Endodontist or General Dentist: Who Does Root Canals
Both do. An endodontist is a specialist with at least two further years of training after dental school, and by their own association's figure only about three per cent of dentists are one.
The difference, stated by the people it describes
The American Association of Endodontists describes its members as "highly skilled dental specialists in diagnosing and treating tooth pain and performing root canal treatment", who "have completed at least two extra years of training beyond dental school". It also publishes a figure for how many there are: "Just 3 percent of dentists are endodontists."
A general dentist can and routinely does perform root canal treatment. Nothing about the procedure is reserved to a specialist, and for a straightforward front tooth there is often no reason to go anywhere else.
One note on sourcing, because it matters here more than usual. The AAE is the endodontists' own professional association, and its patient pages carry other comparative figures about how many root canals a specialist performs against a general dentist. We have left those out, because they arrive without a study we could open and read, and an unsourced comparison published by an interested party is advertising rather than evidence. The training length and the share of the profession are structural facts about how dentistry is organised, which is why those two are here.
The schedules take notice of specialists
Pennsylvania's schedule does something quietly interesting: on several of the surgical endodontic lines — repair of root resorption, and surgical exposure of a root surface — it restricts the provider specialty codes to two values, rather than the "All" that appears against its ordinary root canal lines. The schedule is not describing who is better; it is describing who the programme will pay for that particular procedure.
Washington State's corrections service goes further and publishes an entire fee schedule for endodontic services on its own. That is a payer treating this work as a distinct specialty with its own price list, and it is the most detailed of the three documents this site reads by a wide margin.
When a referral tends to happen
We are not in a position to tell you when you should be referred, and any list of triggers from a website would be a guess dressed as guidance. What we can do is describe the kinds of things that make a tooth harder work, from the published descriptions of the procedure itself: more canals, narrower canals, curved roots, a tooth that has already been treated once, a root that may be cracked, and a tooth at the back of the mouth that is difficult to reach and to keep dry.
A dentist who refers you is making a judgement about their own hands and their own equipment on your particular tooth. That is a good sign rather than a bad one, and it is worth asking what specifically about the tooth prompted it.
What it changes about the bill
On the documents this site reads, not as much as you might expect: the fee schedules price the procedure by code and tooth position rather than by who is holding the instrument. The Pennsylvania schedule allows $500.00 for a molar root canal whether a specialist or a general dentist does it.
That is a statement about a payer's schedule, not about the wider market. What a specialist practice charges privately is not something any free source publishes, and we are not going to estimate it. The three published documents behind every price on this site are set out on our page pricing root canal treatment from three fee schedules.
There is one practical cost that does change, and it is easy to miss: a referral often means a second problem-focused examination and a second set of X-rays at the specialist practice. On the schedules here that is $39.52 to $104.00 for the exam and $8.00 to $40.00 for the first X-ray of the tooth. It is not large, but it is not zero, and it is worth asking whether the existing X-rays can be sent on.
Questions worth asking
- What about this tooth made you refer me — or made you decide not to?
- How many of these do you do?
- Can my existing X-rays go with me, or will they be repeated?
- Who does the crown afterwards: you, or the specialist?
- What is the total for everything, from both practices?
That fourth question causes more confusion than any other. Treatment and restoration are separate procedures at separate codes on every schedule we read, and when a specialist does the first and your own dentist does the second, it is genuinely easy to end up with two quotes that neither of them thought to add together. The chapter on whether the tooth needs a crown afterwards and what that costs goes through that half of the bill in detail.
Neither of them can be chosen on price alone
If a tooth is difficult, the thing you are buying with a specialist is the odds on the first attempt — and the alternative to a first attempt that holds is a second one, which on both schedules that price it costs more than the first. That is not an argument for always going to a specialist. It is an argument for asking what the difficulty actually is, and for treating "it is straightforward" and "it is complicated" as different situations rather than the same purchase.
Questions about who does it
Is an endodontist better than a general dentist for a root canal?
They are more specialised: by their association's own description, at least two further years of training beyond dental school, and about three per cent of dentists. Whether that changes the outcome for a specific tooth depends on how difficult that tooth is, which is a judgement made by somebody looking at it. General dentists perform root canal treatment routinely and nothing about the procedure is reserved to a specialist.
Does a specialist cost more?
Not on the payer schedules we read — those price the procedure by code and tooth position rather than by who performs it. What a specialist charges privately is not published by any free source we could find, so we print no figure for it. The cost that does reliably appear is a second exam and a second set of X-rays at the new practice, unless the existing ones can be transferred.
Why was I referred?
Ask. There is a concrete answer — the number or shape of the canals, a previous treatment on the tooth, a suspected crack, how far back the tooth sits — and the person who referred you has it. A referral is a dentist making a judgement about the particular tooth rather than an assessment of you.
Can I ask my own dentist to do it instead?
You can ask, and the useful version of the question is why they referred it in the first place. If the answer is about the difficulty of that specific tooth, that is worth weighing against the fact that retreatment costs more than treatment on every schedule that prices both.
Who does the crown, the specialist or my dentist?
Either, and it varies by practice. Settle it before the treatment starts, because this is the most common way somebody ends up with a bill they did not expect — the treatment and the restoration are separate procedures at separate fees, and when two practices are involved nobody automatically adds them up for you.
Carry on
The prices behind all of this are on what a root canal costs on three fee schedules.
Anaesthetic and Sedation for a Root Canal
Local anaesthetic is the default and is included in the procedure — it has no separate line on any schedule we read. Sedation is a different thing entirely, billed by the quarter hour, and it is worth knowing what that costs before you say yes.
Do You Need a Crown After a Root Canal?
On the schedules that price both, the crown is roughly half of the total bill — and the endodontists' own guidance says it depends mostly on which tooth it is. Back teeth generally get one; front teeth often do not.