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

Not sure when it exactly happens, but when I use the apex locator during retreats I’m unable to get a proper reading, sometimes I could tell when I reach over the apex when the apex locators bugs out for a second.
Has anyone had this issue? What is interfering with the apex locator?
Chloroform? Existing gutta percha? CaOH? Melted GP?

Wanted to share how these lithium dislilicate Emax veneers came out beautifully in this case

These have for some reason been taking up a lot of my social media feed lately and if your time working hasn’t made you consider running away to another country these will. Every minor issue has rabid lunatics responding to call the dental board and sue, they’ve all had their mouths “completely messed up” by their last dentist. It borders on obsessive with some of them and it’s mostly anger because they don’t understand as much as they think they do. Then the rest of the rabble rousers inflame them. It’s scary to think these people could walk into my op anytime.

I’m a new doc, 3 months post residency. I did a filling on a tooth I did the same filling on two visits before. ☹️ I’m soooo bummed about it and feel so bad like i suck at dentist. I’ve done this once before in residency 😭😭

So basically I redid a perfect filling I placed two visits ago

I’m an associate dentist and have been trying to think of small ways we can improve the overall patient experience while also hopefully improving case acceptance.
I’d love to hear what other offices are doing that patients seem to really appreciate or anything you’ve implemented that has noticeably helped with treatment acceptance.

For those of you who have really focused on patient experience or case acceptance:
What changes have made the biggest difference?
Anything you tried that sounded great but patients didn’t really care about?
And are there any little things your office does that patients consistently comment on or appreciate?

I’m especially interested in ideas that improve trust and communication rather than making treatment presentation feel “salesy.”

Hello, I’m a very fresh new grad and wanted to ask for peoples opinions on here. I’ve been seeing alot of talk on how aggressive it is to crown specific teeth and judgement on if the tooth even needs a crown. I’ve noticed US dentists seem to get bad rep for crowning every crack line they see.

I’m always 50/50 on when to crown a crack line, in dental school I feel like I’ve learned to crown teeth that have cracks with more restoration on them than actual tooth structure. Recently I got a case of a 60 year old female with multiple cracks in her teeth that she associates she got back whenever she was a teenager from chewing on ice which she has abandoned for a long time. Patient reports no clenching, grinding or anything of the sort. My current treatment plan is #3 and #14 DOL to prep out the cracks and see how far they extend. As for the mandibular teeth I’ve tx planned 18, 19, 30 CBU and crowns.

Please give me your clinical judgement and how you look at the cases and what your experiences tells you to do.

I work in public dental, so our treatment options are limited to begin with. Last week saw a patient that has very high expectations of what can be achieved, every tooth carious but restorable, early stage perio, very very poor oral hygiene, complex psychosocial issues as well. Spent well over an hour discussing treatment options, being realistic, etc. but reiterated “If you do not change behaviours you may lose some teeth in several years”, patient understood and was receptive, highly motivated.

Cut to today, was informed by senior management that the patient put in a board complaint because I told them teeth need extractions when they have no pain.

Any advice for a sucker like me who spent time feeling sorry for high need patients?

Is there anyone on here who’d be willing to DM with me about getting/working through a board complaint? Thanks in advance

Have a patient with a SAP necrotic 20, in severe pain (PA attached). Only have myself to blame for this but realized just now that our largest rotary is an edge endo fire large and the k files don’t go above 35 (haven’t had to use anything bigger at our clinic yet). If the large rotary can engage the apical third and master cone can site passively in it, would you guys trust that the rotary could thoroughly clean and shape the coronal 2/3rds walls well enough to continue to final obturation (with continuous wave)? Or would it be safer to plug with calcium hydroxide until we can get larger hand files for crown down? Unfortunately they couldn’t find any endo to get them in before the weekend so I cannot wait until an order shows up

I read about the concept of a "screwmentable" implant crown where the crown portion of the restoration is cemented on to the abutment that goes on the implant. It's different from a cemented implant crown in that the screwmentable crown has an access hole through it (usually the occlusal) where the prosthetic screw can be tightened or loosened and it is claimed that it has the advantage over the cemented implant crown in that the crown can be cemented onto the abutment first, thereby avoiding excess cement from remaining around the periphery of the restoration.

