As we begin a new year, it is both appropriate and energizing to look ahead—to consider where our specialty is going and how the American Association of Endodontists will continue to lead in an increasingly complex healthcare environment.
The AAE enters 2026 with a new Strategic Plan for 2026–2028 that reflects thoughtful deliberation, broad input, and a clear-eyed understanding of the challenges and opportunities before us. Developed through focused work by the Board of Directors and refined with staff expertise, this plan provides a shared framework to guide our priorities, investments, and actions. Just as importantly, it ensures that the Association’s efforts remain aligned with our mission, values, and long-standing commitment to saving natural teeth.
First and foremost, the plan reaffirms our commitment to the public.
Our primary goal is clear: the public should prioritize saving their natural teeth and seek endodontists as their trusted choice for endodontic care. To achieve this, the AAE will continue to strengthen Worth Saving as our flagship public awareness campaign and expand education around oral–systemic health through A Healthy Mouth = A Healthier You. These efforts highlight not only the importance of tooth preservation, but also the specialized training and expertise endodontists bring to patient care. We will continue to elevate our digital and social media presence through high-impact content, member collaboration, and the thoughtful use of credible influencers. At the same time, the Association will be prepared to identify and address mis- and disinformation as it arises, helping to protect patients while reinforcing trust in the specialty.
Equally important is our focus on members.
The strategic plan recognizes that AAE members must continue to lead the advancement of endodontics. Over the next three years, we will sharpen and clearly communicate the value of AAE membership, strengthen leadership development and succession, and expand opportunities for collaboration, education, and engagement. The plan also places renewed emphasis on supporting educators and increasing the number of endodontists teaching at all levels, recognizing that education and mentorship are essential to sustaining the specialty and preparing the next generation of endodontists.
The AAE’s role as the leading authority for endodontic knowledge is another cornerstone of the plan.
We will continue to elevate and modernize clinical resources, ensuring that guidelines, position statements, and assessment tools reflect the highest level of evidence-based care. In parallel, the Association will strengthen its data infrastructure, collecting and analyzing practice and demographic data to better inform advocacy, education, and future planning. Supporting meaningful research and increasing member engagement with research outcomes remain central to this work, reinforcing the AAE’s role as a trusted source of scientific and clinical guidance.
Finally, the plan reinforces advocacy as a strategic priority.
The AAE will continue to advocate for evidence based, patient centered endodontic care by strengthening relationships with organized dentistry, regulators, and third-party payers. We will work to expand patient access to high-quality endodontic care, demonstrate the value of endodontist provided treatment across the oral health system, and ensure that our specialty’s voice is heard in discussions that shape the future of oral healthcare.
This strategic plan is not a rigid roadmap, it is a living framework. It allows the AAE to remain agile while staying anchored to our mission, values, and purpose. You will see it reflected in our programs, communications, advocacy efforts, and partnerships as we move forward.
As we enter this new year, I want to thank our volunteers, Board members, committee members, and staff for their dedication and leadership. Together, we are positioning the AAE, and the specialty of endodontics, for a strong, relevant, and confident future.
I wish you a healthy, successful, and fulfilling New Year.
By Dr. Bobby Nadeau
The pace of technological advancement in the fields of augmented reality and artificial intelligence is increasing rapidly. The emergence of more powerful computers and a better understanding of machine learning is now allowing new possibilities in clinical Endodontics. Augmented reality (AR) is a technology that overlays digital information, such as images, text, or 3D models, onto the real world in real time, typically viewed through a smartphone, tablet, smart glasses or dedicated AR headsets.
Artificial intelligence (AI) is the development of computer systems capable of performing complex tasks that typically require human intelligence much more efficiently. The main subfields of AI include machine learning, deep learning and computer vision. Machine learning include systems that improve from experience and data without being explicitly programmed. Deep learning is a subset of machine learning using multi-layered neural networks. Computer vision allows for the interpretation and understanding of visual information.
Guided Endodontics
The concept of image guided Endodontics (IGE) was first described by Clark and Khademi in 2010 (1). IGE can be defined as a minimally invasive, precision-driven philosophy and technique for locating root canal systems using 3D imaging as the primary guide for access cavity design, rather than relying solely on the traditional 2D radiography and average anatomical knowledge.
The emergence of computer guided Endodontics now allows clinicians to use real-time 3D imaging, preoperative planning software, and intraoperative tracking systems to precisely guide surgical instruments during an operation. This is particularly useful in cases of canal calcification and microsurgeries. The benefits of guided surgery in general include more minimally invasive and efficient procedures and the potential for enhanced post-operative healing and outcomes. Computer guided Endodontics carries a more complex setup and involves a significant financial investment and steep initial user learning curve.
3D Model Guided Endodontics
This technique involves the use of pre-operative CBCT data to produce a 3-dimensional segmented model of different dental structures. The author uses Relu Creator (Belgium), a browser-based software that utilizes AI, mainly convolutional neural networks, to produce segmented 3D models of different structures from CBCT data. This software allows the automatic segmentation of structures such as hard tooth structure, canal spaces, bone, sinus cavities and inferior alveolar nerve canal. The final segmented 3D model can be exported from Relu Creator and imported into a smartphone application which allows viewing and manipulating the 3D model. The smartphone is mounted onto the surgical operating microscope using a custom smartphone adapter (Zumax Medical, China) as shown in figure 1. The smartphone is connected to the DentSight AR Heads-up Display module (Zumax Medical, China) through HDMI connection (Fig 1). This allows the injection of the segmented 3D model into the field of view of the microscope. This augmented reality setup allows the clinician to view deeper structures not visible to the naked eye (root dentin, osseous structures, canal space) overlayed in real time on top of the real patient anatomy as seen through the microscope. The clinician can manipulate the 3D model in real time directly onto the smartphone to orient and position it in the desired position.
Figure 1
Non Surgical Case
This patient presented with an upper central anterior with pulpal necrosis, symptomatic apical periodontitis and a receded canal (Fig 2). A CBCT was taken and a 3D model segmenting the hard tooth structure and canal space was produced using Relu Creator. The 3D model was overlayed within the clinical field of view as seen through the microscope using the setup described above. The 3D model was positioned in the same orientation as the real anterior tooth as seen through the indirect vision of the dental mirror. The access cavity is performed, guided by the 3D model, and the root canal treatment subsequently completed. Previously, using CBCT data, the clinician would be required to manually scroll up and down the different slices of the scan in order to assess the relationship between the canal position and the external form of the crown of the tooth to plan the access adequately. The benefit of 3D model guided Endodontics is that, for the first time, the clinician can obtain the relationship between the canal space and the outer form of the crown of the tooth all within one view. The augmented reality setup allows the clinician to maintain focus on the surgical field without having to look away at an external monitor.
Figure 2
3D Model Guided Endodontics for Microsurgery
The same technique described above can be utilized to overlay hard structure over the patient’s gingiva to plan flap designs and root resections during Endodontic microsurgeries. Figure 3 shows the outline of the hard tooth structure overlayed on the patient’s jaw as seen through the microscope by the operator.
