American Association of Endodontists

By Dr. Albert (Ace) Goerig

Every endodontic career begins with transitioning from residency to private practice. The choices made during this period can significantly influence short- and long-term career success.

While practice ownership is a desired goal for many new endodontists, the economics of high student debt coupled with the major investment costs of a startup or practice purchase seem prohibitive at first. For many young endodontists, associating in a practice after graduation can help to build financial stability and reduce debt.

Associateships can also provide another incredibly valuable advantage for endodontists beginning their career: being mentored by an experienced practitioner in private practice. Rather than the low rung on the ladder to professional success, an associateship can be the springboard to enhanced clinical and practice knowledge that will bolster future goals. Whether the associate stays in an employment position or eventually moves on to their own practice, the knowledge gleaned from a mentor relationship accelerates success.

Direct Clinical Mentoring

It is in the interests of the practice owner that associates can complete cases effectively. New associates come out of their residency with educational knowledge and some practical case experience, but they fall short on the real-world variety of clinical conditions often encountered in practice. Mutual success is improved when the owner doctor recognizes and develops a direct clinical mentoring environment with the associate.

Among the first benefits is providing the associate with diagnostic insights and treatment planning guidance. Easy cases are easy, but when complicating factors are revealed in testing and 3D scans, reviewing a challenging case with a more experienced endodontist is a great advantage to the young doctor. No one wants a failed case, and a few moments reviewing case records together can boost confidence in achieving a successful outcome.

The second benefit of clinical mentoring is the opportunity to learn over-the-shoulder from the owner endodontist. Every endodontist builds on the clinical techniques that give them the greatest predictability for success, and it’s highly instructive for new endodontists to explore the clinical choices and methods that the owner doctor uses. Clinical tips can range from surgical techniques, complex twisting canals, broken files, or even something as fundamental as suturing.

The third benefit of clinical mentoring is learning how to develop and maintain clinical focus during treatment. This includes how to delegate to and work with a dental assistant to complete cases smoothly. Great dental assistants significantly improve the doctor’s ability to complete cases efficiently and learning how to communicate and coordinate the patient’s treatment with a highly trained dental assistant is a vital skill. A great mentor will often assign their most experienced dental assistant to support the associate at first.

The fourth benefit of direct clinical mentoring is learning how efficient diagnosis and treatment enables the associate to achieve improved clinical productivity. That allows the schedule to be optimized as the associate’s clinical mastery increases, leading to better availability for patient cases, and improved flexibility in the schedule for emergency patients in pain.

Observational Mentoring

While the primary job of an associate is to provide clinical care without responsibilities for practice management, associates benefit from observing the entire practice environment. Any associate who foresees future practice ownership (possibly even in the practice they are associating through a future buy-out of the owner), can learn much about practice operations and leadership in advance.

One aspect that every practice owner needs to pay attention to is managing referral relationships and marketing. Associates are generally hired to increase the clinical capacity of a practice when the number of referred cases exceeds the availability of the owner doctor (assuming the owner doctor isn’t hiring an associate to facilitate a reduction in their own schedule). The right level of practice success indicates referral relationship and marketing success that young doctors can learn from.

Likewise, the non-clinical operations of the practice are incredibly useful for observational mentoring. This includes observing how the practice administrative team functions, operational aspects like insurance, payments and accounts receivable, team leadership by the owner doctor, financial goals and decision-making. It’s an inside view of what it takes to own and manage a successful endodontic practice, and it can dramatically shorten the learning curve when an associate eventually moves into practice ownership themselves.

Not all Associateships are the Same

Even though mentorship through associating is a wonderful opportunity for a young endodontist, it is important to realize that not every associateship is the same. Not all owner doctors have the same aptitude to be mentors, and their practices may not be perfect examples of business success. It does require some self-leadership and effort by the associate to make the best of whatever situation they are in.

The good news is that there is high demand for associates in endodontics. So, young endodontists looking for associateships can carefully select the practices they end up working for. Ideally, potential associates should look for practices that are highly successful with an owner doctor who is welcoming, consultative, lifestyle-focused, and deeply cares that the associate achieves success, both professionally and financially. That attitude sets up a productive and collaborative relationship leading to enjoyable days driven by mutual support for excellent patient care.

Dr. Ace Goerig is an ABE Diplomate and owner of Endo Mastery. For more information, visit www.endomastery.com.

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Compiled by Dr. Priscilla L. Carpenter

Dr. Marvin Payen is currently a second-year endodontic resident at Case Western Reserve University, SDM.

The Paper Point: Today, we’re excited to shine the spotlight on Dr. Marvin Payen! We know how packed the schedule can be for a resident, so we truly appreciate you taking the time to chat with us. Thank you for being here!

Dr. Payen, let’s start at the beginning — born in Coney Island, raised in Spring Valley, NY. How did your “roots” shape who you are today, both personally and professionally?

