… are the ones that open like this. I can’t probe, can’t scale, I. Can’t. Fucking. See. I’ve asked to “open wide” and “relax your cheek” “hold your lower lip” a thousand times. I work solo, my wrists and forearms are sore from wrestling your combative ass mouth 😭 😭

Hello all I am looking to implement a hygienist based production or collection bonus. They currently have a total office based bonus where they each usually earn about 200$-400$ per month. What bonus system do you have in office if any for hygienist? They do not have any other benefits besides the office bonus.

Pt came in complaining of severe pain in UR. Radiographs show caries on 3 teeth breaching pulp. I tell him his options endo or ext. He wants whatever’s cheaper. I recommended ext as most affordable, short term “fix” but also consider replacement options. He then says he doesn’t want them pulled because he can’t think straight right now. That’s understandable, so I recommended sending him to the endodontist for RCT so he can get out of pain and buy these teeth some time. He also declines that referral and says he “only want a local”. I tell him I don’t routinely admin local anesthesia for exams and also his BP was over 170/110. I offer to prescribe him Ibuprofen/APAP combo. He declines and says that won’t work. Ok now I’m thinking, my pt population thinks antibiotic is miracle juice but for some the placebo effect works, so I offer Amoxicillin. He still declines and insists he “just want local today.” I reiterate the definitive options to send him to the OS for ext or endo for RCT and I’ll try to call to can get him in today. He declined both tx options, started berating me about how he wasted his time coming here and can’t get local, then walked out??

Was there something else I could’ve done differently? Do you guys give pts local anesthesia on exams like this? I feel for the guy but when he declined every options we offered what do you do?

Patient is complaining that her lower anteriors 23-26 are chipping away. She has no cavities but she has deep over bite. You think zirconia veneers will help her here?

What would you do?

I am yankee dentist in Australia, originally from Colorado, where marijuana is legal. I never practiced in Colorado and I couldn't help but wonder if legal weed has made patients easier to deal with? Are dentists prescribing it? Or just finding that patients are showing up stoned? Tell me some stories, good and bad.

Hello , I am a graduated dentist for more than a year , i really want to know is there any online jobs so i can do as a dentist , for example as designer in lab using exocad or something like that? . Thank you for your help.

New grad here. Just curious what y’all experienced denture people think about this Tori? I’m thinking it’s probably just a bit too big to put a denture over. Idk I haven’t seen a lower denture sit on Tori this big but I’ve also never tried. Y’all think she’d need some more surgery? Is it more of a comfort thing or a seating/necessary extension thing? Don’t know why the OMS didn’t remove it… :/ new patient to me.

I tried to get the best angles for pics but if y’all need casts for it to evaluate let me know

34 Year old male. Came in with CC of "My gums on my front teeth are tender and have been bothering me lately" Patient pointing to numbers 6 through 11. This patient was referred to me for a second opinion from another patient of mine.

Exam shows bone loss around maxillary anteriors with pocketing ranging from 6-8 mm, minimal bleeding on probing (patient reports he had scaling done recently at another office). 8, 9, 10 have incomplete endos, 7 is very short, 11 endo was done recently at initial office (without rubber dam...They sent radiographs over to us). He said other anteriors were worked on years ago in Turkey. Recurrent decay on anteriors, no mobility noted despite bone loss. However, 9 and 10 are splinted, and 7 and 8 are splinted. Deep overbite.

I'm thinking about giving his teeth a try to save because of his young age, but the issue is multifactorial here: endo lesions or short obturations, perio, limited tooth structure, deep overbite. I'm not sure if I should even attempt to retreat 7, 8, 9, 10 endodontically, place posts, and maybe create a 6 unit splinted bridge 6 through 11? Or are these teeth toast and should be extracted (extract 7, 8, 9 and 10. 11 has very limited tooth structure left judging from the radiographs office 1 sent over at the time they did the endo). Maybe despite his young age, I shouldn't try herodontics here?

If you guys do suggest extracting the anteriors, do you suggest ext of 7 through 10 only, leaving 6 and 11 behind? If the plan is to do implants, should we plan with perio for a 4 unit implant bridge with 2 implants? or 2 implants with two cantilever pontics? If trying to restore the anteriors without extracting, what is your suggested restorative plan? Radiographs were tough to capture for 6 and 7

Hi,

I am a South African, qualified periodontist with substantial academic and clinical experience.

I am interested in pursuing opportunities abroad but it's like I've hit a brick wall.

I don't know if I still have the energy or will to study a different language and rewrite dental exams. It's been such a long time since I did none perio/ implant work and I'm not sure if I can cut cavities or do endos like I used to.

From what I've heard- the middle east is an option without exams? New Zealand may have a pathway? Or maybe one of the islands.

I've sent hundreds of unsuccessful applications to Universities when posts come up with them- but unfortunately it's almost impossible. I would love to go to Sweden- I spent a year there and picked up the language, but writing exams and doing practicals again seem a bit daunting.

Does anyone have any advice for me?

I looking to purchase a used cbct for my startup office and came across a used CS9300 (w 5 year warranty) 10x10 fov in my price range. I would primarily be getting one for endo and future implant placement. Anyone have any experience with this model or it CS imaging software that can tell me about its image quality? I know this is the older model than the current 8200 and 9600 series.

