This study assessed the effect of patients' presenting conditions on genera
l practitioners' (GPs') self-reported endodontic referral patterns, and com
pared GPs' perceived indications for referral with those of endodontists, T
he study was based on a self-administered, confidential survey distributed
to 79 GPs and 7 endodontists who provide care to members of one Dental HMO
in the Pacific Northwest. GPs were most likely to recommend referral for te
eth they felt needed surgical retreatment, but GPs and endodontists did not
always agree on indications for referral. Compared with GPs, endodontists
were more likely to recommend referral for patients with complex problems,
but not necessarily technically difficult teeth. Compared with those with l
ess experience, GPs with more than 10 yr both in dentistry and at this HMO
were more likely to recommend (a) referring difficult cases rather than per
forming endodontic therapy themselves and (b) extracting perforated or root
-fractured teeth prior to obturation rather than continuing treatment. Indi
cations for referral that maximize favorable dental outcomes need to be ide
ntified.