Dr. Marvin Payen: Growing up in Spring Valley, NY, I was exposed to a mixture of cultures, families trying to build something, and a strong sense of community. This gave me the skills to connect with people from all walks of life and how to stay grounded. I was taught early that you had to work hard for what you wanted. Personally, it gave me a lot of pride in my roots and a real appreciation for where I come from. Professionally, it’s made me adaptable, hardworking, and good at navigating different environments. Spring Valley, NY helped shape my drive and how I show up in the world.

The Paper Point: You’ve earned degrees from St. John’s, Towson, Howard, and now, in a few months, Case Western — that’s quite the academic journey! How have these diverse learning environments shaped your perspective as a future endodontist?

Dr. Marvin Payen: Yeah, it’s certainly been a journey. Each institution played a unique role in shaping how I think and who I’m becoming as a future endodontist. I’ve met some amazing people along the way who’ve helped me get to this point. St. John’s gave me a strong academic foundation and really pushed me to take ownership of my goals early on. Towson helped me grow personally being in a different environment and challenged me to adapt.

Howard was a turning point. I gained a sense of purpose, community, and excellence while I was there. It deepened my passion for dentistry and reinforced the importance of representation and service in healthcare.

Now at Case Western, I’m focused intensely on the clinical and technical skills needed to be a great endodontist. It’s a privilege to be learning from some amazing individuals here.

The Paper Point: Community outreach seems to be a big part of your story — from Mission of Mercy to the Christian Dental Society. What did those experiences teach you about service, leadership, and the power of dentistry beyond the clinic walls?

Dr. Marvin Payen: Those experiences honestly changed the way I see dentistry. Mission of Mercy, the Christian Dental Society, and other outreach work reminded me that dentistry isn’t just about fixing teeth. It’s about showing up for people when they need it most. Along this journey, I heard this quote so many times, “you’re not just treating a tooth, you’re treating a person.” That has always sat with me. The patients I saw at these outreach events hadn’t had care in years, and being able to provide that they needed it the most, was powerful.

These experiences taught me that service is about being present, listening, and meeting people where they are. And from a leadership standpoint, I learned how to work with diverse teams, stay organized under pressure, and lead with compassion because when you’re out in the field, things don’t always go as planned, but people still count on you.

The Paper Point: What was your “aha” moment that made you fall in love with endodontics? Was there a specific case or mentor that inspired you to pursue the specialty?

Dr. Marvin Payen: My “aha” moment with endo wasn’t just one big dramatic case but encountering great endodontic professors and attendings at HUCD. These individuals were all super passionate and always calm under pressure. I had the privilege of observing their interaction with patients who came in with severe pain, severe anxiety, and were convinced the tooth had to be pulled. By the end of the appointment, the root canal procedure was completed, the patient was out of pain and was genuinely grateful for the treatment. That’s when I started seeing endo differently, not just as a technical specialty, but as something that could truly change how a person feels about dentistry and their overall well-being. When my professors, attendings and even classmates encouraged me to pursue endo, I was extremely flattered. I was taken back that they believed I could be an endodontist. At that point, I couldn’t imagine doing anything else.

The Paper Point: You’ve worked as a general dentist before starting your endo residency. How has that experience informed your approach to patient care now as a specialist-in-training?

Dr. Marvin Payen: Working as a general dentist before starting my endo residency gave me a really solid foundation. It taught me how to build trust with patients, communicate clearly, and manage a wide range of clinical situations. I think having that general practice experience helps me approach treatment with more empathy, and it’s made me more intentional about patient education and comfort. Overall, it’s helped me stay grounded. I know what it’s like on both sides, and that perspective makes me a better clinician.

The Paper Point: Case Western is known for its strong clinical and academic training — what’s been your favorite part of residency so far? Any memorable cases or “firsts” you’ll never forget?

Dr. Marvin Payen: Honestly, one of my favorite parts of residency at Case Western has been the hands-on clinical experience. The volume and complexity of cases we see have pushed me to grow so much in such a short time. You’re constantly challenged, but also supported by faculty, attendings, support staff and fellow co-residents, who are truly invested in your growth; not only as an endodontist, but as a person. Dr. Mickel has cultivated a family atmosphere, at Case Western, that makes this all possible. I can’t imagine completing my residency anywhere else.

I would say every case is somewhat memorable, for their own particular reason, whether it be the actual root canal procedure or just patients themselves and managing them. Each case is unique, requiring a different approach/mind set. These cases continue to change me for the better as I work towards being an endodontist. This is what makes every day in residency feel meaningful.

The Paper Point: I love that! With your Haitian heritage, how has culture influenced your approach to patient care, leadership, and how you show up in the profession?

Dr. Marvin Payen: Being Haitian has shaped so much of who I am, especially when it comes to how I care for others. Our culture is rooted in resilience, humility, and community. I try to instill those values in the way I approach patient care every day. I never take for granted the opportunity to make someone feel heard, respected, and cared for.

