Endo Mastery



For endodontic practices, the doctor’s time is the most valuable asset. In very efficient and highly productive endodontic practices, the doctor and dental assistants work as a choreographed team to minimize the doctor’s time for each case. This allows the doctor to move smoothly from patient to patient, and to complete more cases per day without stress or idle time.


The baseline for establishing the choreography of your clinical team should be what the doctor is legally required to do in your state. Aside from a limited number of personal preferences for the doctor, dental assistants should be responsible for everything else that needs to be done in the clinical area during patient appointments.

Optimizing the Dental Assistant Role

Most endodontists learn marketing by trial and error when they first start to practice and have lots of time. After a few years of “hustling” to establish key referral relationships, they settle into the patterns of those relationships, occasionally adding a new referrer to the mix. Marketing often takes a backseat at this point.


At a certain point (and almost certainly when growth plateaus), you need a more disciplined and systematic marketing strategy. That includes a half-time marketing coordinator who prioritizes and nurtures referral relationships with regular meaningful contact.


When Endo Mastery begins to work with a coaching client, one of the first areas we look at is who is doing what during patient appointments. Here are some of the most common areas where doctors tend to under-utilize their assistants:

Assistants should be adept at establishing rapport with the patient and making them comfortable with what is going to happen during their appointment. They create value and appreciation for the doctor, so that the patient has confidence and trust. When the doctor enters the treatment room, they only need a few minutes to greet the patient and begin their diagnostic process.

Retraining isn’t about learning again how to do something; it’s about learning how to do something better. In that light, retraining is actually an ongoing process, because dental teams should always be striving to improve.


Every time something good happens, it challenges you to ask what can be done to keep the good times rolling. Every time something negative happens, it always challenges you to look for ways to improve so it doesn’t happen again.


But adapting to these challenging questions is a challenge in itself because often the answer isn’t definitive. Sometimes you are asking team members to be creative and try new things. That’s when you often experience resistance from your team … maybe not open disagreement, but the harder-to-detect “lack of genuine effort”. Team members get attached to doing things in a certain way, they become good at that, and they are often reluctant to step out on a limb when there is no clear benchmark for success.


In retraining, mindset matters more than anything. You have to create a culture that values learning and growth, accepts there are going to be bumps on the road to anything new, and rewards people who fully engage with the process. It’s groupthink, and progressive encouraging leadership that reinforces vision and goals is vital.

Assistants should complete CBCT scans and a prescribed set of radiographs. The CBCT image and supporting PAs should be manipulated to the doctor’s preferred screen view, so that everything is ready for the doctor when they enter the treatment room.

Assistants should deliver pre- and post-op instructions to the patient, and answer all their questions prior to the doctor arrival and after treatment is completed.

Assistants should ensure treatment room and trays are set up properly, with everything the doctor may need during treatment within reach without having to leave chairside. The lead clinical assistant should maintain a clinical manual for the practice and update it whenever there is a change or improvement identified by the doctor and team.

Assistants should prepare all treatment notes and reports to referring doctors according to a template established by the doctor. Doctors can quickly review and approve the notes and reports daily.

Like many business owners and healthcare providers, endodontists have a tendency to want to “do it all”. However, with systematic and careful training, a doctor can be confident and begin to trust in their team to take over more of the appointment process. In return, as assistants develop more comprehensive roles in the practice, daily flow and productivity can significantly improve while the stress of patient care is reduced.