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By Elisabeth Lisican

When Dental Clinics of North America approached Dr. Sami Chogle for a topic idea, he knew exactly where to steer the conversation: artificial intelligence. What began as a bold pitch has now evolved into a full-fledged special issue—Modern Endodontics: Focus on AI—edited by Drs. Chogle, Mark Desrosiers, and Asma Khan.

In an interview with the AAE, the endodontic editorial trio reflected on the process of shaping this forward-looking issue, the urgency of AI integration in dentistry, and the unique opportunity for endodontics to lead.

What’s Inside the Issue:

  • Foundational Technologies and Tools
    The opening chapters provide a broad overview of current technologies assisting endodontists and highlight diagnostic innovations related to periapical radiolucencies (PARLs), root fractures, and external cervical resorption (ECR).
  • Advances in Imaging, Robotics, and Prognosis
    From 3D imaging and surgical guides to robotic integration and AI’s role in predicting treatment outcomes, several articles examine how intelligent systems are enhancing precision and decision-making.
  • Practice Management and Ethics
    A deep dive into how AI is influencing the business and ethical dimensions of endodontic care, with attention to patient privacy, professional responsibility, and emerging best practices.
  • Endodontic Education Reimagined
    Two chapters explore how virtual reality, augmented reality, and AI-based simulation are transforming how endodontic skills are taught and learned—both at the student and continuing education levels.
  • Looking Ahead
    The final two chapters take a bold step into the future, considering what’s next—and what lies beyond the horizon—for endodontics as AI tools continue to evolve and embed themselves into clinical practice.

An Idea Whose Time Had Come

“I’ve worked with DCNA in the past… back in 2012 when things were warming up with regenerative endodontics,” Dr. Chogle explained. “That was my cue as well in terms of AI—seeing the increase in publications, the interest in dental applications.”

Although the idea was initially met with some skepticism, the editors quickly demonstrated the depth and breadth of AI’s relevance to the specialty.

“I think we convinced them that there was enough potential for us to create an issue solely based on artificial intelligence within [endodontics],” said Dr. Chogle. “Of course, once the idea was on the table, I had to bring in the real brains behind the whole issue.”

Why AI Matters to Endodontics

Each editor emphasized that the special issue is about more than just trend-following—it’s about preparing the specialty for transformative change.

Dr. Desrosiers noted, “AI is big for everything, not just endodontics… this is going to make our specialty look good … as a specialty, we’re at the forefront.”

Dr. Khan added, “As endodontists, as educators, we really need to educate ourselves… We need to play an active role in how these applications are developed, how they are used in our offices.”

AI’s rapid growth means the specialty can’t afford to wait: “It’s sort of insidious, creeping into a lot of dentistry and non-dental fields as well,” said Dr. Chogle. “Hopefully this helps readers understand that it’s already here.”

Addressing Misconceptions

One key goal of the issue is to clarify what AI is—and what it’s not.

“AI is not a threat, or should not be a threat,” said Dr. Khan. “It’s really a good tool to help us serve our patients better.”

She advocated for reframing the conversation: “We should start thinking in terms of augmented intelligence… it augments or helps the endodontist. It is not meant to replace endodontists.”

Dr. Desrosiers cautioned against assuming AI is ready-made: “It is a tool that has to be used with caution… Certainly right now it’s the bleeding edge, but it is changing so quickly.”

AI in Education: Learning and Teaching in Real Time

As educators, all three editors acknowledged the unique challenge of teaching a rapidly evolving subject.

“We’re learning it and we’re learning how to teach it at the same time,” said Dr. Desrosiers. “While this is challenging, the potential is very promising.”

Dr. Khan outlined how AI is already changing education at every level—from didactic lectures to simulation labs to continuing education. “The teaching and learning experience is richer and more personalized,” she said.

Dr. Chogle offered a glimpse into the future: “We had a resident use AI and augmented reality to practice a procedure on a virtual patient—the same patient they were going to see. They practiced the surgery virtually, and then did it.” He called it “a good teaching tool for residents to be able to practice before they get into the surgical field.”

Cross-Disciplinary Collaboration and Editorial Insights

While most authors featured in the publication are endodontists, a few chapters brought in contributors from other disciplines—particularly for ethics and practice management. These chapters had a lasting impact on the editorial team.

“The ethics chapter really opened my eyes,” said Dr. Desrosiers. “It’s a lot broader than I first thought.” Dr. Desrosiers also said he was impressed by contributor Kim FitzSimmons’ (AAE’s Chief Marketing & Communications Officer) chapter, “Endodontic Practice Management.”

“I was really impressed with how far ahead of the curve she was compared to what I had perceived,” he said.

Dr. Khan added, “It was fun to collaborate with different disciplines. It was an enriching experience.”

No Favorites—But Lots to Be Excited About

When asked if they had a favorite chapter, the editors were unanimous: every piece adds value.

“Even if you tried [to pick], there was a good amount of overlap,” said Dr. Chogle. “It’s like a complete monograph.”

The contributors also represented a range of career stages—from residents to veteran educators—which added depth and variety.

AI’s Potential and the Role of the AAE

The editors offered a glimpse of what excites them most about AI’s potential. Dr. Khan sees AI as a bridge between biology and technology: “It could evaluate a patient’s individual factors and help us determine the best prognosis.”

Dr. Chogle emphasized the potential in practice management and patient communication, citing an AI-powered video that could translate practice information into multiple languages: “A very small aspect, but it’s how it’s incorporating into almost everything we’re doing.”

As the issue prepares for publication, the editors also are looking forward to the AAE remaining engaged and proactive.

“This is a first step,” said Dr. Chogle. “But it does need a proactive and consistent effort that will help us stay on top of AI incorporation into dentistry.”

The issue, “Modern Endodontics: Focus on AI,” will be available in print and digitally later this month via DCNA. Learn more at https://www.dental.theclinics.com/.

About the Editors:

Mark B. Desrosiers, DMD, currently serves as Secretary of the AAE Board of Directors and teaches part-time at the Boston University School of Dental Medicine.  He is fascinated by the technological changes in our specialty both in materials and Artificial Intelligence.  His “free” time is spent traveling with his wife and visiting his children and grandchildren.

Dr. Asma Khan is a tenured Professor at UT San Antonio. She received her dental degree from India, her PhD in Neuroscience from the University of Maryland, and her Certificate in Endodontics from UT Health San Antonio. She currently serves on the Council of Scientific Affairs of the American Dental Association and is a member of the Scientific Advisory Board for the Journal of Endodontics. Her research interests include the use of AI to improve clinical practice and the development of new diagnostics and analgesics.

Elisabeth Lisican is the AAE’s assistant director of communications & publishing. 