Culturally, there’s a strong emphasis on showing up with respect, working hard, and lifting others as you climb. I try to lead by example, with compassion, and always looking for ways to support those around me. Whether it’s mentoring, volunteering, or just bringing a positive energy to the team, I try to bring those values into everything I do.

My heritage keeps me grounded. It reminds me of why I do this and who I’m doing it for, not just for myself, but for my family, my community, and future patients who might see a part of themselves in me.

The Paper Point: Outside the operatory, you love cooking, music festivals, and movies. What’s your go-to dish in the kitchen, and what’s the last movie or concert that blew you away?

Dr. Marvin Payen: My go to dish would be Chili and Baked Ziti. I’ve gotten great reviews, especially from my mom, who’s a tough critic, haha. I want to perfect making other dishes and cuisine when I leave residency and actually have free time. Other than being a dentist, I wanted to be a chef, travel the world and try other cuisines. I don’t know if you’re familiar with Anthony Bourdain. He had a show on the Travel Channel, called No Reservations. His show embodied what I wanted to do and how I wanted to live my life, if I were a chef.

The last performer who blew me away was Burna Boy. I saw him at a music festival in Brooklyn, NY, a couple months before residency started. He’s a great performer!! Mind you, it began to rain during his set. He still had people on their feet, dancing as if it wasn’t raining at all. The energy was unreal. I highly recommend it!

The Paper Point: Dr. Payen, it’s been a pleasure speaking with you! Before we close, are there any final thoughts or words of wisdom you’d like to share with our readers?

Dr. Marvin Payen:

Here are some words of wisdom/quotes that have helped along my journey:

You don’t know what you don’t know
Never Stop Learning
Strive for Excellence
Be Humble
Lift as We Climb

Thank you again for considering me for the paper point, it has been a pleasure and privilege.

Dr. Priscilla L. Carpenter is chair of the AAE’s Resident and New Practitioner Committee.

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By Dr. Tung Bui

How smarter prompts lead to smarter practice and learning

Introduction

Prompt engineering; the practice of crafting purposeful and structured inputs for large language models (LLMs), is fast becoming a key skill for the endodontic resident. For residents, AI tools like ChatGPT, Claude, and OpenEvidence can act as co-pilots. But to make the most of them, residents must learn how to frame prompts effectively. Like setting the stage for an actor, prompting AI is about defining the role, context, task, and tone to receive clinically relevant, safe, and useful responses.

Think Like a Director: Framing the Scene

Effective prompts help large language models (LLMs) perform more like endodontic specialists, and one of the most practical strategies for guiding an AI response is the “role-task-tone” approach. For example, a user might say, “You are a board-certified endodontist,” to assign the role, followed by, “Evaluate this patient’s lingering pain post-retreatment,” as the task, and add, “Explain in a compassionate, patient-friendly way,” to set the tone. LLM output quality improves when both the role and task are explicitly stated. The LLM will generate more relevant and structured responses when it is pre-framed as a subject-matter expert rather than when it receives an open-ended query.

Clinical Use Cases: Efficiency Meets Precision

Endodontic residents can apply prompt engineering to enhance various aspects of clinical training. By crafting effective prompts, they can improve clinical decision-making by eliciting more precise differential diagnoses, treatment planning suggestions, and evidence-based recommendations from AI tools. Prompt engineering also streamlines documentation by generating well-structured clinical notes, patient education materials, and referral letters with greater speed and consistency. Additionally, it can support the analysis of complex cases by guiding AI to synthesize literature, compare treatment options, and simulate expert reasoning, ultimately serving as a valuable adjunct to both education and practice.

Diagnostic Support

Prompt: “You are an endodontist. List differential diagnoses for persistent pain following nonsurgical retreatment of a maxillary premolar. Include next diagnostic steps. Provide references from peer reviewed studies.”

This prompt structure enables AI to simulate clinical reasoning, often mirroring diagnostic pathways that align with textbook or evidence-based protocols. While AI lacks clinical intuition, its ability to summarize diagnostic options aligns with recent findings that LLMs can support, but not replace clinical judgment.

CBCT Justification

Prompt: “Provide evidence-based reasons for using CBCT in a suspected vertical root fracture of a previously treated molar.”

Using AI for evidence synthesis has already proven valuable. Tools like OpenEvidence can cite AAE guidelines and systematic reviews in seconds, reducing cognitive and time burden while supporting evidence-based dentistry.

Uncommon Clinical Conditions

Prompt: “Act as an oral medicine expert. Provide causes and treatment options for burning mouth syndrome. Suggest treatment options. Include when to refer.”

This is particularly helpful for residents encountering orofacial pain that falls outside the pulp-periodontal spectrum. LLMs can highlight medical-dental overlaps but must be supervised to avoid misapplication of outdated or oversimplified data.

Academic Applications:

Residents can apply prompt engineering to enhance various aspects of clinical training. By crafting effective prompts, they can improve clinical decision-making by eliciting more precise differential diagnoses, treatment planning suggestions, and evidence-based recommendations from AI tools. Prompt engineering also streamlines documentation by generating well-structured clinical notes, patient education materials, and referral letters with greater speed and consistency. Additionally, it can support the analysis of complex cases by guiding AI to synthesize literature, compare treatment options, and simulate expert reasoning, ultimately serving as a valuable adjunct to both education and practice.

