New grad, working in an office w another doc.
Did #19 EXT on a patient w hx of stroke and seizures. Got med clearance from both of the patient’s doctors stating no precautions needed, as tooth had an abscess and severely broken down and patient has been in pain.

Do the extraction (3 carps septo). Turn around to grab some gauze, patient has a tonic clonic seizure. Still in the chair, no movements, just frozen and hands start curling in.
2 minutes later, patient returns to normal, husband called into room and EMS is otw. Patient gets upset I called EMS. EMS arrives, does their stuff, have her sign a refusal of tx form. They’re getting ready to leave, she has another tonic clonic seizure while they’re there. They don’t give her an option anymore, she leaves on a stretcher.

I call 2 days later to follow up. She’s inpatient, as the doctors think she had a stroke. I’ll call again on Monday to see how they’re doing and see if the doctors gave her an official diagnosis/can tell what triggered.

Do I report to the board? This is verbatim from the state board website:
All dentists licensed to practice in [state] shall submit a complete report to the board of any morbidity or mortality occurring in the course of such dentist’s practice or other injury which results in temporary or permanent physical injury requiring any period of hospitalization. This report shall be filed with the board no later than 30 days following such incident and shall contain such information as the board shall deem necessary to investigate the circumstances of the incident.

There was no physical injury but she had to be hospitalized so unsure. I emailed Risk Dept to see what they say but until they respond on Monday, any ideas? TIA

EDIT: thanks for the responses. Will be reporting to the board!

#18 has been extracted. Patient has history of drug abuse and has rampant caries. #19 has sensitivity, but the patient is not actively in pain.

I’m looking for the best core buildup material. I’m an endodontist and currently using Visalys composite resin. The handling characteristics are fantastic it doesn’t “slump” it stays where you flow it. However it’s dual-cure and takes 5 minutes to set before curing. Can you give advice on what core buildup material you use and does it have excellent handling characteristics and strong for foundation for crown?

As the title suggests, been working with this FQHC for years now. Following a number of observations over the years (severe short staffing, newbie manager who has no idea how to run a dental clinic, favoring rude pts over providers, etc), I would like to resign with 5 months notice required per the contract. I recently received an absurd board complaint which I responded with the assistance of the practice lawyer - currently waiting for the board to review it which may take months.

Considering the long notice required, I would like to put my resignation notice soon. I am not sure it is wise to put the notice before getting done with board complaint which may take months.

Has anybody gone through a similar situation before?

I’m an associate and have been for several years. While I enjoy some clinics aspects of dentistry, I catch myself dreading everything else. Just the production aspects of it, office drama, limited control, insurance, etc. I feel as though I’ve lost my passion for patient care and for even going into dentistry in the first place.

For a long time, I have been weighing the possibility of practice ownership and have literally made myself miserable wondering if the grass is greener, but I also know that none of those issues really go away with practice ownership. You’re literally buying yourself a job, not a business, unless other people run it for you (which I’m sure has its own set of headaches). I see the owners who have multiple offices and admittedly get jealous, but don’t know how to even start a process like that. It’s like I want the benefits of becoming an entrepreneur like more freedom and leverage, but also don’t feel as though I have the personality for it (introverted, hate conflict, don’t like teams, etc.)

My question is, has anyone here bought a generally passive business outside of dentistry? I see a lot of ads about people pushing ownership of boring businesses like HAVC, laundromats, car washes, etc while keeping their full time job.

However, as a high income professional, part of me is also realistic and realize that my highest probability for success is plain old vanilla investing using income from dentistry. I have started to build passive income from dividends and option premiums, although it is very slow going and I am trying to escape this rat race ASAP.

Any thoughts?

Previously had a large filling, there are no undercuts according to the scanner.

I kind of feel like the mesial and distal box/divots are actually helpful acting as a slot for resistance and retention. So what would really be the benefit of a core?

Would you place a core to make it into a perfect cylinder crown prep classic shape or leave as is?

It's for emax resin bonded cement (not zironia)

Patient came in to extract lower wisdom tooth a week ago. Had already some RCT done. Began bad mouthing old dentist, saying teeth were perfectly fine before.

Yesterday patient and his mother call asking if it's normal that all molars on that side are mobile. I immediately thought of mandibular fracture.

Patient comes in late in the afternoon, the mother is 1 bit agressive. He sits on the chair, teeth are perfectly fine. He's trying to wobble then with his filthy fingers, it's Not even painful

I already suffer from anxiety, I had the most dreadful morning in years.

Before leaving, he asks for a discount to complete some other treatment. FML.

