Approximately 80% of all root canals in America are completed by general dentists who have 2 years of clinical training in dental school. The American Dental Association (ADA) Code of Ethics states that a dentist must refer a patient to an endodontic specialist when the dentist lacks the necessary expertise to treat the patient to ensure the patient's well-being. This is based on "beneficence" (to act in the patient's best interest) and "non-maleficence" (do no harm). Endodontic specialists receive an additional 2-3 years of residency training in endodontics, with some programs awarding a certificate in endodontics while a few select programs also award a masters degree, generally in oral biology. Those endodontists who further their education and knowledge base pursue board certification which is common practice and expected in medicine. Board certification in endodontics is very important for endodontists who are serious about understanding and learning the science behind endodontic diagnoses and treatments, so they can better serve and educate their dental colleagues, patients and the public. It is important to note that board certification does not equate to clinical expertise and excellent hand skills, as those aspects are either innate- born from natural talent, or developed over decades of conscientious practice in pursuing excellence in clinical care of patients. Diagnosing accurately in endodontics is not always straight forward, and it is important to seek out an expert endodontist who has the sophisticated knowledge to know how to help you. "We don't know what we don't know." When excellent surgical skills are partnered with board certification and real scienfitic knowledge, a powerhouse endodontist is born to tackle the most challenging endodontic cases to help save patient's natural teeth, which promotes oral health and overall health, long-term. Endodontics is essentially an apprenticeship, and under the right direction and care of excellent mentors, a thoroughly trained endodontist can save just about any tooth, with certain exceptions (separate blog post). But to be sure, as patients, one should always try and obtain an accurate endodontic diagnosis prior to pursuing an extraction of a tooth.

What if a patient doesn't want to be referred to a specialist when a dentist recommends it? Under the ADA Code of Ethics, dentists are not allowed to comply to substandard care. It is the dentists' professional responsibility to effectively communicate the importance of specialty referral with their patients. 

Our teeth are bodily organs that house nerves that connect intricately through various pathways to our brains. Think about this carefully. If you had a paper cut on your finger, would you so easily go and amputate your entire arm? Never! But this is what may be happening with patients who are not aware that their natural teeth can be saved via sophisticated endodontic therapies that are confirmed to have long-term success due to misinforation or lack of accurate information. Newer technologies (some, not all, and we are selective about what we use here at Liberty Endodontics), surgical techniques and advanced medical materials have significantly improved the outcomes and success rates of endodontics backed by science. Our goal as endodontist should be to preserve your natural "dental pulp" or nerve first, and in the event the nerves inside of your teeth cannot be saved, then our second goal should be to preserve your natural tooth. This is the latest movement of "minimally invasive endodontics" supported by the American Association of Endodontists (AAE) and backed by current research. Pursuing this path may be controversial because it is less productive for most dental offices, however, preserving patient's natural bodily organs can only help promote better oral health and overall health and should be the primary focus (patient care first) of all dental professionals. 

At Liberty Endodontics, a practice limited to root canals, we have worked with and continue to work with wonderful dentists who are some of the best restorative dentists (general dentists and prosthodontists), oral surgeons, periodontists, pediatric dentists, oral pathologists, and oral medicine TMJD doctors in the Tri-State Region. When your dentist refers you to Liberty Endodontics, it is a positive sign that your dentist puts your well-being first and really cares about your oral health! Call us today to schedule your appointment: (914) 713-4622.