Literature Summarization

Prompt: “Summarize the main findings from recent articles in the Journal of Endodontics on regenerative endodontics. Include citations.”

AI can be a rapid literature assistant. However, clinicians should confirm citations since LLMs have a reputation of fabricating falsehoods to “please” the user.

Board Preparation

Prompt: “Create a board-style clinical case question about root perforation management. Include four answer choices and rationale.”

LLMs are helpful as supplementary tools for test preparation. They should be used to reinforce, not replace structured board review.

Patient Communication

Prompt: “Explain to a patient why a root canal may need to be redone. Keep it under 100 words and written at a sixth-grade reading level.”

Prompt engineering makes it easy to generate plain-language explanations, a skill that is vital for improving patient understanding and satisfaction.

Tools of the Trade

ChatGPT: General-purpose LLM with high-quality prose and reasoning capabilities.
Claude: An LLM with good at long-context memory and nuanced language.
Perplexity AI: Web-augmented model with reliable citation links.
OpenEvidence: Medical-specific LLM offering literature-based, structured answers with references.

Using multiple tools ensures a broader evidence base and enables cross-validation of facts, which enhances the reliability and depth of clinical or academic conclusions. Different AI platforms and databases often draw from unique datasets, algorithms, and reasoning strategies. By consulting more than one tool, users can compare outputs, identify discrepancies, and converge on well-supported answers rather than relying on a single source that may have limitations or biases. This approach not only strengthens critical thinking but also mirrors the multidisciplinary process of peer review and collaborative diagnosis, fostering a more rigorous and nuanced understanding of complex issues.

Ethics and Oversight

While AI output can be fast and impressive, residents must approach it with caution and responsibility. It’s essential to fact-check everything, as large language models (LLMs) are known to “hallucinate” sources or generate plausible-sounding but incorrect information. Protecting patient privacy is also critical; identifiable data should never be entered into publicly hosted tools. Clinicians should guard against automation bias, where a confident AI-generated answer may unduly influence decision-making; clinical judgment should always take precedence.

Conclusion

Prompt engineering is a powerful skill for the endodontic resident. It allows AI to be used not just as a novelty, but as a functional tool; supporting clinical decisions, enhancing writing, and accelerating learning. Like hand skills, good prompts improve with deliberate practice. By learning how to “direct the scene,” residents can harness AI’s potential while maintaining professional standards and clinical oversight.

Dr. Tung Bui is a Board-certified endodontist with Specialized Dental Partners, practicing in Tucson, Arizona. He also serves as a clinical endodontic instructor and lecturer with the NYU Langone AEGD Tucson program and Spartanburg Regional Healthcare System AEGD program. When not extending the life of teeth, he is sourcing and roasting exquisitely rare third-wave coffees and pursuing outdoor adventures. As a futurist investor, he devotes his time into exploring emerging and disruptive technologies. He currently chairs the AAE Connection Committee. Disclosure: The author has no financial interests, and the opinions expressed are solely his and not those of the AAE. AI tools were used for editing. You can contact Dr. Tung Bui at apexologist@gmail.com.

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By Priscilla L. Carpenter, DDS, MS

It’s a joy to kick off the year with you all as Chair of the Resident and New Practitioner Committee (RNPC) for the AAE! As I step into my third year on this committee, I can genuinely say it’s been one of the most fulfilling parts of my professional journey so far. Getting to serve you—the future of endodontics—is an honor, a privilege, and a whole lot of fun.

For those I haven’t had the pleasure of meeting yet, I’m Priscilla L. Carpenter, an endodontist practicing in Charlotte, N.C. I completed dental school at Howard University College of Dentistry (Class of 2021) and wrapped up my residency at the University of Florida in 2023 (GOOOO GATORS!!!).

I’m a proud Charlotte native and the middle child of six—yes, six! Growing up in a big, close-knit family taught me the value of community, resilience, and always showing up for one another. I’ve carried those values with me into dentistry, and will continue to carry them as I matriculate into this role.

Outside the operatory, you’ll usually find me trying out new recipes, planning my next travel adventure, or enjoying the chaos and joy of life with my husband, our daughter, our pups, and our amazing circle of family and friends.

As spring blooms around us, so does the excitement (and maybe a little bit of stress) of what’s ahead—graduation season! To our second- and third-year graduating residents: this is your moment. Between studying for written boards, preparing for mock orals, job hunting, and maybe even gearing up for a big move, it can feel like a whirlwind. But take a breath, and remember: “keep your eyes on the prize, not the process.” You’ve made it this far and you’re almost there!

To our first- and second-years: your time is coming, and this season is about building. Dive deep into the clinical and academic challenges. Ask questions. Learn from your faculty, your mentors, and each other. These moments will shape the kind of endodontist you’ll become.