 


On October 16, the global endodontic community will come together to celebrate World Endodontic Day—a day dedicated to raising awareness about the specialty of endodontics and its vital role in preserving natural teeth.

Origins of World Endodontic Day

The concept was first proposed by Dr. Gopi Krishna, President Elect of the International Federation of Endodontic Associations (IFEA), during the World Endodontic Congress in Chile in 2022. His idea of “having a common annual day of celebration for Endodontics globally” was unanimously approved by member societies and associations. We caught up with him recently to dig into the origins and meanings behind the special endodontic holiday.

Why October 16?

After much deliberation, IFEA chose October 16 to honor two milestones. First, it marks the birthdate of Dr. Louis Grossman, one of the foundational fathers of modern endodontics. Second, it commemorates the month when IFEA was formally registered. As the organization explains, “we choose October 16th as a day to dedicate and commemorate the world of Endodontics”.

Global Participation

Today, 49 national endodontic associations and societies—including the American Association of Endodontists—are official partners in celebrating the day. The list spans every continent:

Australian Society of Endodontology (Australia)

Bangladesh Endodontic Society (Bangladesh)

Belgian Association for Endodontology and Traumatology (Belgium)

Brazilian Endodontics Society (Brazil)

Canadian Academy of Endodontics (Canada)

Chilean Endodontic Society (Chile)

Colombian Endodontic Association (Colombia)

Croatian Society of Endodontology (Croatia)

Czech Endodontic Society (Czech)

Egyptian Association of Endodontists (Egypt)

Association For Endodontics For Ecuador (Ecuador)

Finnish Endodontic Society (Finland)

French Society of Endodontics (France)

Academia de Endodontia de Guatemala (Guatemala)

German Society of Endodontology and Traumatology (Germany)

Greece: Hellenic Society of Endodontics (Greece)

Hong Kong Endodontic Society (Hongkong)

Indian Endodontic Society (India)

Indonesian Endodontic Association (Indonesia)

Iranian Association of Endodontists (Iran)

Iraqi Endodontic Society (Iraq)

Israel Endodontic Society (Israel)

Italian Endodontic Society (Italy)

Japan Endodontic Association (Japan)

Jordanian Endodontic Society (Jordan)

Korean Academy of Endodontics (Korea)

Lebanese Society of Endodontology (Lebanon)

Lithuanian Society of Endodontology (Lithuania)

Malaysian Endodontic Society (Malaysia)

Mexico Endodontic Association (Mexico)

Moroccan Academy Of Endodontics (Morocco)

Netherland Association for Endodontics (Netherland)

New Zealand Society of Endodontics (New Zealand)

Pakistan Association of Operative Dentistry & Endodontic (Pakistan)

Peruvian Endodontic Society (Peru)

Portuguese Society of Endodontology (Portugal)

Endodontic Society of the Philippines (Philippines)

Saudi Endodontic Society (Saudi Arabia)

Spanish Association of Endodontics (Spain)

Swiss Society for Endodontology (Switzerland)

Academy of Endodontology R.O.C. (Taiwan)

Thai Endodontic Association (Thailand)

Turkish Endodontic Society (Turkey)

Emirates Endodontic Society (UAE)

Ukrainian Endodontic Association (Ukraine)

British Endodontic Society (UK)

Uruguay Endodontic Society (Uruguay)

American Association of Endodontists (USA)

Venezuelan Society of Endodontics (Venezuela)

Raising Public Awareness

While endodontists and dentists already conduct numerous conferences and meetings worldwide, World Endodontic Day is unique in its outward focus. According to IFEA, “we do not have a combined global platform aimed towards the public in improving their awareness regarding prevention, treatment and preservation of natural dentition. This day would bring public focus on the relevance of endodontics in improving the quality of general health of an individual”.

2025 Celebrations

This year, IFEA is hosting an online Global Endodontic Symposium by eminent academicians Prof. Jose F. Siqueira Jr and Dr. Jeeraphat Jantarat that telecast online for the benefit of all dentists and students present in the 49 member countries of IFEA.

“We recommend national societies to conduct public awareness campaigns in the form of social media campaigns, print and radio awareness interviews to sensitize the general public regarding our specialty.”

How Members Can Participate

Individual endodontists and AAE members can join in by celebrating in their own practices—educating patients about modern advances that make root canal treatment more predictable and painless. As IFEA notes, “we are recommending dentists and endodontists to celebrate this day in their practices by sharing information about newer advances in technology and materials”.

Inspiration from Past Events

Previous celebrations have been ambitious and inspiring. For example, the Indian Endodontic Society organized a nationwide campaign spanning 22 cities and broadcast in 12 languages, with a unified message: “Endodontists are dental specialists in saving natural teeth”.

Looking Ahead

IFEA will conduct its 2028 World Endodontic Congress in New York in partnership with the AAE in 2028. Members are encouraged to save the dates Sept. 13-17, 2028.

The Key Takeaway

The message of World Endodontic Day is simple yet powerful: “Endodontics helps us preserve your natural teeth for a healthy smile and a healthy life!!”

Learn more about IFEA at ifeaendo.org.

Last year, I attended my first Educators Conference. Go figure, by chance more than design, I found myself in a room full of educators. ENDOPALOOZA, as we fondly call it, is the joint gathering of the Educators Conference and the APICES Conference for residents, held in conjunction with one another annually.

My presence in the Educators Conference wasn’t planned. I had been invited to APICES in my role as President-Elect, with no speaking responsibilities—just an opportunity to observe. On that first morning, before the residents arrived, I wandered into the Educators session. It was a lively conversation among Pre-Doctoral Directors, complete with a ball-tossing exercise where whomever caught the ball had to answer the moderator’s question. Within minutes of sitting down, the ball landed in my hands.

I don’t remember the exact question, but I remember how I began my response: “I’m not really an educator, but…” That’s when my colleague and friend, Dr. Mark Byron of West Virginia University, quickly interrupted me. Though I teach at WVU just one day a month—six to eight times a year at best—he looked at me and said: “Yes, you are an educator, and we are happy to have you whenever you can come.”

That message was loud and clear—not just from Dr. Byron, but from the entire room. Almost every institution is in need of endodontists to teach. And any endodontist willing to give their time, even in small amounts, is both welcomed and needed.

A Shortage We Can’t Ignore

Fast forward to this past August, when ENDOPALOOZA 2025 took us to steamy New Orleans for the 22nd annual APICES Conference. This year’s Educators Conference also welcomed department chairs and, as happens every other year, invited our corporate partners to participate.

Now attending in my role as President, I had speaking responsibilities in nearly every session. The first group I addressed were our corporate stakeholders—companies deeply invested in the health of our specialty. Their chief concern mirrored what I had heard the year before: Where do we find more educators?

