An endodontist is a dentist who completed a residency focused on the pulp and root canals of the tooth, meeting CODA's minimum of 24 months of full-time study; a general dentist is the broad-scope primary provider who performs routine root canals and refers the difficult ones out.
The split is built on referral: a general dentist keeps the straightforward cases and sends molars, retreatments, and complex anatomy to an endodontist — and the endodontist typically refers the patient back to the GP once the root canal is done.
The short answer
A general dentist is trained broadly and is most people's main dentist; an endodontist is a specialist who narrowed to one part of the tooth after an additional residency.
Both can legally perform a root canal — the difference is training depth, case difficulty, and how the patient arrives.
Most general dentists perform some root canals themselves and refer the rest.
An endodontist's practice is built almost entirely on those referrals rather than on patients who walk in on their own.
What each one does
A general dentist runs comprehensive primary oral care — exams, fillings, crowns, extractions, and preventive care — and treats the tooth's pulp and root canal system as one item on a much longer list.
An endodontist does one thing in depth: diagnosing pulp and root problems, performing root canal therapy (especially the cases that are hard to get right), retreating canals that didn't heal, treating cracked teeth and dental trauma, and endodontic microsurgery such as an apicoectomy.
| Comparison | General dentist | Endodontist |
|---|---|---|
| Typical root canal case | Routine, single canal, front teeth or premolars | Molars, retreatments, complex or unusual canal anatomy |
| Training beyond dental school | None required for root canal therapy | CODA-accredited endodontics residency, 24-month minimum |
| Board certification | Not applicable to this scope | American Board of Endodontics (ABE) — voluntary |
| How the patient arrives | Existing patient of record | Almost always on referral |
What the endodontics residency adds
Both start the same way: a bachelor's degree, then four years of dental school for a DDS or DMD, then licensure.
A general dentist can begin practicing there.
An endodontist continues into an accredited endodontics residency — CODA's published minimum is 24 months of full-time study — built around the surgical operating microscope, cone-beam CT imaging, advanced diagnosis of hard-to-locate tooth pain, retreatment of failed canals, and microsurgery.
See what the residency requires for the full accreditation detail.
After residency, most endodontists pursue certification from the American Board of Endodontics (ABE) — voluntary, but a recognized signal to the general dentists deciding who to refer to.
The residency is what the general dentist's training doesn't cover in the same depth, not a different license or a different scope of legal authority.
See becoming a board-certified endodontist for how ABE certification itself works.
Which root canal cases a GP keeps
There's no fixed rule — the line moves with each dentist's training and comfort — but a common pattern holds.
General dentists tend to keep straightforward, single-canal cases on front teeth and premolars, where the anatomy is predictable and access is easy.
What tends to get referred: molars with multiple curved canals, retreatment of a root canal that failed or is reinfected, teeth with unusual or calcified canal anatomy, cracked-tooth cases where the diagnosis itself is difficult, and any case where the tooth's value is worth the endodontist's higher success rate on a hard case.
A GP who places implants or does more endo in-house simply refers less; one with a lighter surgical caseload refers more of the above.
The referral relationship runs both ways
Endodontics is referral-driven in a way most other specialties aren't as purely — a general dentist sends the case, and the endodontist's practice depends on that relationship rather than on direct-to-consumer demand the way orthodontics or pediatric dentistry often is.
The relationship doesn't end when the canal is filled.
An endodontist typically completes the root canal itself and then refers the patient back to the referring general dentist for the crown or other final restoration and for ongoing care — the endodontist isn't the patient's dentist of record.
That two-way handoff, not just the initial referral out, is what makes the relationship between the two roles distinct from a general dentist referring to, say, an oral surgeon or orthodontist.
Pay: tracked under separate codes
The U.S. Bureau of Labor Statistics tracks general dentists on their own occupational code: SOC 29-1021, Dentists, General, with a national median of $170,950 a year (OEWS, May 2025).
See the dentist salary guide for the full breakdown.
Endodontics has no equivalent dedicated code — the BLS groups it into the broader "Dentists, all other specialists" category, which combines several specialties into one figure.
That makes any endodontist-specific number directional rather than precise; see what an endodontist does for that context and its caveats rather than repeating a number here.
This article is general career information, not clinical, legal, or financial advice. Referral patterns, training requirements, and pay vary by dentist, region, and practice.