Endodontics is hard work, both physically and mentally. I’m not complaining, just stating facts. Anyone who has spent some time in the “trenches” practicing clinical endodontics can attest. The other evening as I was pondering my day, I felt especially tired. The reality was I didn’t really do anything different than the previous days. What was different was I had a number of patients questioning the scientific validity of what we do. We’ve all heard it: “Root canals cause cancer, root canals lead to other diseases, how can you leave a dead organ in the body”. My problem, I realized was not that I was any more physically tired than the day before, I was however mentally taxed! As clinicians, we’ve always had to correct patient misunderstandings, misconceptions and mistruths but over the past decade and especially the last couple of years we’ve entered a new era, one in which misinformation isn’t merely occasional, it’s systemic. What patients see on TikTok, hear from influencers, or read in online forums now competes directly with our training and expertise. Instagram is the new Dr. Google where once upon a time we were “bothered”, occasionally, by a patient that looked something up online. The consequences are no longer limited to chair-side confusion-they affect treatment decisions, access to care, public trust, and even governmental policy.
Our surveys show us nearly one-half of young adults and 70% of teens look to social media for health advice. Additionally, one-third to one-half of those that seek advice from social media and act on it, later regret it!
Mis/Disinformation—What’s the difference?
In endodontics, the distinction between misinformation and disinformation is important because the intent behind inaccurate information directly affects how it should be addressed. Misinformation refers to incorrect or incomplete information that is shared without the intent to deceive, often arising from outdated evidence, misinterpretation of studies, or oversimplification of complex clinical concepts. In contrast, disinformation involves the deliberate dissemination of false or misleading claims, often to promote a product, ideology, or personal agenda despite contradictory evidence. While misinformation can typically be corrected through education, clarification, and updated guidelines, disinformation poses a greater threat to patient safety and professional integrity, as it undermines evidence-based decision-making and erodes trust in the specialty. Recognizing this difference allows endodontists and professional organizations to respond appropriately, educating when errors are unintentional and confronting disinformation that is intentionally misleading with clear, authoritative, and transparent guidance.
The New Mis/Disinformation Pipeline
Historically, dental guidance flowed from professional organizations like the AAE or ADA, dental schools, and licensed providers. Patients sought us as a trusted source not only for information but also for care. Today, information reaches patients through platforms optimized for engagement, not accuracy. The more sensational the claim (“root canals cause cancer, fluoride is poison, baby teeth don’t matter”), the faster it spreads.
Compounding the issue is the rise of AI-generated health content, product-driven marketing disguised as advice, and individuals with no clinical background positioning themselves as authorities. Patients often don’t question the source, they respond to tone, relatability, and repetition. Algorithms reward engagement, not truth. And few dental professionals produce content at the same volume, or speed, as influencers.
There is also a growing cultural preference for “natural” or “alternative” solutions, which can make evidence-based care seem overly clinical or commercial by comparison unless we explain the why behind our recommendations.
Additionally, today’s polarized political climate has eroded public trust in institutions, causing even established dental science, like fluoride use or root canal safety, to be questioned through ideological lenses rather than evidence. As a result, misinformation in dentistry is no longer just a matter of correcting facts, but of rebuilding trust in the profession amid competing narratives driven by algorithms, influencers, and regulatory conflict.
Real-World Consequences for Dentistry
We are seeing predictable outcomes:
- Delayed or refused treatment: Patients forgo root canals, fluoride therapy, sealants, or restorative care based on online claims.
- Increased emergencies: Abscesses, advanced decay, and lost teeth rise when misinformation delays intervention.
- Fragmented trust: Patients come into appointments skeptical, guarded, or convinced they need to “fact-check” clinical advice.
- Longer chair-side time: More of our conversations now begin with myth correction rather than prevention or treatment planning.
- Professional vulnerability: Misconceptions create pressure on standards of care and influence legislation and insurance policies.
These effects are not isolated to any one demographic. Colleagues in rural practices, urban clinics, faculty settings, and private offices report similar patterns. Misinformation is now a shared challenge across the profession.
Our Responsibility, and Opportunity
Misinformation and disinformation will not be corrected by silence. Patients are not rejecting evidence as much as they are reacting to what feels familiar, human, and repeated. This is a communication problem, not an intellectual one, and we are well-positioned to address it.
Here are some practical ways we can address this problem.
- Reach out to the AAE This year the AAE launched a “Mis/Disinformation Response Toolkit” (org/misinformation)
What the AAE Is Doing to Confront Mis/Disinformation
The American Association of Endodontists has made addressing dental misinformation and disinformation a strategic priority, recognizing that these false narratives now directly affect patient trust, treatment decisions, and the practice of evidence-based endodontics.
In response to the rapid spread of misleading claims about root canal treatment on social media, the AAE has taken deliberate steps to engage misinformation where it originates. This includes recent collaborations with credible, medically aligned social media creators to dispel common myths about root canals using clear, relatable, and evidence-based messaging. By partnering with trusted voices who already reach large public audiences, the AAE is helping ensure accurate information appears in the same digital spaces where misinformation thrives — and in a format patients are more likely to see and understand.
Beyond the toolkit, the AAE continues to monitor emerging misinformation trends, integrate myth-busting education into member communications and continuing education, and engage with media outlets to proactively elevate accurate, evidence-based information about tooth preservation and endodontic treatment. These efforts reflect a broader commitment not only to correcting false claims, but to rebuilding public trust in dental science through transparency, consistency, and credible communication.
- Address it directly and early. When patients mention online claims, responding with empathy and clarity works far better than dismissal.
- Strengthen patient-facing communication.
Brief, visual, relatable explanations beat jargon. Patients don’t need our textbooks, they need our translation. - Engage where misinformation lives.