If you’re anything like me, you like to plan—and plan well. But what I’ve learned as I step into this role is that the most meaningful parts of this journey can’t be scheduled. Yes, the RNPC is here to manage key communications and events like The Paper Point, APICES, and the AAE Career Fair, to name a few—but above all, we’re here for you.

Whether you’re dreaming of starting your own practice, exploring a future in academia, weighing a job offer, looking for mentorship, or simply interested in getting more involved with the AAE — we’re here to help guide and support you along the way. Whatever you’re working through, our committee is just an email away. We want to be your sounding board, your support system, and your biggest cheerleaders.

Mark your calendars: APICES 2025 is happening in New Orleans, August 15–16, and we’ve got an amazing schedule in the works. Resident registration opens in July—so stay tuned, and come ready for learning, connection, and a little bit of fun (okay, a lot of fun—it’s New Orleans, after all!).

In closing, I’ll leave you with this:
Your journey in endodontics is uniquely yours. Own it. Celebrate it. And never forget that you’re part of a community that believes in you every step of the way. We’re in this together—and the best is yet to come.

With gratitude and excitement,

Priscilla L. Carpenter, DDS, MS
Diplomate, American Board of Endodontics
Chair, Resident and New Practitioner Committee

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As the American Association of Endodontists ushers in a new chapter of leadership, the organization pauses to reflect on a year of tremendous progress under the steady guidance of Immediate Past President Dr. Natasha M. Flake and to look ahead with optimism as Dr. Steven J. Katz begins his tenure as AAE President.

Dr. Flake’s presidency was marked by a thoughtful, member-focused approach that emphasized growth and collaboration. During her time at the helm, she championed initiatives that supported clinical excellence, elevated public awareness of endodontics, and empowered members through education and advocacy. Known for her warm and steady leadership, she fostered open dialogue across the AAE community and remained deeply engaged in the work of advancing the specialty—always with a strong sense of mission and purpose.

Dr. Flake focused on the goals of our strategic plan, set by the Board of Directors. She pursued initiatives to increase public awareness of endodontists and the value of saving natural teeth; to further our members as leaders in the global advancement of endodontics; to advance the specialty through knowledge and evidence, and to advocate for quality endodontic care.

Now, with Dr. Katz taking the baton, the AAE is poised to continue that momentum. A respected clinician, educator, and volunteer leader, Dr. Katz brings decades of service to organized dentistry and endodontics.

Looking forward, Dr. Katz identified key challenges the specialty must face head-on: a shortage of endodontic educators, reduced NIH funding, the erosion of water fluoridation efforts, changes in government departments affecting dental education, and state-level threats to specialty recognition.

As President, Dr. Katz has expressed a clear commitment to enhancing the value of AAE membership, supporting academic and private practice endodontists alike, and ensuring the Association remains a strong advocate for both patients and professionals. His focus on listening first and leading with integrity makes him a natural successor to Dr. Flake and a steady guide for the year ahead.

This period of transition is one not just of leadership but of shared vision. Both Drs. Flake and Katz understand that the strength of the AAE lies in its engaged membership and its commitment to staying at the forefront of science, education, and patient care. As the AAE continues to evolve, the organization remains in capable hands—and more united than ever in its mission to save natural teeth and support the endodontic community.

Dr. Katz concluded his AAE25 remarks with a call to action for members:

Get involved with the AAE—join a committee or attend events.
Teach, even part time.
Support access to care programs.
Leverage AAE’s patient education materials.
Engage in advocacy—every letter or petition counts.
Consider Board certification.
Contribute to the Foundation for Endodontics.
Surround yourself with colleagues who inspire you.

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By Bradford R. Johnson, DDS, MHPE

“An ounce of prevention is worth a pound of cure.” (attributed to Benjamin Franklin circa 1700’s)

Although serious medical complications related to dental treatment are believed to be rare, careful pre-operative evaluation is essential, especially since patients are living longer and age is an independent risk factor for medical complications (1). In addition to age, ASA physical status classification and stability of systemic disease are significant preoperative risk factors.

A challenge all clinicians should consider is that positive responses to questions on standard health history forms do not clearly lead to specific determination of risk for dental treatment. Adding to this, patients may fail to disclose potentially relevant details of their medical history on the assumption that those details are not important (2). During the initial patient interview, it should be confirmed that the list of medications is consistent with reported findings on the health history.

As a brief starting point, consider cardiovascular disease. If we exclude alcohol, opioids, and cannabis, cardiovascular drugs (primarily antihypertensives) and anticoagulants are two of the most common drug classes related to emergency hospital admissions (3). The top ten most frequently prescribed drugs include four antihypertensive medications and direct acting anticoagulants (DOACs) (when grouped together as a drug category).

Cardiovascular disease and associated sequalae (e.g., hypertension, coronary artery disease, arrhythmias, and congestive heart failure) is the most common chronic disease that can be associated with increased risk.

