We are unable to accept referrals for endodontics (either
primary or retreat) if the tooth is not of strategic importance -
this would, for example, include teeth that are supporting
essential bridgework, or if the tooth contributes to the
maintenance of a functional dentition (normally a shortened dental
arch of 10 occluding pairs). Most cases accepted for
treatment will be taken to a point where the referring practitioner
should be able to complete treatment.
Referrals not fulfilling the following criteria shall be
- De-novo treatment has been attempted
- There is a specific problem with the tooth, which cannot
otherwise be treated in general practice (cases of complexity 1 and
2 difficulty will normally be referred back with advice); for
> complex root canal anatomy (such as
sclerosed canals or excessive curvature)
> separated instruments
> management of open apices, resorption and
- The tooth is of strategic importance to the patient in terms of
function (normally a shortened dental arch of 10 occluding
- Molar teeth can only be considered for endodontic treatment if
they are strategically important teeth to maintain function, or if
they are important to the retention of a prosthesis.
- The tooth is restorable and functional; it is the
responsibility of the referring dentist to ensure that the tooth is
caries-free, has good periodontal prognosis and any unsatisfactory
restoration has been replaced to ensure a coronal seal is
- Where the medical history supports endodontic therapy over
extraction (e.g. risk of osseonecrosis due to bisphosphonate
medication or previous radiotherapy)
- The patient is a regular attender in practice and is well
motivated with no active caries or periodontal disease.
- The letter of referral contains an indication of the history of
the problem and of the treatment carried out to date.
- A recent (within 3 months) high quality periapical radiograph
of the tooth in question must be sent with the referral letter.
Digital print-outs must be of diagnostic quality.
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