February 2017
Volume 38, Issue 2

Tips for Getting to the Root of Quality Care

Roger P. Levin, DDS

Although many general dentists perform root-canal therapy, there will always be cases that require the skills and experience of an endodontist. For this reason, it makes sense, in terms of meeting the high standards of both clinical care and case management, for general practitioners to cultivate and maintain strong relationships with endodontic practices.

If you have not done so recently, review your approach regarding patients in need of root canals and interdisciplinary cases involving endodontists and their teams. Then, assess your current situation and plan for improvements, if necessary.

Consider the root-canal cases you’ve performed in the past year. Did you encounter any difficulties? Was your schedule disrupted significantly by endodontic emergencies? Do you need to make any changes in your approach to root-canal cases? After this assessment, think about the types of cases you usually refer, along with other factors, and reevaluate which endodontic practices to recommend to your patients. Several issues should be considered. Not all endodontic practices are alike, and they change over time. An endodontist you highly respect may now be letting a less experienced associate handle most cases. Conversely, a practice once known for poor customer service may have vastly improved in this area. Perhaps, a growing number of your referred patients are asking for a more conveniently located endodontic practice. Periodically looking at all aspects of your referral options is important for both your bottom line and your patients’ well-being.

People Skills

Meet or speak with your endodontists regularly to catch up personally and “talk shop.” Even though endodontists should be reaching out to you to keep the relationship strong, do not hesitate to take the initiative. Professionally, this contact can help you stay up-to-date on endodontics and also sharpen your judgment about which cases are suitable for which endodontic practices. It will help you maintain a personal sense of who you’re sending your patients to see. In addition, you’ll be laying the foundation for a smooth restorative “hand-off.” During these discussions, ask endodontic practices for patient-education materials. If you find yourself telling a patient that he or she needs a root canal, this will allow you to supplement your explanation and treatment recommendation with a printed brochure or fact sheet. Endodontic practices should be happy to provide these to your practice in quantity, especially if the pieces promote their practices.

Now that you have provided your patient with information and treatment options, help them make the connection with the endo­dontic practice. Some referred patients will take matters into their own hands—contacting the endodontic practice, asking questions about the process, and making an appointment in a timely way. Other patients, however, will look to you and your staff for help. Train your staff to be sensitive to patient uncertainty; this includes offering assistance to move the process forward and volunteering to help schedule the patient at the endodontic office. This is especially important with root-canal cases because pain can escalate quickly.

Further, the patient should not be expected to serve as the communications link between the two practices. Rather, you should inform the endodontic practice about the patient’s diagnosis and history, provide radiographs, and make yourself available for a doctor-to-doctor discussion of the case. If the patient is truly in need of urgent attention, that message will carry more weight coming from you rather than the patient. Overall, the idea is for the patient experience to be seamless, easy, and reassuring. With that said, the completion of the referral should not signal the end of your involvement in the case. After all, it’s your patient experiencing a significant dental procedure and possibly a high state of anxiety, not to mention pain. Having your staff proactively determine when the procedure is scheduled enables you to discuss the outcome with the endodontist.

Soon after the root canal has been completed and you’ve had an opportunity to discuss it with the doctor, call the patient. Ask how he or she is feeling, indicate that the endodontist said the procedure went well, and explain what to expect in the recovery and what the next steps will be. These steps should begin with the patient being referred back to your practice for restoration.


Aside from clinical notes you’ll add to the patient file, keep separate documentation about the referral process and results. Patients probably won’t be able to critique how the root-canal procedure was handled, but you should note how they were welcomed and made comfortable, whether the doctor and team explained the procedure, how thorough the after-care information was, and other factors. These comments, combined with your professional opinion, can help guide your future endodontic referrals.

Keeping patients healthy and happy is relatively easy when all of the dental needs are routine. But when a crisis occurs, be prepared to rise to the occasion. Whether you perform the root canal yourself or refer the case to an endodontist, ensure that all the protocols are in place to achieve the best clinical outcome and further strengthen the patient’s relationship with your practice.


Roger P. Levin, DDS

Founder & CEO, Levin Group, Inc.

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