A root canal specialist, called an endodontist, is a dentist with additional years of accredited training in diagnosing and treating problems inside the tooth. Many root canals are done by general dentists. You are more likely to need an endodontist for retreatment, complex canal anatomy, root-end surgery or pain that is hard to diagnose.
If you live in Thunder Bay or Northwestern Ontario and have been told you need a root canal, this guide from Redwood Dental Centre explains what an endodontist does, how their role differs from your general dentist’s, which situations usually lead to a referral, how the referral process works and what insurance or the Canadian Dental Care Plan may cover.
What Is a Root Canal Specialist (Endodontist)?
An endodontist is a dentist who has completed a dental degree and then a graduate program in endodontics, the branch of dentistry focused on the pulp and the tissues around the roots. In Ontario, only dentists who hold a specialty certificate from the Royal College of Dental Surgeons of Ontario (RCDSO) can call themselves endodontists or specialists.
The pulp is the soft tissue inside the tooth that contains nerves and blood vessels. When it becomes inflamed or infected, root canal treatment removes it, cleans and shapes the canals inside the roots, and seals them. Endodontics is one of 11 dental specialties recognized in Ontario. General dentists may also provide root canal treatment, but they must not present themselves as specialists.
Endodontist vs General Dentist: Who Does Your Root Canal?
Your general dentist usually diagnoses the problem and can treat many root canals, especially on front teeth and straightforward back teeth. An endodontist focuses on endodontic care and typically handles cases that are more complex, need retreatment or require surgery. Your dentist decides together with you whether a referral makes sense.
| General Dentist | Endodontist | |
| Training | Dental degree | Dental degree plus graduate specialty program in endodontics |
| Registration in Ontario | General dentist with the RCDSO | Certified specialist with the RCDSO |
| Scope of practice | Full range of dental care, including many root canals | Limited to endodontic diagnosis and treatment |
| Typical root canal cases | Straightforward canals, first-time treatment | Retreatment, complex anatomy, surgery, difficult diagnosis |
| Restoration afterward | Places the crown or filling | Usually sends you back to your dentist for the final restoration |
Whichever provider treats the tooth, your general dentist normally places the final crown or filling and remains your main point of contact.
Signs You May Need Root Canal Treatment
Common signs that a tooth may need root canal treatment include pain that lingers after hot or cold, pain when biting, swelling or tenderness in the gums near a tooth, a pimple-like bump on the gum and a tooth that has darkened. Some infected teeth cause no symptoms and are found only on an X-ray.
The usual causes are deep decay, a failing or leaking filling, a crack, repeated work on the same tooth or an injury. The American Association of Endodontists notes that trauma can damage the pulp even without visible cracks. Symptoms alone cannot confirm the diagnosis; a dentist needs to examine the tooth and take X-rays. For more on the treatment itself, see our Root Canal Therapy in Thunder Bay page.
When Is a Referral to a Root Canal Specialist Recommended?
A referral to an endodontist is usually recommended when the case is beyond what your general dentist routinely treats. Common reasons include a previous root canal that has failed, canals that are curved, narrowed or hard to locate, the need for root-end surgery, uncertain diagnosis and certain dental injuries.
- Retreatment: a tooth that had a root canal before but is painful or infected again.
- Complex anatomy: extra, very curved or calcified (narrowed) canals, often in molars.
- Surgery: an apicoectomy, where the tip of the root is removed and sealed through the gum.
- Unclear source of pain: symptoms that do not point clearly to one tooth.
- Cracked teeth: cases where the extent of a crack needs specialized assessment.
- Trauma: some injuries, particularly to young permanent teeth with roots still developing.
- Instrument or access problems: blocked canals or obstacles from earlier treatment.
- Medical considerations: health conditions that make longer or more complex treatment harder to manage in a general setting.
A referral is not a sign that something has gone wrong. It reflects your dentist matching the case to the right provider.
If a referral is suggested but you are worried about cost or travel, say so. Your dentist can explain what happens if treatment is delayed, whether the tooth can be stabilized in the meantime and which alternatives exist, so you can make an informed choice rather than putting the decision off.
How Does an Endodontist Referral in Thunder Bay Work?
An endodontist referral in Thunder Bay usually starts with your general dentist examining the tooth, taking X-rays and sending a referral with those records. The endodontist’s office then contacts you to book a consultation, provides its own estimate and returns you to your dentist for the final restoration.
- Diagnosis: your dentist examines the tooth, tests it and takes X-rays.
- Discussion: your dentist explains why a referral is recommended and what the options are, including treating the tooth in-office, referral or extraction.
- Referral: your dentist sends notes and images to the endodontist.
- Consultation and treatment: the endodontist assesses the tooth, gives a separate estimate and treats it if appropriate.
- Restoration: you return to your dentist for the permanent filling or crown, which protects the treated tooth.
Where you are referred depends on availability and the type of treatment needed. Ask your dentist which endodontist they refer to, expected wait times and whether travel will be needed.
Questions worth asking before you accept a referral:
- Why is a specialist recommended for this tooth?
