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Dr. Nivine El-Refai

A board-certified endodontist who has focused on saving teeth for more than 25 years, who teaches endodontic residents at Case Western Reserve University, and who publishes research in her specialty.

Dr. El-Refai smiling beside her surgical microscope, with her American Board of Endodontics certificate on the wall behind her

I take my time with every patient, and I tell you the truth about your tooth.

I truly care about the people I treat, and I want every one of them to have a good outcome. That starts with an accurate diagnosis, so I never rush it. I take your 3D scan myself and go through it with you, slice by slice, so you see what I see and understand your options before anything begins.

I’m not a miracle worker, and every treatment carries some risk. When a case is uncertain, I explain the risks and the chances of success before we begin, and I recommend treatment when I believe it has a good chance of lasting. I would rather give you an honest answer than an easy one.

I choose materials and techniques because the research supports them, and I measure my work by how well teeth heal and how long they last. Teaching endodontic residents at Case Western Reserve since 2000, and publishing research in our specialty, keeps me close to what the evidence shows.

Outside the office, you’ll find me with my family, traveling, fishing, playing tennis, jogging, gardening, or reading, often in another language. I speak English and Arabic.

What I want for every patient is simple: a tooth that heals and lasts, and the confidence of understanding exactly what was done and why.

Dr. Nivine El-Refai

Dr. Nivine El-RefaiBoard-certified endodontist

Away from the office

A few of Dr. El-Refai’s own photographs from her travels.

  • The Three Sisters, three sandstone towers above a forested valley in the Blue Mountains
    Blue Mountains, Australia
  • A turquoise cove below a green headland on the Sydney coast
    Sydney, Australia
  • Green mountain ridges under rolling cloud in the Iao Valley on Maui
    Maui, Hawaii
  • A long sandstone cliff above a wide forested valley in the Blue Mountains
    Blue Mountains, Australia
  • The ocean along the Sydney coast, seen past flowering coastal shrubs
    Sydney, Australia
  • Rainforest running down to the ocean on the coast of Maui
    Maui, Hawaii
  • The entrance of Luxor Temple lit at night, with its obelisk and great seated statues
    Luxor Temple, Egypt
  • A red sunset behind palm trees and a minaret across the Nile
    The Nile near Luxor, Egypt
  • Two standing statues and their long shadows on the lit wall of Luxor Temple
    Luxor Temple, Egypt
  • The obelisk at Luxor Temple rising into the night sky, seen from below
    Luxor Temple, Egypt
  • Golden clouds at sunset over fields and palm trees in the Nile Valley
    The Nile Valley near Luxor, Egypt
  • Visitors in silhouette before the lit gateway of Luxor Temple at night
    Luxor Temple, Egypt
  • The gold mask of Tutankhamun, striped in blue and gold
    Grand Egyptian Museum, Giza
  • The colossal statue of Ramesses II beneath the angled roof of the museum’s grand hall
    Grand Egyptian Museum, Giza
  • Gold hieroglyphs in rows of cartouches on a dark stone wall
    Grand Egyptian Museum, Giza
  • A painted wooden head of the young Tutankhamun rising from a lotus flower
    Grand Egyptian Museum, Giza
  • An inlaid ceremonial chair with a curved seat, and a footstool, in a glass case
    Grand Egyptian Museum, Giza
  • Two standing stone coffins carved with calm faces and columns of hieroglyphs
    Grand Egyptian Museum, Giza

Credentials and ongoing education

Board certification, teaching, research and leadership in her specialty.

25 years focused on saving natural teeth
2014 the year she became a Diplomate of the American Board of Endodontics
5 peer-reviewed papers
2 languages spoken: English and Arabic
  • Board-certified endodontist Diplomate of the American Board of Endodontics since 2014 and an active Diplomate today. The specialty’s highest credential, earned through written and oral examinations and case review.
  • Clinical Assistant Professor Teaching endodontic residents at Case Western Reserve University School of Dental Medicine since 2000.
  • Published in the Journal of Endodontics Five peer-reviewed papers, four of them in the Journal of Endodontics, from root canal chemistry to tooth survival and facial pain, most recently in 2025.
  • President, Ohio Association of Endodontists Led the state’s association of endodontists for 2025 to 2026.

