Date on Master's Thesis/Doctoral Dissertation


Document Type

Master's Thesis

Degree Name



Oral Biology

Committee Chair

Clark, Stephen J.

Author's Keywords

Post-graduate education; Referral decision; Endodontic education; Treat decision


Dentists--Attitudes; Endodontics--Study and teaching; Medical referral


The decision by a general dentist to treat or refer a patient needing endodontic therapy may be based on multiple variables. Students attending dental schools with endodontic specialty programs could be exposed to a referral system with endodontic residents managing difficult cases and they could have patients transferred to residents for completion of treatment if complications occur. Whereas, students at schools without endodontic programs may have to treat more difficult cases due to a more limited ability to refer cases. The primary aim of this study was to compare the opinion of general dentist graduates trained with and without endodontic programs as to whether they would be inclined to treat or refer to a specialist their patients requiring specific endodontic procedures. After IRB approval, a survey was electronically distributed to the members of the Kentucky Dental Association using the online survey tool Surveygizmo®. General dentists were asked their gender, dental school attended, year of graduation, history of any GPR/AEGD training, and presented a list of 18 specific endodontic procedures or possible complications. They were asked whether they (1) would likely treat the patient, (2) would likely refer the patient, or (3) were neutral. Presence/absence of an endodontic graduate program during the years of their dental education and the number of years of practice were calculated from the data provided. Odds ratio was used to assess statistical significance. Surveys were electronically distributed to 955 members of the Kentucky Dental Association. 230 dentists (24%) responded with 191 general dentists completing the survey. 137 respondents (71.7%) were male and 54 (28.3%) were female. 92 (48.2%) trained at a dental school without an endodontic program and 95 (49.7%) trained at a school with an endodontic program. Dentists trained at a school without an endodontic program were significantly more likely to treat rather than refer (1) teeth with calcified canals (23.9% vs 9.5%, P = .017), (2) teeth with significantly curved canals (28.3% vs 9.5%, P = .001), (3) periapical surgery on anterior teeth (16.3% vs 6.3%, P = .037), and (4) endodontic treatment on patients with traumatic injuries such as avulsion (52.2% vs 34.7%, P = .019). The results of this study indicate the presence or absence of an endodontic graduate program during a student's dental education may influence subsequent decisions in private practice to either refer to a specialist or to treat patients requiring endodontic therapy.