Dentaltown May 2017 - 121

continuing
education

course, we also want to help our patients by
looking after them with our own two hands.
If you choose to perform your own root
canal treatments, however, there are risks
and benefits to be aware of. Nowadays, we
often stress only the bright side of endodontics
and make it seem simple, but overlooking
the realities we face and the potential pitfalls
could mean trouble. In hopes of keeping you
out of trouble, I'll identify common clinical
mishaps you may face, and discuss how you
could avoid those potential headaches.1
So, pardon the occasional careful and
somber tone of this article-but stressing
the potential clinical, fi nancial, practice
management and legal pitfalls is aimed to
help you, your patients and your practices.

Part 1: Practice management
There are many benefits and complications to your practice when doing your
own root canals. Table 1 highlights the
pros and cons of performing root canal
treatments in-house. First, the positives
about endodontic treatments. Keeping root
canal treatments in-house often benefits your
patients, who usually prefer the convenience
and comfort of being treated by a familiar,
trusted face instead of being sent to an
unknown specialist.
Your practice benefits from in-house
treatment because your schedule is busier.
Your production also benefits as you perform more root canal treatments; if you're
proficient and efficient, then providing this
service could be quite lucrative.
This has become increasingly possible in
recent years with the introduction of newer
endodontic armamentaria. For instance,
some new nickel titanium files work more
efficiently and enable canal instrumentation
with fewer files and steps. Examples are the

TABLE 1: Pros and cons of keeping root canal treatments in-house
PROS

CONS

* Patients' convenience and comfort
when treated by their doctor.
* Increased production.
* Lower overhead (if root canals are
performed efficiently).
* Busier schedule.
* Personal satisfaction.

* Increased overhead (if root canals
are performed inefficiently).
* Potential for mishaps.
* Loss of patient/patient trust.
* Medicolegal risks.
* Increased capital costs.

WaveOne Gold (Dentsply Sirona) and One
Shape (Micro-Mega) which enable one file
to perform all or most of the mechanized
instrumentation. Such files have simplified
root canal treatments and, for routine cases,
may also reduce treatment times.2
If the root canal quality is not compromised, faster root canals are of great benefit to
your patients, your overhead and production.
Let's face it: No patient-or, should I say,
few patients-love going to the dentist and
spending time in the chair. Faster root canals
mean patients are happier. Furthermore,
spending less time on a procedure makes
your practice more productive and reduces
your office overhead.
Finally, so long as you enjoy performing
root canal treatments, you'll be happy
to know you can provide this important
service to your patients. And in the process
you'll diversify your clinical practice. It's
a satisfying feeling we get when we can
directly look after the patients we've come
to sincerely care for.

we can't ignore the elephant in the room,
which is one of the reasons I love Dentaltown
magazine's motto of "real dentistry for real
dentists."
A case in point is the following: A busier
schedule benefits the practice production
and overhead, but only if you can perform
root canals efficiently and effectively. If
you run into trouble with a case and end
up spending too much time completing
the root canal, it may be a loss financially.
Pardon the obvious, but if the total cost
of your practice overhead, including endo
materials and hourly overhead, ends up
being more than the income from the root
canal, your practice will be losing money.
It's not uncommon to see dentists spend
multiple appointments and many hours on a
root canal. And, unlike a hygiene procedure,
spending extra time on a procedure doesn't
mean you can bill more. In the end, you may
spend more time but still bill the same fee.
In this case, you may end up paying
the patient, so to speak, to sit in your chair
instead of making a net profit from the
procedure. In such a scenario, you'd be
better referring the case to an endodontist.
Furthermore, patients can tell when you run
into trouble as you spend too much time

Potential troubles
Now we get to the potentially somber
side of endodontics. Performing root canals
efficiently and easily is fun to talk about, but

Disclosure:
The author declares that neither he nor any member of his family has a financial arrangement or affiliation with any
corporate organization offering financial support or grant monies for this continuing dental education program.
dentaltown.com \\ MAY 2017

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Table of Contents for the Digital Edition of Dentaltown May 2017