Associations, academic leaders, and even individual clinicians can and should coexist with influencers on digital platforms, not ignore them. Every endodontist has the same opportunity to go online and combat misinformation - 5. Equip the whole dental team.
Assistants and administrative staff are often the first to hear patients’ doubts. Consistent internal messaging matters. - Use real patient outcomes.
Stories of avoided complications or successful interventions carry weight against abstract fearmongering. - Advocate at the regulatory and educational level.
Mis/Disinformation influences policy and curricula, and our organizations must stay ahead of that curve.
Reclaiming Authority Without Arrogance
Patients are not the enemy, and neither is curiosity. The problem is not that people seek information, but that they rarely know how to evaluate it. As licensed professionals, we carry both the burden and the privilege of being trusted sources. Countering misinformation doesn’t mean entering the social media fray uninvited—it means being visible, responsive, and unified in tone and message.
We can’t prevent every influencer post or dental myth from circulating, but we can ensure our voice remains louder, clearer, and grounded in data and patient outcomes. The more we lead the dialogue rather than react to it, the stronger our influence becomes.
Misinformation and Disinformation is not going away, but neither is dentistry’s responsibility to protect patients from it. By acknowledging the problem and responding strategically, we reinforce the credibility of the profession and safeguard the health of those we serve.
By Christine I. Peters, DMD; Bettina Basrani, DMD, MS, PhD; and Ove A. Peters, DMD, MS, PhD
Almost every clinician who performs root canal therapy has lived some dreadful moment leading to a halt of treatment: something does not look and feel right or behaves incorrectly. Anatomy surprises us, the root canal is not to be found or is tight and the instrument suddenly looks shorter. Perhaps there is unexpected bleeding. Abrupt pain could be experienced during treatment. The patient returns the next day with a swelling, or worse, with a story that begins, “Ever since you treated me yesterday, my face feels different.”
Endodontic treatment follows a structured sequence: diagnosis, access, cleaning, shaping, and obturation—but biology rarely adheres strictly to protocol. Patients bring complex medical, dental, and emotional histories that influence outcomes in ways we cannot always foresee.
We hope mishaps never occur, but the reality is that procedural errors and complications are an inherent part of endodontic practice. Entire textbooks1 have been devoted to endodontic mishaps because, statistically, they can happen to every clinician over a long enough timeline. What matters most is not whether errors occur, but how we recognize them, respond to them, and prevent them from happening again.
At the 2025 AAE Annual Meeting in Boston, our session “What Happens When Everything Goes Wrong?? Errors and Complications in Nonsurgical Root Canal Treatments—And How to Make It Right” gave us an opportunity to explore serious, sometimes surprising events that can occur during routine procedures. We explored a broad spectrum of complications ranging from misdiagnosis and non-healing lesions to access errors, irrigation accidents, subcutaneous emphysema, file separation, and unusual anatomical variations. Some of these events are rare; others are preventable missteps that can occur particularly when we are rushed, fatigued, or working in anatomically challenging situations.
In this Communiqué contribution, we expand on two consequential classes of complications: irrigation-related accidents and shaping-related mishaps. Clinicians consistently identify root canal treatments as stressful2: They share common themes: anatomical complexity, loss of control at a critical moment, and the importance of deliberate decision-making once a problem arises.
Our goal is to provide practical guidance and pragmatic prevention advice, so that when complications occur, clinicians have both a systematic approach for managing them and the confidence to make the right decisions for their patients: clinically, ethically, and emotionally.
As we emphasized at the AAE Meeting in Boston, mistakes happen and are not the end of the road. They are opportunities for reflection and refinement. When clinicians understand not only what went wrong, but why, our profession as a whole becomes safer and stronger.
Irrigation Mishaps: When Chemistry Meets Anatomy
Among all endodontic complications, sodium hypochlorite (NaOCl) accidents evoke perhaps the strongest emotional response. They are sudden, dramatic, and unsettling for both patient and clinician. A routine appointment can change within seconds into an acute event marked by severe pain, rapid swelling, and soft-tissue discoloration that may evolve over hours or days.
Although these accidents are often perceived as unpredictable, clinical experience and published data reveal consistent patterns3. Most NaOCl injuries occur in the maxilla, particularly in molars where buccal cortical bone may be thin or fenestrated. Female patients appear disproportionately represented, likely reflecting anatomical differences in bone and soft-tissue thickness. In a significant subset of cases, an unrecognized perforation, resorptive defect, open apex or bone fenestration creates a pathway for irrigant extrusion even when technique is otherwise careful.
Anatomy alone, however, does not cause a sodium hypochlorite accident. Most events result from positive pressure irrigation combined with momentary needle wedging or overly deep placement. When coronal escape of irrigant is blocked, solution follows the path of least resistance into periapical or soft tissues. The clinical presentation, immediate sharp pain during irrigation, profuse bleeding, rapidly expanding swelling, and ecchymosis, is distinct and should not be mistaken for a routine postoperative flare-up. (Fig. 1)
When an irrigation accident occurs, the clinician’s response matters enormously4. Immediate cessation of treatment and clear, calm communication are essential. Gentle irrigation with saline helps dilute residual NaOCl. Cold compresses in the initial phase, appropriate analgesia, and selective use of corticosteroids help manage inflammation and pain. Antibiotics are indicated when mucosal integrity is compromised or infection risk is elevated. Close follow-up, particularly during the first 24 to 48 hours, is critical, and advanced imaging or medical collaboration may be necessary when swelling threatens deeper fascial spaces.
