Future of Endo specialty

[rs17]

I am a fourth year female dental student, and interested in Endo. I like to get some feedback from endodontists on this forum.

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[Cranjis McBasketball]

I am a fourth year female dental student, and interested in Endo. But I hear negative feedback from faculty and a family friend who is an endodontist about rotaries and implant affecting his referrals. I like to get some feedback from endodontists on this forum. It seems number of referrals are going down and Apico's are rarely done except anterior teeth in today's market. He feels market is getting tougher every year and he is having a hard time to get referrals. His referrals are mainly re-treatments. He encouraged me to apply to oral surgery which is another specialty I am interested, but at the same time 4-6 year is a big commitment especially for a female provider who wants to start a family. I kept my rank and GPA high so I only need to take CBSE if I want to do oral surgery. But I like to hear more from specialist or even GP's about this subject.

I work for an endodontist and he said the same thing about Oral Surgery. He isn't worried about the endodontics specialty though. As he pointed out, most young dentists try and do the root canals cause they have a big loan to pay off. However, he said once that loan is paid off and they've been working for a while dentists just don't like to do root canals. So his referrals are mainly, and probably always will be, from the older dentists. He also pointed out that the patients that get their root canals done from young dentists almost always are back within 5-10 years for re-treatments. So in the end, he still sees them. Plus he makes a ton of money and has a very nice lifestyle.

 

[EndoRes2016]

I am a fourth year female dental student, and interested in Endo. But I hear negative feedback from faculty and a family friend who is an endodontist about rotaries and implant affecting his referrals. I like to get some feedback from endodontists on this forum. It seems number of referrals are going down and Apico's are rarely done except anterior teeth in today's market. He feels market is getting tougher every year and he is having a hard time to get referrals. His referrals are mainly re-treatments. He encouraged me to apply to oral surgery which is another specialty I am interested, but at the same time 4-6 year is a big commitment especially for a female provider who wants to start a family. I kept my rank and GPA high so I only need to take CBSE if I want to do oral surgery. But I like to hear more from specialist or even GP's about this subject.

GP's doing more Endo does not hurt the Endo specialty at all. Plenty of retreats to go around. And most GP's won't (shouldn't) tackle the hard cases like long teeth or teeth with extreme curvatures or any barrier cases or revascularizations. They simply cannot provide the same standard of care as an endodontist with specialized equipment (ultrasonics, microscope, CBCT, etc) to their patients. I'm not worried about Endo at all.

 

[wildrice]

Surgical endo is becoming more rare with time - mostly because of the options that implants provide for patients. Ultimately, most patients want less dentistry.

Apart from that, endo and OS are quite different - in terms of scale. That being said, endo and OS are probably the specialties that have the least to worry about relative to eventual variability in the economy - even though endodontists do ~20% of the NSRCTs. Ortho can be a real bucket of crabs if you want to live in popular areas (SoCal, Fl, DC -> Boston corridor)

 

[rs17]

Thank you guys for your feedback. I started to study for CBSE for 2 months, but eventually realized Endo is a better specialty for me. I have visited several programs and will apply to Endo next year. I look forward to getting into an Endo program next year.

 

[Alpha Centauri]

Thank you guys for your feedback. I have started to study hard for CBSE and apply to OS this summer. OS has a broad scope and less concerns about future unlike other specialties. But I appreciate everyone's feedback.

Good luck

 

[vellnueve]

Some of my closest friends are endodontists. Very few GPs will want to tackle difficult molars or retreats regularly as the armamentarium is very costly and the procedures aren't cost effective if you're not doing them exclusively. Endo is going nowhere.

 

[TanMan]

I once wanted to do endo... but then I realized that you don't need to be an endo to do root canals. Technology makes it very easy to do most of them, and as a GP, RCT, buildup, and crown is your bread and butter. Endo isn't going anywhere, that's for sure, but as a specialist, you'll get the more difficult cases and the screw ups as well. You can't do crowns or crown lengthening as an endodontist.

 

[hahadino2771]

Absolutely agree with this posting. GPs should be able to do all the easy rcts.
Endodontists will get super hard cases like second molars, retreats, calcified canals, limited mouth opening, crazy patients etc

endo is not going anywhere. It is fair for GPs to expand their scope of clinical practice to the extent that they are comfortable with, including implants, extractions, basic orthos, and easy pedos. But that does not mean that endos will struggle. Endos will still do well but they just end up working on hard ass cases.

No matter what kind of cases are referred out to specialists, they should be thankful and appreciate of the referrals from GPs. After working with multiple specialists around my area, it is all about personality, attitudes and relationship with GPs that heavily affect on success of specialists.

