Who’s Treating What? Comparing Root Canal Patients of Endodontists and General Dentists
Authors: Mungia R, Funkhouser E, Law AS, Nixdorf DR, Rubin RL, Gordan VV, Fellows JL, Gilbert GH, and the National Dental PBRN Collaborative Group
A new Network study sheds light on the differences in patients and teeth treated by general dentists (GDs) versus endodontists. With over 1,700 patients enrolled across 153 practices, this research offers a comprehensive look at how root canal treatment (RCT) varies by provider type.
What Was the Study About?
The study aimed to compare patient demographics, tooth characteristics, and pre-treatment conditions between those receiving RCT from GDs and those treated by endodontists. Data were collected from both patients and practitioners before treatment, including pain levels, psychosocial factors, and clinical findings.
Why It Matters
Understanding who gets treated where—and why—can help improve referral practices, address disparities in care, and ensure patients receive the most appropriate treatment for their needs.
Key Findings
- Endodontists Treat More-Complex Cases: They were more likely to treat molars (75% vs. 43% for GDs) and patients with higher education levels.
- GDs See More-Advanced Pathosis: GDs treated more teeth with deep probing depths (≥5 mm) and radiolucency and prescribed more antibiotics.
- Demographic Differences: Endodontists treated higher percentages of female, non-Hispanic white, and college-educated patients.
- Pain and Stress: Endodontists’ patients reported higher pain levels before treatment, but GDs’ patients reported higher stress.
- TMD Screening: 41% of all patients screened positive for temporomandibular disorders (TMD) up to 30 days prior to RCT, with a higher proportion among endodontists’ patients.
Clinical Implications
- Referral Patterns Reflect Access and Complexity: Endodontists are more likely to receive referrals for complex molar cases, while GDs often manage patients with more-advanced periodontal issues.
- Socioeconomic Factors Influence Care: Patients with higher education and likely higher socioeconomic status are more often treated by specialists.
- Pain Management Practices Vary: GDs prescribed more antibiotics, raising questions about antibiotic stewardship in general practice.
Conclusion
This study underscores the distinct yet complementary roles that general dentists and endodontists play in providing root canal therapy. While both are integral to delivering comprehensive dental care, they serve different patient populations and perform treatments with varying complexity. Understanding these differences can support more-informed referral practices, enhance patient outcomes, and guide future research aimed at improving equitable access to specialized dental care.
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