Abstract Introduction: Endodontics is a core component of general dental practice, yet many general dentists perceive root canal treatment as complex and prefer referral to specialists. Confidence in endodontic knowledge and skills influences whether practitioners treat independently or refer. This study assessed confidence levels and referral patterns among general dentists in Al-Madinah Al-Munawwarah, Saudi Arabia. Materials and Methods: A cross-sectional, paper-based questionnaire survey was conducted among practicing general dentists at 11 governmental hospitals/health centers and 25 private clinics. A total of 266 dentists participated. The validated questionnaire assessed confidence in endodontic care and referral practices. Data were analyzed with SPSS using Chi-square tests to determine associations between confidence and influencing factors. Results: While 83% of respondents reported confidence in their endodontic knowledge, only 42% felt confident in their diagnosis competence. Confidence was positively associated with years of experience and participation in professional development ( P < 0.05). Among those with diagnostic confidence, 66.7% performed full root canal treatments ( P < 0.05). Higher confidence was also linked to undertaking complex procedures such as orthograde retreatment. Risk of litigation was a concern for most general dental practitioners (88%), and 84% expressed a need for more training opportunities. Conclusions: The majority of general dentists in Al-Madinah Al-Munawwarah demonstrated confidence in their endodontic knowledge, particularly with greater experience and training. Diagnostic confidence was limited among the majority, with those reporting lower confidence tending to restrict care to emergency pulp extirpation. Referrals to specialists were mainly for complex retreatment cases, although more confident dentists referred less.
Aloufi et al. (Sat,) studied this question.