In the Educators Workshop, the refrain was the same: There is a significant shortage of endodontist educators at every level, in nearly every institution. President-Elect Dr. Craig Noblett had proposed a survey to identify unmet needs. The results confirmed what many of us suspected: Most institutions have open positions for full-time pre-doctoral directors, graduate program chairs, and department heads. Some institutions face vacancies in all three.

Inspiring the Next Generation

The next day, I addressed our residents. I spoke about the value of the AAE, the importance of belonging to a strong professional organization, and the many ways we support members at every stage of their careers. I reminded them that the AAE’s strength depends on the leadership of our younger members. But I also emphasized something even more fundamental: the responsibility to give back.

To give back to our profession, to our Foundation, and—most importantly—to our students. Because if we fail to provide robust endodontic education at every level, if we lose the ability to shape the narrative and convey the importance of our specialty, then we risk losing endodontics itself.

A Clear Path Forward

I wish I could offer a simple solution. I cannot. There is no easy fix. The systemic issues of funding and institutional politics are real and will not be solved overnight. But what we can do—what each of us must do—is address the challenge personally.

Most of us can volunteer a half day or a few days here and there. And if you think back to your own training, chances are it was the volunteer faculty who made the deepest impression. Practicing endodontists who may not have considered themselves “teachers,” but who showed up, shared their experiences, and helped shape us into the professionals we are today. They modeled the realities of practice, offered wisdom beyond textbooks, and shaped our professional identities.

Our Turn to Step Up

The future of endodontic education doesn’t rest solely on full-time faculty or department chairs. It rests with every member of our specialty. Each of us has benefitted from those who gave their time to teach us, and now we carry both the privilege—and the responsibility—to do the same for the next generation.

I no longer say, “I’m not really an educator.” Because being an educator isn’t defined by a title or a contract. It’s defined by the willingness to share what you know, to mentor those coming after you, and to safeguard the future of our specialty.

So I leave you with this: Be the person who shows up. If each of us contributes to the greater good of the profession, together we can shape the brightest future for endodontics.

Contributed by Luke Fehrs

If the title of this piece has your head spinning already, you’re not alone. Insurance jargon can be convoluted and confusing. Add to that that your real job, running a dental or medical practice means juggling patient care, staff, and operations, you really can’t be expected to know all these terms, too. Unfortunately, you can’t afford not to read the fine print in your insurance policy (or lease) because one overlooked detail could leave you with a huge bill if disaster strikes. A fire, flood, or other property loss can put your practice on hold. The right coverage can help you reopen quickly, while the wrong coverage can leave you rebuilding on your own dime.

Two critical types of coverage every commercial tenant should understand are Business Personal Property (BPP) and Improvements and Betterments (I&B).

Business Personal Property Coverage for Dental & Medical Practices

Picture this… If you unscrewed every piece of dental equipment from the floor, unbolted the chairs, cut the roof off of the building, and turned it upside down—everything that fell out would go with you to the next office. That’s your business personal property.

BPP includes your movable equipment, furniture, computers, and supplies. In a dental office, that means dental chairs, x-ray machines, tools, IT equipment, and anything else you can take with you.

The coverage amount should be based on the direct replacement cost of these items. You can determine this by looking at purchase agreements, supplier quotes, or industry equipment lists.

What Is Improvements and Betterments Insurance for Commercial Tenants?

Now think about the parts of your space you can’t just pick up and move: the walls, flooring, light fixtures, cabinetry, and built-in features that make your office functional. That’s what Improvements and Betterments coverage protects.

If you removed all your movable property and a fire destroyed the building, you (as the tenant) would still be responsible for rebuilding the interior in the event of a total loss.

In most cases, a landlord will only restore the building’s “shell.” This means the four walls, a ceiling, and a floor. You would walk back into a barren shell and have to reconstruct everything else yourself.

Valuing I&B coverage is less straightforward than BPP. It’s often estimated based on local construction costs per square foot. A rough starting point might be $250/sq. ft. at the time of this writing, but that number climbs significantly in large metro areas.

Avoiding Disputes with Landlords Over Insurance Responsibilities

Many disputes between tenants and landlords after a property loss happen because of unclear expectations. Both sides often assume the other will pay for the interior rebuild, which can lead to costly delays and frustration.

It’s also becoming more common for landlords to specify in the lease agreement that tenants are required to carry coverage for improvements and betterments, precisely to avoid this kind of finger pointing.

Why Your Lease Agreement Is the Key to Proper Coverage

Your lease is the ultimate guide to your insurance responsibilities. It spells out exactly what you’re on the hook for if your space is damaged or destroyed.

Always have an attorney review your lease before you sign and before you purchase coverage. Insurance agents can give you a general understanding of what’s needed, but they can’t interpret your contract with legal authority.

Here’s a business property protection checklist you may find helpful:

Business Property Protection Checklist

Business Personal Property (BPP)

☐ List all movable items you own: equipment, furniture, computers, supplies.

☐ Calculate your replacement cost (use purchase agreements, supplier quotes, or inventory tools).

☐ Confirm with your insurance agent that your BPP coverage limit matches today’s replacement value.

Improvements & Betterments (I&B)

☐ Identify fixed interior features you’ve added, like walls, flooring, lighting, cabinetry.

☐ Get a cost-per-square-foot rebuild estimate from your local contractors.

☐ Make sure your I&B coverage matches the full rebuild cost, and not just what’s in your budget.

Lease Agreement

☐ Review your lease for clauses on rebuild responsibility.

☐ Confirm what your landlord’s policy covers (usually the “shell” only).

☐ Have an attorney review it before you sign or renew.

Annual Review

☐ Recalculate equipment values annually, because things do change in price.

☐ Update your I&B estimates for inflation and construction cost changes.

☐ Adjust your coverage whenever you renovate or add major equipment.

Understanding the difference between Business Personal Property and Improvements and Betterments coverage, and making sure both are valued correctly, can save you from expensive surprises. The goal after a loss should be to get back to seeing patients quickly, not arguing over who pays for the drywall.

Do you have a question about business insurance?

We have answers! Contact us today for a no-obligation conversation with one of our experienced business insurance team members.

About Treloar & Heisel

Treloar & Heisel, an EPIC Company, is a financial services provider to dental and medical professionals across the country. We assist thousands of clients from residency through retirement and strive to deliver the highest level of service with custom-tailored advice and a strong national network. For more information, visit us at treloaronline.com.

Luke Fehrs is Account Executive, Treloar & Heisel, LLC,domiciled in PA.
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Insurance products offered through Treloar & Heisel, LLC.