I already stopped referring out to arrogant, aggressive oral surgeon around me, but apparently my other GP buddies in town blacklisted him for referral. so it is not the technology that determines the fate of specialists. It is all about personality and relationship. Be nice to GPs.

I once wanted to do endo... but then I realized that you don't need to be an endo to do root canals. Technology makes it very easy to do most of them, and as a GP, RCT, buildup, and crown is your bread and butter. Endo isn't going anywhere, that's for sure, but as a specialist, you'll get the more difficult cases and the screw ups as well. You can't do crowns or crown lengthening as an endodontist.

 

[makohunter18]

I've spoken to many GDs who don't do RCTs. They refer everything, easy and hard, out. Referrals are out there.


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[Longshot.308]

This is simply an observation I don't have any emperical data on this. I graduated dental school 6 years ago so I am a farily recent graduate. I feel like endodontic training expecially in molars is getting less and less in dental school I feel like dentists that graduated 20-30 years ago had more expereince in school with molar endo. I see young grads that get out focusing a lot of their time and continuing education into implants. Implants seem to be the sexy popular thing to be able to do right now. Certainly there are teeth that get extracted for an implant that would have maybe gotten an attempt at a root canal 20 years ago but I think that young grads are focusing their skills on implant placement and not endodontics. So i think there will contine to be a healthy referral source for endodontists for years to come.

 

[PTSD]

Established endos will continue to get endo referrals from their gp friends whose debts are paid off and only want to do the dentistry they enjoy. The young gps coming out of school with 400k of debt can't afford to refer to endo. If they think the second molar endo looks hard, it turns into the ext/graft/implant from the course they took last Saturday. Don't ask specialists in their 50s and their similarly aged referrals about endo. Ask the young guys who just took a master endo A- Z this Saturday course how many endos they plan to refer. Ask a 30yo endo how many referrals he is getting from 30yo gps. Look at dentaltown. People scoff at the idea of referring. Better to take a "mini-residency" and teach yourself on the job.

 

[Cranjis McBasketball]

Established endos will continue to get endo referrals from their gp friends whose debts are paid off and only want to do the dentistry they enjoy. The young gps coming out of school with 400k of debt can't afford to refer to endo. If they think the second molar endo looks hard, it turns into the ext/graft/implant from the course they took last Saturday. Don't ask specialists in their 50s and their similarly aged referrals about endo. Ask the young guys who just took a master endo A- Z this Saturday course how many endos they plan to refer. Ask a 30yo endo how many referrals he is getting from 30yo gps. Look at dentaltown. People scoff at the idea of referring. Better to take a "mini-residency" and teach yourself on the job.

I work for an endodontist and i cant tell you how many people come in because a GP screwed up a root canal haha either screwed it up and didnt finish or did it within a year ago and the people are back. Its all new grads too. So hes never been busier

 

[Endo16]

I work for an endodontist and i cant tell you how many people come in because a GP screwed up a root canal haha either screwed it up and didnt finish or did it within a year ago and the people are back. Its all new grads too. So hes never been busier

After working for few months, I realize how happy I am with a choice of becoming Endodontist. It is a great career.

 

[56101991]

Are the "screwed up" cases in addition to other referrals enough to keep you busy each week?


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[Cranjis McBasketball]

Are the "screwed up" cases in addition to other referrals enough to keep you busy each week?


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Probably many factors determine this. Im just a low assistant, but for the endodontist I work for, yes we are extremely busy. However he has been practicing 20 years and has an extreeeeeemely great reputation and relationship with all the dentists in the area. However, he hired an associate a few years back and he didnt last cause there just wasnt enough for him to do. So probably a lottttt that determines if youre going to be busy

 

[piratesword]

I am a GP with 11 yrs exp and residency in Operative Dentistry. I like endo, do most of RCT even retreat. In general I refer difficult cases. I am applying to endo this year, hopefully, will get accepted
I have an endodontist friend and asked him about his future. As many colleagues said, Endodontist still find patients. For sure, implant, new endo systems (that is accessible to GP) has decreased referral. Old dentist, busy young dentist always refer endo, as 1-1.5hr for rct that return in $650-850, doesn't worth for GP as he/she could do 2 crowns or 8 fillings that produce more than $1000.
I worked in many places and covered absent dentists. You won't believe it but I have seen disasters. A lot of unprofessional dentists do crappy rct, and unfortunately rct takes awhile to fail. By the time it fails, GP might quit from the office, patient moved. So all these failed rct will go to endodontists.
Second, endodontist only need to work 3-4 days, 3-4 cases a day to make good money.
In my point of view, endodontist should start to consider implant as prosthodontist did to boost their production.