Figure 3
Summary
The 3D model guided technique using the DentSight AR Heads-Up Display module and Artificial Intelligence based software has the potential to give clinicians real time visual guidance during Endodontic procedures. As opposed to more complex computer guided systems, this technique is more cost effective and easily integrated into the microscope based workflow. The future of 3D model guided Endodontics will utilize computer vision with object recognition and object tracking to ensure the segmented 3D model remains overlayed in the appropriate position/orientation despite patient movement during the procedure (Fig 4).
Figure 4
References
1- Clark JR, Khademi JA. Modern molar endodontic access and directed dentin conservation. Inside Dentistry 2010;6(8):58-71
Compiled by Rae Burach
Robert Hanlon, D.M.D., is a practicing endodontist and AAE member residing in Southern California. A longtime member and volunteer of the California Dental Association (CDA), Dr. Hanlon has just become the first endodontist president of the organization. We talked with him about why this position is so meaningful– personally and professionally– and how it can further strengthen the relationship between specialists and general practitioners.
AAE: What does it mean to you to be one of the first endodontist presidents of the CDA, and what do you hope it represents for specialists?
RH: I’m truly honored and humbled to become the 156th president of the 27,000 member California Dental Association (CDA). I was actually quite surprised to find out that I am the first endodontist to hold this position. Many leaders and past leaders in AAE leadership come from the CDA. AAE Past Presidents like Mahmoud Torabinejad, Alan Gluskin, and Stefan Zweig come to mind. I first met incoming AAE President Craig Noblett fifteen years ago when we were both members of the CDA Political Action Committee. Current AAE ADPAC Representative Ken Tittle is another CDA member. I chose a somewhat different path and focused more of my time at the CDA rather than the AAE. I was Chair of CDA’s Government Affairs Council for several years and CDA’s Political Action Committee for more than a decade. One only has a limited amount of time, and I decided to focus my attention with my state organization rather than the AAE.
AAE: What are your top priorities/goals for your CDA presidency, and why those now?
RH: I’ve always been of the belief that a leader’s job is not to institute his own personal goals or agenda, but to facilitate the implementation of the strategic plan that the associations Board of Directors has mutually agreed upon. That’s my goal, that’s my job. With that said, if there is one thing that I would like to focus on it is wellness. Being a young endodontist today is extremely stressful. Many of us are isolated and practice alone. We see patients in pain. We squeeze emergencies in wherever we can in our already busy schedules. Factor in student loan debt, staffing issues, rising overhead costs, stagnant or decreasing reimbursement rates from dental benefit plans and it all adds up to increasing stress levels. I know of two endodontic colleagues here in California who took their own lives. This is where we as a profession – as a specialty and as individuals – have to do better. We have to be willing to reach out to our colleagues in trouble and ask them “How are you doing?” Starting a conversation and listening to what they have to say. We need to embrace our roles as ambassadors of the specialty of endodontics, but we also need to embrace our roles as friends, colleagues and members of the dental community.
AAE: How has your perspective as an endodontist influenced the way you approach leading a statewide general dental organization?
RH: If I could sum up my leadership style in one word it would be “collaborative.” As an endodontist, you have to have a collaborative relationship with your referral base. To be a successful endodontist, you have to learn how to get along with a diverse group of referring doctors. For example, as I become more mature in my years (I’m a Baby Boomer), I’m finding that the younger generation of dentists don’t want to communicate with me the same way I communicate with general dentists of my generation. I have to be able to collaborate with them to find common ground on how we communicate with each other. Some prefer email, some prefer text messages, some like a phone conversation. I find the same thing leading the CDA. Our Board as well as our general membership is very broad and diverse. The collaborative skills that I have developed as an endodontist have also served me well in my ability to be collaborative with my Board of Directors and to communicate our message to the general membership through a variety of different channels.
AAE: What do you think general dentists most need from specialists at this point in time, and vice versa?
RH: I think we both need better collaboration and communication skills. My best referring doctors give me all the information I need including recent and, in some cases, historic radiographs prior to me seeing the patient. And some send a referral slip with a tooth number circled and nothing more. General dentists need to know that their endodontic colleagues are there to support and help them. We as endodontic specialists need to get out into the communities where we practice and help educate not only general dentists but other specialists about what it is that makes endodontics so special and unique. With the nationwide shortage of endodontic faculty in dental schools, some dental students are barely exposed to endodontics by endodontists. We need to be willing to step up and give lectures to our local dental societies, study clubs and things as simple as a quick Lunch & Learn within our own offices. We as specialists need to be there to help educate and support those within our dental communities.
AAE: You’ve spent years involved in organized dentistry. What first motivated you to get involved, and what kept you saying “yes” since then?
RH: I’m a third-generation dentist in my family. My grandfather was a general dentist and my father’s older brother was a general dentist. My father was a physician who practiced to the age of 85. From a young age, my father would say to me in Latin, “cui multum datur, multum exspectatur,” which translates to, “to whom much is given, much is expected.” That phrase has reverberated in the back of my head since I was a young boy. That’s probably what motivated me in the beginning to get involved, giving back to a profession that has given so much to me. What propelled me to put forth my name to be CDA President was the words of the Jewish Schlor Hillel the Elder: “If not me than who, if not now than when.” What has probably kept me saying ‘yes’ all these years is that a lot (not all) of it has been fun, the personal fulfillment that I have obtained, the many relationships that I have developed over the years, and the gratification of knowing that the profession of dentistry is a little bit better because of some of the things I was able to accomplish over my career.
By Dr. Steven J. Katz
As we look ahead to 2026, I’m energized by the strength of our specialty and the growing momentum behind the American Association of Endodontists’ advocacy agenda. The policy landscape continues to evolve quickly, bringing new challenges and opportunities for endodontics. What remains constant is our responsibility to protect patients’ access to specialized care and to safeguard the professional autonomy that makes this care possible.
Grounded in the Association’s state and federal priorities, our outlook for 2026 is clear. We will advance specialty recognition, pursue meaningful insurance reform, and push back against misinformation that threatens oral health and evidence-based care.
Continuing the Push for State-Level Specialty Recognition
Specialty recognition remains one of our highest priorities—and for good reason. In many states, outdated or inconsistent regulations still create confusion about what it means to be an endodontic specialist and, in some cases, limit how patients find and access our care. The AAE will continue to advocate state by state for clear, enforceable recognition of endodontics as a specialty, ensuring that the public, legislators and dental boards understand and respect the advanced education, clinical expertise and patient outcomes tied to endodontic care.
In 2026, our strategy includes strengthening relationships with state dental societies, mobilizing grassroots engagement and supporting legislative and regulatory efforts that protect the integrity of specialty advertising and licensure standards. Specialty recognition is not symbolic—it directly influences patient safety, informed decision-making and sustaining the future pipeline of endodontists. I encourage every member to stay engaged when calls to action go out. Your voice and expertise matter.