Is there a simple way to quantify risk for an adverse event during dental treatment? The short answer is: no, but several strategies may be considered. First, consider three factors: ASA status, estimated procedural stress, and patient’s self-reported anxiety level. ASA 4 patients will almost always require a medical consult and treatment in a facility that is equipped for continuous monitoring and emergency care intervention if needed. ASA 3 patients present with moderate to severe systemic disease that limits activity but is not incapacitating. Patients in the ASA 3 category can usually be safely treated in a properly equipped office (that is: trained staff, supplies, and equipment to manage a medical emergency if needed), but a medical consult may be advisable. A stress reduction protocol should also be considered. This could include any or all of the following: morning appointments, shorter appointments, oral premedication (e.g.: triazolam 0.25mg prior to the appointment – this may require a sedation permit in some states), N2O/O2 sedation, limited use of epinephrine, and adequate pain management.

When compared to NS-RCT, surgical RCT (which would typically score higher on a procedural stress scale than NS-RCT) induces more significant physiologic changes, including increased heart rate and higher systolic blood pressure (4). Patients with above average dental anxiety are also at greater risk for significant physiologic changes, and therefore potentially at increased risk of an adverse cardiovascular event (4).

Using a risk assessment index (RAI) composed of 14 variables, Yan Q et al. found that even minor surgical procedures are associated with high risk for patients with frailty (5). Endodontic microsurgery was not specifically considered in this study although it could reasonably be considered a “minor surgical procedure.” In this group of patients (frail), clinicians should carefully consider whether the potential benefits of the surgical procedure outweigh the increased risk (5).

Another potentially useful risk assessment tool is consideration of a patient’s functional capacity as measured in METs (metabolic equivalent tasks) and reserve capacity. This provides a general idea of a patient’s ability to handle additional stress. For example, 1 MET would represent oxygen consumption while sitting quietly and a 4 MET score would indicate the oxygen consumption during mild exercise such as raking leaves or climbing a flight of stairs without shortness of breath, fatigue, or chest pain. Patients unable to meet a 4 MET demand during these normal daily activities are at an increased risk for serious perioperative CV event during dental treatment due to lack of reserve capacity (6).

The prevalence of hypertension in the U.S. using current guidelines of >130/80 is estimated to be approximately 45% (7). A common clinically relevant concern is deciding when blood pressure is too high to proceed with dental treatment. Yarrows et al., conducted a review of the literature and concluded that cancelation of a dental appointment is seldom necessary based on blood pressure, in patients under a physician’s care (8). In the absence of angina pectoris or signs or symptoms of acute congestive heart failure, a high preoperative blood pressure less than 180/110 is not an indication to postpone or cancel a dental appointment. Blood pressure > 180/110 may even be acceptable if certain conditions described by Yarrows et al are met (8). Even so, a commonly accepted maximum preoperative blood pressure of less than 180/110 is a reasonable guide for all routine dental procedures with the possible exception of patients with significant dental anxiety, multiple risk factors, and/or surgical procedures that may require local anesthetic with higher concentrations of epinephrine (9).

References:

1) Reuter NG, Westgate PM, Ingram M, Miller CS. Death related to dental treatment: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2017;123:194-204.

2) Erian D, Quek SYP, Subramanian G. The importance of the history and clinical examination. JADA 2018;149(9):807-814

3) Ayalew MB, Tegegn HG, Abdela OA. Drug Related Hospital Admissions; A Systematic Review of the Recent Literature. Bull Emerg Trauma 2019 Oct;7(4):339-346.

4) Georgelin-Gurgel M, et al. Surgical and Non-surgical Endodontic Treatment-Induced Stress. J Endod 2009;35:19-22.

5) Yan Q, Kim J, Hall DE, Shinall Jr MC, et al. Association of Frailty and the Expanded Operative Stress Score with Preoperative Acute Serious Conditions, Complications, and Mortality in Males Compared to Females: A Retrospective Observational Study. Ann Surg. 2023 Feb 1;277(2):e294-e304.

6) Little and Fallace’s Dental Management of the Medically Compromised Patient. 10^th Ed. 2024. p.8

7) ACC/AHA High Blood Pressure Guidelines Lower Definition of Hypertension. November 2017.

8) Yarrows SA, Vornovitsky O, Eber RM, Bisognano JD, et al. Canceling dental procedures due to elevated blood pressure: Is it appropriate? JADA 2020;151(4):239-244. JADA 2000;151(4):239-244.

9) Little and Fallace’s Dental Management of the Medically Compromised Patient. 10^th Ed. 2024. p.44.

Dr. Bradford Johnson is a current Counselor and a Past President of the ABE.

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The American Association of Endodontists brought together a dynamic global community of dental specialists for AAE25, held April 2–5, 2025, at the Hynes Convention Center in the heart of Boston. From cutting-edge clinical education to inspirational leadership moments and meaningful networking, AAE25 delivered on every front—affirming its role as the premier event in endodontics and breaking previous attendance records with a total of over 4,600 attendees!

