Endodontics in Focus: Dr. Shreyas Oza Discusses Training, Challenges, and Innovation (Part-1)

Dr. Shreyas Oza: That’s a great question. In India, an MDS degree, including endodontics, is a three-year program. In the U.S., endodontic training varies between two years, two and a half years, or three years and three months. In India, completing an MDS program results in a master's degree, whereas in the U.S., earning a master's degree is not a requirement—you receive a certificate that qualifies you as a certified specialist, which is sufficient for state board recognition.

The key difference lies in the scope of procedures taught. In the U.S., endodontic training primarily focuses on root canals, periapical surgery, vital pulp therapy, and anything related to pulp preservation. In contrast, India’s MDS in Endodontics and Conservative Dentistry has a broader scope, encompassing operative dentistry, which is not a primary focus of the specialty in the U.S.

Regarding training methodologies, the procedures are largely the same, but execution varies between countries. For example, in the U.S., the use of dental operating microscopes is standard in specialty programs. In India, most residents rely on loupes with additional lighting, as access to microscopes is limited. Endodontic microsurgery is emphasized significantly in the U.S., whereas in India, its importance in MDS training may not be as pronounced.

Another significant factor is technology. Advanced endodontic equipment is expensive, making it difficult for many Indian dental schools to provide access to students. Even if students in India receive training with this technology, they may not have access to it once they start practicing due to cost constraints. While high-end cities may afford such advancements, a vast majority of India cannot, which creates a notable disparity in training and practice.

Dr. Shreyas Oza: Beyond just the system, the level of dental education in India has improved significantly. Institutions are hiring more qualified professionals, and platforms like yours are educating the public on oral health. About 15–20 years ago, patient awareness was much lower—most people associated dental treatment solely with either fillings or extractions. Root canal treatment was not always presented as an option, either due to the dentist’s limitations or the patient’s financial constraints.

In the U.S., general dental awareness is higher. While a varying levels of misinformation exists just like anywhere in the world, there is a habitual tendency for patients to visit the dentist regularly, making preventive care more accessible. Additionally, dental insurance plays a major role. Many insurance plans cover advanced procedures like root canals, though with limitations. For example, if a root canal costs around $1,200–$1,500, patients may hit their insurance cap for the year. This factor influences treatment decisions; if a procedure is covered under pain management, patients opt for it, but if not, they may still choose extraction due to cost concerns.

The major difference between India and the U.S. in this regard is patient education and the insurance system’s role in preserving teeth.

Dr. Shreyas Oza: In a massive country like India, there will always be a need for dentistry—especially good dentists. Saturation is natural in bigger cities, just like in any developed area with airports, good restaurants, and educational facilities. But whether you're in the U.S. or India, your skill set is what sets you apart. If you’re willing to put in the effort to develop expertise that few others offer, your competition automatically reduces.

That said, challenges exist in India, mainly because the average patient’s ability to afford dental care is limited. That’s the biggest difference between India and the U.S. If India had better insurance systems or financial support for new graduates, fewer dentists would switch careers.

There’s nothing wrong with changing paths—I fully support exploring new opportunities. My reason for moving to the U.S. was research, as the country leads in dental innovation. Others might feel India is too saturated and see greener pastures abroad—that’s valid too. It all depends on individual goals. But with the right skills, you can reduce competition and thrive.

Dr. Shreyas Oza: The best way to learn is by jumping in—but not blindly. Join an established dentist who can mentor you. Focus on learning something new daily, whether it’s patient greetings, record management, or practice basics—things dental school doesn’t teach.

Soft skills matter just as much as clinical skills. How you treat patients and staff defines your success. I learned a lot by observing senior dentists in Mumbai—their patient interactions taught me more than any lecture.

Master the basics first: root canals, extractions, and fillings are your bread and butter. Advanced procedures like implants or periodontal surgery come later, once you’ve our own confidence with the basics and the patient’s trust. I don’t recommend taking an implant course right after graduation—focus on foundational skills first.

Dr. Shreyas Oza: Exactly. You must first understand what good dentistry looks like. Social media helps—many dentists share excellent work online. During your BDS internship, seek guidance, but the drive to improve must come from you. Every filling, every root canal should be done to the best of your ability.

Dr. Shreyas Oza: In India, even specialists like orthodontists perform extractions and fillings. I believe this dilutes the value of their specialization, as their income per patient would be higher if they focused solely on their specialty. In the U.S., as an endodontist, I have the option to practice the entire scope of dentistry, but I choose to perform only root canals because it is more economically efficient. In India, it is possible to master multiple disciplines without necessarily specializing.

If you are passionate about research or wish to gain in-depth expertise, pursuing an MDS can be beneficial. However, if your interests are more clinically focused, seek out mentors and courses to sharpen your skills—an MDS is not a requirement for success in those areas. Unfortunately, many patients in India often associate an MDS with superior skills, which is not always the case. A BDS graduate can possess exceptional skills in performing the same procedures, provided they dedicate time and effort to develop them. Specialization should only be pursued if you are truly passionate about the subject.

Dr. Shreyas Oza: Honesty, respect, and kindness are key. Be transparent about treatment plans, outcomes, and costs. Document everything and have patients sign off—it builds trust.

A comfortable clinical experience (painless injections, proper post-op care) boosts retention. Word-of-mouth referrals follow naturally. Educate patients—explain why they need a crown or root canal. A 2-minute explanation raises their dental IQ and fosters trust.