder to do well. That has shifted. Matt is studying at master’s level precisely because the field has moved on so much in the last decade or two.

“The equipment and the materials that we have now have maximised our success rates, and made it a lot more of an efficient procedure as well.” — Matt Cottam

Higher success rates mean more teeth that were previously borderline are now saveable in skilled hands. Finer instruments reach further into curved canals, modern irrigation cleans more thoroughly, and better sealing materials give the tooth a longer working life. The procedure itself is also more comfortable: with a topical gel before the injection and a properly numbed tooth, many of Matt’s patients fall asleep during treatment.

Root canal vs implant: thinking long-term

Patients sometimes ask whether they may as well skip the root canal and go straight to an implant. It is a fair question, and Matt’s answer is honest: implants are a brilliant solution when there is no tooth left worth saving. But where a tooth can be successfully restored, choosing to remove it usually means committing to more treatment, not less.

Implant pathways involve extraction, healing, surgical placement, integration time and a final crown. They are predictable and long-lasting in the right patients, but they take months and they replace one healthy structure with a man-made one. A successful root canal at Atrium can usually be completed in one or two visits and leaves the original tooth in place, ready to do its job for years.

For Surrey patients weighing up cost over a lifetime, the maths frequently favours keeping the natural tooth first.

What this looks like in Camberley

At Atrium Dental in Camberley, Matt’s approach to these decisions is unhurried. A consultation usually involves a thorough clinical examination, modern imaging, and a clear conversation about what the tooth needs and what the alternatives would involve. Where a root canal is the right answer, he will explain how the treatment will run and what to expect afterwards. Where it is not, he will say so and talk through the replacement options with the wider Atrium team, including the implant work led by his colleague and mentor Matt Golightly.

What patients consistently get is a recommendation based on what is genuinely best for the tooth — not the fastest or the most lucrative path.

Book a consultation

If you have been told a tooth is in trouble and you would like a calm, expert second opinion, Matt is happy to take a look. You can read more about root canal treatment at Atrium, learn about our dental implant options for cases where a tooth genuinely cannot be saved, or contact the practice to arrange an appointment with Matt in Camberley.

MEET

Matt Cottam

Dentist · BDS Birm 2020 · GDC 290331

Matt Cottam qualified from the University of Birmingham in 2020 and has since developed a special interest in endodontics, currently working toward his Master's in the field. He joined Atrium having known the practice principal, Matt Golightly, since he was a teenager — Matt G was his own dentist, first encouraged him into the profession, and has mentored him through training and into clinical life.

Known for his calm and caring manner, Matt is especially popular with nervous patients. He takes the time to get to know each person before treatment begins and uses modern numbing techniques that make procedures genuinely comfortable — many of his patients fall asleep during longer appointments. He is a strong advocate for saving natural teeth wherever possible, a philosophy that runs through his approach to root canal treatment.

Outside of dentistry, his ideal day off would be spent on a sunny golf course abroad, enjoying a relaxing round in great weather.