Endo Tips & Tricks You Probably Haven’t Thought Of Yet

If you’re a dentist, you’re probably trying to decrease your chair time. Especially when it comes to doing root canals. After all, who doesn’t want more efficiency, so you can fit in another patient or head home early? But how often can you say that you’re thinking out of the box when it comes to endo efficiencies? As someone who LIVES by her endo tips and tricks, I wanted to share a few of my favorites that you might not have thought of before. 

That way, you can reduce your chair time, and make more money, while freeing up some majorly-deserved time in your schedule. 

Endo tips and tricks to rock your socks off – #1: File length

This one helped me free up some crucial time: Know what length hand file will give you the best reading for your working length. And get prepped ahead of time. 

When your working length is on point from the second you begin, it will positively impact the rest of your procedure all the way up to your obturation. When your working length is off, though? It will either make your final obturation look long or short and could even cause bleeding from the periapical area. Hello, frustration!

Let me break down my basic approach: 

• Whenever I have a tooth that’s working length is 22mm or shorter, I will use a 21mm rotary file.
• When I have a tooth that’s working length is 23-26mm, I will use a 25mm rotary file. 
• And when I have a tooth that is 27mm or longer, I use a 31mm rotary file.

However, those are not the length hand files I use when I am trying to get a working length. Instead, I go longer earlier.

Let me explain what I mean. 

First of all, I never use a 21mm hand file to get a working length. Why, you might ask? Well, the answer is simple: I need space for the clip of the apex locator and the rubber stopper along the shank of the hand file. So, I give myself that space with a longer hand file.

For any tooth up to 23mm in length, I will use a 25mm hand file to get a proper working length. For anything above a 23mm estimated working length, I will use a 31mm hand file in order to make my life easier.

And voilá! I have reduced frustration with my equipment, protected my energy, and am way faster at achieving the outcome I’m after (plus an accurate working length)! It’s a subtle strategy with a huge impact. Check out the pic below to see what I mean.

Hack #2: Get that gutta percha organized!

Another one of my endo tips and tricks that has become second nature is being consistent with how I organize my gutta percha. 

I never understand when I see a dentist writing with a sharpie on a piece of paper during treatment which canal each cone goes into. You are wasting your valuable time every second you spend jotting these things down. And those seconds add up, my friends. Not to mention, infection control gets a little hairy, too. Instead, memorize a pattern and be consistent!

Place the cones in the same order EVERY. SINGLE. TIME. Yes—every time! That is what I do.

I always place my mesial cones first and my distal cones second. Then, if I have more than one mesial cone, I place my buccal cone first and my lingual cone second. So, if I have 4 canals in the tooth and look at my cones laid out on the table, I see them in this order every time: MB, ML, DB and DL.

Makes sense, right? Then, I go through the rest in the same order (seriously—every time!). If I am doing a premolar with two canals, I place my Buccal cone to the left and my Palatal cone to the right. Capiche?

Here’s what it looks like in practice. (Except I don’t actually write anything down… the letters are just there to help you see how I organize everything.)

This doesn’t have to be your system, but it definitely works for me, and it’s a huge time-saver!

It’s easy peasy, so don’t over complicate things, Instead, develop and use simple systems that keep you consistent. Because when you can put little things like this on autopilot, you free up a lot of brain space for more important stuff, and free up minutes from every procedure. 

Endo Tip #3: Using your rubber dam

Here’s a quick and easy endo trick: Don’t punch your rubber dam hole in the middle of the rubber dam!

Using a rubber dam for your root canal is mandatory. It’s not optional, so making up excuses on why you’re not using one doesn’t cut it. Seriously! 

I preach on this topic a lot, because if you want to serve your patients well (and cover your butt legally), you gotta use the darn thing. 

Being smart about your rubber dam will also majorly decrease your frustrations (because they CAN be frustrating to use).

Before you punch your hole in the rubber dam, think about what tooth number you are doing and notice that most of the teeth are offset from the middle. You can even download my rubber dam template so it takes the guesswork out of the whole process. And eliminating the guesswork is important because, when you have a hole that is not strategically placed, the rubber dam will sit on the patient’s face in a way that feels like it’s in the way.

I usually see dentists going straight for the middle of the rubber dam and I promise, this is going to lead to some frazzled nerves and some real annoying challenges. Think about it—the middle of the rubber dam would be right over the uvula. And that’s just wrong! 

Skip the guesswork—download my rubber dam template here

Do yourself this little favor and make your life easier by punching that hole with intention. I tend to place it offset from the middle, and since I am usually doing molars, I punch it like the following image. Then, I can rotate or flip the rubber dam to make it match the quadrant that I am working in.

That’s a pretty easy fix, am I right or am I right? 

What’s your takeaway?

I’m all about endo tips and tricks that make our jobs easier—because saving teeth is important business, and we need all the energy and attention we can get to pour into each case. 

I’ve spent more than a decade collecting endo hacks that are simple, smart, and economical. And here’s something I know for sure: you don’t have to spend money to save on chair time. 

Be smart and be consistent, and start training your team on why you do the things the way you do. That way, they can have it all ready for you when you sit down. Empower them to be your allies, not your underlings!

Consistency, teamwork, and some planning really do go a long way. 

While you’re planning—go ahead and download that rubber dam template as a first step. And then drop me a line in the comments below to let me know other ways you’re optimizing your processes!

– Sonia