By Drs. Anil Kishen and Meetu Kohli

The evolution of endodontics has seen a paradigm shift from traditional, more aggressive approaches to those emphasizing the preservation of tooth structure. Minimally invasive endodontics seeks to conserve the dentin and natural biomechanical structure of the tooth while maintaining or improving clinical outcomes. This article distills the essence of the 2025 AAE presentation by Drs. Kishen and Kohli, which explored the biological, biomechanical, and clinical consequences of minimally invasive approaches in endodontic treatment.

Defining Minimally Invasive Technique

The term minimally invasive originates from the medical field, particularly in reference to laparoscopic, keyhole, and robotic surgeries, which serve as alternatives to traditional open surgical approaches. The primary advantages of minimally invasive procedures such as those for gallbladder removal, hysterectomy, hernia repair, cardiac interventions, or joint surgery are centered on the reduced size of the surgical incision and, consequently, the wound itself. Numerous meta-analyses have demonstrated that minimally invasive surgery is associated with less postoperative pain, improved quality of life, a lower incidence of complications and infections, quicker recovery times, and shorter hospital stays [1]. However, the limited surgical access inherent to these techniques may hinder tactile feedback and reduce visibility of the operative field. Therefore, systematic reviews have also evaluated whether the clinical outcomes of minimally invasive approaches are comparable to those of open surgery, as any compromise in outcome would represent a significant limitation [2].

In the context of endodontics, the biological objective of treatment is to prevent and treat apical periodontitis while preserving the long-term function, aesthetics, and health of the tooth and surrounding structures. As apical periodontitis is a microbial/biofilm-associated disease, successful treatment relies on effective disinfection of the root canal system, proper obturation, and restoration. However, achieving these goals necessitates access, instrumentation, and preparation of the canal system, all of which involve removal of dentin. The cumulative loss of dentin due to both caries and procedural intervention can ultimately weaken the structural integrity of the tooth, increasing the risk of fracture and potentially compromising its long-term functionality.

Understanding Dentin: A Unique Composite

Dentin, the main structural tissue of teeth, is a natural composite made of inorganic content, organic matrix, and water. Essentially, water exists in both bound and free forms. Bound water integrates tightly with mineral crystals and the collagen network, only being removed at high temperatures [3]. Free water, however, fills dentinal tubules and voids in the matrix and significantly contributes to dentin toughness [4]. Free water plays a critical role in maintaining the viscoelastic properties of dentin. Aging, systemic conditions like diabetes, and external treatments such as irradiation can weaken the dentin and make teeth more prone to vertical root fractures (VRF). Moreover, environmental and ethnic variations affect dentin’s microstructure and mechanical properties, complicating a one-size-fits-all approach to endodontic treatment [5, 6, 7, 8]. Thus, it is important to realize that there are physiological (non-iatrogenic) and iatrogenic factors (endodontic treatment procedures) that can alter the mechanical characteristics of dentin.

Biomechanics and Tooth Function

A tooth is a dynamic structure that responds to masticatory stresses and thermal changes. Stress and strain distribution patterns vary across teeth, while it is established that stress induced by chewing is predominantly distributed in the cervical region of the root. However, the nature of stress distribution in a tooth is influenced by tooth anatomy, contacts with adjacent teeth, and support from alveolar bone [5, 9]. Endodontically treated teeth exhibit altered biomechanical behavior due to the loss of intra-pulpal hydrostatic pressure and subsequent loss of free water in dentin, regardless of the size or shape of the access cavity. This underlines the importance of preserving cervical root dentin or peri-cervical dentin (PCD), which is crucial in transferring functional stresses and ensuring long-term survival.

Does Minimally Invasive Endodontics Enhance Tooth Strength?

Traditional endodontic access cavities are associated with increased cuspal flexure and higher concentrations of stress and strain, which can make teeth more susceptible to fractures. Contracted endodontic cavities (CECs) aim to preserve dentin and reduce overall stress, but in vitro studies have yielded mixed results regarding whether this consistently improves fracture resistance, particularly when bonded restorations are used. A review of the literature suggests that while preserving coronal tooth structure and PCD is generally beneficial, the evidence remains divided on whether this translates into significantly enhanced fracture strength [10-15]. Most studies concur that dentin conservation reduces the risk of catastrophic tooth failure. However, the impact of minimally invasive techniques on the fracture resistance of teeth restored with bonded composite resins or onlays remains inconclusive [16-18]. Additionally, increased apical enlargement and taper during canal instrumentation have been consistently linked to reduced root strength, especially in anatomically complex regions such as isthmuses and middle mesial canals, where fracture risk is elevated [19-21]. These findings suggest that, beyond access cavity design, the size and taper of canal instrumentation are critical factors in root biomechanics. In many cases, smaller and more conservative preparations may offer mechanical advantages without compromising disinfection efficacy.

Restoration: Critical to Long-Term Success

Preserving the dentin located around the cervical area of the root or PCD is a central goal in minimally invasive endodontics due to its critical role in maintaining tooth strength and structural integrity. Several strategies have been proposed to restore or preserve this important zone. These strategies include the use of flowable composites and giomers to bond and reinforce PCD, as well as conservative access cavity designs that preserve marginal ridges and maintain the tooth’s inherent structural integrity.

The type and timing of restoration are critical factors in the long-term survival of endodontically treated teeth. Molars without full cuspal coverage have significantly lower survival rates in a 10-year retrospective study. Presence of crowns resulted in 91% survival rate compared to direct restorations (76%) [22]. Restorative options for endodontically treated teeth include both direct and indirect approaches, each with distinct advantages and limitations. Direct bonded composite resins are conservative but sensitive to polymerization shrinkage and the C-Factor, and their success depends heavily on the quality of the remaining dentin. Indirect adhesive restorations, such as onlays, offer improved strength and aesthetics while still preserving tooth structure. Importantly, restorations that provide full cuspal coverage, incorporating a 2 mm ferrule and well-designed occlusal contacts, significantly enhance the tooth’s biomechanical resilience and longevity. While short-term survival rates for indirect restorations are promising, long-term outcomes are strongly influenced by factors such as residual dentin quality, occlusal forces, and the effectiveness of bonding techniques [23].

Disinfection: A Compromised Trade-Off?

Minimally invasive access and instrumentation techniques, while advantageous for preserving tooth structure, may compromise the efficacy of root canal disinfection, particularly in complex canal anatomies and the apical third [24-26]. The conventional syringe-needle irrigation method with antimicrobial agents remains the clinical standard, yet its effectiveness is limited by its inability to adequately reach and disinfect the entire root canal system [25]. Furthermore, the correlation between bacterial load reduction and clinical healing outcomes remains unclear, especially in cases where conservative approaches are used. To overcome these limitations, emerging technologies are being explored to enhance antimicrobial efficacy within minimally prepared canals.

