Oral Health Group

Misadventures in Endodontics: Turning a Negative into a Positive

June 4, 2021
by Gary Glassman DDS, FRCD(C)

As a specialist, a significant portion of my patients present after endodontic treatment has failed or was abandoned mid-treatment, due to an unforeseen complication. Throughout my career, I have seen my fair share of my own failed treatments, and I have witnessed the distress these situations can cause my colleagues as I certainly know they cause me many a sleepless night.

Among dentists, perfectionism is common. Many of us have strived for excellence our entire lives, so when mistakes happen – and they inevitably do – we become like an ostrich, and bury our heads in the proverbial sand, hoping the problem just goes away. Choosing not to dwell on failures ensures they will continue to happen and doing so means the loss of what parents love to call a “teachable moment”.


Businesses work tirelessly to anticipate mistakes and outright failures in the hope they can avoid problems and, when errors occur, learn how to do better in the future. Abraham Wald, a Hungarian mathematician, took survivorship bias into consideration during WWII when calculating how to minimize the loss of bombers. When planes riddled with bullet holes made it back, the first thought was to reinforce the planes where they noticed the shrapnel did the most damage. Wald thought otherwise. He rightly stated that these planes returned safely despite the damage, so it was best to reinforce planes in between these “most-hit” areas, as that was where the planes that never returned were fatally damaged. It is crucial, therefore, that we share our failures with an open mind and the enthusiasm as we do our successes, so that we may all learn how to serve our patients even better! Imagine an Instagram page devoted to failed treatments! It may be difficult to post but, oh, the learning that could be had.

Due to the nature of our work, information sharing doesn’t happen as often as it should. Clinicians in hospitals are mandated to share their errors in Morbidity and Mortality conferences to ensure, with the best of their ability, that these errors never happen again. Dentists often work in isolation, toiling away in their own clinics without the benefit of the regular interaction of their colleagues in a “safe space” where ego is removed from the equation, to ensure the best in patient care. I am lucky to be a part of a large network of clinicians with dedicated support teams who regularly host study clubs to openly discuss failures so we may objectively dissect the treatment into its component parts to attempt to find the source of the problem.

We need to reframe the lens with which we view failure. Mistakes are painful, but from defeat, with a focus on education and mutual collegial support, we can learn more and do better.

About the Author

Gary Glassman, DDS, FRCD(C) Curriculum Vitae. Dr. Gary Glassman graduated from the University of Toronto, Faculty of Dentistry in 1984 and was awarded the James B. Willmott Scholarship, the Mosby Scholarship and the George Hare Endodontic Scholarship for proficiency in Endodontics. A graduate of the Endodontology Program at Temple University in 1987, he received the Louis I. Grossman Study Club Award for academic and clinical proficiency in Endodontics. Dr. Glassman lectures globally on endodontics and is on staff at the University of Toronto, Faculty of Dentistry in the graduate department of endodontics. Gary is a fellow of the Royal College of Dentists of Canada, Fellow of the American College of Dentists, endodontic editor for Oral Health, endodontic editor for Inside Dentistry, Faculty Chair for DC Institute and Chief Dental Officer for dentalcorp Canada. He maintains a private practice, Endodontic Specialists in Toronto. Visit www.drgaryglassman.com or www.rootcanals.ca He can be reached at gary@rootcanals.ca.

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