An Educational Experience Like No Other

AAE25’s robust scientific program offered more than 100 hours of continuing education, drawing from the profession’s leading voices in clinical care, research, and education. With a wide range of learning formats—including lectures, hands-on workshops, poster presentations, and small-group discussions—the meeting was designed to accommodate varied learning styles and interests.

Popular tracks included:

Nonsurgical Root Canal Therapy, with updates on bioactive materials, instrumentation, and irrigation.
Surgical Endodontics, focusing on microsurgical techniques and case selection.
Trauma and Emergencies, offering guidance on treating complex traumatic injuries and managing challenging diagnostic scenarios.
Practice Management and Innovation, highlighting strategies for running an efficient, patient-centered practice.

The Endo Plus track was especially well-received for its interdisciplinary approach, combining topics in periodontics, restorative dentistry, systemic health, and more. It emphasized how collaboration and comprehensive care models can improve outcomes and elevate the specialty.

A special panel revisited predictions from the 2013 session Endo in 2025, comparing those forecasts to present-day advancements. This retrospective sparked rich dialogue about how far the specialty has come—and where it's headed next.

General Session and Keynote: Starting Strong

AAE25 opened with high energy at the General Session, where attendees were welcomed by AAE President Dr. Natasha Flake and inspired by keynote speaker Ryan Leak, a best-selling author, entrepreneur, and leadership coach. Leak’s message about embracing risk, overcoming failure, and redefining success struck a powerful chord with clinicians, educators, and researchers alike.

His keynote set the tone for a meeting grounded in purpose and progress—a reminder that the pursuit of excellence in endodontics is both professional and deeply personal.

Recognition and Reflection: Honoring the Best

The Edgar D. Coolidge Awards Brunch on Saturday, April 5, was a heartfelt celebration of the individuals whose careers have profoundly shaped endodontics. From early-career volunteers to lifetime educators and visionary researchers, the honorees shared moving stories of mentorship, service, and scientific achievement.

The recipients were Dr. Francisco Nieves (Spirit of Service New Practitioner Award), Dr. Demetrick LeCorn (Spirit of Service Career Award), Dr. Paul Abbott (Louis I. Grossman Award), Dr. Brian Mykleby (Calvin D. Torneck Part-Time Educator Award), Dr. Carla Falcon (Edward M. Osetek Educator Award), Dr. Brad Johnson (I.B. Bender Lifetime Educator Award), and Dr. Ken Hargreaves (Edgar D. Coolidge Award).

These inspiring moments underscored the deep commitment, innovation, and humanity that drive the specialty forward.

Community and Connection

Beyond the CE and honors, AAE25 was a celebration of shared purpose and community. Attendees reconnected with friends and colleagues at the Welcome Reception and created new memories at Celebrate Boston!, a signature social event held at the historic Boston Public Library.

Throughout the meeting, attendees participated in networking lounges, alumni receptions, poster sessions, and discussion groups. Young professionals and residents had ample opportunity to meet mentors, explore career options, and deepen their engagement with the AAE community.

Shaping the Future of the Specialty

AAE25 also provided a platform for professional advocacy and governance. Members gathered for district caucuses and the General Assembly, where key association business was conducted and incoming leadership was officially installed.

In her final remarks, Dr. Natasha Flake reminded members of their collective power to “make endodontics look good”—through excellence in practice, generosity of spirit, and a willingness to lead.

Looking Ahead to AAE26

As the event concluded, energy remained high with anticipation for AAE26, scheduled for April 15–18, 2026, in Salt Lake City, Utah. With the success of AAE25 as a foundation, the future of the meeting—and the specialty—looks bright.

AAE25 proved once again that endodontics is not only a specialty defined by clinical skill but also by connection, innovation, and a commitment to preserving natural teeth and improving patient lives. As attendees return to their practices, classrooms, and labs, the lessons and inspiration from Boston will undoubtedly echo throughout the year.

Stay tuned for our full photo album!

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The Member Center at AAE25 buzzed with energy and conversation this year as we hosted two exciting meetups designed to bring our community closer—both in person and online.

Endofluencer Meetup
Earlier this week, we welcomed several of our favorite social-savvy members for an Endofluencer Meetup! These talented content creators—affectionately dubbed “Endofluencers”—help us educate the general public about endodontics and the importance of saving natural teeth through their vibrant presence on platforms like Instagram and TikTok.

Attendees had the chance to meet these online standouts face-to-face, ask questions, swap content ideas, and even witness a bit of behind-the-scenes magic as our Endofluencers collaborated with AAE staff to create new content live from the show floor. From myth-busting to humor to patient education, these all-stars continue to amplify our message in fun, relatable ways. Stay tuned to AAE social channels to see what they’ve created on-site at AAE25!