Redefining Minimally Invasive Endodontics

Minimally invasive dentistry involves more than just conservative cavity preparation and dentin preservation; it also emphasizes patient education, caries prevention, early detection, and timely intervention [27]. In the context of endodontics, a minimally invasive approach extends beyond carefully designed access cavities and conservative shaping of the root canal system. It involves a broader perspective that includes accurate diagnosis and an understanding of the etiological and biological factors influencing disease progression to guide appropriate treatment decisions [28]. This paradigm includes the early identification of pulpitis and the implementation of conservative therapeutic measures such as vital pulp therapy, aimed at preventing the need for root canal treatment. In persistent lesions with failing primary treatment, alternative treatments like root-end microsurgery or tooth replantation may offer more conservative and biologically sound solutions compared to re-instrumentation of the root canal system. Ultimately, minimally invasive endodontics aims to preserve the natural tooth structure while effectively managing disease and maintaining long-term oral health.

Next-Gen Innovations: The Role of Nanotechnology and Tissue Engineering

A pivotal insight from the presentation was the recognition that periapical healing depends on more than just bacterial elimination; it is also shaped by the interactions between microbial communities and the host immune system. This reflects a paradigm shift from a purely antimicrobial approach to one that incorporates immunomodulation as a fundamental component of healing. Key findings indicate that prolonged inflammation can significantly hinder tissue repair, whereas targeted modulation of the immune response may facilitate the transition from a diseased state to regeneration by balancing pro- and anti-inflammatory signals.

To address the biomechanical deficiencies in dentin caused by dehydration and aging, researchers are developing advanced biomaterials that not only reinforce tooth structure but also promote healing. Among these innovations, bioactive and functionalized nanoparticles have shown considerable promise. These nanoparticles can disrupt bacterial biofilms, inducing collagen cross-linking within the dentin extracellular matrix – a process known as microtissue engineering [29] and modulating immune responses to enhance tissue repair [30]. By guiding cellular behavior to reduce inflammation and support organized regeneration, bioactive engineered nanoparticles significantly expand the regenerative potential of endodontic therapy. The integration of both antibacterial and immunomodulatory properties in these materials represents a major advancement in minimally invasive endodontics, offering the potential for improved mechanical durability and superior clinical outcomes in endodontically treated teeth.

In conclusion, minimally invasive endodontics is not a one-size-fits-all solution but rather a dynamic concept requiring careful balance between conservation, disinfection, and restoration. The future of endodontics lies not just in doing less, but in doing optimized preservation of dentin while enhancing its strength, ensuring effective microbial control, and harnessing the host immune machinery for optimal healing. With continued innovation and evidence-based refinement, minimally invasive endodontics holds the potential to significantly elevate both functional outcomes and patient satisfaction in modern endodontics.

Figure 1: Summary showing the highlights and takeaways.

Figure 2: Sequential radiographs highlight the role of mechanical preparation and biological disinfection in achieving and maintaining periapical health.

Figure 3: Diagram emphasizing the balance between dentin preservation (function) and disinfection with obturation (health) in endodontic treatment. Preservation must not compromise disease control.

 

References

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  2. Flaifel M, Eichenberg S, Mohandes B, Taha E, Kollman L, Flemming S, et.al. The outcomes of robotic ileocolic resection in Crohn’s disease compared with laparoscopic and open surgery: a meta-analysis and systematic review. Techniques in Coloproctology 2025 March 29:88
  3. Jameson MW, Hood JA, Tidmarsh BG. The effects of dehydration and on some mechanical properties of human dentine. J Biomech 1993; 26:1055–65.
  4. Kishen A. Vedantam A. Hydromechanics in dentine: Role of dentinal tubules and hydrostatic pressure on mechanical stress-strain distribution. Dental Materials. 2007;23(10):1296-306.
  5. Kishen A. Mechanisms and risk factors for fractures in endodontically treated teeth. Endodontic topics 2006;13:57-83;
  6. PradeepKumar AR, JothiLatha S, Durvasulu A, Muralidhar L, Vimalesh Alagu J, Shereen J,Kishen A. Impact of Type 2 Diabetes Mellitus on the Occurrence of Vertical Root Fracture: A Case Control Study. J Endod 2024 Jan 24:S0099-2399(24)00039-6;
  7. Ivancik, Dwayne D Arola. The importance of microstructural variations on the fracture toughness of human dentin. Biomaterials 2013 Jan;34(4):864-74;
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  9. Asundi A, Kishen A. In vivo strain and in vitro stress distribution in dental supporting structures- a strain gauge and photoelastic analysis. Archives of Oral Biology 2000; 45:543-50).
  10. Plotino G, Grande NM, Isufi A, Ioppolo P, Pedullà E, Bedini R, Gambarini G, Testarelli L. Fracture Strength of Endodontically Treated Teeth with Different Access Cavity Designs.

J Endod. 2017 Jun;43(6):995-1000.

  1. Peng W, Zhou X, Gao Y, Xu X. Effect of Access Cavity Preparation on Dentin Preservation, Biomechanical Property, and Instrumentation Efficacy: A Micro-Computed Tomographic Study. J Endod. 2022 May;48(5):659-668.
  2. Vorster M, van der Vyver PJ, Markou G. The Effect of Different Access Cavity Designs in Combination with WaveOne Gold and TruNatomy Instrumentation on Remaining Dentin Thickness and Volume. J Endod. 2023 Jan;49(1):83-88
  3. Meyerson D, Li FC, Kishen A. Photomechanical investigation on the impact of endodontic cavity design on the biomechanical response in mandibular posterior teeth. J Endod 2025 Jan;51(1):78-84.
  4. Abou-Elnaga MY, Alkhawas MAM, Kim HC, Refai AS. Effect of Truss Access and Artificial Truss Restoration on the Fracture Resistance of Endodontically Treated Mandibular First Molars. J Endod. 2019 Jun;45(6):813-817.
  5. Krishan R, Paqué F, Ossareh A, Kishen A, Dao T, Friedman S. Impacts of conservative endodontic cavity on root canal instrumentation efficacy and resistance to fracture assessed in incisors, premolars, and molars. J Endod. 2014 Aug;40(8):1160-6.
  6. Selvakumar RJ, Surendran S, Sundar S, Arul B, Natanasabapathy V. Impact of Contracted Endodontic Access Cavities on the Fracture Resistance of Endodontically Treated Teeth After Mechanical Aging by Simulated Chewing Forces. J Endod. 2023 Sep;49(9):1176-1182.
  7. Daniel A, Saleh AR, Al-Jadaa A, Kheder W. Impact of Access Cavity Design on Fracture Resistance of Endodontically Treated Maxillary First Premolar: In Vitro. Braz Dent J. 2024 Mar 22;35:e245676.
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  9. Keleş A, Keskin C, Karataşlıoğlu E, Kishen A, Versiani MA. Middle Mesial Canal Preparation Enhances the Risk of Fracture in Mesial Root of Mandibular Molars. J Endod. 2020 Sep;46(9):1323-1329.
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Dear Endodontic Residents & New Practitioners,

