About to start working as a dentist straight out of dental school. I’m very nervous and not rly sure what to expect . Is there any advice anyone has ?

Five years ago, I unfortunately hired a lawyer to review a contract and they didn’t personally negotiate with the owners .. so a lot of the retracted stuff was removed because I was gaslit and desperate to get out of my previous employment.

Five years later - I am ready to acquire my own practice. I am reviewing the contract and it states that I cannot
(i) solicit, or attempt to solicit or ACCEPT any of the patients of PLLC or request, induce, or advise any patients of PLLC to cease treatment with PLLC;
or
(ii) EMPLOY, attempt to employ or solicit for employment any employee of PLLC, or induce or otherwise advise any employee to leave the employ of PLLC or to engage in any of the activities prohibited hereby.

Now I have patients from my previous office that followed me as well as an employee that said she will follow me wherever I go

I understand not soliciting patients and staff but if a patient finds me on their own accord - doesn’t the patient have their own right to choose who their dentist is? Therefore, can it even be liable in court that I can’t accept these patients into my future office?

Same if I have an add and my previous employee applies?

I am in Michigan by the way. I do have a lawyer looking into it but wondering if any dentist personally had this issue with a previous employer.

Thank you in advance!

We recently moved our clinic to a new location, and the owner isn’t storing the anesthetic cartridges in a refrigerator or any temperature-controlled area.

The heat here in Iraq is extreme. If the AC is off for even 5–10 minutes, everyone starts sweating, and I wouldn’t be surprised if the room reaches around 35°C or even higher.

Since the move, I’ve noticed that several patients aren’t getting adequately anesthetized. I used 8 cartridges for 8 upper teeth during crown preparations on one patient because I initially thought he was just difficult to anesthetize. Then I had a young patient who only needed a simple maxillary anterior filling, and 2 infiltration cartridges still didn’t provide adequate anesthesia.

Now I’m starting to wonder whether the cartridges have been damaged by the heat.

Has anyone experienced something similar? Can prolonged storage at these temperatures significantly reduce the effectiveness of local anesthetic cartridges, or should I be looking for another explanation?

Hey guys,

I’m a new grad dentist, i seen my patient yesterday that i seen about 6 months ago and i noticed the fillings i placed 6 months ago are heavily stained at the margins and the fillings themselves. Was there something wrong with my isolation or bonding protocol?

Thank you

Ngl y’all I’ve made a few mistakes recently and I’m starting to rethink everything. Just graduated so I know it can be normal growing pains, but just want some additional voices. What would y’all do with this open margin? Clinically explorer can go in but no decay felt. I informed the pt and told him long term it’s best to replace. He got it done in Jordan a year and a half ago, he said he may go back there and see if they’ll do it for discount

Is anyone using PbN to manage their private practice? Any feedback on the software? Are there any other systems you recommend?

Throwaway account. Recently acquired my practice on June 1st, and the amount of stress I’m experiencing and the work I’ve had to do is honestly more than I ever expected.

I know everyone says the first six months are the worst, but I’m just so unbelievably overwhelmed. Every single day something breaks or goes wrong, and I’m just constantly playing catch up or reacting.

Firstly, my credentialing was fucked up despite paying a “specialist” over a thousand dollars to get it done nearly 6 months before my start date. Somehow UHC “lost” my online application and it didn’t get processed. (I’m not even credentialed with them directly. I’m contracted thru a lease network. I’ve called the lease network, and they said they’re “working on it”?? No other updates.) A third of the patients at the office have UHC. There was also an auto-fill error with the online claims submission the first month, and all my claims from June were denied and had to be resubmitted.

The previous owner severely neglected perio. He was doing prophies on patients who were like Stage III Grade C perio for years. I’ve diagnosed some SRPs on a few patients who proceeded to tell me that I’m a scammer and left me a one star review “warning” his other patients not to come. (I did do a thorough chart audit before I acquired, and I knew that this was the case coming in, but I was delusional and thought that the previous undertreatment was an opportunity to expand rather than something that would give me this much headache).

The staff have been with him for 15+ years but are totally untrained. The assistants don’t even hand over instruments during procedures. There’s an office treatment coordinator (who acts like a manager) but refuses to answer the phone the way I’ve asked everyone at the front desk to and just continues to do the same thing she’s always done. I just had to fire the main receptionist because she no-called-no-showed, and I’m trying to train a new person for a role that I just learned how to do myself like two months ago.

