One of the largest, growing groups of self-pay patients are those over the age of 60. Many of them want to know all the options when it comes to a tooth that is having problems.

According to a 2013 study published in the Journal of the American Dental Association, properly performed endodontic treatment has a success rate equal to implants But this really depends on referring doctors knowing when it is possible to try to save a tooth.

Dr. Lou Berman, a Maryland-based endodontist and Spear faculty member, developed three new Study Club modules to assist referring doctors in determining if a tooth is endodontically salvageable, if periodontal treatment is necessary, and if a tooth can be considered restorable.

“When endodontic treatment is performed without doing a good prognosis assessment you run the risk of a lot of losses; potential loss of the tooth, the potential of unnecessary loss of bone, loss of patient who had a loss of money to treat a tooth that was a loss from the beginning,” Dr. Berman said. “For (referring doctors) to present options to the patient, they need to know themselves what to try to save and what can’t be saved.”

For endodontists, periodontists and oral surgeons, showing any one of these new modules will demonstrate to their study club the importance of referring doctors knowing all the options to treat a patient, he added.

“This will help build trust in your recommendations,” Dr. Berman said. “Patients will be more committed when they know all the options, and if they choose to extract and place an implant, it results in a quality referral.”

Each module presents multiple real-life cases with Dr. Berman methodically assessing and treatment planning each case — some successfully and some not.

Optimizing Success in the Endodontically Treated Tooth

Dr. Berman discusses how to determine the depth of a crack, cold tests and other clinical evaluations, pulpal problems, fracture necrosis, biologic width and invasive cervical root resorption.

Assessing Endodontic Potential and Restorative Implications

Dr. Berman examines five different cases involving pain assessment, cracks, apical lesions, curved mesial roots, pulp necrosis, non-vital teeth, a complicated crown fracture and a partial pulpotomy.

Determining Endodontic Success

Dr. Berman examines removing a silver point for re-treatment, invasive cervical root resorption, furcation bone loss, internal bleaching, necrotic pulp and the protocol for overfilling sealant.

Considering that endodontic treatment is the foundation for restorative treatment, proper prognosis assessment is imperative before providing any dental treatment. Proper treatment planning and an understanding as to the necessity, or potential, for healing of endodontic treatment is key.

The new endodontics modules will leave Study Club members more confident in their ability to:

  • Assess teeth that are endodontically compromised and determine the potential prognosis
  • Methodically approach endodontic assessment
  • Determine when endodontic treatment, re-treatment or extraction is appropriate