Selecting endodontic cases

Charlie Nicholas considers how to decide whether to treat or refer.

It is fair to suggest that from a GDP’s point of view, endodontic treatment is rarely a favourite and is something some want to avoid altogether. Having gone from a GDP who dreaded performing root canal treatment to a happy referral endodontist, I have run the gamut.

So, what changed my mind? It was the result of gaining a better understanding that there is more to endodontics than we are taught at undergraduate level; that prudent case selection is key to help build confidence and skill, as is having the right tools for the job and that all-important ‘c’ word – communication.

Communication and cost
At the heart of every successful treatment is effective communication – you do not need me to tell you that. Yet there is something about endodontics that makes it all seem slightly trickier.

It is tempting to be swayed by your patients’ preferences, which will often be to have you perform any treatment for three main reasons:
1. They trust you
2. You are cheaper than a specialist
3. They do not want to go to another practice or see someone else with whom they are not familiar