Endodontist or general dentist: who should carry out your root canal treatment?

Every dentist is trained to carry out root canal treatment, and many do it well. A practice devoted to endodontics is not a criticism of your dentist; it is a resource your dentist can use for the teeth that need more time, more equipment or more experience than a general practice can reasonably provide.

What "endodontist" means

Endodontics is the branch of dentistry concerned with the dental pulp and the tissues around the root. In the UK the title "specialist endodontist" is protected and may be used only by dentists on the General Dental Council's specialist list. Many dentists who are not on that list nevertheless limit their work to endodontics, having undertaken further training, and describe themselves as endodontists or as practising endodontic dentistry. Whoever treats you, the useful questions are the same: how much of their work is root canal treatment, and what equipment and time do they use for it?

What is done differently

• Magnification. An operating microscope is used routinely rather than occasionally. It is the single biggest difference in finding every canal and in managing complications.
• Time. Appointments are long enough to complete the treatment in one or two visits without hurrying.
• Diagnosis. Because the practice sees difficult cases every day, unusual pain patterns, cracks and referred pain are familiar territory.
• Equipment and materials. Electronic length measurement, ultrasonics, activated irrigation and modern sealing materials are standard rather than optional.
• Experience with failures. Retreating previous root fillings, removing posts and broken instruments and carrying out root-end surgery are routine.

Teeth that benefit most

• molars, especially upper molars with their frequently hidden fourth canal;
• teeth with curved, narrow or calcified canals;
• teeth that have had root canal treatment before and have become infected again;
• teeth with posts, crowns or bridges that must be preserved;
• cracked teeth, where the prognosis depends on an accurate assessment;
• injured teeth and young teeth with incompletely formed roots;
• cases where a previous attempt was abandoned because the canal could not be found or negotiated;
• anxious patients who need an unhurried, carefully explained appointment.

Working together

An endodontic practice does not replace your dentist. We treat the inside of the tooth; your dentist places the crown or filling that protects it and continues your routine care. After treatment your dentist receives a report with X-rays and our recommendation for the restoration. If you have been referred, we will keep your dentist informed throughout; if you have come to us directly, we will write to your dentist with your permission.

Do you need a referral?

No. Many patients contact us directly, sometimes for a second opinion on a tooth they have been told cannot be saved. Bring any recent X-rays, or ask your dentist to send them, and we will assess the tooth and explain the options. Our tooth pain diagnosis page describes the consultation.

The short answer

For a straightforward front tooth, your own dentist may be the right choice. For a molar, a retreatment, a crack, an injury or a tooth that has already defeated one attempt, a practice that does endodontics all day and uses a microscope for every case gives the tooth its best chance. Either way, ask the questions above — a good dentist will welcome them.