Fighting for Insurance Reform That Protects Endodontic Autonomy
Insurance reform will be a defining priority in 2026. Across the country, endodontists are facing increased interference from dental benefit plans, particularly around non-covered services and payment mechanisms such as virtual credit cards. These practices do more than complicate administrative tasks—they undermine fair reimbursement, increase burden and can distort clinical decision-making.
Dental plan reform and related measures, including accountability tools like dental loss ratio transparency, remain top-tier priorities at both the state and federal levels. Our goal is straightforward: preserve the autonomy of endodontists to provide care based on patient need—not insurance convenience. In 2026, we will continue to advocate for policies that promote transparency in dental benefits, curb payment systems that add unnecessary burden and reinforce clinicians’ ability to make decisions grounded in evidence and patient-centered care.
Confronting Misinformation and Defending Science-Based Policy
Another urgent priority is combating misinformation that influences public perception and affects clinical decision-making. We continue to see false narratives about root canal treatment gain traction, leading some patients to avoid necessary procedures or pursue inappropriate alternatives.
In 2026, the AAE will continue working with federal agencies and states to ensure policymaking reflects sound science and real-world clinical expertise. We will also equip members with timely resources to address misinformation in their communities and with their patients. The voice of endodontics must remain visible—because silence leads to poorer health outcomes and diminished public trust.
A Shared Responsibility—and a Real Opportunity
I am confident about what we can achieve in 2026 because I see the strength of our specialty when we act together. Whether we are advancing specialty recognition, challenging unfair insurance practices or correcting misinformation, our success relies on sustained member involvement. Advocacy is not separate from clinical excellence—it protects it.
Thank you for what you do every day for your patients and for our specialty. The AAE will continue to lead boldly, and I ask you to stand with us in the year ahead. Together, we will safeguard the future of endodontics and the essential care our patients deserve.
Compiled by Elisabeth Lisican
For decades, the connection between oral health and systemic disease has focused largely on periodontal inflammation — leaving other common dental infections overlooked. In a landmark two-year longitudinal metabolomic study published in the Journal of Translational Medicine, Dr. Sadia Niazi and her team turn the spotlight on apical periodontitis, one of the world’s most prevalent oral diseases, and its potential role in metabolic dysfunction. Using advanced serum metabolomics, the research suggests that successful endodontic treatment may do more than save teeth — it may help rebalance systemic inflammation, glucose regulation, and lipid metabolism. In this Q&A, Dr. Niazi discusses the motivation behind the study, its key findings, and why this emerging evidence — detailed in the study “Longitudinal metabolomic analysis reveals systemic metabolic improvements following endodontic treatment” (read the study here) — could reshape how dentistry and medicine view root canal therapy as part of health care.
Context & Motivation
Lisican: What initially motivated your team to investigate whether root-canal / endodontic treatment might have systemic metabolic effects — beyond just resolving the local dental infection?
Dr. Niazi: What inspired my research was this gap that I observed, while the link between periodontal disease and systemic conditions such as diabetes and cardiovascular disease is globally recognized, the systemic impact of apical periodontitis had received surprisingly little attention and remained largely unexplored. Yet biologically, apical periodontitis and periodontal disease share similar inflammatory and microbial pathways that could plausibly influence systemic health.
What made this even more compelling was the high global prevalence of AP – it is the third most common oral disease, affecting nearly 50% of the global population. but its systemic impact and its recognition as a non-communicable disease remain largely ignored This raised an essential question: if AP is this widespread, could it also be contributing to systemic metabolic burden?
My earlier longitudinal study provided the first clue. We observed that after successful endodontic treatment, patients not only showed reduced systemic inflammatory markers but also improvements in key metabolic syndrome indicators such as HbA1C and lipid profiles. This suggested that treating the infection locally might exert broader metabolic benefits.
To understand why, I advanced the research using a multi omics longitudinal approach. By analyzing patients’ metabolomic profiles alongside serum biomarkers and clinical metabolic data over time, we sought to uncover the mechanistic pathways linking AP to systemic metabolic dysfunction, and to healing after endodontic treatment.
In short, my motivation stemmed from a major knowledge gap, the high global burden of AP, and early evidence from my own work showing that endodontic treatment may influence far more than the tooth – it may help rebalance systemic inflammation and metabolism.
Lisican: In your view, why has the connection between chronic dental infections (like apical periodontitis) and metabolic health been under-studied until now?
Dr. Niazi: The connection between chronic dental infections – such as apical periodontitis – and metabolic health has been under studied largely because medicine and dentistry have historically operated as two separate disciplines. This division has unintentionally reinforced the idea that the oral cavity is somehow disconnected from the rest of the body, when in reality it is the primary gateway to the entire body. By treating oral health in isolation, we overlooked the possibility that infections in the mouth could influence systemic inflammation and metabolic health.
Another reason is that global health research has traditionally focused on the “major” non communicable diseases – diabetes, cardiovascular disease, and obesity – without considering that chronic oral infections are also non communicable diseases that may act as persistent inflammatory drivers that worsen these conditions. Because the mouth is physically distant from many affected organs, its role as a potential source of systemic inflammation was simply not linked.
That mindset is now shifting. We now recognize that oral infections can disseminate pathogens and inflammatory mediators throughout the body, influencing metabolic pathways and contributing to disease vulnerability. The connection between oral and systemic health has become a central theme in modern global health discussions. Importantly, the World Health Organization now explicitly acknowledges this relationship and has integrated it into Global Health Strategies and the Bangkok Declaration, amplifying the powerful message: “No Health Without Oral Health.”
This shift and publication of this current study is finally bringing apical periodontitis – into the spotlight as an important contributor to metabolic health. It is only now that we are beginning to appreciate that what happens in the mouth doesn’t stay in the mouth – and chronic dental infections deserve the same attention as other inflammatory drivers of metabolic disease.
2. Study Design & Methods
Lisican: Could you walk us through the design of your two-year longitudinal metabolomic study — e.g., how many patients, what were the follow-up intervals, what kinds of analyses were done?
Dr. Niazi: Our study, published in the Journal of Translational Medicine, is the first two year longitudinal investigation to track how endodontic treatment influences systemic metabolism. We followed 65 patients treated at Guy’s and St Thomas’ NHS Foundation Trust, collecting blood samples before treatment and at multiple follow up intervals over two years.
Using nuclear magnetic resonance spectroscopy, we monitored 45 metabolites longitudinally, giving us a detailed picture of changes in amino acids, glucose, lipid metabolism, and insight into the broader metabolic pathways. This multi layered, integrated approach – combining metabolomics, serum biomarkers, microbiome, and clinical metabolic indicators data – represents one of the most comprehensive investigations to date into how endodontic treatment of apical periodontitis can influence whole body health.
Lisican: What were the key inclusion and exclusion criteria for participants (e.g., no diabetes, no systemic inflammatory disease, etc.), and why were those criteria important?
Dr. Niazi: We applied very strict inclusion and exclusion criteria to ensure the results reflected the true impact of apical periodontitis – without interference from other health conditions. We recruited medically healthy patients with AP who were referred for endodontic treatment at Guy’s Dental hospital.
