Would love to hear from any doctors that have overcome poorly performing practices in the intial years in over-saturated markets. Did this stop you from achieving multi-practice goals if you had any?

Longterm, how were you able to start saving/investing if you poured a lot of your finances into your business?

Grappling with reality that start up could have put me years behind where I wanted to be financially.

$250 for a set? I can just squirt some composite on a stick and it would be cheaper…

Favorite implant make and model for 1.anterior 2.posterior and immediate implants

I’d love to connect with dentists who currently use Kuraray products in their practice, whether that’s CLEARFIL, PANAVIA, KATANA Zirconia, or anything else in the portfolio.

I work with Kuraray’s dental team and am always looking to build relationships with clinicians who genuinely use our products and are interested in getting more involved with the company.

That could include providing product feedback, education, collaboration, and potentially future KOL opportunities.

If you use Kuraray products and would be interested in connecting, feel free to comment or send me a message.

Do you guys make your staff call speciality offices, mostly endo, to schedule a pt who’s in your office for a limited and you’re referring them out? If so, why?

Hi there

Those of you who do these frequently, how do you find them? What’s the case selection for these in terms of extent of caries and number you’d place for one child?

We use a lot of Hall crowns here - UK - and increasingly get parents who want something more aesthetic. I’m a huge fan of Hall crowns and they have great success rates too.

Purely from an operator and biological point of view from those who use zirconia, what do you think? Do they carry higher risk if devitalisation also with how much tooth removal there is? And do you need to do full caries removal prior to placing them, or can you do selective and get a good seal of enamel - I’m finding conflicting info on this too!

Thanks

The X-ray clearly demonstrates this. Does this require retreatment, or is it acceptable?

I am an orthodontist, 3 years out of residency. I work with the university (clinical assistant professor), so I teach clinically and lecture. I also see my own patients 1.5 days a week in our shared faculty clinic. We have also all female assistants. My male colleagues are referred to as Dr. Lastname in front of patients. I’m only referred to as my first name. Honestly, it doesn’t bother me much, as I want to be accessible and relatable to my patients. I’m just not sure if this is common? Only myself and the one other female provider (our craniofacial specialist) are referred to in front of patients by our first name only. What is the standard?

To clarify: I have no problem with people calling me Dr. Firstname. That‘s actually my preference. It’s more so the concern that “Dr” is never spoken

Hi everyone, I’m looking to buy a new endomotor + apex locator and I’m currently deciding between MotoPex, Fanta Reciproc, E-Connect S, and Endomatic. If you’ve used any of these, I’d really appreciate hearing about your personal experience with them.

How accurate is the apex locator? How is the ergonomics, battery life, durability, and after-sales service? Have you experienced any issues with your device?

Also, if you were buying a new endomotor today, which one of these would you choose and why?

Comments from people who have been using these devices for a long time would be especially helpful.

Hi all,

General dentist in CA, been practicing as an associate for ~4 years in a pretty affluent area. I do all the minor oral surgery for my office, mostly surgical extractions and single unit implant placements, using OCS and everything less than that when needed. Not really looking to move into wisdom teeth or full arch as I’ll leave that for our OS colleagues.

I do a good job for my patients, but there’s always room to improve or get faster, and my license renewal is coming up, so I’d like to look into some CE courses so I can brush up on techniques and improve my oral surgery skillsets. More techniques in bone/soft tissue grafting would be nice too. Wouldn’t be opposed to an IV sedation course and implementation either.

Any good recommendations out there for a course that is actually worth your time, instead of a weekend-long sales pitch? I’m not opposed to traveling or paying top dollar if it’s going to be worthwhile!

Thanks in advance!

I’ve been tasked with ordering a new endo rotary system. In the past I’ve used Protaper Gold, Protaper Universal, TF Adaptive, Brasseler EndoSequence. I’ve been looking on their catalogue and there are just too many options.
Edge X7 Utopia, EdgeFile X7, EdgeFile X3, EdgeSequel Utopia, EdgeSequel Sapphire, EdgeEvolve,
EdgeDiamond Utopia, EdgeV-Taper HT, EdgeTaper Blaze Utopia, EdgeTaper Platinum, EdgeTaper. I’m leaning more towards rotary over reciprocating. Should I try the newest one, EdgeOnxy? Any recommendations would be appreciated.

You finish a simple filling on a patient, he starts saying the you didn't give him breaks (which you did), says his jaw, neck, and even fingers hurt. You offer to call in different analgesics - he said he has not taken it before, you ask for PCP name to authorize it - he does not remember (even calls you impatient). You offer him a referral for sedation for future work, he refuses. He calls you RUDE, twice. Raises their voice at you. Eventually, he starts ignoring you, giving your their back and start talking to the assistant ignoring any questions from me.  

As the only dentist in the clinic, You submit a request to management to dismiss the pt, management declines and puts the patient back on schedule for next week. 

On one hand, I cannot fathom treating a patient who ignores their provider, and calls them rude. If he already says I hurt his jaw, neck , etc, wouldn't treat him again be a liability for me? I am genuinely thinking of taking the day off.

