A general dentist is legally allowed to do almost everything. Whether they should is a judgement call about volume and difficulty, and the answer changes with the case. Understanding who does what tells you whether a referral is caution or upselling.
The recognised specialties
- Orthodontics and dentofacial orthopedics. Braces, aligners, bite correction, jaw growth in children. Two to three years of residency after dental school.
- Endodontics. The inside of the tooth: root canals, retreatment of failed root canals, cracked-tooth diagnosis, apicoectomy. If a general dentist refers a molar root canal out, that is normal and usually right.
- Periodontics. Gums and the bone that holds teeth in. Deep cleanings, gum grafts, crown lengthening, and a large share of implant placement.
- Prosthodontics. Rebuilding. Complex crowns and bridges, full-mouth reconstruction, dentures, implant restorations.
- Oral and maxillofacial surgery. Extractions including impacted wisdom teeth, implant placement, jaw surgery, facial trauma, biopsies. The only dental specialty that routinely uses general anesthesia in office.
- Pediatric dentistry. Children and adolescents, plus patients with special healthcare needs at any age.
- Oral and maxillofacial radiology. Interpreting complex imaging, usually behind the scenes.
- Oral and maxillofacial pathology. Diagnosing disease in oral tissue, including biopsy interpretation.
- Oral medicine and orofacial pain cover non-surgical management of oral disease and chronic facial pain, including temporomandibular disorders.
- Dental anesthesiology and dental public health round out the twelve.
There are twelve recognised specialties in total. The complete and current list, with the requirements behind each, is maintained by the National Commission on Recognition of Dental Specialties and Certifying Boards. Anything not on that list, including "cosmetic dentist", "implant specialist", and "sedation dentist", is a description of what someone does rather than an accredited credential. That does not make those dentists less skilled. It means you should ask what training and case volume sits behind the label.
When a referral is the right call
| Situation | Usually goes to |
|---|---|
| Root canal on a molar, or a retreat | Endodontist |
| Pockets over 5 mm, bleeding, bone loss | Periodontist |
| Impacted wisdom teeth | Oral surgeon |
| Implant in the aesthetic zone | Periodontist, prosthodontist, or oral surgeon |
| Child under 3, or a child with high anxiety | Pediatric dentist |
| Full arch rehabilitation | Prosthodontist |
A referral does not always mean higher cost. Specialists are frequently faster at their own procedure, and faster often means less anesthetic, fewer visits, and a better long-term result on a tooth you only get to fix once.
Questions to ask before accepting a referral
- What specifically about my case is outside your usual scope?
- Roughly how many of these do you do a year, and how many does the specialist?
- Will the specialist re-do the diagnostics, and will I pay twice for imaging?
- Who handles the follow-up, you or them?
The specialty bodies, for background reading
Each specialty maintains a patient-facing site worth reading before an appointment. The American Association of Endodontists' patient section is unusually clear on what a root canal involves, and the American Academy of Pediatric Dentistry publishes the age-based guidance most pediatric practices follow.
Our directory splits listings by specialty, so you can see the orthodontists, oral surgeons, endodontists, and periodontists in your city rather than filtering a list of every dentist.