Prefer to refer?

Having received only basic endodontic training as undergraduates, most GDPs leave dental school without much exposure to more complex aspects of endodontic treatment, in particular in molars and endodontic re-treatment. It is this restricted education and lack of experience that potentially deters them from pursuing a career in this exciting discipline further. Consequently, whilst all GDPs will offer endodontics as a treatment, when faced with cases that are not straightforward, sadly the option of extraction is often pursued and many potentially treatable teeth are lost. Research from the American Association of Endodontists shows 97 per cent of GDPs referred within the past year and endodontists received 85 per cent of their patients from GDP referrals. This is a pattern that is developing further in the UK and when faced with the decision to treat or refer, many GDPs will choose the latter.

When it comes to the reasoning behind referral decisions, a survey conducted in England in 1992 showed that the most common reason was for retreatment, followed by the inability to control pain and/or swelling, and the inability to diagnose the cause of the endodontic problem. More recently, GDPs stated that a ‘relatively short waiting time’ was a primary factor for influencing their decision to refer to a specialist endodontist or someone with ‘enhanced skills’.