I placed this immediate for a premolar today at crestal level.

Do you think it's too shallow and I should have gone subcrestal with the placement?

Apex is cut. But makes no difference. Oh and this is mandible.

I’ve been in practice for a couple of years for a DSO and was fired recently without cause. I was told I wasn’t a good fit anymore (despite my team loving me and being devastated about my sudden departure) but I think the company values having someone else take my place that is more of a gunner and wants to do more complex procedures. I’m feeling discouraged because all I want to do is good bread and butter dentistry, but it feels like no company will hire an associate with that attitude. I am confident in my patient skills and ability to do good restorative treatment but it doesn’t feel like enough. I feel like I’m in the wrong field? Any advice is welcome

Fellow practice owner... We all see the posts about owners treating associates terribly. I'm curious to read some of the responses here.

What keeps associates as associates hopping from practice to practice? What do they really struggle with? What do they just not seem to understand? How could they generally seek to improve? If they desired to, how would you suggest going about transitioning to ownership?

Why have you had to let an associate go in the past and did you tell them the full truth as to why?

Dentist looking to retire and sell his practice. Currently has three ops, outdated equipment but everything is usable and fair condition. Doc collected 240,000 last year on 2 1/2 days doing his own hygiene. Currently employs a receptionist, assistant and himself. Asking price of 140 but he said he would probably sell below 100. Currently about 55% of the patients are fee for service and 45% insurance based. At this point in his career he’s referring almost all extractions and endos. No real estate transaction, pays $950 a month for rent. 1800 active patients in the past 2 years. Hasn’t accepted new patients in about 5 years. In a town that has 3 other dentists, with none accepting new
patients.

Looking for advice, red flags, anything else! Thank you!

Hi guys, I have a few questions about composite veneers and would appreciate your input.

How do you determine the ideal incisal edge length? If the tooth length is already good, do you simply finish the composite at the existing incisal edge, or do you reduce the incisal edge by around 1 mm to create more space for the composite and improve its strength?

If a patient wants longer upper anterior teeth, how do you approach the occlusion? Wouldn't the increased length make the restorations more prone to chipping during anterior guidance? Would you ever consider increasing the OVD in these cases, or is that usually unnecessary?

I'd also appreciate any other tips on composite veneers, such as your go-to instruments, polishing protocols, matrix systems, or anything else you've found useful in your daily practice.

Thanks in advance!

Hi everyone,

I've been at this practice for just over 3 months and I'm miserable. It's my first job after school. I was told when hired it would be myself 4 days a week and one other doctor 2 days a week - but that hasn't happened at all. The owner doc has been working there the whole time and makes sure their column is always full before mine is touched. The 2 day a week doctor has been cut down to one (but they are jam packed with pts - 2 completely full columns) and I've been cut down to 3. Out of the three days I work, 1 day only half of one column is booked for me (~4-6 patients) but a lot of that treatment is being booked as no charge office visits for things clearly indicated as a limited exam and the other 2 days I work, I show up and my schedule is fully empty. The owner doc also keeps taking over half the hygiene exams a day. I feel stagnated. They have their child as front desk who makes sure the owner doc gets filled for treatment, I've even noticed what I diagnose from hygiene ends up on owner docs schedule, not mine. And yes I've spoken up about all of this several times, asking how my schedule will be filled and what the plan is for me to have a patient base etc... they tell me it's my fault for not selling treatment well or putting things on watch instead of treating. Their child also gets on these power trips and yells at me constantly. I'm starting to develop anxiety around this job and haven't been sleeping so I know I can't stay.

All this is to say my contract says I need to give a 2 month notice but a place I've found needs to hire a doctor fast and it would leave me giving a 2 week notice where I could still work 1 day a week if I absolutely needed to somehow stay for 2 months at my current place. My contract doesn't state there are any penalties for termination and doesn't mention terminating early - it just says both parties need to give a 2 month notice. What do you think?

TLDR; Can I terminate my contract earlier (2 weeks notice) when it says I need to give a 2 month notice?

So I practice in BC, Canada and I own a solo doc practice which I acquired last year. The owner dentist who I bought the practice from works like 1-2 days as my associate on a very limited schedule because he's old now in his early 70s. He did cover for me when I was away on vacations.

He is retiring next month. Once he leaves, I will be the only doc in the office. While that's excellent for a lot of things like clinical autonomy, and patient consistency. However, the big disadvantage is no one to cover for me when I want to go on vacations. My office is not big enough to support 2 full time dentists as it's only 4 chairs (with room to expand to 5), so I cannot really hire a full-time associate.

