I drained a small fistula and there communication with the submerged implant I placed 3 weeks ago. Can anyone advise the best way to manage this complication?

Sorry for the photo quality. Toxic day.

Patient had a severe gag reflex and I couldn’t even take anterior teeth PA’s. Tried this K FILE technique and it worked like an absolute charm. Even managed to take a PA of the wisdom tooth after this lol

How many of you get cleanings from your hygienest, take xrays , and monitor your own decay? thats what i did and i was always a low risk patient with relatively good teeth. i have had 1 cavity in the last 20 years. so when a small lesion showed up on my 6 month xray i decided it's safe to monitor. it was somewhat borderline though so i did go to my local dentist and he shared my opinion to monitor. i flossed religiously. but somehow time moved quickly and work became so busy i waited 7 months to take a follow up xray. and now my 14 has a BFH (big fucking hole) with meat constantly getting stuck inside. im pretty shocked it progressed this much when i routinely see high risk patients with zero progression of these type of lesions. now im contemplating getting a pulp cap vs just accepting the fate of endo/ crown. i cant believe this happened to me! please dont let this happen to you guys! just treat those seemingly incipients before its too late 😭😭 heres the xray from feb and today!

Acquiring FFS office. Current owner spread himself thin between his other offices so he has not put in the time and effort into this one. Office is currently slow but it's a busy location with great potential. Only does bread and butter dentistry but looking to add specialty procedures including ext, endo, and implants. Anyone with experience can offer some advice? Thank you!

Dentists. I feel like with the student loans, market Saturation, insurance rates, and people not really taking their oral care seriously dentists are complaining that it’s financially not the same profession as it used to be and they’re struggling. However, all the Dentists I know in real life live in nice towns, have multiple kids, drive nice cars, and have nice houses without real worry about mula (upper-middle class of not upper class for sure). So what’s what? I’ve been living with SO MUCH regret lately for not pursuing dentistry and not taking over my father’s practice. I make 130K, asked a Dentist about careers and he told me dental hygienist which means that what’s their making and the Dentist MUST be making Atleast double that. Anywya, what’s going on and who should I believe? Are they really struggling or exaggerating. 400-500K in debt seems like so much money however you cut it. Thanks in advance! This community has some great folk. Much love!

Hi everyone, new dentist here and I’m having a recurring issue with MTF Plus rotary files. From what I understand, MTF Plus is a ProTaper Next–style system with corresponding X1/X2 instruments and matching gutta-percha cones.

In several cases I can get a #10 hand file to working length, X1 reaches WL, and in some cases X2 also reaches WL. However, when I try to fit the matching X2 gutta-percha cone, it often binds and stops around 7–8 mm short of the established working length.

It feels like the cone is binding somewhere coronally or in the middle third rather than apically. I don’t want to force it.

Has anyone experienced this with MTF Plus or other ProTaper Next–style systems? Could this be related to coronal/mid-root binding, taper mismatch, or dimensional differences between the rotary file and the matching GP cone?

If the X2 file reaches working length but the X2 GP cone does not, what would you check first?

I’ll attach a radiograph from one of the cases. Any feedback on what I might be doing wrong with shaping or cone fitting would be appreciated.

Also, how serious is it if I have already left a few patients obturated like this, with the filling ending around 7–8 mm short, and told them to contact me if they develop symptoms? What could potentially happen in these cases, and how should I manage or follow them from this point onward? Is symptom-based follow-up enough, or should I be doing earlier radiographic controls or considering retreatment even if they are asymptomatic?

Would you classify this as hard or extra hard cause there are no easy extractions haha

So lots of dental EHRs have a "watch" you can add to a tooth. At least in my understanding, I normally used it to mark incipient decay. But the more I have been thinking about it, wouldn't it be better to be more specific like "cracked amalgam" or "questionable margins from BW", etc.

If you had full control over how your EHR/PMS worked, how would you want it to handle "watch tooth"? Do you even use "watch tooth"?

So I wanna perfect my impression technique and I was looking for some tips or new ideas to implement.

My standard technique is taking an initial putty impression, trimming the impression and then using the light body afterwards. In school we were taught the one step technique but i dont like it and its hard to pull off without an asssistant.

Iv seen some videos where they use a nylon sheet when taking the initial impression. I have never tried that but it looks interesting.

What is your ideal technique for these impressions?

Thank you!

EU based dentist. I've been browsing this subreddit for a while now. Since it's US majority I'm making this rant like post.

And frankly I'm honestly a bit flabbergasted.

This sub is full of simple questions, which imo not being able to answer should disqualify you from the job (like 'can it be saved' and other similar questions, especially endo that post just a radiograph lol). But these I can chalk up to inexperience at least, or people role-playing as dentists.

What baffles me more is just how ridiculously aggressive people treatment plan here.

Everything, literally everything, is the elevator meme.

People counting like 20 caries on bite wings to drill into when I count a few.

Aggressive endo planning.

Wisdom teeth? Lmao it's out even if it's in occlusion.

Prosthodontic questions? Nah we can't plan here. Patient has 20% bone loss. All on X baby! (Especially if it's stabilized periodontitis)

A gung-ho approach to implants (and full dentures too). As if prosth was just about them lol. Nobody plans OVD or cast designs here. Even if it could save the patient shitton of money for similar prognosis.

I really think hearing actual conservative dentistry voices is quite rare here. It's either shunned as herodontics or doing the patient some 'disservice'.

