When Should a GP Refer a Root Canal? Cracked Teeth, Trauma & Endo Referrals | Dr. Ryan Walsh
February 4, 2023 · 44 min
When should a general dentist refer a root canal, and when can you treat it yourself?
Show notes
When should a general dentist refer a root canal, and when can you treat it yourself? Endodontist Dr. Ryan Walsh breaks down the three kinds of referring dentists he sees, the cracked-tooth clue that should send you straight to a crown, and why a lesion you've "watched" for five years deserves a second look. He also covers how specialists use CBCT differently, why trauma cases should reach the endodontist the same day, and how a two-way relationship with your specialist makes you a better clinician.
In this episode:
- The three referring dentists: El Presidente, the Perpetual and the Potential
- Why you should secret-shop your own front office
- The most common endo pitfall for GPs: diagnosis
- Cracked teeth: "when I bite it just right," and why about 80% just need a crown
- Tooth Sleuth, cotton-tip and saliva ejector tricks for finding the crack
- Don't just watch that lesion: when to send it for a scan
- How specialists use small field of view CBCT, and why overreads matter
- Dental trauma: why the endodontist should see it as soon as it happens
📰 Plus dental news from early 2023: Dental Assistant Recognition Week, a Ninth Circuit ruling on Medicaid pay for dental therapists, a dental tourism emergency in Costa Rica, the FTC's proposed non-compete ban, and the CDT overhaul project.
Dr. Ryan Walsh is an endodontist in Keller, Texas. He graduated from the University of Iowa College of Dentistry, completed his endodontics residency at Baylor in Dallas, and lectures to dentists and endodontists on endodontics and bioceramics.
Chapters:
0:00 Intro
1:45 News: Dental Assistant Recognition Week
2:24 News: Ninth Circuit ruling on dental therapists and Medicaid
2:55 News: a dental tourism emergency in Costa Rica
4:16 News: a car crashes into a dental office
5:07 News: the FTC's proposed non-compete ban
5:40 News: the CDT overhaul project
6:24 Meet Dr. Ryan Walsh
10:28 The three kinds of referring dentists
12:16 "Dr. Perpetual": referrals with strings attached
14:11 "The Potential": the secret shopper call
15:00 GPs do 80% of root canals
16:14 Secret-shop your own front office
19:22 The most common GP pitfalls in endo
20:39 It comes down to diagnosis
21:35 Cracked teeth: "when I bite it just right"
22:22 Most cracked teeth just need a crown
22:47 Tooth Sleuth, cotton tips and saliva ejectors
25:17 Cracked teeth since COVID
26:15 Why referring makes you a better dentist
28:00 Building a two-way relationship with your endodontist
30:20 Don't just watch that lesion
31:45 How specialists use CBCT differently
33:34 Overreads from a medical radiologist
34:37 Most incidental findings are outside the teeth
37:45 CBCT as an early screening tool
38:37 Dental trauma: call your endodontist right away
41:46 A trauma case: monitoring pulp vitality
43:29 Coming up: histology, and Ryan vs. Tom Viola
45:10 Closing: referrals are a two-way street
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