To avoid confounding effects, we excluded anyone with factors known to influence inflammation or metabolism. This included smokers, pregnant women, patients with periodontal pockets >4 mm, and anyone with chronic inflammatory or autoimmune diseases such as asthma, inflammatory bowel disease, rheumatoid arthritis, Crohn’s disease, liver disease, or cancer. We also excluded patients who had taken antibiotics in the previous 3 months, had undergone surgery within 6 months, or were on medications that affect bone or metabolic pathways.
These criteria were essential because we wanted to isolate one question:
How much does apical periodontitis alone influence systemic metabolism and inflammatory profiles?
By removing all obvious confounders, we ensured that any metabolic or inflammatory changes we observed could be confidently linked to the infection, and to its resolution after endodontic treatment.
Lisican: Why did you choose nuclear magnetic resonance (NMR) spectroscopy of serum samples as your analytic method? What advantages does that method offer?
Dr. Niazi: I chose NMR spectroscopy because it is one of the most powerful and precise tools available for analyzing the body’s metabolic fingerprint. Unlike conventional blood tests that measure only a handful of markers, NMR allows us to track dozens of metabolites and lipoprotein subclasses simultaneously, giving a far richer picture of how the body processes fats, glucose, and other key molecules. For our longitudinal two year study, NMR detected subtle biochemical shifts over time, allowing us to follow how systemic metabolism changes, as an apical periodontitis infection is treated and healed. So, using NMR, we generated one of the most detailed metabolic profiles ever produced in endodontic research and uncovered changes that can’t be explored using standard laboratory methods.
3. Main Findings
Lisican: Your study reports significant changes in 24 out of 44 measured serum metabolites after successful endodontic treatment. Could you highlight which metabolic changes you found most meaningful (e.g., decreases in glucose, pyruvate, branched-chain amino acids; changes in lipids; increase in tryptophan)?
Dr. Niazi: One of the most striking findings was the clear shift toward a healthier metabolic profile after successful endodontic treatment. We observed reductions in serum glucose, pyruvate, cholesterol, and fatty acids, providing robust evidence that treating an endodontically infected tooth can meaningfully improve both glucose and lipid metabolism.
We saw a significant reduction in branched chain amino acids- metabolites strongly linked to insulin resistance, diabetes risk, and abnormal lipid profiles. Their decline suggests an improvement in the body’s ability to regulate glucose and fats.
Equally important was a progressive rise in tryptophan, a metabolite known to have protective effects against cardiovascular disease. Together, these changes indicate a shift toward a more favorable cardiometabolic state.
Lisican: How quickly did some of these changes become detectable (e.g., at 3 months, 6 months, 1 year, 2 years)? Are there both short-term and long-term effects?
Dr. Niazi: Some changes appeared surprisingly quickly. Within just a few months, patients already showed healthier cholesterol and fatty acid levels, indicating early improvements in lipid metabolism.
Other benefits unfolded more gradually. Blood glucose levels continued to fall over the entire two year follow up period, suggesting sustained improvements in insulin sensitivity and long term metabolic risk. Inflammatory markers also dropped progressively, showing that systemic inflammation steadily decreased once the endodontic infection was resolved.
Lisican: Your team suggests that metabolites associated with the tricarboxylic acid (TCA) cycle may be key regulators of the metabolic improvements. What does that imply about the biological mechanisms underlying the link between oral health and systemic metabolism?
Dr. Niazi: The metabolites that changed most consistently were those connected to the tricarboxylic acid (TCA) cycle – the central energy producing pathway of the body. This is a critical insight. It suggests that chronic apical periodontitis doesn’t just create local inflammation; it disrupts fundamental energy metabolism pathways, raising blood sugar, elevating cholesterol, and driving systemic inflammation.
Our findings imply a clear biological mechanism: Microbes and their toxins from an infected tooth can enter the bloodstream, trigger inflammatory responses, and interfere with energy metabolism. Once the infection is eliminated through endodontic treatment, the TCA cycle appears to normalize, restoring metabolic balance.
This is a powerful message. It shows that oral health is a metabolic health issue. An infection at the tip of a tooth can influence glucose processing, lipid regulation, and inflammatory pathways throughout the body. Treating that infection may help reduce long term risks of conditions such as diabetes and cardiovascular disease.
4. Clinical & Public Health Implications
Lisican: Based on your findings, what would you say to patients or general medical practitioners who view root canal therapy as purely “dental / cosmetic”? Could endodontic treatment now be considered part of holistic metabolic health care?
Dr. Niazi: It’s time to go beyond teeth and adopt a holistic approach to health, I firmly believe. For too long, dentistry and medicine have operated in separate silos, even though the mouth is biologically the main entry point to the entire body. What we now see in our metabolomic data is that a diseased tooth can influence blood sugar, cholesterol, inflammation, and even core energy production pathways and that successful endodontic treatment reverses many of these harmful effects.
This means endodontic therapy has real potential to become part of holistic metabolic health care, especially for patients at higher risk of cardiometabolic disease.
I envision a future where dentists and physicians work side by side, sharing information and co managing patients with chronic inflammation or metabolic risk or other vulnerable patients. That includes creating referral pathways, pilot programs for high risk patients, and training/educating clinicians on the profound links between oral infection and systemic disease. This isn’t just an academic idea; it’s a call to action.
Message for Patients
People must understand that their mouth is the main gateway to your general health, so looking after their oral health – and getting disease treated early – is the best course of action.
Ignoring an infected tooth isn’t a small issue: it can influence your whole body health for years.
Root canal treatment isn’t just about relieving pain or saving teeth – it’s about protecting your overall health, particularly the risk of chronic conditions like heart disease and diabetes.” So don’t ignore dental infections.
Ultimately, there’s nothing better than saving your own teeth – and safeguarding your systemic health in the process. Remember the WHO message: “No Health Without Oral Health.”
Message for Medical Practitioners
Root canal therapy should be recognized as an evidence based tool for lowering systemic inflammation and improving metabolic markers. Incorporating oral health assessments into general medical practice could transform prevention strategies for diabetes, cardiovascular disease, and chronic inflammatory conditions.
The best approach for high-risk patients should be referred to dental teams at the earliest stage of their journey to establish an effective preventative regime, so that timely endodontic treatment can be carried out to optimize oral health, and reduced related systemic risks
Lisican: Might it be possible to use serum metabolite markers (e.g., tryptophan, certain amino acids) as prognostic biomarkers for systemic health improvements after dental treatment? Your study hints at that — could you elaborate.
Dr. Niazi: Our findings suggest that serum metabolite markers – such as tryptophan, specific amino acids, glucose and lipids – could potentially serve as prognostic indicators of systemic health improvement following dental treatment, but this idea is still in an exploratory phase. What our study demonstrates is that treating chronic oral disease doesn’t just resolve local inflammation; it is also accompanied by measurable shifts in circulating metabolites that are linked to immune regulation, oxidative stress, and metabolic homeostasis. The pattern we observed indicates real potential; however, these need to be validated in larger, longitudinal cohorts. So, our study hints that serum metabolites may eventually become part of a precision health toolkit that links oral health interventions to whole body outcomes. But further research is essential before these markers can be translated into routine clinical practice.