Her path

  1. 1992

    BDS, Cairo University Faculty of Oral and Dental Medicine, then associate dentist in the faculty’s private practice

  2. 1993

    Dental internship, Cairo University

  3. 1995

    Chief resident, Restorative Dentistry, and clinical preceptor, Cairo University

  4. 1998

    DDS, Case Western Reserve University, with the Sherwood/Hrutkay Award for Excellence in Endodontics; associate dentist in a Cleveland practice during her residency

  5. 2000

    MSD in Endodontics, Case Western Reserve University, and begins teaching its endodontic residents

  6. 2001

    Opens her practice, limited to endodontics

  7. 2014

    Diplomate, American Board of Endodontics

  8. 2023

    Fellow, International College of Dentists

  9. 2025

    President, Ohio Association of Endodontists, 2025 to 2026

Education and training

  • July 1998 to August 2000MSD, major in endodontics, Department of Endodontics, Case Western Reserve University School of Dentistry, Cleveland, Ohio
  • June 1996 to May 1998DDS, Case Western Reserve University School of Dentistry, Cleveland, Ohio
  • February 1994 to September 1995Chief resident, Department of Restorative Dentistry, Cairo University Faculty of Oral and Dental Medicine
  • November 1992 to November 1993Dental internship, Cairo University Faculty of Oral and Dental Medicine
  • September 1987 to June 1992BDS, Cairo University Faculty of Oral and Dental Medicine

Professional experience

  • September 2000 to todayDepartment of Endodontics, Case Western Reserve University School of Dental Medicine, first as a volunteer instructor and now as a Clinical Assistant Professor
  • July 1998 to June 2000Associate dentist, private practice, Cleveland, Ohio
  • February 1994 to September 1995Clinical preceptor, Cairo
  • May 1992 to September 1995Associate in the faculty private practice, Cairo

Published research

  1. Winegar CY, Mickel AK, El-Refai NY, Williams KA. Current perspectives on the adjunctive use of botulinum toxin A in endodontic practice for nonodontogenic pain management, a web-based survey. Journal of Endodontics, 2025.
  2. Patil K, Khalighinejad N, El-Refai N, Williams K, Mickel A. The effect of crown lengthening on the outcome of endodontically treated posterior teeth, a 10-year survival analysis. Journal of Endodontics, 2019.
  3. Bachala D, El-Refai N, Greenfield E, Aminoshariae A, Mickel A. The effect of lunasin on RANKL-mediated osteoclast formation from RAW 264.7 cells. Journal of Endodontics, 2018.
  4. Hottel TL, El-Refai NY, Jones JJ. A comparison of the effects of three chelating agents on the root canals of extracted human teeth. Journal of Endodontics, 1999.
  5. Rizk M, Khalighinejad N, El-Refai N, Feng Z, Williams KA, Mickel A. The immune response profile of activated macrophages following lunasin treatment, lunasin as a potential anti-inflammatory medicament. World Journal of Oral and Maxillofacial Surgery, 2018.

Her research projects

  • 2000An in vitro evaluation of the residual antimicrobial effects of hydraulically placed calcium hydroxide. Advisors: Andre Mickel, DDS, MSD, and Jefferson Jones, DDS.
  • 1998The effect of three chelating agents on extracted human teeth. Advisors: Jefferson Jones, DDS, and Timothy Hottel, DDS, MS.
  • 1995Counteracting the effect of arsenic in treated teeth with a calcium hydroxide base. Advisor: Khalad Ezzat, BDS, MS, PhD.
  • 1994Variation among dentists in shade and color matching. Advisor: Amina Abd-El-Salam, BDS, MS, PhD.

