General Dentist doing root canals?

[pandaman]

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Call me stupid, but I am seriously clueless. Until now, I've always thought endo specialists only do root canals. But my friends tell me gp could do them too. Is that true?

J

 

[mofo]

General dentists can do whatever they feel comfortable doing, otherwise they refer the patient to a specialist.

 

[s.mutans]

Nope, I did not know that either. I spoke with a general dentist the other day and a GD can do anything that entitles him/her in their Degree definition. A gd can even do ortho if he is skilled at it. I do hesitate though how a patient would feel about the quality of work they will receive. It is cheaper if you go to the general dentist, but the quality?

😕

 

[ddstothecor]

In general, a practitioner may provide any service he/she feels comfortable doing. However, it is the responsibility of the general dentist to recognize their limitations. This involves realizing when your services may not be on par with the others who specialize, or have specific training in a given area.

 

[noodle]

The real answer is that endodontists limit their practice to endo. General Dentist can practice any area of dentistry. Example, General Dentist X determines that tooth #14 has pulpal pathology. He or she refers to Endo Y for RCT. Endo Y does endo and sends final radiograph back to General Dentist X for post and Crown. General Dentist Z determines that tooth #14 has pulpal pathology and does the RCT, post and crown. Specialist take general dentists out to lunch in ordered to get referals. They also give general dentists tickets to sporting events and send flowers at Christmas. Most of the endo done in this country is done by General Dentists. In California and Michigan 75 percent of Orthodontics are done by General Dentists. This will be increasing with the introduction of Functional Orthodontics and Invisalign. There are many wonderful continuing education courses on endo, ortho, tmj, prosthodontics, pedo, oral surgery etc. The General Dentists sends the Hard Stuff to the Specialist. Many procedures can be kept in the General of Family Practice. In some cases General Dentist charge more than specialists. They have a wide range of knowledge while the specialist are limiting their practice to one area.

 

[yosemitesam]

Also, a lot of referrals are sent out not because treatment is beyond the ability of the general practitioner but because it is economically advantageous to focus his efforts on tasks where is he is more efficient. If he has plenty of business why would he waste the time and bother of a root canal when he has other, more profitable options.

 

[ktran02]

Originally posted by noodle
In California and Michigan 75 percent of Orthodontics are done by General Dentists... .. ...There are many wonderful continuing education courses on endo, ortho, tmj, prosthodontics, pedo, oral surgery etc.

Is this true? 75% seems quite high, plus I had the impression that the field of Ortho doesn't offer too many cont. ed courses to General dentists.

 

[noodle]

Check out this web sight. I think this will so you what has happened in Ortho in the last twenty years.

 

[noodle]

Forgot the s. Sorry! Click on the Ortho icon! Have fun!

 

[DrJeff]

Originally posted by yosemitesam
Also, a lot of referrals are sent out not because treatment is beyond the ability of the general practitioner but because it is economically advantageous to focus his efforts on tasks where is he is more efficient. If he has plenty of business why would he waste the time and bother of a root canal when he has other, more profitable options.

With the advent of rotary endodontic instrumentation and NiTi files, endo is one of the most cost profitable proceedures in my office. When you can complete a molar endo for a little over $800 in an hour, a premolar for about $700 in around 45 minutes, and an anterior for about $600 in around 30 minutes, you can see that endo can be very profitable for your practice. Additionally, after you do the endo in your office, thats extra production that you keep in your office in addition to that build up and crown that you'll do

For example. I'll now for an anterior tooth, book my patients for about an hour and a half and do the endo, build up and crown all in one visit. After having just done over $1500 in production in less than 1/3 of my morning time that I work, the rest of the morning can then be "cruise control" procedures and you still know that it's been a profitable morning😀

Become very proficient at endo can be a very enjoyable, and highly profitable skill to have in your bag of tricks!

 

[pandaman]

Dr. Jeff,

I believe you are a general dentist, how did you become so proficient at doing root canals? Because my general dentist always refer patients who need root canals to endodontist. PLus,if any 'super general practioners' can do root canals, woudln't endodontists go out of business?
wondering...

james

 

[yosemitesam]

Thanks for the advice Dr. Jeff. It's nice to have someone on these boards who really knows what he's talking about. 🙂

 

[DrJeff]

Originally posted by pandaman
Dr. Jeff,

I believe you are a general dentist, how did you become so proficient at doing root canals? Because my general dentist always refer patients who need root canals to endodontist. PLus,if any 'super general practioners' can do root canals, woudln't endodontists go out of business?
wondering...

james

Yes, I'm a GP. For my endo proficiency, I was fortunate enough to have the opportunity to to ALOT (200+ canals) during my residency years, and frankly since I started using rotary instrumentation about 5 years ago I really enjoy doing endo. Do I send endos out too my local endodontist, you bet (especially maxillary 2nd molars, severe root curavature, ANY retreats, and the appearance of calcified canals/pulp stones, and that doesn't say antyhing for the patients who just I just get the vibe about that they're going to be trouble) I probably do about 90-95% of the endo that my patients need, the rest get to go and see the local endodontist. I know of some dentists in mya rea that HATE endo and the only way that they'd do any endo is if their own mother begged and pleaded for them to do it. I like it, and I'm very comfortable doing endo.

The big thing that I's reccomend for any GP with any interest in endo is take a hands on CE course. I've taken 3 seperate hands on endo CE courses and about 8 other endo lecture CE courses. The first hands on course I took was by the manufacturer of my rotary system (Tulsa/Dentsply) and I was practicing and learning the technique in plastic canals. I will also say tha the technical support that I've received from Tulsa/Dentsply has been exceptional over the years. I've also taken weekend hands on CE endo courses in the last few years by by Dr. Stephen Buchanen and Dr. Kit Weathers. Both of them expanded on the basics that my original course tought me and got me thinking about minor differences in technique to make the procedure more efficient. Basically once your comfortable with not only the instrumentation involved with rotary endo, but also canal anatomy it is really a quick, easy, fun and profitable procedure.

CE courses can be wonderful and enlightening. just make sure in the future that you bring a critical and open mind to a CE course, because while you're all getting a sound/solid dental education at your school, a different perspective/technique presented at a CE course may just make your practice of dentistry alot more enjoyable and easy.

 

[groundhog]

Listen to the Rev Dr Jeff all you aspiring dentists. He is a prophet who preaches the truth. I believe advances in dental procedures will soon cause endo and ortho to fade as specialities. Computer assisted technologies will enable all GP's to perform ortho and endo at a very economical price for the patient. That is a good thing. Ortho on the front end for the young folks (along with a good hygience/check up program) is the most cost effective way to help insure long term healthy teeth and support tissue. Root canals on the back end helps the old folks retain their dental infrastructure which greatly adds to their quality of life.

I'm one who believes that dentistry is already a medical speciality and that many of the so called dental speciality procedures are presently needed because of economic factors rather than professional ability factors. I believe technology will cause those economic factors to shift in favor of the GP. As Dr Jeff has hinted, I would advise any newly minted GP minded DDS/DMD's to take GPR's and to schedule all of the CE for themselves and staff that can be economically worked into their practices