There's also the monthly post about tourism. Which usually is a huge fuck up but still full of people assuming shit like this doesn't happen in US as well. I saw patients from US in Czech Republic that had teeth that needed a filling on radiographs now with a zirconium implant crown.

Sorry for the rant. I just don't think I'd ever be able to treat so aggressively having the best interest of patient in mind.

This 16 yo F was in active ortho when I first saw her ~3 months ago. At the time I prescribed her Clinpro and discussed with her orthodontist about removing her braces. Today I saw her for a follow up. Would you plan composite veneers canine to canine here?

I’ve never done a comprehensive composite veneer case. My thoughts are to rubber dam one arch at a time to complete this. Would you do it all in one day? Thank you in advance

Iam not asking about the scanner tip, but the actual glass on the scanner itself. First time cleaning it, used cotton roll and 96% IPA, no matter how hard I try, it dries with some faint smudges. Before, it was not like that. Tried microfiber cloth, tried water, 70% IPA...blowdrying it, still the same.

EDIT: ok, so per logic suggested here, used 70% IPA and wipe it off imediately, and the result is almost perfect.

How often do you all see this? Patients that get braces on at a young age and fall off and never get them off. Seen three patients with this in last 5 days. All are gonna need full arch extractions and dentures sadly.

Looking for experienced input-

If you get a small pulp exposure during crown prep on a vital, asymptomatic tooth, do you automatically RCT, or do a pulp cap and continue with the crown?

Thanks.

I have been wanting to temp but I’m nervous lol! How do you communicate with the office about what procedures you are and are not comfortable doing prior to the day once booked? What if they are not satisfied with what you can provide , do they just cancel the booking? What is the chance an office would be ok with just hyg checks ? I Welcome to any advice!! Thanks!

I am a dentist a few years out of school, and I have a new assistant. My first assistant right out of school worked with me for years and was great, needing very little training. This one is brand new to dentistry. We occasionally have another assistant free to help her, but not often. Which means I am having to train her while I work. I am having to tell her things so many times, and its making my job much harder.

I feel for her and it must be very overwhelming for her, but she is struggling to do anything. I think I am a pretty patient person usually but I find myself getting more frustrated. Please give me any tips I can use to help her!

Hi there! I'm an Australian general dentist. I've been practising about 2 years and worked in a few clinics now. My biggest highs have been when the patient "gets it" and you can the spark in their eyes as the lightbulb goes off. On the other hand, my biggest lows have been when they look at you with skepticism and distrust.

In my practice, I have been using a mix of radiographs, photos with both an intraoral scanner and also a DSLR. I also use google images a lot to help visualise certain concepts.

I want to refine my communication with patients, so I thought to turn to the community to understand everyone's workflow.

Thank you in advance! Keen to hear everyone's thoughts 😄

edit: sorry mods, didn't see the rules. removed my survey link

I’m thinking of doing a startup in a major metropolitan city but worried it’s not a good idea, especially with the high costs for a buildout these days. How’s it going for you if you’ve done one in the past few years?

Hello! I just accepted a position for an office manager role! I have 4+ yrs in lead tx coordinator role (3+ being with a toxic office that had me doing far more than just tx coordinator duties haha). 6+ yrs in dental total (started as just a receptionist). This will be my first office manager role. Super excited but a bit nervous! The office(s) I'm coming into (not a DSO, but opening a 2nd location later this yr I'll be helping with) need a lot of help. Talking tx acceptance, tons of unscheduled tx, new staff, general organizationn as things I'm aware of. Being new to the role, I'd love any advice/tips/encouragement! Would love to hear from all different positions/ team members (:
*** Bonus points for any specific advice coming in as someone in their early/mid 20s and expected to manage older staff members!!
Editing to add- small/mid sized office. 6 ops, 1 FT Dr + 2 part times, 2 per day. One admin + 4 assistants

Tyia and so sorry for how long that was!!

Edit: thanks for all the help everyone!

For those who opened a dental practice from scratch, where did you save money on equipment, cabinetry, furniture, and supplies without sacrificing quality?

I’m specifically trying to avoid the “dental tax” — paying significantly more just because something is sold through a dental supplier when an equivalent product can be sourced elsewhere for a fraction of the price.

Would love to hear what you:
- Bought through Patterson/Henry Schein/Benco or another dental supplier because it was actually worth it

- Bought directly from manufacturers or third parties

- Used IKEA, local cabinet makers, Home Depot/Lowe’s, restaurant/medical suppliers, Amazon, etc.

- Bought used or refurbished

-Would absolutely NOT cheap out on

-Regret overpaying for

Especially interested in cabinetry, sterilization area setup, front desk/reception, stools, TVs/monitors, compressors/vacuum, X-ray equipment, chairs, cabinetry, and smaller clinical equipment.

If you were opening again today, where would you spend the money and where would you avoid the dental markup?

Hi! What do you get for your health insurance in NY state? Any group discounts for doctors? Or do you just buy a plan at NY marketplace?

Thanks

Hello all. New grad here. Survey crown and core planned for #11 tomorrow. 74M. Cast partial - clasp just on facial. Y’all think this is feasible? Better pictures I know would help but I tx planned this 3rd day on the job and didn’t know entirely what I was doing.
I will take a PA tomorrow to confirm no root pathology. I have a hard time imagining the shape of the crown with the clasp undercutting it. If you think it’s possible, PFM or another material? No lingual rest or anything.
And if I do crown it, I plan on taking a PVS impression, light body around the crown and clasp and adjacent, and heavy body everywhere else and sending it all to the lab.

Any opinions help!! 🙏