Happy Fall! As the season turns and the leaves change, I’m excited for some great opportunities ahead for those of you who want to deepen your involvement with the AAE, grow in leadership, and showcase your work. Here are a few things you definitely don’t want to miss:

What’s Coming Up

  • AAE Insight Track: Surgery (2025): If refining surgical skills and elevating patient care lights you up, this is one you’ll want on your radar. The 2025 Insight Track on Surgery takes place November 13-15, 2025, at the Omni Rancho Las Palmas Resort & Spa in Palm Springs, California.  Over several focused sessions, experts will walk through case selection, guided microsurgery, soft tissue management, anatomy, grafting, and more. It’s small-group, hands-on-friendly, packed with CE, and also gives you breathing room to reset, connect, and recharge. 
  • Committee Nominations: AAE has many committees, Resident & New Practitioner Committee among them, filled with colleagues who are shaping our specialty. Serving on a committee when you’re early in your career can be incredibly rewarding. You gain insight, build networks, and learn leadership firsthand. Nominations are open now, with deadlines by October 31, 2025 for terms starting in 2026. 
  • Abstract Submission for AAE26: If you’ve got research, case work, or an interesting new angle on something clinical, now is a great time to get that abstract ready. The call for oral, poster, and table clinic presentations for AAE26 (April 15–18, 2026, Salt Lake City) opens September 24, 2025 and closes November 14, 2025. 

For Those Preparing for the ABE Oral Examination (October 2025)

I know the oral exam can feel daunting; like no matter how much time you’ve spent preparing, there’s always one more topic you wish you had reviewed again. But here’s a mindset shift that can really help:

  • Someone once told me, you may never feel “ready” but you can feel prepared! Focus on what you do know, not what you’re unsure about. Build confidence in your strengths.
  • Use these next few weeks to polish those strengths, practice case discussions, think through treatment plans, and revisit literature in the areas you feel solid.
  • In dental school, my friends and I had a mantra before every big exam. Whether it was boards, clinicals, or anything in between: “You’ve already passed, you just have to take the test!” Walk in with that same mindset of victory. You’ve put in the work, earned your place, and proven you belong. Now it’s simply your moment to show it. Believe in what you’ve built and success will already be yours.
  • Lastly, everyone who sits on the other side of that table is rooting for you. Deep breaths. You’ve put in the work. Trust in your preparation and in yourself.

Want to Write, Share, Contribute?

Our committee always welcomes voices from residents and new practitioners. Whether you’re sharing a standout clinical case, a personal story from your journey, or even a favorite recipe (yes, we love a little extra flavor!), The Paper Point is your space to shine. No rigid guidelines, just genuine contributions that inspire and connect.

If you’re curious, need guidance, or want to submit something, don’t hesitate to reach out at PCarpenter.DDS@gmail.com.

Remember: You’re capable. You’re growing. And you’re already doing more than you realize.

Warmly,
Priscilla L. Carpenter, DDS, MS
Chair, Resident & New Practitioner Committee

“Excellence is never an accident. It is always the result of high intention, sincere effort, and intelligent execution.”
— Aristotle

I vividly remember my first experience observing clinical endodontics nearly ten years ago—and being immediately captivated. I watched, mesmerized, as the practitioner meticulously instrumented and irrigated microscopic canals, working with incredible focus to save a tooth that would have otherwise been lost. At the time, I was a dental assistant—bright-eyed, curious, and eager to learn. That experience ignited something in me that I couldn’t quite define then, but looking back now, I know it was the beginning of a life-changing journey.

At that time in my life, I was in a season of transition and exploration. Having just completed my undergraduate studies, I worked a variety of jobs—from selling cars at a local dealership to delivering pizzas, and even providing bedside support to patients in hospice care. These jobs were not glamorous, but each one taught me something valuable about people, communication, empathy, and hard work. Still, I felt like something was missing. I craved a career that would challenge me intellectually, demand precision, and allow me to make a lasting impact on others.

As fate would have it, I eventually found myself working alongside three general dentists who introduced me not only to the clinical side of dentistry but to its broader philosophy. Watching them work, I became especially fascinated by the delicate and technical nature of endodontic procedures. There was something profoundly satisfying about seeing a severely compromised tooth brought back to life through skill, patience, and science. That fascination quickly became a calling.

From that moment on, I immersed myself in the world of endodontics. I began following leading voices in the field such as Dr. Ali Nasseh, Dr. Clifford Ruddle, Dr. Kenneth Hargreaves, and Dr. Mahmoud Torabinejad. Their lectures, articles, and online content became regular fixtures in my life. I spent evenings and weekends absorbing everything I could—watching case reviews, reviewing treatment protocols, and learning the intricacies of materials and instrumentation. I wasn’t just trying to get ahead—I was genuinely in love with what I was learning.

During dental school, that passion continued to grow. Thanks to the guidance of faculty mentors and local endodontists in the Tampa area, I had the opportunity to further explore the specialty. My predoctoral education included opportunities to participate in organized dentistry and endodontic research, both of which deepened my appreciation for the specialty and solidified my desire to contribute to it in a meaningful way. These experiences taught me the value of collaboration and how powerful mentorship and community can be in shaping one’s professional path.

What has most profoundly shaped my passion for endodontics is the mentorship and generosity of the professionals who came before me. My journey began as a dental assistant, where three individuals took the time to invest in me—sharing their knowledge, skills, and passion for the field. That early guidance sparked a genuine curiosity, which grew as I engaged with educators and clinicians who freely shared resources and insights with the broader dental community. Now, as a practicing dentist, I strive to carry that same spirit forward—mentoring and supporting new graduates just as others have done for me, time and time again.

As a general dentist practicing in my hometown of Dallas, I carry these lessons with me daily. I strive to deliver excellent care, not only in technical execution but also in the relationships I build with my patients. I challenge myself to bring the same level of commitment and integrity to each case, no matter how routine it may seem. As C.S. Lewis wrote, “Integrity is doing the right thing, even when no one is watching.” That quote resonates with me deeply—it’s how I’ve approached my practice from day one.

Nearly four years into practicing general dentistry, my enthusiasm for endodontics has only grown stronger. I find myself constantly drawn back to the procedures and concepts I first fell in love with as a dental assistant. Whether I’m studying new techniques, exploring innovative biomaterials, or engaging in online discussions with colleagues, I remain deeply committed to growing in this field. My ultimate goal is to one day become a full-time endodontist and educator, helping others discover the same passion that transformed my own career.