Despite the alarming early presentation, outcomes are generally favorable. With structured supportive care, most patients recover fully, even after severe tissue reactions. In many cases, the long-term impact of the event depends less on the injury itself than on how it is managed and communicated.
Prevention remains the most effective strategy. Safe irrigation requires respect for anatomy and constant control: avoiding needle binding, maintaining distance from the working length, ensuring visible irrigant backflow, and using side-vented needles with gentle pressure. Adequate canal preparation before irrigation is essential. When risk factors such as large lesions, immature apices, or suspected fenestrations are present, modifying the irrigation strategy, or using negative-pressure systems, can significantly reduce risk. While NaOCl accidents cannot be entirely eliminated, thoughtful technique and anatomical awareness make them exceedingly uncommon.
Shaping Mishaps: When Instruments Meet Reality
Shaping complications tend to develop more quietly than irrigation accidents. They often begin with subtle warning signs: a file that catches unexpectedly, loss of tactile feedback, or a slight deviation noticed on a radiograph. If not recognized early, these small deviations can progress to ledges, transportation, perforations, or instrument separation.
Many shaping mishaps originate during assessment. Two-dimensional radiographs, while indispensable, cannot fully represent three-dimensional root canal anatomy. Severe curvatures, apical bifurcations, S-shaped canals, and unusual molar or premolar configurations are easily underestimated. Small field-of-view CBCT has proven invaluable in complex posterior cases and can meaningfully alter treatment planning before irreversible steps are taken. (Fig. 2)
Insufficient glide-path preparation remains another major contributor. Contemporary nickel–titanium systems are remarkably capable, but they cannot compensate for a canal that lacks a smooth, reproducible pathway5. Without an adequate glide path, rotary or reciprocating instruments are subjected to increased torsional and cyclic stresses. In addition to classic torsional failure and cyclic fatigue, emerging evidence highlights torsional fatigue as a combined failure mechanism affecting modern instruments.
Instrument fracture remains one of the most anxiety-provoking events in endodontic practice. Yet presence of a retained instrument fragment itself is not synonymous with failure6. The prognosis depends heavily on fragment location, canal anatomy, remaining tooth structure, and the quality of disinfection achieved prior to separation. Aggressive retrieval attempts, particularly without magnification or appropriate training, can convert a manageable complication into perforation, root fracture, or tooth loss.
When a file fractures, the most important immediate step is restraint. Clinicians must review anatomy and obtain additional imaging when necessary. The next step is to evaluate whether retrieval, bypassing, retention, or referral is most appropriate preserves both the tooth and the clinician’s judgment. Transparent communication with the patient is essential. Referral, when warranted, reflects professionalism rather than inadequacy.
Preventing shaping mishaps relies on respect for anatomy, for instruments, and for one’s own limits. Establishing a reliable glide path, allowing files to cut without force, maintaining lubrication and irrigation, and limiting instrument reuse are all critical. Single-use protocols remain the safest option in challenging anatomy. Knowing when not to proceed is a hallmark of clinical maturity.
The Path Forward
Endodontic complications are never welcome, but they are powerful teachers. They remind us that dentistry is not merely a technical sequence, but a dynamic interaction between biology, judgment, and human responsibility. Excellence is not defined by the absence of errors, but by the ability to recognize them early, respond thoughtfully, and recover in a way that prioritizes patient safety and trust.
Clinicians may focus on procedural errors such as the ones described here while not considering other unfavorable outcomes such as life-threatening infections7 or even not recognizing a neoplasm. Irrespective, when we think that everything goes wrong, the most important action may be the simplest: pause, reassess, and proceed deliberately. Complications are not the end of the road, they are opportunities to refine judgment, deepen understanding, and deliver better care for our patients.
References
1 Torabinejad M, Sabeti M (eds). Management of Endodontic Complications. 1st edn, 2023, Quintessence, Batavia, IL, USA
2 Dahlström L, Lindwall O, Rystedt H, Reit C. ‘Working in the dark’: Swedish general dental practitioners on the complexity of root canal treatment. Int Endod J 2017;50:636-645
3 Cho-Kee D, Basrani BR, Vera J, Ordinola-Zapata R, Aguilar RR. Sodium Hypochlorite Accidents: A Retrospective Case-series Analysis of CBCT Imaging and Clinician Surveys. J Endod 2025 51:1485-1489.
4 Farook SA, Shah V, Lenouvel D, Sheikh O, Sadiq Z, Cascarini L, Webb R. Guidelines for management of sodium hypochlorite extrusion injuries. Br Dent J 2014;217:679-84.
5 Plotino G, Nagendrababu V, Bukiet F, Grande NM, Veettil SK, De-Deus G, Aly Ahmed HM. Influence of Negotiation, Glide Path, and Preflaring Procedures on Root Canal Shaping-Terminology, Basic Concepts, and a Systematic Review. J Endod 2020;46:707-729.
6 Parashos P, Messer HH. Rotary NiTi instrument fracture and its consequences. J Endod 2006;32:1031-43.
7 Shemesh A, Yitzhak A, Ben Itzhak J, Azizi H, Solomonov M. Ludwig Angina after First Aid Treatment: Possible Etiologies and Prevention-Case Report. J Endod 2019;45:79-82.
Figure 1: Clinical impression of a sodium hypochlorite accident. Photographs show the dramatic progression in the first 24 hours.
(Case courtesy Dr. Ray)
Figure 2: Clinical example of a mandibular second molar with unusual anatomy. Postoperative radiographs show the presence of a retained instrument fragment along with further procedural errors.
The AAE Constitution and Bylaws Committee presents proposed revisions to the Constitution and Bylaws of the American Association of Endodontists. These proposed revisions have undergone review by the committee, AAE Legal Counsel, and the AAE Board of Directors. The General Assembly will vote on these proposed changes at its meeting on April 17, 2026 in Salt Lake City.