Honors and memberships

Honors

  • Sherwood/Hrutkay Award for Excellence in Endodontics, Case Western Reserve University, 1998
  • Horace Wells Senior Student Award, American Dental Society of Anesthesiology, for outstanding achievement in dental anesthesiology, 1998
  • The Quintessence Award for academic achievement, Quintessence Publishing
  • Certificate of Merit, American Society of Dentistry for Children, on the recommendation of the Case Western Reserve faculty
  • Certificate of Appreciation, Case Western Reserve University School of Dentistry
  • Certificates of appreciation, American Association of Endodontists Annual Sessions, 1999 and 2000
  • Fellow, International College of Dentists, 2023

Memberships

  • American Board of Endodontics (Diplomate)
  • American Association of Endodontists
  • Ohio Association of Endodontists (President, 2025 to 2026)
  • International College of Dentists (Fellow)
  • American Dental Association
  • Academy of General Dentistry
  • Greater Cleveland Dental Society
  • Akron Dental Society
  • Egyptian Dental Union

Certificates

  • Diplomate, American Board of Endodontics
  • Dental license, State Dental Board of Ohio
  • North East Regional Board of Dental Examiners
  • Degrees and certificates, Case Western Reserve University
  • International Dental Congress, Egyptian Dental Association, Cairo, November 1993
The Ohio Association of Endodontists President's Plaque presented to Nivine Y. El-Refai, President of the O.A.E., 2025 to 2026
President of the Ohio Association of Endodontists, 2025 to 2026.
Dr. El-Refai receiving her fellowship certificate at the International College of Dentists convocation in 2023
Inducted as a Fellow of the International College of Dentists, October 2023.

Experience with the hardest cases

Dr. El-Refai sees every patient herself, from the first exam and 3D scan to the final visit. Her experience covers the most difficult work in the specialty: severely calcified canals, internal and external resorption, dental trauma in children and adults, vital pulp therapy and pulp regeneration, and teeth that have not healed after earlier treatment.

Most treatment is completed in one visit, and every tooth leaves with a permanent filling, never a temporary one. Many of our patients come to us on the recommendation of someone we have treated, and you do not need a referral.

Dr. El-Refai beside the small-field 3D cone beam scanner in her office
Dr. El-Refai takes and reads every 3D scan herself.

Our mission

Our mission is to give every patient outstanding care in a gentle, calm and relaxing setting, using the best evidence-based technology. We treat every patient as we would a member of our own family, and we combine ethics with technology so that you are fully informed about your endodontic choices.

We believe you should be treated in a calm, unrushed atmosphere where every option, question and concern can be reviewed in full. Dr. El-Refai analyzes your images with you in detail so that you can make an informed decision. We use a diagnosis-based approach to improve and maintain your long-term dental health, and we aim for excellent clinical care and excellent service alike.

We know many people are apprehensive about root canal treatment. Our goal is a comfortable, positive experience that meets and exceeds your expectations. We are privileged to have your trust.

Why see an endodontist

Endodontists are dentists who complete at least two more years of advanced training after dental school and limit their practice to endodontic treatment.

  • Experience. On average, endodontists perform nearly 25 root canal treatments a week, while general dentists perform fewer than two.
  • Efficiency. Because they focus solely on endodontic treatment, endodontists are efficient and precise, which means a better experience and faster healing.
  • Availability. Most endodontists make room for emergency cases, so treatment is not delayed and pain is relieved quickly.
  • Technology. Endodontists use tools such as operating microscopes, digital imaging, ultrasonic instruments and fiber-optic illumination to treat patients quickly and comfortably.

Today, root canal treatment is often no more uncomfortable than having a filling.

Video by the American Association of Endodontists. Watch on YouTube
Dr. El-Refai with fellow inductees at the International College of Dentists ceremony in 2023
With fellow inductees, International College of Dentists, 2023.

Our team

  • Jennifer, administrative assistant, at Gentle Endodontics

    Jennifer

    Administrative assistant

    Welcome to our practice! I am the friendly face at the front desk. I am happy to answer your questions, plan your appointments, help resolve concerns and make your visits positive. It is important to me that each of you enjoy a feeling of ease and confidence in our office. In my spare time, I love to travel, shop, stay active, and spend time with family and friends.

Our office

The front desk and waiting area
A treatment room with a dental chair and microscope
The small-field 3D cone beam scanner in its imaging room
A treatment room with a forest scene lit in the ceiling above the chair

Relief starts with a call

Call or text, and we will find the soonest time that works. If you are in pain, tell us when you call, and we will do everything we can to see you the same day.

330-721-1350 Request a visit

3985 Medina Road, Suite 160, Medina. Mon, Tue, Thu 7 am to 4 pm; Wed by appointment; Fri closed.

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