To me, endodontics is far more than a series of procedures. It’s a philosophy centered on preservation—a belief in the value of saving what nature created. No artificial substitute can fully replicate the structure, function, or beauty of a natural tooth. That mission to preserve, restore, and elevate patient care is what continues to drive me forward.

I’m incredibly grateful to the staff at AAE Communications and to the entire AAE Connection forum community. Your generosity, insight, and mentorship have been instrumental in my growth, and I look forward to continuing to learn from this amazing network of professionals.

I’m excited about what lies ahead and can’t wait to connect with many of you in the upcoming application cycle as I pursue my dream of becoming an endodontist.

Dr. Stanley John is a general dentist and aspiring endodontics resident. He can be reached at stanleydmd@gmail.com or follow him on Instagram @stanleycjohn.

By Lisa Radman White

You’ve invested a great deal of time, money, and perhaps even blood, sweat, and tears into your education. Becoming an endodontist is a significant accomplishment—one that typically is only an option if you finished at the top of your dental school class. But after the hard work of earning your credentials, one of the most critical decisions remains:

Where will you work?

Will you become an associate in a private practice or in a corporate setting? Will you narrow your search to a particular location? Will you purchase a practice or attempt a startup?

Let’s explore the true story of Dr. A (not his real name), and how a major career decision set him on a difficult path—and how he ultimately turned things around.

The Dream: A Startup in a Competitive City

I met Dr. A during a “Life After Residency” Lunch and Learn presentation at his endodontic program. By then, he had already decided to open a startup practice in a large, competitive metropolitan city—his wife’s hometown.

Confident in his training and compassionate personality, Dr. A fully expected to succeed. He was the kind of clinician you’d bet on: well-spoken, personable, kind, and highly competent. On paper, he was the perfect candidate for a thriving solo practice.

But reality didn’t cooperate.

Despite his strengths, Dr. A struggled to gain traction. The general dentists in the area had entrenched referral patterns that they were unwilling to break, no matter how good Dr. A was. With patient volume low, he turned to insurance plans to boost numbers. Unfortunately, the insurance companies didn’t need him—and they knew it. They added him at reimbursement rates even lower than what other local endodontists were receiving. His molar root canal fee through insurance hovered around $500.

The Struggle: Overworked and Underpaid

While accepting insurance plans did increase his collections to over $500,000/year, it wasn’t enough. After factoring in practice loans, student debt, and living expenses, Dr. A’s take-home pay was around $100,000. His wife had to keep working, which wasn’t part of the life they had envisioned. The city had been her choice—but not under these circumstances.

Two years in, Dr. A called me with a new request:

“What’s the most profitable practice you have for sale right now?”

The Pivot: A Strategic Move to the Midwest

We had just listed a practice in a mid-sized Midwest city with an overhead of only 26%. It was 100% fee-for-service, and the current owner was netting $850,000/year working four days a week.

Dr. A wasted no time. He flew out to see the practice on a Friday and by Monday had submitted a full-price offer.

Thankfully, his startup had been built on a tight budget, and even though he sold it for just $125,000, the remaining loan balance didn’t prevent him from securing financing. Why? Because banks in the dental space primarily care about cash flow. If a practice is priced correctly and cash flow is strong, they’ll finance 100% of the purchase price, plus working capital—and in this case, even enough to pay off his remaining startup loan.

The Outcome: Redemption and Relief

Relocating to the Midwest meant:

  • Lower cost of living
  • Lower staff costs
  • Significantly higher income
  • Mrs. A could now stay home with the kids

While they no longer lived near her family, they could afford to travel anytime. Life stabilized. Their financial future looked bright again.

The Takeaway

You might not be planning a startup in a highly competitive market—but I hope Dr. A’s story makes you pause and reflect. Your career decision after residency is one of the most important ones you’ll make.

Some considerations:

  • Associateship: You may not control your schedule or the insurance plans you’re required to accept, but you should have clinical autonomy.
  • Practice Ownership: Your net income (after covering practice expenses and loan payments) should still meet or exceed what an associate makes.

You’ve chosen a great profession. Now, make sure you build a great career with it.

Lisa Radman White is the president of Radman, White & Associates, Inc., a firm dedicated exclusively to endodontic practice transitions. The company was founded in 1998 after her father discovered firsthand how difficult it was to sell his endodontic practice.

Compiled by Dr. Austyn Grissom                                                    

Dr. Josh Presley is a second-year endodontic resident at Nova Southeastern University. In this Resident Spotlight, he shares more with us about his journey to dentistry, his passions outside of the clinic, and what he envisions for his future.

The Paper Point: Thanks for taking time to chat, Dr. Presley. Let’s start by telling everyone a little bit about yourself.

Dr. Presley: I appreciate you giving me your time as well, Dr. Grissom. I’m originally from Pensacola, Fla., and right now I’m in Davie, Fla., in my last year of endo residency at Nova Southeastern University. My wife and I have a son that’s a few months away from turning two years old, so we’re soaking up the baby phase as much as we can. I enjoy hunting and fishing, and the outdoors in general. I think people would say I help keep the mood light and have a good sense of humor.

Dentistry is a second career for me, so I guess I was a non-traditional dental student. I used to work in the pharmaceutical industry in the quality control lab and then spent my last year with that company doing validation work and product development. I got a master’s degree in biology to improve my dental school application during that time. My wife and I moved from Pensacola to Maine when she started her PhD program, and I got into dental school soon after at the University of Colorado. We lived in the Salt Lake City, UT area for a year while I was in an AEGD program at Roseman University. I got into the Nova endo program while we were in Salt Lake City and now we’re here.

The Paper Point: Awesome! Did you ever consider continuing your career focusing on baseball- either as a player or a coach?

Dr. Presley: Yeah, my childhood dream was to follow in my dad’s footsteps and play pro baseball. Luckily my dad always pushed me to be a doctor of some sort because I never grew out of the scrawny kid phase before my baseball career ended. I had the opportunity to coach high school baseball for a couple of years; two brothers on those teams are currently practicing dentistry today!

The Paper Point: At what point did you decide to pursue endodontics? Did you consider any other dental specialties?

Dr. Presley: I grew up thinking I wanted to be an orthodontist, but an experience right before leaving for dental school got me seriously considering pursuing endodontics instead.

About a month before I had to move away to start school, my wife developed the worst facial swelling I’ve seen to this day. She was prescribed antibiotics initially, but we ended up in an endodontist’s office when her pain and swelling persisted. At the time, I’m not even sure if I knew what an endodontist was. He found out I was about to leave for dental school, so he let me come watch the whole procedure. I remember being blown away by the technology in his office and thinking all the screens and radiographs he had in the operatory looked like something from Star-Trek. He completed a root canal for one of her molars, which she still has to this day.

