Practice Statements Clarify Endodontic Treatment for All Practitioners

Dentistry Today


The American Association of Endodontists (AAE) Board of Directors released two practice statements crafted to improve patient care by all providers of endodontic treatment during its annual meeting in Denver on April 25.

As general dentists perform most root canals but lack the advanced training of endodontists, the AAE developed a white paper to describe the current standards of practice for endodontic treatment that apply to all practitioners. The AAE notes that general dentists should evaluate their competency and skill level against these standards to determine when patients should be referred to a specialist.

AAE White Paper on Treatment Standards” identifies the knowledge, skills, and behavior that define competency in endodontics for any dentist who performs nonsurgical endodontic treatment, the AAE says. It also describes current methods of endodontic access, canal shaping, disinfection, obturation, and restoration.

“The AAE identified these treatment standards to uphold the principles of best practices for nonsurgical root canal treatment,” said AAE president Garry L. Myers, DDS. “Our goal is to ensure patients receive the highest levels of care. If general dentists believe they cannot meet these standards, they have two ethical choices: refer to a specialist or acquire the necessary skills.”

The paper accompanies the AAE’s white paper on endodontic competency released last year, which describes the standards of diagnosis, treatment planning, and prognostication for endodontic treatment.

Also, the AAE reports that patients with long-term sinus problems could actually have an endodontic infection that manifests in the maxillary sinus and has been misdiagnosed by dentists, otolaryngologists (ENTs), or radiologists. Maxillary sinusitis of an endodontic origin (MSEO) refers specifically to sinusitis secondary to periradicular disease of endodontic origin, excluding sinusitis secondary to other dental etiologies.

Previously termed “the endo-antral syndrome,” MSEO requires an accurate diagnosis of the condition followed by appropriate endodontic treatment or extraction to remove the source of the endodontic pathogens associated with the periapical disease and secondary sinus infection.

Position Statement: Maxillary Sinusitis of Endodontic Origin” describes the diagnosis, radiographic examination, clinical examination, and treatment of MSEO. It also encourages collaboration between ENTs and endodontists to achieve the best patient outcomes. While endodontic treatment often can resolve sinusitis, the AAE says, some patients may need additional medical treatment. 

“Typically, patients see a family physician or ENT for what they suspect to be a sinus problem. In fact, MSEO is often overlooked by ENTs who are unfamiliar with endodontic pathology. General dentists may also overlook the cause because the patient lacks dental symptoms,” said Myers.

“Endodontists are uniquely trained and equipped to diagnose and properly manage endodontic disease that manifests in the maxillary sinus. The AAE hopes this paper will go a long way in helping our members establish relationships with ENTs to properly diagnose and treat MSEO,” Myers said.

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