Insights from My Endodontic Journey

By Kevin W. Yu, DMD, MS

“Ready in room 5!”

I check the schedule for a third time. I know what I’m doing… right? I start making my way down the hall toward the operatory, lingering in the doorway for a moment before stepping inside.

That was my first day seeing patients as a newly minted dentist. Several years have passed since then, and I now recognize that my time as a general dentist not only developed my ability to deliver comprehensive care, but also taught me how to communicate effectively with patients, how to navigate the chaos of everyday clinical practice, and how to advocate for patients and the profession. As I reflect on my early clinical experiences, I can clearly see how much my clinical skills have improved. More importantly, I can see how general dentistry shaped a more well-rounded understanding of what it means to be a healthcare provider, a sentiment I carried with me into residency.

One of the earliest lessons I learned as a general dentist was that patients rarely present with just a dental issue. Patients came not only for routine cleanings or urgent extractions but often brought with them expectations, anxieties, financial concerns, and complex medical and dental histories. Learning to see the bigger picture beyond just the tooth helped me provide more strategically planned and thoughtfully executed care. This perspective stayed with me throughout residency, where the nature of endodontics can make it easy to focus narrowly on a single tooth. Our CBCT scans are often limited to only capturing a few teeth, and our operating microscopes offer such high magnification that our field of view may be reduced to just a few millimeters. Despite this microscopic focus, my general dentistry background helped me maintain a wider clinical lens. I routinely considered how each case fit into the patient’s overall restorative plan, whether the treated tooth needed an immediate restoration or could tolerate a brief delay, and how the long-term prognosis of that specific tooth aligned with the health and function of the rest of the dentition and the patient as a whole. This mindset allowed me to anticipate restorative challenges, collaborate more easily with referring providers, and build trust with patients by connecting endodontic treatment to their overall oral health goals.

But seeing the bigger picture defined more than just the treatment plan, it also deepened my appreciation for the emotional toll dental treatment can bring to patients. In particular, I saw how root canal therapy often triggered feelings of anxiety and fear in patients, fueled by previous traumatic experiences, horror stories shared by family or friends, or negative portrayals seen in the media. While some patients preferred not to hear the details, many wanted to understand what the treatment involves, why it was necessary, and whether they were making the right decision regarding their treatment. My time in general dentistry prepared me for the nuanced, patient-centered communication required in daily practice. General dentists are often the first to see a patient in a dental emergency and with that comes the responsibility of delivering difficult news, explaining the diagnosis, presenting treatment options, and translating radiographic or clinical findings from dental jargon into terms patients could easily understand. Over time, I learned how to assess a patient’s dental literacy level, emotional state, priorities, and expectations in order to communicate more effectively. Whether I was explaining procedural steps and risks or providing reassurance during treatment, these skills helped me build rapport and manage expectations. Ultimately, this foundation in communication reduced patient anxiety, streamlined procedures, and improved the overall patient experience.

Just as strong communication helped me navigate difficult conversations and procedures, a commitment to learning became vital as I encountered more and more complicated clinical situations. While practicing as a general dentist, I quickly realized that although dental school had provided the fundamentals, it was my responsibility to build on that knowledge in order to respond confidently to whatever situation walked in the door. This sparked a commitment to lifelong learning that I carried into my endodontic residency at Marquette University School of Dentistry. There, I benefited from faculty mentorship, national conferences and symposiums, and study clubs that exposed me to a wide range of philosophies, technical insights, and clinical strategies that helped refine my approach to endodontic treatment. However, what surprised me most during residency was how much I learned through teaching. Preparing lectures and mentoring predoctoral students in both clinic and sim lab forced me to clarify my thinking and articulate the biological principles and clinical rationale behind each decision. Whether explaining a diagnosis, instrumentation technique, or material choice, I had to ensure my reasoning was both clear and sound. Watching students grasp complex concepts and improve their procedural technique under my guidance was rewarding and reminded me that teaching benefits both the learner and teacher.

As I grew clinically and academically, I also began to appreciate the impact I could have beyond the operatory through leadership and advocacy in organized dentistry. After graduating from dental school, I became involved with the Berkeley Dental Society, eventually serving as President. I brought a public health perspective to the board of directors as the only member treating California’s Medicaid population, and helped organize volunteer opportunities with the Berkeley Free Clinic, a nonprofit organization that offers free medical and dental care to the underserved. As Chair of the Continuing Education Committee, I curated general membership meetings that featured diverse speakers from both academia and private practice. These experiences showed me how organized dentistry can influence both clinical practice and public policy. During residency, I had the opportunity to serve on the Practice Affairs Committee of the AAE, where I gained insight into efforts to advance the specialty on a national level. I have also come to appreciate that advocacy happens not only through formal roles, but in daily clinical practice. Endodontists advocate every day by challenging the outdated perception that root canal treatment is inherently painful. By educating patients, delivering compassionate care, and sharing evidence-based practices, we help shift the narrative around endodontics one patient at a time.

Whether through clinical care, teaching, or advocacy, my experiences helped me answer the question of what it means to be an endodontist. Endodontic residency refined my technique, improved my understanding, and taught me how to manage complex cases with confidence. But it was general dentistry that gave me perspective on the patient experience and the realities of practice outside the specialty. Now, as I enter my career as an endodontist, I am thinking not only about how to tackle challenging canal morphologies, but also about the person attached to the tooth. I am thinking about how to bridge the gap between specialty care and general practice. I am thinking about how to continue growing, not just as a clinician, but as a communicator, collaborator, and educator. Each step in my journey has laid the foundation for the next, shaping not only how I practice, but who I am becoming as an endodontist.