Meet the JOE Editors Meetup
On another high note, we hosted a Meet the JOE Editors Meetup to honor the 50th anniversary of the Journal of Endodontics. Members of the Editorial Board Committee—including Editor-in-Chief Dr. Ken Hargreaves—joined us in the Member Center for a lively and informal conversation with attendees. It was a unique opportunity to hear directly from the minds behind the leading publication in endodontic science and research.

The editors were eager to engage and celebrate this publishing milestone with the AAE community.

Both meetups reflect what makes AAE25 so special: meaningful connections, authentic conversations, and the celebration of members who help shape our specialty—whether it’s online, in the operatory, or in the pages of the JOE.

Thank you to everyone who joined us!

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The American Association of Endodontists marked a significant moment of leadership transition today during the General Assembly at AAE25 in Boston, as Dr. Natasha Flake officially passed the gavel to Dr. Steven Katz, ushering in his term as AAE President for 2025–2026.

The ceremonial handoff was more than symbolic—it celebrated continuity, commitment, and the future of the specialty. In his first address as President, Dr. Katz expressed deep gratitude to his predecessor and laid out a vision grounded in advocacy, mentorship, and collaborative strength.

Dr. Katz, a Cleveland-based endodontist with more than 35 years in private practice, shared personal reflections on his professional journey, beginning with a pharmacy degree and culminating in his Board certification 25 years after completing his residency. His story, filled with persistence, mentorship, and service, resonated with the crowd.

His career path hasn’t been a straight line, he explained. After working as a pharmacist, he went back to school for dentistry, then practiced for two decades before pursuing Board certification. That process reignited his passion for service and got him more deeply involved with the AAE.

Dr. Katz acknowledged the support of his family, practice partners, and mentors. He also celebrated the AAE’s current momentum, noting that the specialty is not only growing but thriving—even as other areas of dentistry face headwinds.

In his home state of Ohio, he explained, a proposed change to specialty advertising laws could allow dentists without CODA-accredited training to market themselves as specialists.

To meet these challenges, Dr. Katz announced his intention to build a coalition of dental specialty groups to unify and amplify advocacy efforts.

He concluded with a call to action for members:

Get involved with the AAE—join a committee or attend events.
Teach, even part time.
Support access to care programs.
Leverage AAE’s patient education materials.
Engage in advocacy—every letter or petition counts.
Consider Board certification.
Contribute to the Foundation for Endodontics.
Surround yourself with colleagues who inspire you.

With the gavel now in Dr. Katz’s hands, the AAE enters its next chapter led by a president who pairs deep clinical experience with heartfelt passion for the specialty and its future.

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In a heartfelt speech at the President’s Breakfast, ADA President-Elect Dr. Richard J. Rosato made one message unmistakably clear: he is committed to a strong and collaborative relationship with the American Association of Endodontists.

Dr. Rosato, who described himself as a first-generation college graduate and rural practice owner, opened his remarks by affirming his connection to AAE leadership and the broader specialty community. Drawing from personal experience and values, he used the moment to reinforce his intent to lead with humility, purpose, and partnership.

Supporting Specialty Recognition and Advertising Standards

Dr. Rosato’s commitment to working alongside the AAE extends to advocacy battles happening at the state level. As the ADA continues to back legally recognized specialties, Dr. Rosato expressed support for the fight to uphold specialty advertising laws, such as those under review in Ohio. He recognized the importance of protecting the public from misleading claims and ensuring patients can identify true experts in their care.

Joining Forces to Combat Misinformation

Dr. Rosato also signaled his intent to work hand-in-hand with the AAE to fight health misinformation, citing specifically the community water fluoridation issue.

A Vision for Unity and Respect

At the center of Dr, Rosato’s address was a powerful pledge: to work together with the AAE to advance shared goals. One point was the need to be “United in Purpose.” Dr. Rosato warned against allowing political divides to impact the collective mission, urging instead a focus on what truly matters: improving oral health for all.

Listening and Transparency

Dr. Rosato committed to building a “culture of listening.” He emphasized the importance of transparency and ensuring that all voices across the dental profession are heard—including those in specialties like endodontics.

Protecting Clinical Autonomy

Dr. Rosato’s additional pledge underscored his respect for specialists and generalists alike. “Respect all dentists” and “protect the doctor-patient relationship” signaled his support for clinical autonomy and ethical care decisions.

Shaping the Future—Together

In another point, Dr. Rosato encouraged the AAE and its members to join him in shaping the future of the profession. He referenced the idea of being the “first domino”—a leader who sets positive change in motion. A nod to Abraham Lincoln’s quote, “Predict it… shape it,” served as a call to action for dental leaders to create, not just anticipate, what comes next.

Key Issues on the Horizon

While the tone of the speech was relational, Dr. Rosato didn’t shy away from the challenges facing dentistry. He briefly noted priority issues including insurance reform, workforce development, access to care, education, wellness, and technology—including the growing influence of AI. He also reaffirmed ADA’s role in defending community water fluoridation amid misinformation, particularly in states like Utah.

Dr. Rosato ended his remarks with gratitude for the AAE’s continued partnership and contributions to organized dentistry.

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