The proposed changes are summarized below.
Educator Member Proposed Changes
The Constitution and Bylaws Committee considered proposed amendments to the AAE Educator Membership category, brought forward by the Membership Engagement Committee, the Educational Affairs Committee, and the AAE Board. The amendments provide for an expansion of Educator membership eligibility to include internationally trained endodontists who hold full-time faculty positions in CODA-accredited programs in an effort to recognize their academic contributions to the specialty. The proposed revision would enable these members to serve on AAE committees and receive some of the access and benefits of Educator membership while maintaining existing limitations regarding voting privileges and eligibility for officer positions.
Foundation for Endodontics Proposed Changes
The Foundation for Endodontics has undertaken a multi-year effort to modernize its governance and update its governing documents. Several of the Foundation’s governance updates necessitate corresponding changes to AAE governing documents. The AAE Board has reviewed and approved these changes, including removal of the requirement in the Foundation’s bylaws that the Foundation’s changes to its own bylaws undergo AAE Board review and approval, except when changes directly impact the AAE Bylaws.
Key updates which require changes to the AAE Bylaws, and thus, approval by the General Assembly, include:
- Removing the Foundation mission statement from AAE bylaws to avoid future misalignment, while retaining it within the Foundation’s own governing documents.
- Updating Board of Trustees composition to reflect a new proposed structure.
- Revising term-length references to align with the Foundation’s new trustee and officer service structure.
- Updating language regarding nomination, election and approval processes for Foundation trustees and officers by the AAE General Assembly.
Constitution Amendment Process
The Constitution and Bylaws Committee proposes suggested revisions to article XII of the AAE Constitution intended to clarify the process by which constitutional amendments may be proposed. This issue arose during recent governance work, when questions emerged regarding how amendments are properly initiated and transmitted for consideration.
Compiled by Dr. Austyn Grissom
Dr. Stephanie Sawyer is in her second year of endodontics residency at the University of Alabama at Birmingham. In this Resident Spotlight, Dr. Sawyer shares more with us about her journey to endodontics, her commitment to personal wellness, and what is on the horizon for her future after residency.
The Paper Point: Thanks for taking time to chat, Dr. Sawyer. Let’s start by telling everyone a little bit about yourself.
Dr. Sawyer: I’m currently a second-year endodontic resident at the University of Alabama at Birmingham. I’m originally from Long Island, New York, but Alabama has truly become a second home over the past several years. Outside of dentistry, I love staying active, trying new restaurants, traveling, and cooking with my husband—who is a prosthodontist. I’m very passionate about maintaining balance between my professional goals and personal wellness, which has been especially important during residency.
The Paper Point: What first sparked your interest in becoming a dentist, and later, endodontist?
Dr. Sawyer: My interest in dentistry started with my appreciation for the combination of medicine, problem-solving, and hands-on procedures. As I progressed through dental school and later through my AEGD and time in private practice, I found myself drawn to complex cases and diagnosing the “why” behind a patient’s pain. Endodontics stood out because it blends critical thinking, precision, and the ability to provide immediate relief to patients who are often in significant discomfort. That ability to make a meaningful impact in a short amount of time ultimately solidified my decision to pursue endodontics.
The Paper Point: For any of our readers in dental school who are on the fence between practicing after graduation versus pursuing endo residency right out of school: how did that time you spent in your AEGD and then private practice as a general dentist influence the way that you approach life as an endodontic resident?
Dr. Sawyer: Spending time in an AEGD and then in private practice was incredibly valuable for me. It helped me build confidence, efficiency, and strong communication skills before entering residency. I gained a deeper understanding of what general dentists need from specialists, which has really shaped how I approach referrals and case planning. It also gave me perspective—I came into residency more focused, intentional, and appreciative of the opportunity to specialize. I truly believe that those experiences made me a better resident and will ultimately make me a better endodontist.
The Paper Point: Will you be presenting any of your research at AAE26 in Salt Lake City?
Dr. Sawyer: Yes, I will be presenting at AAE26 in Salt Lake City. During residency, I have been primarily involved in one main research project evaluating the antimicrobial properties of oregano oil. While we are still awaiting the finalized qPCR data for that study, I will be presenting a table clinic focused on the relationship between medication-related osteonecrosis of the jaw (MRONJ) and endodontic procedures, including both surgical and nonsurgical treatment considerations. I’m looking forward to discussing clinical decision-making, risk assessment, and how endodontic therapy can play an important role in the management of these complex patients.
The Paper Point: I know that you are very intentional about your fitness and wellness routine even during this busy season. Tell us about what you do to stay active, and any tips you might have for the rest of us who are already slacking off our New Years Resolutions?
Dr. Sawyer: Staying active is a big priority for me, especially during stressful seasons. I try to keep things realistic and flexible—whether that’s a spin class, a run, a walk, a hike, or a quick HIIT workout. My biggest tip is not aiming for perfection. Even 20–30 minutes counts. I also remind myself that movement is something I get to do, not something I have to do. Giving yourself grace and building consistency over intensity makes a huge difference long term.
The Paper Point: One of the things that I miss most about Birmingham, AL is the food scene! If someone reading this happens to be passing through Birmingham, AL for the day- give us a recommendation for: a place to grab breakfast, a lunch spot, and your favorite dinner restaurant.
Dr. Sawyer: Birmingham truly has an amazing food scene and is one of the things I’ll miss most. For breakfast, you can’t go wrong with Hero Doughnuts or O’Henry’s. For lunch, I love Real and Rosemary or El Barrio—both are must-stops and never disappoint. Dinner is where Birmingham really shines, and some of my absolute favorites are Helen, Galley and Garden, and Current Charcoal Grill. And to finish the night, the cocktail scene is just as good—Key Circle Commons and Adios are hands-down my favorite spots.