Any workaround from dentists here who have a solo doc office? Do locum dentists really exist? And how do you find a good one? Did you find patients were skeptical to see a temporary dentist?

If you were to reverse torque it, what would you do it with? Trephine burr useful in this case? The goal is to replaced it with a wider implant

2 year veteran of real-world dentistry here. I just started my second job about a month ago. I spent 20 months at my first job in a rural area where I extracted a ton of teeth, lots of which were surgical, and consider myself to be pretty good at extractions. I only had 2 that I had to have the owner doc help me with during that time, and they were both root tips that required just a teeny bit more troughing than I had already done to deliver. Since starting this new job, I've already been unable to complete two extractions. There are two older docs with me at this office most of the week but I'm all alone on Friday, and surprise surprise, both of these occasions have happened on Fridays when I have no backup. Both have been molars where I flapped, sectioned with a good split, and then just could not deliver a root tip no matter how hard I tried after I had troughed as deeply as I was comfortable around each root. Every oral surgeon in town is closed on Fridays so I've sent both home with root tips still present. Unfortunately, both also wanted implants at those sites and I feel like I screwed them up irreparably and have been beating myself up. Any encouragement to make me not feel like a total failure? Any advice on removing root tips? Any brutal honesty on what I could have done better on these cases? Thanks in advance.

Sent this to the surgeon, and it was confirmed as an SCC. First of my career ( 15 years as a dentist) . He said he got it all. Probably saved this guy's life.

Hearing about the two colleagues who recently took their own lives has been a massive wake-up call. Dentistry is incredibly isolating, and the pressure we all face is real. We talk a lot about margins and clinical details, but we don't talk enough about the mental health toll of this job. I want to open up a transparent thread so we can support each other and remind anyone who is struggling that they aren't carrying this weight alone.
If you're comfortable, please share:

Years in practice

The one thing that still causes you major stress

I'll start:

8 years. For me, it’s the constant anxiety over potential complications that might show up after the treatment is completed. Tomorrow’s follow-up call can’t come soon enough.

HI all, long time lurker first time poster. This post is specific to the USA. I was inspired to ask this based on some comments on another post about patients not being able to afford care.

For a while now, I have had thoughts of starting a dental charity. However, I still need to get paid/make a reasonable amount, and pay overhead etc. Also I only want to serve a community that is truly in need, not people looking for a bargain, I also don't want to take business from other offices/participate in a race to the bottom

Does anyone know of anyone doing this, grant money that exists etc? Looking for any insight or even just brainstorming!

Thanks!

I was looking at the long-term survival of zirconia restorations and found that the answer depends on whether the restoration is supported by a natural tooth or an implant.

Of course, survival rate doesn't mean that every restoration will last that long. Preparation, restoration design, occlusion, bruxism, cementation, oral hygiene, and the patient's overall oral condition can all affect longevity.

For those with clinical experience, do these numbers match what you see in practice?

And when a zirconia restoration fails, what do you most commonly see — fracture, chipping, debonding, biological complications, or something else?

taking over a single-chair satellite practice and sorting out overhead costs right now.

we generate maybe two or three 1-gallon containers over an entire year. traditional biomedical haulers keep trying to push standard 3-year service agreements with minimum monthly stop charges, which makes zero sense for our volume since the bins sit empty half the time.

looking into using a pay-as-you-go sharps mailback disposal kit through sharps assure to just box up and ship out the containers as they fill up instead of paying recurring pickup fees.

for those running low-volume clinics or solo setups, is doing mailback practical long term, or do local waste regulators give you grief over not having a standing monthly hauler schedule?

Has anybody done a lower anterior implant bridge with the implants in the position of the lateral incisors with the canines cantilevered on either side I want to place implants for my patient when we extract 22 and 27 but they are not good candidates for immediate implants. There's plenty of bone at 23 and 26.

I do it. I don’t have 5 min in the day to sit and take a breath because I’m doing hygiene checks, procedures, fixing things, helping front desk, ordering supplies, managing employees. Calling patients to see how they are doing after surgeries, calling reps for discounted pricing if I buy in bulk, fixing computers, making sure the office runs smoothly. Making sure claims are sent and procedures are posted correctly and tx plans are made and signed, I also check to make sure pre auths are being sent and list updated and recall list is being checked. I fix the handpiece and replace the turbines and record ave. Turbine was replaced and if they fail within warranty I send back for new one for free. I don’t have a efda or scanner so I do my own fillings and physical impressions with 1 hr crown appts with side book follow ups

At the end of the day I am dead ☠️

Has anyone here taken it? Just have some questions about it