What happened afterward really sealed the deal for me though, as I give that endodontist credit for saving my wife’s life. Her symptoms resolved after treatment until the evening she finished the antibiotic prescription a week later. The pain and swelling came back over the course of just a couple of hours; she had sepsis. The endodontist had her come in immediately for evaluation and made the referral to an oral surgeon that had hospital privileges. The endodontist let us know that we’d probably be in the hospital for several nights for administration of IV antibiotics, which is exactly what happened after the oral surgeon helped get my wife admitted. She was discharged after five nights. She was just starting to get better when we left the hospital, and everything completely resolved after a couple of more days of oral antibiotics.

The Paper Point: Wow.. that is an incredible testimony to the impact that our work as endodontists can have on a patient and their family members. Now that you are on the flip side of things, what has been the most impactful part of your endo residency so far?

Dr. Presley: It’s hard to pick just one part of my residency as the most impactful. I think my best experiences are tied to the people I’ve treated. Our patients can feel pretty anxious about whatever treatment they’re in for. When people let me know that they appreciate me, they trust me, that I’ve helped them understand their treatment, or even that they’re not scared of root canals anymore, I feel confident that I’ve provided the best service for them that I could’ve.

As far as a recent impactful experience, we treat prisoners at Nova at times, and I treated a woman’s #8 that had partially fractured away after trauma. I built the tooth back up as best I could. She told me I gave her smile back, and she left in tears of happiness. That impacted me and reinforced that we should be giving everyone our best.

I can’t talk about the most impactful part of my residency without bringing up the faculty, staff, and my co-residents. They’re all just good human beings. It’s hard for me to describe everything I mean when I say that, but being a good person is the most important quality in my eyes. We have a very positive and supportive environment at Nova.

The Paper Point: Between Northwest Florida, Alabama, Maine, Colorado, Utah, and Southeast Florida… do you have a favorite place that you have lived? Do you know where you would like to land after you complete your residency program?

Dr. Presley: I caught some monster trout and had plenty of fun outdoors while I was in dental school in Colorado, but the fly fishing in Maine was probably a little bit better overall. I just don’t like having to drive in snow! My wife and I are taking a hard look at moving to Texas after I’m done with residency, she’s originally from there and I’ve loved visiting. We’d love to live in a more rural area somewhere in the South, but we’ll have to see where opportunity takes us.

The Paper Point: What’s the secret to balancing being a full-time husband, father, and endo resident? Any wisdom to share with those who might be in a similar phase of life?

Dr. Presley: It’s my wife that makes it all possible. Our son is a few months away from turning two, so he’s still very dependent on her. She’s looking to finish up her PhD program soon, and fortunately she’s able to work from home because she’s taken on so much more with having our first kid and then me starting endo residency right after. I do my best to spend as much time with them as possible. I get everything done concerning residency stuff as early as I can on Saturday so I can spend the rest of the weekend with them, and I hit the weight room in the morning before heading to school during the week so I can spend time my son and give my wife a little bit of a break when I get home for the evenings. You’ll have to ask me this again after I take my oral boards to see if my strategy was solid.

The Paper Point: Let’s imagine you had 24 hours all to yourself… how would you spend it?

Dr. Presley: I think I’d want to be in Saskatchewan, Canada, deer hunting. I’ve never been out there but have heard that’s the place to be. If I knew how to elk hunt a little better maybe I’d say that’s what I’d do instead.

The Paper Point: Nice! I also love the outdoors, and I am already counting down to next year’s Annual Meeting in Salt Lake City (SLC). I can’t pass up the opportunity to ask a former SLC resident: do you have any “can’t miss” activities for those of us who will be in Utah for AAE26 next April?

Dr. Presley: The mountains are right there, so you need to head at least a little outside of town and see some scenery. I didn’t do any skiing in the year I was there, but if the snow is still good there’s great skiing and snowboarding opportunities within an hour of SLC. If you’re able to spend extra time, the national parks in Utah are beautiful; there’s Zion, Arches, Canyonlands, Bryce Canyon, and Capitol Reef.

The Paper Point: Before we part, what is one motivational quote that has inspired you to keep going on the tough days?

Dr. Presley: It’s not a specific quote, but when things get tough and we fall, “get up.”

Dr. Austyn Grissom is former chair of the AAE’s Resident & New Practitioner Committee.

By Dr. Dakota Bailey, DDS 

The journey to specialize, in whatever specialty, should be after careful consideration and hands-on experience. I originally had planned to be a general dentist. I had grown up shadowing my general dentist practice and envisioned myself taking over his office after graduation. During dental school it became quite clear to me that specializing in endodontics was how I wanted to redirect my career path. This decision was made from excellent mentorship and my involvement with the American Association of Endodontists (AAE). 

As I got my application together to apply to endodontic residency, it was recommended to me that I take some time to work either in private practice or complete a General Practice Residency (GPR) to “strengthen my application” and to “get experience”. I’ll admit- I was frustrated. I felt ready. I had well surpassed the requirements for root canals needed to graduate and I was even chosen as a teaching assistant for the endodontics lab. Even so, after graduation I went to a General Practice Residency at the University of Tennessee Medical Center in Knoxville, TN. 

While I was a resident, we were able to work closely with several endodontic practices and met for study clubs learning the newest and most innovative practices involving endodontic therapy. I taught myself how to operate using a microscope and routinely performed advanced endodontic procedures—cases that would have been impossible to take on during dental school. The clinical experience was invaluable, but what truly stood out was the importance of treatment planning. I cannot stress how critical a year of general practice is when becoming an endodontist. 

In school we learn the textbook definition about what “restorability” of a tooth is. In practice, understanding restorability is an entirely different concept- deep margins, soft tissue management, and what can realistically be restored. In school you learn the ideal presentation of a crown, restoration and extraction. Life is never so simple and rarely ever ideal. I learned what the restorative dentist will likely look for because I was the restorative dentist. 

After my year in Knoxville, I went back to West Virginia University for endodontic residency, where I had attended dental school. Now in my second year, I continue to build on the foundation laid during my GPR as well as the skills I gained in my first year of residency—managing complex cases, refining my efficiency under the microscope, and deepening my diagnostic ability. Since I had already become comfortable using the microscope for both root canals and restorative procedures, the transition into residency felt more natural. More importantly, I found that being able to communicate treatment expectations from both a specialist and general dentist’s perspective helped me foster stronger relationships with both patients and referring doctors. 

I wanted to share this experience because I had the mindset of many of the dental school graduates ready to immediately take the next step to specialize. An extra year to learn, gain confidence, and practical understanding has made me a better practitioner, and I encourage others considering specialization to explore the same path.