The Paper Point: When you and your husband cook together, do you guys have a favorite dish that you make?
Dr. Sawyer: We love cooking together and enjoy experimenting with all different kinds of cuisine—from Mediterranean dishes to Thai food. One of our absolute favorites to make at home is Jet Tila’s green curry. It’s a recipe we keep coming back to and always feels like a fun night in the kitchen together.
The Paper Point: Once you complete your residency training this June, what’s next for you?
Dr. Sawyer: After graduation, my husband and I are planning a trip to Northern Italy to celebrate the completion of residency and this chapter of our lives. Following that, we’ll be relocating to the DMV area, where I’ll be joining a prosthodontic and endodontic specialty practice, Prostho.Endo.Dental Group. It’s a unique opportunity to work alongside a husband-and-wife prosthodontic/endodontic team, which makes it especially exciting for both of us.
The Paper Point: That’s awesome! You both deserve an amazing trip to celebrate each of your accomplishments, and I know that y’all are going to have a great time in Italy. Before we part, what is one piece of advice or motivational quote that has inspired you to keep going on the tough days?
Dr. Sawyer: One quote that has always stuck with me is: “You don’t have to be perfect—you just have to keep going.” Residency can be challenging, but remembering why you started and trusting the process makes all the difference.
Dr. Austyn Grissom is former chair of the AAE’s Resident and New Practitioner Committee.
There is something special about January, the quiet pause between what was and what is possible. The new year doesn’t require perfection. It doesn’t demand that we have everything figured out. Instead, it offers something much more powerful: the chance to begin again. As we step into a new year, I find myself reflecting on what fresh beginnings truly mean. Even after busy seasons and full calendars, we are always allowed to start again; with intention, with hope, and with purpose.
In many ways, that same spirit mirrors the heart of our work and our profession. Endodontics is founded on restoration, renewal, and second chances; on helping patients preserve what matters most and rediscover comfort, confidence, and hope. It is truly a privilege to do work that, quite literally, offers people the opportunity for a new beginning.
This year, my goal is to keep our collective momentum moving in the right direction: forward. Forward in excellence. Forward in connection. Forward in leadership. Whether you are a resident, a new practitioner, or someone who has been engaged with the AAE for years, my hope is that 2026 becomes a year in which every member feels seen, supported, and inspired to contribute.
With the new year underway, I wanted to share a few important updates and reminders:.
One major milestone on the horizon is AAE26, taking place April 15–18, 2026, in Salt Lake City, Utah. There is truly nothing like being together in person at the annual meeting; learning, reconnecting, exchanging ideas, and surrounding ourselves with colleagues who challenge us to be better. If you haven’t registered yet, I encourage you to do so soon and begin planning your travel and accommodations early. These moments of connection are invaluable.
And last, but certainly not least, please mark your calendars for APICES 2026, happening August 14–15 in St. Louis. APICES continues to be one of the most meaningful experiences for residents and new practitioners as you navigate the transition from residency to the realities of practice. The RNPC is already working on an engaging and impactful program, and we cannot wait to see you all there. Registration will open June 2026.
I want to acknowledge that every new year brings different realities for each of us. Some are entering a season of growth. Some are navigating uncertainty. Some are building practices, managing families, overcoming personal hardship, or simply trying to keep all the plates spinning. Wherever you are, I want you to know: you belong here. And we are stronger together. Endodontics is a specialty defined by precision, patience, and resilience. Every day, we solve problems, relieve pain, and restore confidence. That work matters, and so does the way we support one another while doing it.
As we turn the page into 2026, I encourage you to lean in. Share your story. Submit an article. Ask questions. Build relationships. This organization is not just something you belong to, it is something that can shape you, support you, and help you grow.
If you have an idea you’d like the RNPC to bring to life, questions about the transition from residency to the “real world,” want to learn more about getting involved with the AAE, or are ready to submit an article for the next edition of The Paper Point, please feel free to reach out anytime at PCarpenter.DDS@gmail.com. I would love to hear from you.
Warmly,
Priscilla L. Carpenter, D.D.S., M.S.
Resident and New Practitioner Committee Chair
By Danielle Caplain
What You’ll Learn
- How AI search engines decide which endodontists to recommend for root canals and why this changes everything for new specialists.
- A zero-cost optimization strategy you can implement this week to make AI assistants your biggest referral source.
- Why traditional GP referral strategies are becoming less effective and how to position your practice as AI’s go-to endodontic recommendation.
You just opened your endodontic practice. You’re visiting general dentists with donuts and sending thank-you cards for referrals. But while you’re playing the traditional referral game, your potential patients are asking ChatGPT about their tooth pain and trusting AI to recommend specialists.
Here’s the reality: in 2026, your biggest referral source isn’t the general dentist down the street. It’s artificial intelligence. And if you’re not optimized for AI discovery, you’re invisible to patients who start their healthcare journey with an AI conversation.
Why AI Referrals Are Your Practice’s Secret Weapon
Think about how your patients find you now versus how they found you last year. They used to Google “endodontist near me” and scroll through options. But now they’re asking AI assistants questions like: “I have dental anxiety and need a root canal. Which endodontist in my area specializes in nervous patients and offers sedation options?”
The AI doesn’t randomly pick a practice to recommend. It synthesizes information from across the web, evaluating your online presence, your expertise signals, your patient communication style, and dozens of other factors to determine if you’re the right match. When you understand how to feed AI the right information, you become the default recommendation for specific patient needs.
