An audit of endodontic diagnostic documentation compliance among undergraduate dental students in a UK primary care–based dental school

BACKGROUND: Erroneous pulpal and periapical diagnoses can lead to inappropriate treatment planning, unnecessary procedures, and compromised patient outcomes. While undergraduate endodontic education emphasises history taking, clinical testing and radiographic assessment, less is known about how consistently students document diagnostic conclusions in clinical records. AIM: To evaluate the completeness and compliance of endodontic diagnostic documentation among undergraduate dental students, benchmarked against British Endodontic Society (BES) and European Society of Endodontology (ESE) standards, and to explore trends across different stages of training. METHODS: Records of 196 root canal treatments completed by Year 3–5 Bachelor of Dental Surgery students (2022–2024) were reviewed. Audit standards were based on the British Endodontic Society Guide to Good Endodontic Practice (2022) and United Kingdom record-keeping guidance. Parameters included history-taking, sensibility testing, radiographic justification and reporting, and documentation of provisional and definitive diagnoses. Compliance was analysed descriptively, with limited inferential comparison where appropriate. RESULTS: Compliance with core record keeping elements was high across all cohorts. Documentation of diagnostic conclusions and signs and symptoms varied across student groups and academic years. Provisional diagnoses were recorded in 12.37% of cases overall, whereas definitive diagnoses were documented in 66.31%, with the highest compliance observed in Year 5. Documentation of signs and symptoms was 65.83% in 2022–2023, increasing to 67.76% in 2023–2024. CONCLUSIONS: Undergraduate dental students consistently document clinical findings relevant to endodontic diagnosis; however, explicit recording of diagnostic conclusions, particularly provisional diagnoses, and documentation of signs and symptoms remain inconsistent. Strengthening educational emphasis on documenting diagnostic reasoning may support preparedness for independent practice.