Lisican: For patients with pre-existing metabolic risk — for example, people with prediabetes or elevated cardiovascular risk — do you think treating undiagnosed apical periodontitis could become part of a preventive strategy?
Dr. Niazi: Absolutely – that is one of the central messages of our study. For people already at higher metabolic risk, such as those with prediabetes, obesity, hypertension, or elevated cardiovascular risk, treating apical periodontitis – either symptomatic or asymptomatic – should absolutely be considered part of a preventive health strategy.
For high risk patients, addressing AP isn’t just a dental intervention – it’s an opportunity to reduce systemic disease burden. It adds a completely new dimension to preventive medicine.
So, yes – treating AP should be part of metabolic prevention. That is exactly the message this study delivers.
It’s time to rethink oral infections as silent contributors to chronic disease. By identifying and treating AP early, we can potentially help patients stabilize their blood sugar, improve lipid metabolism, lower inflammation, and reduce long term cardiometabolic risk.
In other words, endodontic treatment has a place in holistic healthcare. Treating a hidden dental infection today may help protect against diabetes and heart disease tomorrow.
5. Next Steps
Lisican: Are you or others planning investigations into how long these metabolic benefits last post-treatment — or whether repeated dental health monitoring could maintain systemic health over time?
Dr. Niazi: Yes – absolutely, our study opens the door, and the next phase is to scale up, diversify the cohorts, include patients with metabolic comorbidities, and follow them longitudinally to determine whether sustained endodontic health can indeed preserve systemic metabolic health in the long term.
6. Broader Perspective & Messaging
Lisican: What do you hope dentists, general physicians, and the public take away from your work?
Dr. Niazi:
Patient Message
Root canal treatment isn’t just about relieving pain or saving teeth, it’s about protecting your overall health, particularly your risk of chronic conditions like heart disease and diabetes. Dental infections shouldn’t be ignored; harmful bacteria from an untreated tooth can enter the bloodstream and impact the rest of your body. Ultimately, there’s nothing better than saving your own teeth and safeguarding your systemic health in the process.
Remember the WHO message: “No Health Without Oral Health.”
Dentist Message
Dental professionals must recognize that apical periodontitis, whether symptomatic or asymptomatic, is far more than a localized oral infection. It carries chronic systemic consequences. Early diagnosis and timely endodontic treatment are critical, especially for high risk or medically complex patients.
Our findings reinforce the need to view endodontic care not as an isolated procedure, but as a meaningful component of systemic health management and inflammation reduction and importantly the dentists should work closely with patient physicians to devise a more holistic care for the patients.
Medical Professional Message
We must move toward integrated care, where dentists and general physicians collaborate to identify and manage patient risk. Root canal therapy should be recognized as an evidence based tool for lowering systemic inflammation and improving metabolic markers. Incorporating routine oral health assessments into general medical practice could transform prevention strategies for diabetes, cardiovascular disease, and chronic inflammatory conditions. The best approach for high risk patients is early referral to dental teams, allowing timely endodontic treatment to optimize oral health and reduce systemic risks.
Lisican: Do you believe this study could shift how oral health is prioritized in broader healthcare guidelines (e.g., integration between dentistry and general medicine)?
Dr. Niazi: Yes – absolutely. Our study demonstrates clearly that oral health has tangible systemic effects, and that treating dental disease can influence biological pathways far beyond the mouth. These findings reinforce the urgent need for closer integration between dentistry and general medicine, especially within preventive health frameworks. Oral health must be recognized as a core component of healthcare policy, screening strategies, and chronic disease management — including conditions such as diabetes, cardiovascular disease, and the care of immunocompromised patients, such as cancer patients.
Lisican: If you could send one clear message to patients who might be apprehensive about root canal treatment, what would it be?
Dr. Niazi: My message for anyone feeling anxious about root canal treatment is: a root canal doesn’t cause harm-it prevents it. It is a safe, routine procedure designed to eliminate infection, save your natural tooth, and protect your overall health. Much of the fear surrounding root canals comes from misinformation, especially on social media, so before acting on anything you read online, it’s important to pause and check a few basics.
• First, check credentials – make sure the person giving advice is a qualified professional.
• Then look for reliable sources: Are they referring to reputable scientific evidence, or simply sharing a personal story that may not apply broadly?
• And be extremely wary of sensationalism. If a post sounds extreme, frightening, or too good to be true, it usually is.
Above all, seek guidance from a qualified dentist, not unverified social media sources, when making decisions about dental treatment. Dental infections are not something to ignore – when left untreated, the bacteria and their toxins can spread into the bloodstream and contribute to serious systemic issues, including increased risks of diabetes and heart disease. A root canal isn’t just about saving a tooth; it’s about preventing wider health problems.
And finally, remember that regular check ups and timely treatment are essential. Good oral health is closely linked to good systemic health, and preventive dental care is one of the simplest ways to protect both.
So my message is this: trust evidence, trust qualified professionals, and don’t let misinformation stop you from receiving a treatment that is safe, effective, and genuinely important for your overall health.
By Tung Bui, DDS, FICD
Artificial intelligence is no longer an abstract concept discussed in computer science seminars; it is a tool that is already changing how we teach and practice endodontics. When I mentor AEGD residents about evidence based practice, I often begin by showing how many papers are published each year and how little time we have between patients to review them. This flood of information is not a problem that better memory can solve. It requires technology that helps us find trustworthy evidence and presents it in a way that clinicians can use during a busy clinic session. OpenEvidence is one of the most interesting responses to that challenge. It is a platform built for clinicians, and it rewards the curiosity of educators and students who want to ground their teaching in current research.
What is OpenEvidence?
OpenEvidence is an artificial intelligence powered medical information platform that draws exclusively from peer reviewed medical literature. Instead of scraping the entire internet, the software indexes metadata from PubMed abstracts, full text journal articles, monographs and book chapters. When a user, who must be a verified healthcare professional, asks a clinical question, OpenEvidence identifies potentially relevant sources, selects the most authoritative papers based on relevance, publication date, journal impact factor and citation count, and then synthesizes a short answer with clickable citations. This output arrives within seconds, allowing a clinician to remain in the loop and dig deeper if needed. To limit hallucinations, the system abstains when evidence is inconclusive and always includes references.
The platform is intentionally restricted to healthcare professionals. Physicians, dentists, nurses and other clinicians verify their status by entering a National Provider Identifier or similar credentials. Medical and dental students can register by submitting proof of enrollment. Non-clinicians are permitted only two searches per day, and there is currently no way for the public to purchase unrestricted access. This gatekeeping maintains quality by ensuring that the user community understands the consequences of acting on clinical information. OpenEvidence complies with the Health Insurance Portability and Accountability Act (HIPAA) and will sign a Business Associate Agreement with covered entities, but it warns users not to enter protected health information.