This shift is particularly powerful for young practitioners. While established practices rely on decades of word-of-mouth referrals, you can leapfrog the competition by speaking AI’s language from day one. Your fresh start is actually your advantage. You’re building your online presence specifically for the AI era, not retrofitting an outdated approach.
How AI Actually Finds and Recommends Endodontists
Before optimizing for AI referrals, it’s essential to understand how AI search works. Unlike traditional Google searches that rely heavily on keywords, AI evaluates context, intent, and meaning.
When a patient asks an AI assistant about dental care, the system analyzes text-based information across your website, social media, Google Business Profile, and patient reviews to build a clear picture of what you do, who you treat, and how you treat them.
The key limitation is simple: AI can only recommend what it can clearly understand. If your online presence is vague, image-heavy without explanations, or filled with generic dental language, AI can’t identify what makes your practice different. Practices receiving AI referrals provide specific, detailed descriptions of their expertise and patient-care philosophy.
Let’s consider the scenario mentioned above: A patient asks AI, “I’ve been told I need a root canal, but I’m scared. I’ve heard they’re painful, and I had a bad dental experience before. Is there an endodontist who treats anxious patients gently?”
The AI looks for endodontists who clearly explain:
- How pain is managed during root canal treatment
- What a modern root canal actually feels like
- Options for dental anxiety (gentle techniques, sedation, communication)
- Procedure length and recovery expectations
- How patients are kept informed, comfortable, and in control
If your content only says “We specialize in root canal therapy” without addressing fear, comfort, expectations, and trust, the AI won’t surface your practice, regardless of clinical skill.
This is where an AI-ready content strategy matters. Unlike traditional SEO, which emphasizes keywords and backlinks, AI optimization rewards clarity, depth, and demonstrated expertise, clearly communicating your specialties, your approach, and the problems you solve.
Your Zero-Cost AI Optimization Strategy
Step 1: Audit Your Current AI Visibility
Start by testing how AI currently sees your practice. Open ChatGPT, Claude, or Gemini and ask questions a potential patient might ask: “Who’s the best endodontist for someone with dental anxiety in [your city]?” or “Which practice offers apicoectomies near [your location]?” If your practice doesn’t appear in the response, you know you have work to do.
Document what practices AI does recommend and analyze their online presence. What specific information are they providing that you’re not? This competitive intelligence costs nothing but provides invaluable insights.
Step 2: Create Your AI Training Page
Build a comprehensive page titled “Our Endodontic Approach” that includes:
- Your specific areas of expertise beyond standard root canals
- Your treatment philosophy and patient care approach
- Technology you use and why it matters
- Common problems you solve differently than general dentists
Write as if explaining to someone who knows nothing about endodontics but needs to match patients with the perfect specialist. This approach to AI-friendly dental website optimization ensures both AI systems and patients understand your unique value.
Step 3: Transform Your Service Pages
Your service pages probably list treatments and maybe include some before-and-after photos. That’s not enough for AI. Each service page needs to answer the questions patients actually ask AI about that procedure.
For example, instead of just describing root canal retreatment, address:
- “How long does a root canal or retreatment appointment take, and what is recovery like afterward?
- “Will a root canal hurt, and how do endodontists manage pain and anxiety during treatment?”
- “What does a modern root canal actually feel like compared to what I’ve heard?”
- “What happens if a root canal fails—what are my options?”
Structure each page with clear headings that mirror how people ask questions. This approach serves both AI comprehension and featured snippet optimization in traditional search.
Step 4: Leverage Your Google Business Profile for AI Discovery
Your Google Business Profile isn’t just for traditional local search anymore, it’s prime real estate for AI discovery. The Q&A section and regular posts are goldmines for AI optimization.
Start actively using the Q&A feature. Ask and answer specific questions about your practice, your approach, and your specialties. “Do you offer sedation for anxious patients?” “What insurance plans do you accept?” “Do you see emergency patients on weekends?” Each answered question is content AI can reference when making recommendations.
Create weekly Google Business posts that detail specific aspects of your practice. Don’t just announce “We’re accepting new patients!” Instead, write posts like: “We specialize in helping patients with dental anxiety through our comfort-first approach, including sedation options, extended appointment times, and a dedicated comfort coordinator who stays with nervous patients throughout their visit.”
These detailed posts feed AI systems current, specific information about your practice while also improving your traditional local SEO performance. It’s a win-win strategy that costs nothing but consistency.
Step 5: Build Expertise Through Educational Content
AI prioritizes expertise and educational value when making recommendations. This is where your blog becomes a referral engine. Skip generic topics and focus on content that answers real patient questions while showcasing your clinical strengths.
Create in-depth resources around the procedures you want to be known for. For example, instead of promoting root canals broadly, explain what happens at each stage of the root canal process. These aren’t sales pages, they’re educational assets that signal expertise to AI.
Depth matters more than volume. One comprehensive article explaining your approach to dental anxiety will outperform multiple surface-level posts on general topics.
Step 6: Optimize Social Media for AI Understanding
AI can’t interpret images or emojis, it reads text. Every social media post should include enough written context for AI to understand the procedure, patient concern, and outcome.
Rather than posting a photo with a short caption, explain the situation, the treatment provided, and the patient’s experience. Narrative posts that describe real scenarios, such as helping an anxious or long-absent patient feel comfortable, teach AI not just what you do, but how you do it and who you serve.
Step 7: Generate Detailed, Specific Reviews
AI evaluates review content, not just star ratings. Vague praise like “Great dentist!” offers little insight and won’t influence recommendations.
When requesting Google reviews, guide patients to share specifics: the procedure they had, their concerns beforehand, and how you addressed them. Reviews that mention your process, technology, and comfort measures give AI concrete signals.
