It's been decided: You need to have a root canal. In most cases, your general dentist will be the one to break the news. It might come during what was supposed to be a simple filling; sometimes decay goes deep into the tooth and infiltrates the nerve space, necessitating root canal therapy. Or your dentist might know immediately upon looking at an x-ray; a dark circle of bone loss near the tip of your root can be a dead giveaway. Now the question remains: Who should perform the procedure? Read through this list of considerations to keep in mind when deciding.
When the Answer Is Clear
Your general dentist will be glad to refer you to an endodontist when he or she has reason to believe that your root canal might be complicated. Potential reasons for this might include very narrow or curvy roots, a severe infection, or previous root canal treatment that has gone awry. While some family dentists are comfortable taking on these cases, others prefer to refer patients out to a specialist.
At other times, the root canal therapy may be very straightforward and unnecessary to refer out. For example, if the tooth in question has only one wide canal, your dentist might prefer to perform the procedure him- or herself. Of course, some general dentists do not perform any root canal therapy at all, so in that case, all patients needing root canals will be referred out.
In general, if your dentist has a strong preference either way, it's a good idea to take his or her advice in this matter. There are times, however, when the decision is left up to you.
When Cost and Convenience Are Key
Check with your dental insurance to find out whether seeing a specialist will increase the amount of money you'll need to pay. If there is no endodontist in your area who participates with your plan, you will likely pay less if you see your general dentist. Also, call the endodontists in your area to find out how much they charge for the procedure if you will be paying out-of-pocket for all or part of the root canal. Your general dentist's billing coordinator can tell you the ADA dental code for the exact procedure that you need.
In many cases, it might be more convenient to see your general dentist; he or she knows you, and you've probably chosen the office based on its location and ease of access. Also, it's worth keeping in mind that if you have the root canal done by an endodontist, you will need to return to your general dentist for a final restoration (usually a crown). In some cases, you may be able to have that follow-up procedure started immediately after your root canal is finished if your regular dentist is the one performing it.
When a Specialist Is Necessary or Preferred
Some patients choose to see an endodontist as a matter of personal preference. If you have had a root canal previously and have a relationship with an endodontist in your area, you might feel better about trusting this specialist again.
There are also some cases where the specialized equipment that a root canal specialist has is needed. For example, many endodontists work with surgical microscopes and advanced equipment for measuring the length of your canals. For those with calcified canals or silver wires left in the canal from an old procedure, this equipment can make the procedure more successful. If a type of endodontic surgery called an apicoectomy is needed, a specialist usually has more experience with this procedure and may be the better choice.
In the end, it's your decision who to see for your dental health needs, and the decision should be made with the advice of your general dentist. He or she will be able to go over the pros and cons of seeing a specialist for your root canal therapy and will answer your questions about your treatment plan as a whole.