Origin Story and Business Model
OpenEvidence was co founded by Daniel Nadler and Zachary Ziegler. Nadler is a Harvard trained economist and artificial intelligence entrepreneur who previously founded Kensho, a financial AI firm. During the COVID‑19 pandemic he observed that physicians were drowning in a fire hose of literature where medical knowledge doubles roughly every seventy three days. He assembled a team of researchers from Harvard and MIT, including Ziegler, to build smaller, highly specialized models trained solely on peer reviewed medical literature. The company launched in 2021 under the Mayo Clinic Platform Accelerate program and released its direct to clinician application in 2022.
The go to market strategy treats doctors like consumers rather than hospital administrators. OpenEvidence is free for United States clinicians and students and generates revenue through targeted advertising. The company has raised several rounds of funding: self financed in 2021, a friends and family round in 2023, a seventy five million dollar Series A led by Sequoia Capital in February 2025, and a two hundred and ten million dollar Series B co led by Google Ventures and Kleiner Perkins in July 2025, valuing the firm at 3.5 billion dollars. Those private investments mean there is no publicly traded stock; interested investors would need access to future private rounds, which are typically limited to accredited investors. The rapid adoption with over forty percent of U.S. physicians logging in daily, is proof that the free, advertising supported model can scale. Disclosure; I have been working patiently with my hedge fund manager to acquire private shares of OpenEvidence.
How does it work?
OpenEvidence’s core function is known informally as Ask. Clinicians type or speak a question into a mobile or desktop interface, such as “write home care instructions for apical surgery” or “what is the dosing of Penicillin VK for a ten year old. The platform uses natural language processing to interpret the question and then searches its indexed corpus of more than thirty five million peer reviewed publications. It ranks the articles, extracts the relevant facts and composes a short answer with inline citations. The interface invites follow up questions and may suggest related queries to help refine the search. When viewing citations, clinicians can expand a details button to read a summary of each reference, rate the helpfulness of the response, copy a shareable link and see automatically generated follow on questions. The platform warns users to verify that citations actually answer the question, reinforcing healthy skepticism.
While the standard search is designed for rapid answers, some questions require deeper research. Deep Consult is an AI agent that autonomously reads hundreds of studies and produces a longer research brief. The service runs complex computations, more than a hundred times the compute of a standard search, but remains free for verified clinicians. Deep Consult is useful when preparing literature reviews or when dealing with complex medical histories. For example, when a patient presents to the clinic with a complex medical history, we can request a Deep Consult on the list of conditions and receive a summary of all available evidence, including randomized controlled trials and systematic reviews.
Visits is a digital clinical assistant introduced in 2025. It acts like a medical scribe: recording patient encounters, drafting notes and enriching the assessment and plan with guidelines and current research. Visits allows clinicians to ask questions using the patient’s full history and documentation, organizes patient files into a searchable repository and generates polished notes that can be pasted into the electronic health record. For dental educators supervising residents, this module can lighten the administrative load and model best practice documentation.
The Dialer module provides a HIPAA secure phone line with unlimited minutes and smart caller ID. When calling a patient after hours, the clinician’s personal number is masked, and the call can be recorded or linked to a Visit. The application also offers clinical trial matching so providers can identify active trials for conditions like cemental tears, external invasive cervical resorption, or regenerative endodontics procedures. Inbox, a secure messaging centre, allows clinicians to manage queries and results from the platform, while Discover curates featured stories and recent advances from journals such as The New England Journal of Medicine and JAMA. Looking into the future, one could customize the feed to focus on relevant endodontic topics. These feeds transform idle scrolling into a learning opportunity.
Accessing the service
Downloading OpenEvidence is straightforward: search for the name in the Apple App Store or Google Play, or use the web version (https://www.openevidence.com). After installation, users must create an account. Physicians, dentists and allied providers verify their identity by entering an NPI; dental students and endodontic residents upload proof of enrollment. The platform is free for verified professionals, but non clinicians are limited to two searches per day. Institutions seeking to integrate Visits or store protected health information must sign a Business Associate Agreement [4]. The platform’s terms permit the company to collect usage data and sell anonymized, non personal information for commercial purposes, so educators should remind residents not to enter identifiable patient data.
How OpenEvidence benefits dental educators and residents
The everyday functions of Ask, Deep Consult and Visits make OpenEvidence a natural companion for endodontic education. Residents often struggle to connect pathophysiology with evidence based management. With Ask, a resident confronted with burning mouth syndrome in an endodontic residency program can pose a question like “what are the etiologic factors and management options for burning mouth syndrome” and receive a concise summary with citations that they can read before presenting the case to faculty. When our residents debated whether every patient needs a pre-operative cone beam computed tomography scan, Deep Consult produced a structured report summarizing guidelines, systematic reviews and cost effectiveness analyses. That report grounded our discussion in evidence rather than anecdotes and allowed us to model critical appraisal skills.
OpenEvidence also shines when we evaluate new technology. Sales representatives often pitch devices like GentleWave with claims of superior cleaning and less postoperative pain. By asking the platform for a Deep Consult on the device, we quickly learn whether independent trials support those claims. If the evidence is weak or only animal studies exist, we can protect our budgets and our patients. Similarly, when a patient asks whether a muscle relaxant we plan to prescribe interacts with their antiretroviral medications, the platform surfaces drug monographs and interaction studies. Instead of relying on memory or generic interaction checkers, we see the primary literature.
Educators can integrate OpenEvidence into lesson plans. Assign students to craft endodontic questions and evaluate the AI’s responses. Users can filter searches by All, Guidelines and Standard of Care or Clinical Evidence, with results that are tagged as Highly Relevant, Leading Journal or New Research. Those tags help students judge the strength of evidence and understand that not all papers are equal. Encourage residents to follow the citations, read the original articles and consider the applicability to endodontic practice. Remind them that OpenEvidence is an experimental tool and does not replace critical thinking.
Why use a purpose built platform instead of general large language models?
General purpose large language models such as ChatGPT are trained on vast swaths of the internet, including blogs, social media and satirical sites. Daniel Nadler argues that “an index of websites is not an index of facts”. Because mainstream models do not differentiate between high quality medical research and unreliable sources, they are prone to error and hallucinations. In contrast, OpenEvidence is trained on peer reviewed publications and selects citations based on relevance and impact. The platform abstains when evidence is insufficient, and it displays citations so clinicians can verify the information. The general public without an NPI is limited to two searches per day; this gatekeeping reduces misuse and encourages proper clinical oversight. In other words, the platform is designed not just to answer questions but to foster evidence based reasoning.
Looking ahead
OpenEvidence’s vision extends beyond answering questions. The company plans to expand globally and develop advanced AI models capable of sophisticated diagnostic reasoning and personalized treatment recommendations. Future modules may integrate with electronic health records to surface evidence during charting and provide application programming interfaces for third party applications. The platform already offers clinical trial matching and is experimenting with ways to help clinicians draft prior authorization letters and patient education handouts. These innovations suggest that artificial intelligence will become an ambient part of clinical workflows, not a separate destination.