- Can the tooth be treated here instead, and what are the risks of each choice?
- How urgent is it, and what should I do if pain or swelling increases while I wait?
- Will my insurance need a predetermination or a referral letter?
- Who will place the final crown or filling, and when?
What Happens at an Endodontist Appointment?
An endodontist appointment usually starts with a review of your referral, X-rays and symptoms, followed by tests on the tooth and sometimes a 3D scan. If treatment goes ahead, the tooth is numbed, isolated with a dental dam and treated, often in one or two visits.
During the consultation, the endodontist may tap on the tooth, test its response to cold and check the gums around it. Some cases need a cone beam (3D) scan to see the root shape, a crack or the extent of an infection. You will then hear the options, including retreatment, surgery or extraction, with a separate estimate.
On the day of treatment, local anesthetic numbs the area. A thin rubber sheet called a dental dam keeps the tooth clean and dry. Many endodontists use magnification, such as a dental microscope, to find and treat narrow or hidden canals. Many people feel some tenderness for a few days, which usually settles with over-the-counter pain relief recommended by the dentist. Afterward, the tooth is sealed with a temporary filling and you return to your dentist for the permanent restoration.
Is Root Canal Treatment Covered by Insurance or the CDCP?
Most private dental plans cover part of root canal treatment, often under basic or major services, depending on the plan. The Canadian Dental Care Plan covers standard root canal treatment on most teeth without preauthorization, while retreatment, apicoectomy and specialist examinations require preauthorization.
Under the CDCP Dental Benefits Guide, effective April 1, 2026:
| Service | CDCP Rule |
| Standard root canal on front teeth, premolars, first and second molars | No preauthorization needed |
| Root canal on third molars | Preauthorization needed; eligible only when the first and second molars are missing and the third molar meets an opposing tooth |
| Retreatment, apicoectomy, retrofilling | Preauthorization needed; 1 of each per tooth per lifetime |
| Complete specialist examination | Preauthorization needed, with a referral and justification |
| Crown after root canal (age 18+) | Preauthorization needed; the tooth must meet restorability criteria and have healed |
The CDCP also applies eligibility criteria, such as adequate gum and bone support, so not every tooth qualifies. For private plans, ask your dentist or the endodontist’s office to send a predetermination, and remember the crown afterward is usually a separate claim. Our article on whether dental crowns are covered by insurance explains that part.
Root Canal Therapy and Referrals at Redwood Dental Centre
At Redwood Dental Centre in Thunder Bay, Root Canal Therapy in Thunder Bay is provided by our general dentists. We are not certified specialists in endodontics. When a case needs specialist care, such as retreatment or root-end surgery, we refer you to a certified specialist in endodontics and send your records, then complete the final restoration with you.
Some soreness for a few days afterward is common, and many people return to school or work the next day. Treated back teeth often need a crown afterward, which we can plan with you through our Crowns and Bridges in Thunder Bay service. We offer direct billing to most insurance plans and accept the CDCP for eligible patients.
Request an assessment through our contact form. If you have swelling or severe pain, see our Emergency Dentistry in Thunder Bay page.
Frequently Asked Questions
What is the difference between an endodontist and a dentist?
An endodontist is a dentist who has completed additional graduate training in endodontics and is registered as a specialist; in Ontario, that registration is with the RCDSO. A general dentist provides a full range of care, including many root canals. Endodontists usually handle complex cases, retreatment and root-end surgery.
Do I need a referral to see an endodontist in Thunder Bay?
Many patients see an endodontist through a referral from their dentist, which brings X-rays and notes along and avoids repeat imaging. Some endodontic offices also accept patients directly. Check with the specialist’s office, and note that some plans, including the CDCP for complete specialist exams, require a referral for coverage.
Why would my dentist refer me for a root canal?
Common reasons are a previous root canal that has failed, curved or narrowed canals, the need for root-end surgery, pain whose source is unclear, a cracked tooth or certain injuries. A referral means your dentist is matching the case to the provider with the most focused training in that type of treatment.
Is a root canal by a specialist more expensive?
Specialist fees are often higher than a general dentist’s for the same procedure, reflecting case complexity and training, but costs vary by tooth, case and office. Ask for a written estimate and a predetermination from your insurer. Remember to budget for the crown or filling your general dentist places afterward.
Can a tooth be saved if a root canal fails?
Often, yes. Options include root canal retreatment or an apicoectomy, both commonly performed by endodontists. If the tooth cannot be saved, extraction followed by an implant, bridge or denture may be discussed. Your dentist or endodontist will explain which options suit your tooth.
Book a Root Canal Assessment in Thunder Bay
Many root canals are completed by general dentists, and an endodontist steps in when a case needs more focused care. Either way, the first step is the same: a proper diagnosis, so you know whether your tooth can be treated in-office or needs a referral.
If you have lingering sensitivity, pain when biting or swelling near a tooth, request a root canal assessment through our contact form. Our dentists will examine the tooth, explain your options and arrange a referral to an endodontist if your case needs one.
This article is general information, not dental advice for your situation. Speak with a dentist about your own symptoms and treatment options.