Dentistry — Referral to an Endodontist for Root Canal Re-treatment
A general dentist refers a 45-year-old woman to an endodontist for root canal re-treatment of an upper left first molar with persistent periapical pathology following a previous root canal. This is an intermediate referral: the case is complicated by prior treatment, but the clinical picture is clear and the referral request is specific.
Letter type
Referral
Write to
Endodontist
Target length
180–200 words
The case notes
Patient: Mrs Jennifer Donaldson, 45 years old; medically fit; no relevant medical history
Tooth: Upper left first molar (26); strategic tooth (heavily restored, no opposing missing tooth)
Presentation: Spontaneous dull aching pain for 3 weeks; pain on biting; tenderness to percussion; no sinus tract; no swelling
Radiographic findings: Periapical lucency at mesiobuccal root; existing root filling appears short of the apex in the mesiobuccal canal; widened PDL space
Previous treatment: Root canal treatment performed 4 years ago at another practice; existing crown — intact, structurally sound
Reason for referral: Re-treatment required — periapical pathology persists; mesiobuccal canal likely undertreated; case beyond routine GDP scope given prior treatment and anatomy
Preferred management: Assess for feasibility of re-treatment (crown removal vs access through crown); if re-treatment not feasible, surgical endodontics as alternative
Task: Write a referral letter to the endodontist, Dr Claire Moore, with all relevant clinical and radiographic information to allow her to plan treatment.
Writing task
Write a referral letter to the endodontist, Dr Claire Moore, with all relevant clinical and radiographic information to allow her to plan treatment.
What to include, what to cut
The hardest mark to win is selection. The same case notes contain decision-relevant facts and distractors. Here is what an examiner expects to see in a Grade B letter for this scenario, and what should be left out.
Include
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The periapical lucency at the mesiobuccal root and that the existing filling appears short of apex in that canal
This is the clinical and radiographic justification for re-treatment. The endodontist needs this specific information to assess the case. A referral without specifying which canal is problematic is clinically incomplete.
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That the existing crown is intact and the question of access through crown vs crown removal
The treatment pathway decision is the key management question. Flagging it saves the endodontist a consultation step and shows the referring dentist has considered the case.
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That the tooth is strategic
This contextualises why re-treatment is being pursued rather than extraction.
Leave out
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Full periodontal charting of adjacent teeth
Not relevant to the endodontic referral unless there is a specific endo-perio lesion.
-
Dietary and oral hygiene advice for the patient
Not appropriate in a professional referral letter.
Criterion in focus · Content
For endodontic referrals, examiners check for: (1) the specific tooth with correct notation, (2) the radiographic finding that justifies referral (periapical lucency), (3) the suspected cause (mesiobuccal canal undertreated), and (4) the specific question being asked. A referral that lacks any of these fails the Content criterion.
Now write the letter — and find out what is blocking your Grade B
Write a 180–200 words referral letter from these notes, paste it into the free checker for an instant read, then submit it for a human grade against all six criteria. Dr Mariam's team returns line-by-line feedback, from $12.