A measured embrace of AI in endodontics
For endodontic educators, AI is not a replacement for mentorship but a catalyst for deeper learning. OpenEvidence demonstrates how a tool built on high quality data, designed for clinicians, can shrink the distance between the literature and the operatory. Whether we are confronting an unusual neuropathic pain condition, debating imaging protocols or evaluating a flashy new device, we can turn to a platform that delivers rapid, referenced answers and encourages us to read the source material. By integrating these tools into our teaching, we prepare residents for a future in which evidence is at their fingertips and critical appraisal is more important than memorization. Artificial intelligence in education is not about abdicating judgement; it is about augmenting our ability to find and apply the best available evidence.
References
- FeldmanA, Shrivastava R. This AI founder became a billionaire by building ChatGPT for doctors. Forbes. July 15, 2025. https://www.forbes.com/sites/amyfeldman/2025/07/15/this-ai-founder-became-a-billionaire-by-building-chatgpt-for-doctors/
- OpenEvidence, the fastest‑growing application for physicians in history, announces $210 million round at $3.5 billion valuation.PR Newswire. July 15, 2025. https://www.prnewswire.com/news-releases/openevidence-the-fastest-growing-application-for-physicians-in-history-announces-210-million-round-at-3-5-billion-valuation-302505806.html
- Jiang Y. OpenEvidence and the future of AI medical assistants. VerticalAI Newsletter. 2025. https://www.newsletter.lukesophinos.com/p/135-openevidence-vertical-ai-for
The Wisconsin Dentistry Examining Board proposed revisions to Chapter DE 6 that would allow general dentists to advertise as specialists even without completing a Commission on Dental Accreditation–accredited residency program. This change would open the door to unrecognized credentials, short-term coursework, and non-CODA training programs being presented to the public as legitimate specialty qualifications. The potential consequences are significant: patient confusion, diminished standards of care, and erosion of the specialist designation our members earn through rigorous education and experience.
In response, the AAE submitted strong formal opposition to the board. We emphasized that specialty recognition and advertising must remain tied to CODA-accredited education or National Commission on Recognition of Dental Specialties and Certifying Boards–approved programs. This framework protects the public from misleading claims and ensures consistency, safety, and competency in the delivery of dental specialty care. Weakening these standards would jeopardize patient safety and undermine the board’s core mission of safeguarding public health.
Our advocacy also underscored the expectations of the public. Research published in the Journal of Dental Education shows that patients overwhelmingly believe that anyone advertising as a specialist has completed an accredited residency, and many would reconsider seeking care from someone without that level of training. In short, the public already trusts that the title “specialist” conveys meaningful, rigorous preparation. It is our shared responsibility—along with state regulators—to ensure that this trust is upheld.
Our message to the Wisconsin Dentistry Examining Board was clear: the AAE stands firm against efforts that threaten the integrity of our specialty. Through direct engagement, evidence-based advocacy, and unwavering commitment to public safety, we continue to protect your ability to practice as true specialists. This action reflects the AAE’s ongoing work to uphold the high standards of endodontics and support the professionals who advance patient care every day.
By Dr. Kayla Tavares Tio, D.D.S., M.D.S.
Insurance carrier misalignment and improper claims processing have become increasingly common sources of strain within endodontic practices. Many providers find themselves caught in cycles of delays, repeated resubmissions and inconsistent information. My practice recently confronted such a challenge when Carrier A and Carrier B failed to honor our timely Carrier A network opt-out and continued to process claims under the incorrect fee schedule.
After months of unsuccessful attempts at internal resolution, the matter was finally corrected—swiftly and decisively—once the Texas Department of Insurance (TDI) became involved. Within days, all claims were reprocessed correctly.
This experience highlights a clear pathway for other endodontists facing similar obstacles: a structured advocacy model grounded in documentation, professionalism and strategic escalation.
The Problem: A Timely Opt-Out Ignored
In January, our practice submitted the required Carrier A opt-out documentation. Despite completing the process, claims continued to return under the Carrier A/Sun Life fee schedule instead of our specially contracted fees. We contacted both Carrier A and Carrier B repeatedly, resending documentation multiple times. Each interaction produced shifting timelines—first 30 business days, then 60, then 90 and eventually 120. Throughout this period, Carrier B maintained that no opt-out was on file.
The issue persisted for months without progress, significantly increasing our administrative burden. Each attempt to correct the problem was met with vague assurances, inconsistent explanations or new waiting periods. Meanwhile, claims continued to process incorrectly.
The Turning Point: Regulatory Oversight
After exhausting all internal channels, our practice submitted a formal complaint to the Texas Department of Insurance. Once TDI reviewed our documentation and contacted Carrier A, the issue turned around almost immediately. Carrier A updated our network status, acknowledged the opt-out and reprocessed all affected claims—something customer service could not resolve over nearly half a year.
This rapid correction underscores the impact of regulatory involvement. Insurance carriers often respond quickly when contacted by state oversight agencies, and regulators take network accuracy and claim integrity seriously.
Conclusion
Advocacy is not only necessary—it works. By following a structured model supported by proper documentation, persistence, professional collaboration and regulatory oversight when warranted, endodontists can overcome carrier barriers and ensure accurate claim processing. This experience stands as a practical and repeatable model for our specialty.
A Structured Model for Endodontists
This experience revealed several steps that may serve other endodontists well.
- Build a strong documentation foundation.
Every form submitted, every EOB received, every call made and every email exchanged should be recorded and organized. Accurate CDT code definitions, specialty standards of care and clinically detailed narratives reinforce code appropriateness and reduce ambiguity. - Communicate clearly and consistently.
Carrier communication should be factual and firm. Clearly state what treatment was performed, why the CDT code is correct and what action is required. Request written confirmation, not verbal assurances. - Leverage professional organizations.
When routine channels stall, the AAE and ADA provide valuable support. Their guidance reinforces correct coding and strengthens the provider’s position. - Escalate when necessary.
If an insurer remains unresponsive—even when provided with correct documentation and explanations—the next step is escalation to the state insurance commissioner. This formal, consumer-protected pathway exists specifically for situations where insurers improperly process claims or fail to act. Regulators can intervene, compel corrective action and ensure carriers follow contractual and statutory obligations.
Documentation Tips That Strengthen Your Position
Strong documentation plays a decisive role in successful dispute resolution. Endodontists should:
- Keep detailed records of all calls, including dates, times, representatives and promised follow-up steps.
- Maintain concise, clinically accurate narratives aligned with specialty standards.
- Retain copies of all claim submissions, EOBs and network correspondence—both electronic and scanned—to create a traceable paper trail.
When preparing a regulatory complaint, clarity is essential. Summaries should outline the issue, timeline, attempts at resolution and the specific action requested. Providing well-organized evidence enables regulators to intervene efficiently and confidently.
The American Association of Endodontists (AAE) is proud to support Michigan House Bills 4593 and 4594, companion measures that strengthen the integrity of dental specialty licensure and protect endodontists ability to provide care. Introduced by Representatives Martus, Bierlein, Rheingans, Rogers, Neyer, Kunse, Schmaltz, and Roth, these bills uphold professional standards while protecting Michigan patients from being treated by specialists with misleading claims of dental expertise.
