Improving patient care by all providers of endodontic treatment is the goal of two practice statements approved by the American Association of Endodontists' Board of Directors at its annual meeting in Denver this week.
AAE White Paper on Treatment Standards
Recognizing that general dentists perform the majority of root canal treatments but lack the advanced training of endodontic specialists, the AAE developed a white paper on treatment standards to describe the current standards of practice for endodontic treatment that apply to all practitioners. General dentists should evaluate their competency and skill level against the standards to determine when patients should be referred to a specialist.
The white paper identifies the knowledge, skills and behavior that define competency in endodontics for any dentist who performs nonsurgical endodontic treatment. It describes current methods of endodontic access, canal shaping, disinfection, obturation and restoration.
"The AAE identified these treatment standards to uphold the principles of best practices for nonsurgical root canal treatment," explained AAE President Dr. Garry L. Myers. "Our goal is to ensure patients receive the highest levels of care. If general dentists believe they cannot meet these standards, they have two ethical choices: refer to a specialist or acquire the necessary skills."
The Treatment Standards White Paper accompanies the AAE's white paper on Endodontic Competency released last year, which describes the standards of diagnosis, treatment planning and prognostication for endodontic treatment.
Position Statement: Maxillary Sinusitis of Endodontic Origin
Patients with long-term sinus problems could actually have an endodontic infection that manifests in the maxillary sinus and has been misdiagnosed by dentists, otolaryngologists (ENTs) or radiologists. Maxillary sinusitis of an endodontic origin (MSEO) refers specifically to sinusitis secondary to periradicular disease of endodontic origin, excluding sinusitis secondary to other dental etiologies. Previously termed "the endo-antral syndrome," MSEO requires an accurate diagnosis of the condition followed by appropriate endodontic treatment or extraction to remove the source of endodontic pathogens associated with the periapical disease and secondary sinus infection.
The AAE's position statement describes the diagnosis, radiographic examination, clinical examination and treatment of MSEO. The statement also encourages collaboration between ENTs and endodontists to achieve the best patient outcomes. While endodontic treatment often can resolve sinusitis, some patients may need additional medical treatment.
"Typically, patients see a family physician or ENT for what they suspect to be a sinus problem. In fact, MSEO is often overlooked by ENTs who are unfamiliar with endodontic pathology. General dentists may also overlook the cause because the patient lacks dental symptoms," said Dr. Myers. "Endodontists are uniquely trained and equipped to diagnose and properly manage endodontic disease that manifests in the maxillary sinus. The AAE hopes this paper will go a long way in helping our members establish relationships with ENTs to properly diagnose and treat MSEO."
Both statements are available on the AAE website at aae.org/guidelines, along with additional clinical resources to aid in case selection and treatment planning.