This thesis analyzed costs and benefits between the recruiting of active duty dentists and the proposed alternative of contracting them instead. Despite aggressive efforts to improve Dental Corps recruitment and retention, the annual loss rate has steadily increased. This has forced the Dental Corps into using alternative programs such as the Health Professions Scholarship Program (HPSP) and the Financial Assistance Program (FAP) in addition to the accession programs already being funded. Also, there are various recruiting costs along with the accession bonus that costs the Navy over $90,000 per dentist recruited. The scope of this thesis included, but was not be limited to: (1) a review of the current structure of pay for active duty Endodontists by referencing Additional Special Pay (ASP), Variable Special Pay (VSP), Dental Officer Multiyear Retention Bonus (DOMRB) and the Board Certification Pay (BCP) that dentists receive while serving on active duty (2) and a summary of private sector pay and incentives for dentists in private practice. The thesis also analyzed the differences between the two with a Cost-Benefit Analysis (CBA) model. The completed research found savings in cost for contracting already licensed and trained Endodontists in place of recruiting a general dentist and training them to become an Endodontist over the 10 year period as composed in the analysis. In addition, a steady-state model verified the CBA and showed savings in cost per year as well. Each model shows significant savings when contracting Endodontists in our shore based MTFs. Furthermore, to mitigate shortages, this research proposes to concentrate resources on military essential competencies and contracting workload for nonmilitary essential functions, such as Endodontists. Note that Endodontists were chosen because they are one of the larger nonessential specialties with billet inventories above the Operational Support Algorithm (OSA).

A survey was conducted to assess the current state of predoctoral endodontic education in the United States. Fifty-one schools received surveys and 73% responded. Seventy-six percent were from public schools with most having a graduate endodontic program (84%). Preclinical training most often began in the spring of second year and clinical training started in the fall of third year (each 54%). All programs that responded stated that endodontists routinely instruct students in the clinic. Sodium hypochlorite 2.5% was the irrigation of choice. Calcium hydroxide was the most common intracanal medicament. Cold lateral condensation with gutta-percha was the most frequently indicated obturation technique. Sixty-two percent of programs had microscopes, with 1-2 cases treated with microscope per week. Findings suggest that endodontists are still an integral part of teaching predoctoral dental students in the United States.

Introduction: There are currently no established guidelines to determine which cases general practitioners should refer to an endodontist for root canal treatment. The American Association of Endodontists (AAE) has developed the EndoCase mobile application (ECA), which utilizes either a full or abridged rubric to assign case difficulty level and provide referral guidelines to general practitioners and dental students. Objective: The objective of this study was to determine whether the abridged criteria of the EndoCase application can help predict the incidence of procedural errors in nonsurgical root canal treatment of mandibular molars in an undergraduate dental clinic based on the difficulty level. Methods: A list of patients who received primary root canal treatment on mandibular first molars in the undergraduate dental clinic from 2015-2020 was obtained. Ninety patients qualified for inclusion. Case difficulty level was assessed using the ECA by three providers with differing levels of experience. Incidence of procedural errors was determined from post-operative radiographs by two calibrated independent observers. Results: The most common endodontic mishaps were errors during access cavity preparation followed by the presence of voids in the root filling, with an incidence of 54.4% and 45.6%, respectively. There were no significant differences regarding case difficulty level and the incidence of total procedural errors nor number of treatment visits. Of the individual error types, the presence of obturation >2mm short of the radiographic apex was weakly correlated with case difficulty level (r = 0.226, pConclusion: There is minimal correlation between the difficulty level of mandibular molars determined by the ECA and the number of treatment visits or overall incidence of procedural errors.