Dr Bob Philpott, specialist endodontist, discusses how to make endodontics work for you, how to improve efficiency and deliver better outcomes for your patients.

When we consider our outcomes in endodontics, ‘is it actually worth it?’ is a question that often springs to mind. Working as a specialist endodontist, I understand the stress that clinicians face and my aim is to try and share some of my experience to see how we can improve efficiency and deliver improved outcomes for our patients.

Endodontics is a rarely appreciated discipline as it can be time-consuming, stressful and patient expectations are usually pretty low. Long, difficult appointments can lead to frustration and drained profitability with the added worry of litigation increasingly brought against clinicians by patients should things go wrong.

Does endodontics pay?

Reflecting on your own practice – do you get paid per root canal treatment, charge an hourly rate or are you salaried depending on where you work? One of the problems in dentistry is that we don’t think enough about profit. We can look at what we are being paid per treatment, but if this takes several visits in difficult cases, it does not reflect the amount of work we actually do.

Maximising efficiency

In endodontics, to get the best possible outcomes, know your own ability and limitations; only take on cases you can comfortably treat and refer cases that you can’t. In that way, treatment can be carried out in a single visit in most cases, saving time, money and stress for both you and your patient.

Keep your setup simple and have your nurse working closely with you. Think of endodontics as ‘four-handed dentistry’ – without your nurse on board you’ll struggle to do a good job. Establish what you hope to achieve, how you’re going to achieve it and the instrumentation and restorative systems you’re going to use.

Less files = less expense

When it comes to cost-effective endodontics the maths is simple: less files = less expense. You need to fully understand how your endodontic tools work to avoid instrument fracture to save on costs. Nickel titanium files offer huge advantages over stainless steel hand files as they are far more resistant to cyclic fatigue whilst allowing you to work in a safer and more effective way.

For me, reciprocation is the way forward. Waveone Gold (Dentsply Sirona) is one of the best improvements in endodontic file systems I’ve seen. Reciprocation can help to reduce overall costs as the majority of cases can be completed using just one single primary file.

It’s also a false economy to use files that come from manufacturers without the reassurance of proven research and development behind them, for example ‘cheaper’ files that can be found online. These files will break and in the new world of compensation culture patients may sue, a situation no clinician wants to find themselves in.

Aim for success

Modern endodontic systems make straightforward endodontic treatment a real option for the majority of general practitioners. Knowing your own ability and only treating cases within your ability not only helps to drive businesses forward, it saves on costs, and importantly, provides the best outcomes for your patients.


To find out more about the extensive range of endodontic solutions, materials and equipment, please visit dentsplysirona.com or call us on 01932 853 422.

You can also access a range of education resources, video tutorials, courses and CPD webinars at dentsplysirona.com/ukeducation.

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