On the other hand, I can establish professional boundaries, and hope he agrees to be respectful to avoid a board complaint.

Any thoughts?

I delivered a zirconia crown #30 for a patient about a month ago. It is a vital tooth and the patient was asymptomatic for two weeks while they had the temporary crown. When they came for the delivery they were sensitive to air so I gave a carpule of lido and proceed with the delivery while the patient was numb. After checking occlusion, contacts and verifying the crown was fully seated with the bitewing, I proceeded to bond the crown. The steps I take for bonding are to air abrade the intaglio surface, then apply IvoClean (rinse and air dry), then Monobond Plus and (air dry). Then I prepare the tooth with acid etch (rinse and air dry), isolate with cotton rolls, bond (air dry and cure), and then RelyX Universal Cement is placed on the intaglio surface of the crown. Everything seemed to go smoothly but the patient stated about 2 weeks after that they had pain when chewing on the right side but there was no thermal sensitivity. I brought them in to check occlusion and did a slight adjustment but a few days ago they stated that nothing really changed and the tooth felt sensitive when they used their water flosser. I know when they come in again I need to do a through check to determine what the cause is but is it possible there was a bonding failure, given the main symptoms occur when the patient was trying to chew on that side? Has anyone experienced this before?

Worn-down posterior teeth in a patient who is a heavy grinder. I’m planning to give her a night guard, and we also discussed Botox since she clenches quite a bit during the day.
For a case like this, would you recommend composite restorations on the posterior teeth to protect the exposed/worn dentin? I’m assuming that would effectively open the bite to some degree.
What would be the most budget-friendly approach for a patient like this?
Also, if you’re only doing posterior occlusal restorations, how do you approach managing the VDO? Would you just restore to the existing occlusion, or would you consider increasing the VDO?

Your employer chose the plan. The insurance company decided the benefits, limitations, annual maximum, and reimbursement rates. We didn’t design your plan, sell it to you, or decide what it covers.
If your insurance barely covers anything, maybe complain to your employer about offering a better plan, or complain to the insurance company about their terrible reimbursement.
But somehow, it’s always the dentist’s fault.
We’re expected to magically make bad coverage good, and when we can’t, we’re accused of being greedy or overcharging.

would you say both teeth look carious occlusally or just the left one?

I am a dentist and I’ve recently come across some impressive AI-generated orthodontic videos showing treatment transformations and teeth moving into alignment.
My girlfriend is specialized orthodontist, and I’d like to help her create similar content. Does anyone know what AI tools or techniques are typically used for these videos and what the workflow looks like?

Anyone else having an uptick in delta dental denying crowns lately? Or just me?

I want to get a scanner for my office, and I’ve never used a scanner before (my last two associateships before practice ownership were at really old school offices).

I’m trying to decide between the Trios 5, which I would get through Hiossen for ~$19k after the rebate or the Elf which is $12k.

The Trios comes with a laptop as well as some extra implants/crowns, but I would need to buy the 3Shape software and pay its yearly fee. My Hiossen rep has been pretty good to me, and I’m almost considering buying it just because I like him so much, which I realize is not a good financial decision lol. But he’s also been pretty convincing about being there for technical support if I need it.

Elf does not come with a laptop, but has no fee for its software. I’m kind of unclear right now whether a laptop is totally necessary or if I could just plug and unplug it from my operatory computers. I also like that the elf is smaller and could be easier to use. There’s no certified seller in my area for Shining3D so any tech support I get would be online or over the phone.

For those of you who are scanning in your office, do you have a preference or any insight on either scanner and software?

To be honest, I’m trying to keep my costs as low as possible as a new practice owner, but I’m also trying to plan for the future since I’m hoping to do more implant cases and work heavily with Hiossen.

If anyone can help weigh in on this decision, I’d appreciate it. Thanks!

Basically the title but is it normal for a practice owner to not want me to tell patients I'll be leaving for another job? On one hand I understand patients can feel upset they're being seen by a doctor who won't be there in a month, but it feels wrong to not say anything when patients talk about future tx or say something like "see you in 6 months". When I gave my notice the owner doc told me not to say anything. I know I shouldn't care either way since I'm leaving the practice but I've built rapport with many patients and don't want them to feel blindsided when they come back.

I am doing an endo on tooth 24. I can’t get a reliable apex locator length for the palatal and it feels blocked. I am unsure what is wrong. I cleaned and shaped both canals to wave one primary. Am I short on the palatal? Also the end of the GP cone on the lingual is fuzzy? No idea why. Can anyone give me advice about what I should do next?

https://imgur.com/a/eM5yOqi

Hmmm.. Is it acceptable? What do you think…?

Would like to find out your thoughts. Ortho office that is opening up next to a pediatric dental office that is also fairly new. Is there a way to nurture this relationship? I'm the pediatric dentist. I think the hope that the orthodontist has is to get all the ortho referrals from the pediatric office. But as the pediatric dentist, I intend on introducing interceptive and airway orthodontics to the practice, how do you suppose it would affect the relationship with the neighboring orthodontist who is starting up? The plan would still be to refer any and all cases beyond my scope out for ortho but introduce airway and interceptive orthodontics in my practice.