When someone asks AI for a dentist skilled in a particular procedure, those detailed reviews make your practice the clear match.
Comparison: Traditional vs. AI-Optimized Referral Strategies
| Strategy Element | Traditional Approach | AI-Optimized Approach |
| Primary Focus | Building relationships with GPs | Creating comprehensive online expertise signals |
| Time Investment | Weekly office visits, lunches | 2-3 hours weekly on content creation |
| Cost | Meals, CE courses, marketing materials | Zero monetary cost |
| Referral Source | Limited to networked GPs | Unlimited AI recommendations |
| Geographic Reach | 5-10 mile radius | Entire service area |
| Patient Type | GP-screened patients only | Direct patients AND GP referrals |
| Scalability | Limited by personal time | Compounds automatically over time |
| Measurability | Difficult to track ROI | Clear analytics and tracking |
Conclusion
The referral landscape has fundamentally changed for endodontists. While many specialists continue to rely solely on traditional GP relationships, AI is quickly becoming a powerful new referral engine. By optimizing your practice for AI discovery, you position yourself as the default specialist recommendation for specific patient concerns—pain, fear, retreatment, or complex diagnosis.
This shift also levels the playing field for newer endodontists. You don’t need decades of referral history; you need clear, comprehensive content that AI can understand and trust. For a deeper dive into how this works, the AI SEO for Dentists ebook breaks down the strategy in detail. You can also request an AI audit to see exactly how you’re being evaluated today.
Start implementing these strategies now, and you’ll be positioned as AI evolves from a curiosity into one of the most influential growth drivers for endodontic practices.
FAQ
Q: Will this replace my need for GP relationships? A: No, this complements GP referrals. Many GPs now use AI tools for research, so optimization helps with both direct patient referrals and maintaining GP relationships.
Q: How long before I see AI-driven referrals? A: Most practices see initial results within 2-4 weeks, with significant growth building over 2-3 months as AI systems continuously evaluate your content.
Q: Do I need special software or tools? A: No special tools required. This strategy uses your existing website, Google Business Profile, and social media platforms with improved content.
Q: Should I mention AI on my website? A: Focus on clear, comprehensive information that serves both human visitors and AI systems naturally, without explicitly mentioning AI throughout.
Q: How is this different from regular SEO? A: AI optimization focuses on depth, context, and answering specific questions rather than keyword density and backlinks alone.
Danielle Caplain is a copywriter at My Social Practice, a dental marketing company that provides dental marketing services to practices across the United States and Canada.
By Dr. Adam Gluskin
Case History: A 56 year old male patient was referred for evaluation of tooth #7 and #8. He is asymptomatic, but his general dentist referred him after observing a buccal sinus tract over tooth #7.
Medical history: Non-contributory, ASA I
Medications: None
Allergies: NKDA
HPI: The patient reports RCT #8 and crowns on #8 and #9 following a bike accident over 20 years ago. The teeth have been asymptomatic ever since, but the patient reports a "bump" in the gums developing on and off over the past year.
Radiographic evaluation: Periapical radiographs of the maxillary anterior teeth show existing PFM crowns on teeth #8 and #9 with previous root canal therapy of tooth of #8 with a large post. The obturation material is lacking in density in the apical portion of #8. Both #7 and #8 lack a continuous lamina dura and a large periapical radiolucency is present compassing both roots. The severe lack of density within the radiolucency indicates a through-and-through lesion.
A limited FOV CBCT was exposed revealing an area of low density (14x12x10mm in dimension) encompassing the root apices of #7 and #8. Significant erosion of the buccal and palatal cortical plates is evident. The alveolar bone around #7 and #8 is intact circumferentially.
Clinical evaluation: Probing depths 2-3mm across all maxillary anterior teeth. None are tender to percussion or palpation. Tooth #7 responded positively to cold testing.
Tooth #7 has class 1 mobility and #8 has class 2 mobility. A buccal sinus tract is present in the attached gingiva above #7. The #8 and #9 PFM crowns are intact with clinically sealed margins.
Diagnosis:
Tooth #7 normal pulp with asymptomatic apical periodontitis
Tooth #8 previously treated with a chronic apical abscess.
Stay tuned! We'll reveal the actual treatment rendered, and the poll results, in a future edition of The Paper Point!
Dr. Adam Gluskin is a member of the AAE's Resident and New Practitioner Committee.
As the New Year begins, it also brings about important changes to our CDT coding terminology for reporting dental services on claims submitted to third-party payers. As endodontics continues to evolve—clinically and technologically—practitioners are encouraged to proactively review and incorporate the latest CDT updates where appropriate, ensuring our practices remain aligned with dentistry’s current standards and payer expectations.
The ADA CDT 2026 Current Dental Terminology Manual includes 60 code changes across multiple procedure groupings, reflecting real-world care patterns and emerging modalities. While changes within the Endodontics chapter itself are few this year, several new and updated codes directly influence how endodontists document care and submit appropriate codes for payments.
CDT 2026 Changes Applicable for Endodontists
- D0461 — Testing for cracked tooth (NEW)
Includes multiple teeth and contra lateral comparison(s), as indicated. Diagnostic aids may include but are not limited to pressure sensitivity testing, transillumination, staining, etc.
- D2956 – Removal of an indirect restoration on a natural tooth
This code applies to crown removal procedures and does not specify the method or reason for removal; however, it cannot be used for the removal of a temporary or provisional restoration
- D9128
Photobiomodulation therapy for the first 15 minute increment, or any portion thereof.
- D9129
Photobiomodulation therapy for each subsequent 15 minute increment, or any portion thereof.