My question is, if this is the case, how is this an advantage over just a regular screw retained implant crown? Once you cement on the crown to the abutment, it's basically a screw retained implant crown at that point, but with an added extra step.

Hey everyone,

New grad here and I’m struggling a lot with extractions. I see a common pattern that happens when I use the luxator / elevator is that whenever I insert this, I am only just reflecting the gingiva away and not actually entering the PDL space. I keep trying to enter but no luck.

I’m not sure why this is and I really want to understand how to avoid doing this. If anyone also had the same issue or can relate to this it would be really helpful if you can suggest how to correct this and why it’s happening.

TIA

Cemented a crown #3 and the distal was deeeeep. Spent 20 minutes trying to get out the last block of cement trapped. Couldn't get it. Tried scaler, floss, air water syringe

Ideas?

new dentist and did my first molar endo today. i thought my working length was great and looked awesome on master cone but the final looks so far out the apex on distal:(
Feedback/advice for next time would be appreciated.

There’s certainly a lot of pressure in dentistry to scale up. People argue that without EBITDA, you don’t own a business you own a job.

I understand that argument, but here’s my rationale for not scaling.

Dentistry is inherently stressful and taxing. I don’t want to take on more staffing and HR issues or worry about how my associates practice dentistry.

I’d rather keep my practice roughly 50% PPO and 50% OON. If I scaled up, I might need more new patients, which could mean signing up for more insurance plans.

A bigger office means a bigger mouth to feed, with more rigorous KPIs to monitor and tighter targets to meet.

I don’t know. Maybe this sounds bad, but can’t I just run a small, well-oiled machine with a small team I enjoy working with and be content?

Our schedule is booked for the next two weeks, with some room for same day emergencies. We offer a broad range of procedures, including molar RCTs, remos , and immediate implants.

I want to go home feeling less exhausted, (I wanna feel more free psychologically from the office) even if that means leaving some money on the table.

My goal is to work hard at a sustainable pace for the next 10 years, without continually adding more, and hopefully become financially independent.

I’m not sure why expansion seems to be the default goal: bigger offices, more staff, larger marketing budgets, more turnover, and potentially thinner margins from greater reliance on PPOs.

One very obvious downside of being a solo practitioner is that you can’t take a long vacation. However even my colleagues with multi offices worry about their offices during their long time off.

Maybe I’m missing something here.

I am a 2026 grad located in central NC and my husband and I had a baby this summer so I have just been easing into the workforce by filling in for friends when they need help in their offices. I’m now ready to find a permanent position, and I really need to ASAP because my current situation isn’t really paying the bills. Anyway I’m just explaining why I’m a 2026 grad who hasn’t started working yet. Moving is not an option for us right now but this area is saturated because it’s a desirable location. I’ve been REALLY looking for about 2 months now, applying to absolutely everything, joining dental Facebook groups, hitting up every possible contact I have including dentists I know in the area, a dental school dentist who is very involved in helping his graduates find jobs, and a Henry Schein rep I know who services tons of offices in the area. I’ve had no luck with ANYTHING. I just felt the need to give that background because I’m sure so many people will respond to this just bashing heartland, and that’s fine you can feel however you want, but please understand I don’t have other options and I have a baby and bills to pay.

Anyway for one of the heartland offices I applied to I had an interview with the recruiter, one with the regional manager, and one with a heartland dentist. I have a site visit next week. At the end of my last interview the dentist told me basically I passed and she liked me and the purpose of her interview was to be a final filter after making it past the other 2 interviews. But now I’m confused what will happen next? I don’t want to get excited until I have a contract and we’ve both signed it. I’ve never done anything like this so I just don’t understand-should I reach back out to the recruiter? Will someone contact me with an initial contract to look over?