Endodontics acceptance criteria

Referring to endodontics

Patients will normally only be offered a consultant appointment if:

The request is for advice/specialist opinion only.
The referral is accompanied by dated, current, relevant and accurately taken and developed peri-apical radiograph with the apex clearly viewable. When photocopies of digital radiographs are sent they need to be of a high quality and diagnostically useful.
The tooth must be restorable after completion of the endodontic therapy. This must be determined by the referring practitioner prior to referral as most accepted cases will be sent back to the referring practitioner for final restoration following RCT.
For posterior teeth it must be a strategically important tooth within the dentition as a whole. Specifically: it could be a functional tooth in a shortened dental arch, a tooth functioning as a partial denture abutment, a molar tooth when it is one of the patient’s only functioning pair of molars.
The tooth has a curvature above 40 degrees in a strategically important tooth.

Patients will not normally be offered a consultation appointment if:

It is a failed case with inadequate obturation e.g. poorly condensed GP, short or long root fillings or leaking coronal restoration in an otherwise straight forward case. These will be returned for treatment in primary care.
The patient is not registered with a dentist.
The patient states that they are ‘keen to save the tooth’ but the prognosis of such teeth is considered poor or unrealistic.
They have poor plaque control or active caries.
The current restoration is so large and/ or below the bone crest that isolation with dental dam cannot be achieved.
That the patient requires or requests sedation or GA for endodontic treatment.
The referral has been made on the patients inability / unwillingness to pay NHS charges.

Teeth with sclerosed or curved (>40 degrees) root canals that are not considered negotiable by a competent GDP from a radiograph of appropriate quality in a restorable tooth of strategic importance.
For removal of posts/separated instruments where the post/separated instrument is retrievable and the tooth is restorable. This is a specific item of treatment and the patient may be sent back to practice for completion of the root canal therapy.
Perforation repair in cases where this is feasible on strategically important teeth.
Management of open apices, root fractures, resorption and trauma in young teeth.
Peri-radicular surgery of failed anterior RCT in the presence of excellent quality obturation where orthograde re-treatment is not feasible and the rest of the mouth has controlled dental disease and there are high quality restorations present with no active periodontal disease.