The updated Endodontists’ Guide to CDT includes all of these changes as well as four new clinical scenarios to assist endodontists in proper coding. These scenarios include removal of an indirect restoration on a natural tooth, patient referral for removal of fractured abutment screw, detailed and extensive endodontic evaluation, and lost composite, protective restoration.
We are officially four months away from May 2026, and that means it’s time to move into full gear for Save Your Tooth Month.
Building on the incredible momentum from last year, our grassroots advocacy campaign is charging forward stronger than ever. In 2025, we achieved record-breaking participation and historic wins, particularly in the number of Save Your Tooth Month proclamations secured through member outreach. Those successes proved what is possible when our members unite with a shared purpose and speak with one voice.
Now, in 2026, we are raising the bar.
Our Goal for 2026: Every State and Territory
This year, our goal is ambitious and clear: for members to submit Save Your Tooth Month proclamation requests in every single U.S. state and territory.
This matters because proclamation requests are the critical first step toward official recognition. When legislators formally recognize Save Your Tooth Month, they help amplify the importance of saving natural teeth and elevate oral health as a public health priority. These efforts also:
- Increase public awareness of the value of endodontic care and the benefits of preserving natural teeth
- Reinforce the role of endodontists as leaders in diagnosing and treating tooth pain and infection
- Encourage better oral health habits—like brushing, flossing, and routine dental visits—that support overall health
- Strengthen relationships with policymakers and expand our advocacy footprint nationwide
How You Can Take Action Now
We encourage all members to use the link below to find your respective state or territory and reach out to your local legislators to request a proclamation declaring May as Save Your Tooth Month. Each message helps build the momentum needed to secure recognition across the entire country.
Wondering how to submit a proclamation? Follow this guide at aae.org/isaveteeth.
Last year’s results were powered by members taking action—and this year, we’re going all-in with the wins and energy from 2025 to make 2026 our biggest year yet.
The article below is copied from The Washington Post. To read it on their website via subscription, click here.
Young adults are the most likely age group to skip dental care, with a recent study finding that 1 in 3 didn’t see a dentist during the previous year.
When Usman Ahmad talks to Gen Z patients about going to the dentist, he makes one case: “It’s about the future.”
If they don’t want a missing tooth, or a marred smile, or difficulty eating later in life, he tells them, keep coming back to the dentist’s chair. Sometimes he uses TikTok or YouTube to help make his point, finding that young adults are more responsive to videos — showing how food builds up between teeth without flossing, for example, or how gingivitis inflames gums and where that can lead.
“It all depends on how you approach them,” said Ahmad, administrative dental director for Mary’s Center, a nonprofit community health center in Maryland and the District. While that’s true of many patients, it’s especially so for a generation that is less likely to show up and open wide.
A study published last fall in the journal Frontiers in Oral Health found that 1 in 3 U.S. adults ages 18 to 35 had skipped the dentist during the previous year — and were most likely of all age groups to have done so.
The consequences can impact overall health and longevity, dentists say — including cardiovascular and brain health. Delaying care also can cause more serious and expensive dental or medical problems down the road, they note.
“Oral health is related to your systemic health in your body. It’s not just your teeth and your gums — everything is connected. Your head is not cut off from the rest of your body,” said Tricia Quartey, a Brooklyn dentist and a consumer adviser spokesperson for the American Dental Association, who said she and her colleagues see young adults who put off dental care after aging out of their parents’ insurance or while moving around for college and jobs.
A lack of insurance as well as income and housing instability were cited by young adults who reported skipping the dentist, the study found. Though those factors affect all age groups, disparities in dental care by socioeconomic status were most extreme among young people, according to the study, which was based on an analysis of more than 127,000 participants’ responses to a survey administered as part of a National Institutes of Health research program.
Dentists recommend twice-a-year office visits, along with good brushing and flossing habits, and say not to wait for something to hurt to see a dentist. They want young people to understand the benefits of oral health: Treating root canal infection is associated with improved heart health, flossing can help prevent dementia, and preventing gum disease can improve life expectancy, research has found.
“If we don’t pay much attention to [this generation], then in the future we will have a weaker workforce,” said Yau-Hua Yu, an associate professor of periodontology at Tufts University School of Dental Medicine, who authored the recent study.
Almost all young people believe it’s crucial to preserve their teeth, but half don’t go to the dentist unless they’re in pain, an American Association of Endodontists survey last year found. The survey indicated that social media could be another factor contributing to that disconnect: About 45 percent of Gen Z and younger millennials get health information from nonmedical sources such as influencers and content creators — and more than half said they regretted a decision they had made based on that information.
“It’s a huge concern,” association President Steven J. Katz said. “They’re getting this incorrect information, they’re making decisions or putting off [care] based on this, and then they live to regret it.”
In Brooklyn, Quartey treated one young woman who damaged her enamel after using a charcoal toothpaste that she saw promoted by influencers. Another asked Quartey about using a nail file to smooth down teeth after seeing it online.
To tackle that disconnect, some dentists are turning to TikTok to spread awareness and reach potential patients, a strategy the endodontists association is pushing.
Quartey and her counterparts at Noble Dental Care began making TikTok videos last year and were “shocked” by the number of new patients who found their practice, she said. They post videos of staff dancing and participating in TikTok trends, but they also answer common questions and debunk myths.
“That is how people are getting information, so I want to at least make sure it’s the correct information,” she said.
Addressing a lack of insurance can be harder, but young adults can look for local clinics, dental schools or community health centers that offer lower-cost dental services, said Romesh Nalliah, associate dean for patient services and a professor at the University of Michigan School of Dentistry.
“The health system for medicine and dentistry is complicated,” he said. “But it’s worth the effort to overcome those challenges.”