 

[gatorfan99]

I am a GP with 11 yrs exp and residency in Operative Dentistry. I like endo, do most of RCT even retreat. In general I refer difficult cases. I am applying to endo this year, hopefully, will get accepted
I have an endodontist friend and asked him about his future. As many colleagues said, Endodontist still find patients. For sure, implant, new endo systems (that is accessible to GP) has decreased referral. Old dentist, busy young dentist always refer endo, as 1-1.5hr for rct that return in $650-850, doesn't worth for GP as he/she could do 2 crowns or 8 fillings that produce more than $1000.
I worked in many places and covered absent dentists. You won't believe it but I have seen disasters. A lot of unprofessional dentists do crappy rct, and unfortunately rct takes awhile to fail. By the time it fails, GP might quit from the office, patient moved. So all these failed rct will go to endodontists.
Second, endodontist only need to work 3-4 days, 3-4 cases a day to make good money.
In my point of view, endodontist should start to consider implant as prosthodontist did to boost their production.

No, Endos don't need to consider implants at all. Endos will always be needed, its a great specialty to get into. An implant is completely different beast and, honestly, boosting production is not something that's needed, if you are good Endo - unless you have poor interpersonal skills or want to work in some ridiculously saturated place (which then again, its sort of your fault for choosing your location poorly).

 

[piratesword]

I agree with you. I am just saying to boost their production if they are not satisfactory with their job.

 

[DDSER1]

If you end up specializing in endo, and aren't getting as much referrals as you would like, could you always give up your specialist status and go back to GD?

 

[RoseEndo]

Market has been affected and new grads will have a harder time than my generation, but it is a still good career.

 

[periopocket]

If you end up specializing in endo, and aren't getting as much referrals as you would like, could you always give up your specialist status and go back to GD?

Yes, you always can. To tell you the truth some of the richest dentists out there are GPs that are junior endodontists capable of churning out molar endo at lightening speeds, then billing for core build up and crown.

To make the big bux you got to be good at at least some kind of specialty procedure whether it be OS, endo or implantology.


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[periopocket]

Market has been affected and new grads will have a harder time than my generation, but it is a good career for women endodontist to be on-call and get called anytime there is a patient. I see more and more in-house endodontist and it is win-win for both GP and specialist. Unfortunately, every one of my colleagues who plan to retire still look for more income, and start a rotary or bioceramic sealer business affecting their own specialty that one day served them to feed their family. We loose best and brightest like you because of these concerns and then program directors look for foreign grads to fill residency spots. And every year we see fierce competition for oral surgery because they had a better vision for their specialty and they kept their scope of training broad enough to survive challenges of today’s market. Best of luck on your application for oral surgery.

Many job openings for traveling endos. Deft win/win for both parties. Amongst the highest number of traveling specialty openings on dental town classifieds and indeed.com. Many traveling jobs for specialties in general so great way to supplement income and necessity while establishing new practice at times.

As for foreign grads occupying specialty programs it's because A.) Money B.) Credentials...many times those foreign grads are amongst the top in their class so many dental schools have made contracts with Saudi to take 1-2 of their best into specialties including endo/perio/ortho...they charge them 100k per year. Many programs would rather take #1 BDS candidate from king saud at 100k per year vs American grad with Lower rank and lower profits for the department. They generally go home after so less competition for department once they complete program to.


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[FanOfCostco]

Many job openings for traveling endos. Deft win/win for both parties. Amongst the highest number of traveling specialty openings on dental town classifieds and indeed.com. Many traveling jobs for specialties in general so great way to supplement income and necessity while establishing new practice at times.

As for foreign grads occupying specialty programs it's because A.) Money B.) Credentials...many times those foreign grads are amongst the top in their class so many dental schools have made contracts with Saudi to take 1-2 of their best into specialties including endo/perio/ortho...they charge them 100k per year. Many programs would rather take #1 BDS candidate from king saud at 100k per year vs American grad with Lower rank and lower profits for the department. They generally go home after so less competition for department once they complete program to.


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It sounds like you are from a school with a 617 area code....

 

[dudeitsme]

What is the daily rate per day for endodontist??? Or is it typically a certain % of production?

 

[periopocket]

What is the daily rate per day for endodontist??? Or is it typically a certain % of production?

Standard: 50% production. Specialist and GP split the cost of materials. Gp provides op and assistant.


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