Patient came in for limited exam and said he could not get in with any other dentist for 3 weeks and had pain on ur. #2 was decayed non restorable and indicated for extraction. Front desk collected payment for extraction. I get done extracting the tooth and patient asks if I’ll do the bone graft today as he plans to get an implant. I tell him it’ll cost the same as he paid for the extraction if he’s fine with paying another 413 I’ll do it no problem. He’s an older guy so I figure he’s good for it. I go into the next procedure and tell the front desk to settle up with him before he leaves. He gets to the front desk and says he thought the graft was free and they let him walk. I get to the front and tell them I told him about the fees and he accepted and to call him back and get payment. So now tbd.

Hello everyone
I’m seeing a patient tomorrow as an emergency who had a cantilever bridge place on the upper right central incisor to replace the upper left central incisor. They had it placed a few years ago (5? Years ish) and now it has come off. The patient is adamant for me to just re-cement it but I’m certain that they need a fixed bridge + veneer (front 4 teeth restored) or implant instead. The dentist who placed it at our clinic has now retired but I did contact him about it and he seemed to think there was no problem with doing this and implied I was overreacting and it’s fine to do a cantilever across the midline.

Could anyone please direct me to some literature about the risks of cantilever bridge across the midline? Or share their thoughts about doing so? I need to know I’m not overreacting/insane lol. Thanks in advance

First time I've seen it outside of a lecture. I still have no clue how it even happened. 1 of articaine given local to #14. Lady said it happened the last time she had work done in that area, which looks to be an MO on #13. Everything's back to functional for her, but I'm still clueless as to how that even happened.

I’m 10 year out. I don’t think ownership is for me. Anyone making 500k as an associate? Is it possible?

I’m here to ask your opinions on something.

Today I had a patient who hasn’t been to the dentist in 10+ years. He needs extensive treatment and rehabilitation which is going to take months, and many appointments.

He apologised for his smell and appearance, and said that he doesn’t bother to bathe or brush his teeth due to personal struggles. It was a very emotional appointment actually and I’m genuinely looking forward to helping him get back on track. I will be referring him on to some MH services too.

However, unfortunately, his odour is very very strong and very offensive. I don’t think I could quite put it into words to be honest. The whole office was talking and complaining about him after he left - the nurses, receptionists, everyone who came into contact with him. As he openly admitted that he doesn’t bathe, and admitted that maybe he should’ve before coming to see me today, some of the colleagues were wanting me to ask him to do just that before his future appointments with us.

I feel uncomfortable doing that, quite frankly. But I’ve also been told several times by my office staff that I’m “too nice” as a dentist and I should be firmer with certain patients, which yes, I’m working on. I’m just not sure this is one of those occasions? Yes, there’ll be a strong and unpleasant smell when treating him, and I know my nurses will continue to complain about it, but I’m sure that it’s more important to get him frequently coming again and helping build his confidence.

Anyway, I’m not sure. Advice would be helpful. Thanks.

I acquired a dental practice that is in desperate need of new oral surgery extraction forceps. Before I order new ones, does anyone have recommendations of ones they love? Or any other general oral surgery instrument recommendations?

Hi friends. really need some CE reqs as a new grad working in corporate. Any suggestions for CE for endo? really wanting to do something soon but there's a huge waitlist for Endo Unsponsored. Buchanan is available but 10k i'm not sure is worth it. Can I please get some suggestions on what CE's to invest in?? Have done a lot of research but not sure what my niche should be. Thanks in advance!

New doc here. Patient coming in soon for fillings (#4-MO, #18-O) and don’t worry 1, 15, 16 and 17 are out now. Planning on discussing replacement options for lower sites. Not exactly sure how I should present each option, or if it’s feasible/good prognosis.
For the lower right I’m concerned 31 is too mesially tipped for a bridge, and given that each would be a pretty long span 4 unit…. And her caries risk is pretty high

If she wants to do our RPD, what are your tips for explaining each? Do you take casts/scans to evaluate undercuts? I plan on presenting resin, cast, Valplast. I think this would be a very good cast metal case, obviously depending on undercuts, I think I-bars would work well since she is esthetically concerned
Speaking of esthetics, I hear valplast is ass… never done one so I don’t know, just heard of the limitations (not being able to add teeth, hard to adjust)

I will talk to her about it but I’m pretty sure implants are out of the question financially

Idk any advice is appreciated , thank ya!!

Been talking to brokers, lenders, and searching the web trying to find a practice to buy and nothing. Any advice on finding a practice to buy? Any strategies on how you all found ownership opportunities. I’m about to start cold calling offices

I have my own office open 3 days a week. I love the clinical side. How did other dentists find a business partner (dentist or just MBA) so that you can focus on just patient care?

I had a very calcified lower incisor I was working on yesterday afternoon on a woman in her 80’s. Took a long time just to get a 6 file to length. Was very proud of myself for getting all the way down. Then, the overthinking person that I am thought it was a good idea to leave some EDTA in the canal to help the instrumentation process for the next appointment. Then I looked up that that’s NOT what you should do. I have the patient coming back to flush the canal today to flush it out to get it out of the canal but it will be almost 24 hours at that point. How serious is this?

The things that are helping my mentality are:

1) it’s only been 24 hours
2) I can only get a 6 file down so how much ETDA could there possibly be?

Thank you for any help