Making a referral

If you're a London general dental practitioner (GDP), please use the pan-London endodontic referral form.

Referrals must meet level 2 or 3 of our complexity guidance. Please see the referral form for details about each level.


All referrals must include a current, dated and diagnostically acceptable parallel-view periapical radiograph(s) of the affected tooth or teeth.

Your referral will be rejected if the diagnostic quality is unsafe for decision-making. For example, if your radiographs fall into grade 1 or 2 of the Ionising Radiation (Medical Exposure) Regulations 2000.

The same quality standards apply if you send paper copies of conventional or digital radiographs with your referral.

Pre-referral checklist

Your patient must have:

  • a stable oral environment and all caries managed
  • tooth or teeth predictably restorable and made functional after removal of disease
  • supragingival sound coronal tooth tissue around the circumference of the mouth with minimum 3mm height and 2mm thickness
  • intact axial pulp chamber walls

For many teeth this is only possible after removal of restoration and placement of a sound, well-fitting provisional restoration before referral.

Where the referred tooth has a de-cemented bridge retainer or caries at the restoration margin, the restoration should be removed by the referring dentist. This is for caries removal and restorability assessment. The tooth should have a sound, well-fitting temporary restoration in place before making a referral.

Your patient must be willing and healthy enough to have endodontic treatment.

For basic periodontal examination (BPE) codes 2, 3 and 4, please confirm the supra or sub gingival debridement has been done using local anaesthetic and periodontal control achieved.

Please make sure your patient knows:

  • we'll decide after an assessment consultation if we're able to accept them for treatment
  • they may need several long appointments and success is not guaranteed
  • the referring dentist is responsible for all restorative phases after completion of endodontic treatment. Not to do so risks both treatment failure and tooth loss

Exclusion criteria

We do not accept referrals for:

  • failed local analgesia after primary and supplemental injections (intraligamental or intraosseous). Sedation or general anaesthetic is needed
  • patients with severely limited mouth opening (inter-incisal opening less than 25mm) who need root treatment in posterior teeth, where access is not possible. Please refer to an appropriate service for treatment of trismus, poor mouth opening or possibly extraction
  • Gagging. Please refer to an appropriate service to treat patient's gagging

Last updated: May 2023

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