HB 4593 authorizes the Michigan Board of Dentistry to issue health profession specialty licenses to dentists who complete advanced training and demonstrate competency in approved specialty areas. Beginning January 1, 2026, only those holding these specialty field licenses may represent themselves as “dental specialists” or claim specialization in any area of dentistry. Endodontists who have completed a CODA-accredited program would continue being able to advertise their services as “dental specialists” while those who obtained credentials derived from short-term courses that do not meet the educational standards necessary for competent specialty practice would no longer be able to advertise themselves as “dental specialists”.
HB 4594 complements this by amending the Public Health Code (MCL 333.16605) to formally restrict the use of certain professional dental titles—specifically including “dental specialist”—to individuals recognized under Michigan law. Together, these bills safeguard the dental profession’s credibility, ensuring that patients can confidently identify and seek care from qualified, licensed specialists.
Endodontists know firsthand how critical it is for patients to trust the expertise of their dental providers. Misrepresentation of specialty credentials not only undermines public confidence but can also result in delayed or inappropriate care. By advancing HB 4593 and HB 4594, Michigan lawmakers are helping to preserve that trust—ensuring patients receive safe, high-quality, and accurately represented dental care.
The AAE applauds the Michigan Legislature for taking action to protect patients and reinforce professional integrity in dentistry. Supporting HB 4593 and HB 4594 means standing for honesty, transparency, and the highest standards of oral health care—principles that define endodontists and the specialty at large.
AAE’s advocacy efforts in 2025 demonstrated the power of strategic planning, strong partnerships, and member engagement. Throughout the year, AAE advanced impactful initiatives that protected the specialty, strengthened practice sustainability, reinforced public health, and elevated the voice of endodontists in state and national policy conversations. Our progress reflects the combined strength of dedicated members, thoughtful leadership, and a clear vision for the future of endodontics.
Defending Specialty Recognition
Protecting the integrity of accredited specialty training remained one of the most urgent advocacy efforts. When the Ohio State Dental Board considered weakening the definition of endodontists, AAE acted swiftly in collaboration with the Ohio Association of Endodontists, ADA, and other partners. Through coordinated letters, testimony, and member mobilization, AAE helped prevent the proposal from moving forward, preserving both patient safety and the clarity of specialist qualifications.
Supporting Student Loan Reform and Workforce Sustainability
AAE remained committed to supporting the next generation of endodontists by advancing policies that reduce financial barriers to specialty training. AAE strongly advocated for the REDI Act, which would pause student loan interest during residency, easing the financial burden on future specialists. AAE also worked closely with the Organized Dentistry Coalition to protect Graduate PLUS Loans, maintain Public Service Loan Forgiveness eligibility, and oppose restrictive caps on federal education financing. These efforts reinforce the importance of accessible, equitable pathways into the specialty.
Advancing Dental Benefits Reform
Reforming dental plan systems continued to be a major focus in 2025, as AAE worked to ensure greater transparency, fairness, and accountability in dental plan structures. A key part of this effort included strengthening the Transparency in Dental Benefits Contracting Model Act to promote clearer and more equitable contracting standards for specialists. AAE also continued its advocacy around Dental Loss Ratio (DLR) policies, supporting efforts in multiple states to require insurers to spend a minimum percentage of premiums on actual patient care. This position reinforces AAE’s commitment to ensuring that dental benefit dollars go directly to treatment—not administrative overhead. In addition to advocating for stronger DLR protections, AAE addressed administrative challenges such as virtual credit card transaction fees, unclear payment protocols, and burdensome billing processes. By pursuing these reforms, AAE sought to reduce unnecessary obstacles that complicate practice operations and to help endodontists focus on delivering high-quality patient care rather than navigating opaque insurance systems.
Mobilizing Grassroots Advocacy
AAE’s grassroots advocacy efforts reached new levels of engagement in 2025, demonstrating the remarkable influence that unified, coordinated member action can have on key policy outcomes. When proposals emerged that posed significant risks to practice sustainability and patient access—most notably the threat to eliminate the Pass-Through Entity Tax (PTET) deduction—AAE members responded with unprecedented mobilization. Endodontists across the country advocated through coordinated email campaigns, personalized outreach to lawmakers, and rapid engagement with AAE’s Action Center. This collective response represented the largest grassroots advocacy effort in AAE’s history and played a decisive role in persuading Congress to preserve the PTET deduction.
Protecting Public Health and Promoting Awareness
AAE’s commitment to public health remained a driving force throughout 2025, with the association taking a proactive and science-centered stance on issues that directly affect community wellness, patient safety, and long-term oral health outcomes. As multiple states introduced proposals to restrict or eliminate community water fluoridation, one of the most proven, cost-effective public health measures of the past century—AAE responded decisively by submitting formal opposition, collaborating with public health partners, and educating policymakers about the extensive body of evidence supporting fluoridation’s safety and effectiveness. AAE also endorsed the bipartisan TEETH Act, reinforcing that any changes to federal fluoridation regulations must undergo rigorous scientific review and uphold safeguards that protect decades of public health progress. Beyond these policy battles, AAE significantly expanded public awareness of the value of endodontic care by securing 19 gubernatorial, legislative, and mayoral proclamations recognizing Save Your Tooth Month, elevating conversations about natural tooth preservation and the critical role of endodontists in maintaining oral health. In parallel, AAE strengthened the specialty’s visibility on the national stage through active participation in key policy forums, including the American Association of Dental Consultants Meeting, where AAE representatives engaged directly with dental plan leaders and benefit administrators to advocate for fair coverage, equitable reimbursement, and recognition of the specialty’s expertise. Combined, these efforts demonstrated AAE’s unwavering dedication to protecting evidence-based public health measures while simultaneously raising the profile of endodontic care across the country, ensuring that both policymakers and the public understand the essential contributions endodontists make to overall health and patient-centered dentistry.
Looking Ahead
As AAE reflects on the achievements of 2025, it is clear that the progress made this year lays a strong foundation for the work that lies ahead, positioning the association to navigate an increasingly complex policy landscape with confidence, clarity, and momentum. The challenges facing the specialty—ranging from evolving dental benefit structures and emerging public health threats to ongoing attempts to dilute specialty recognition and redefine scopes of practice—will require continued vigilance, strategic coordination, and rapid mobilization. AAE enters 2026 prepared to meet these demands, supported by engaged members, committed leadership, and a strengthened advocacy framework that has proven capable of driving meaningful change at both the state and national levels. The association’s focus will remain on championing fair dental benefits, protecting evidence-based public health measures, advancing workforce sustainability, and defending the integrity of accredited specialty training, all while expanding its grassroots capacity and deepening partnerships across organized dentistry and the broader healthcare community. With renewed energy, a clear policy agenda, and the demonstrated power of unified action, AAE looks forward to entering the 2026 legislative session strong, focused, and ready to build on the significant progress achieved together in 2025.