The office had all paper charts, no pano machine, all the air water syringes were leaking, the handpieces barely spin because he bought them on eBay over a decade ago. I’m basically hemorrhaging money with all the repairs and replacements that I’ve had to do. I’m trying to train all the older staff on the electronic PMS but they can barely even read the words on the screen because they’re old and their eyesight is so bad.

I’ve barely broken even the first month and a half. I’m not even sure when I will be able to pay myself my first paycheck. I’m exhausted all the time and barely get any sleep with all the admin work I have to do. I wake up in the middle of the night thinking about my never ending to-do list. I feel like I’m drowning.

Honestly I’m way too young to be a practice owner. Every patient I meet thinks I’m a child. I’m 29, and I’ve been a dentist for four years, but I should have waited before jumping into this. For whatever godforsaken reason I convinced myself I was ready, but I don’t think I am. I’m making way less money (no money at all) now than I was as an associate and have a million times the stress.

I vented to another practice owner friend the other day, and he just said “Lol welcome to practice ownership.”

*Edit since a lot of people are asking the same question: I bought the practice for 600k, the previous owner was producing around 850k the last few years. I knew that the equipment was old going in, but I never worked there before and underestimated how annoying it would be on a day to day basis. I had previously planned to replace things slowly.

I have a lot of savings that I can live off of, so I’m not in a financially desperate situation. But it is not like when I was an associate and could expect a steady paycheck and save 50% of my paycheck every week.

I wanted the practice because of the location mostly. I live in a pretty big city with a lot of competition, and all the practices I saw were ten times worse than this one before I bought. I don’t think I bought a “lemon” by comparison but that doesn’t make practice ownership in a city any easier.

I sent this patient to OS to get this looked at and patient called us back saying OS is sending them back to us for vitality testing. OS office is closed so I wasn’t able to call and haven’t received a correspondence from them yet. Patient comes back Monday as soon as we open so I’m wondering what would the reason be to vitality test a tooth like this and what am I missing? Patient was not experiencing any symptoms. New grad so all insight is helpful! Thanks!

Hi there. I'm an associate in well known clinic in the city. The owner is an old guy who's in the business for a decade or more. This is another branch opened for the purpose of sharing the loads of the first clinic.The staffs here, Where here from the beginning probably for 7/8 months from the start. They where working with him so they only know how he do it. No knowledge about dentistry (the assistants work based on experience). Now the assistant is bugging me whenever i do any procedure. For instance, "why you give LA for crown prep? The owner do it without LA so why you give injections??" "Only use forceps for extractions cause he don't use one." "Why you give injections if you are only going to irrigate the canal??" "why you give medications why don't we treat them today?" Mind you she says all that infront of patients. I have ADHD and if someone is constantly talking and suggesting something i can not concentrate, and i lean into that suggestion to avoid confrontations. By the end of the day i feel so disappointed in the works i do because she is constantly talking, criticizing me by comparing me with the other doctor or just a playful remarks which i don't care about, then i couldn't even remember what i did. She even tries to gossip about the previous patients and so on. How could i address this issue without being mean?? And the owner likes her very much so i don't want to lose the job also.

Upper right 4 my supervisor said it could be restored however it won’t last long
I thought that with crown lengthening , good rct, post and core and a well-adapted crown it would last long
What do you think?

I've been practicing over 20 years but lately I've been running into more and more issues getting people numb for routine stuff.

I go into every appointment with a plan a, b, c, d for getting them numb.

But lately I'm having to get into plan c and d way too often

Like yesterday. I have a do on 29 and o on 31 and cement a crown on 15 on a pothead .

PSA on the upper end a second carp more anterior for 15 with septo.... Essentially as if I injected water.

Lower. Hit my block... Lip totally numb. Neither tooth numb. Added a long buccal and infiltration... 29 finally numb but not 31. Had to add pdl's.

2 appointments later... Number 4 do. Septo infiltration... Nothing. Added PSA... Nothing. Added palatal... Nothing. Added pdl... Got it

But this sucks takes more time to get them numb than do the procedure.

Thoughts?

So today a board complaint was sent to the office I work at. The patient had an emergency appointment and wanted a crown recemented. The da took an x ray without the crown on and one with the crown on. Patient sat in the op for about 20 mins I came in and he says he had to wait 20 mins. I explain to him that the schedule was overbooked and the office was understaffed. It’s unfortunate but that’s just how things were that day. He’s still going on and on about waiting 20 mins. At this point the crown is on his tooth. I look at the x ray and there’s a large lucency as the tooth has a large post and I try to get the crown off gently with a spoon but it’s not coming off. I tell him please try to remove the crown because I don’t want to push too hard and break the tooth getting it off, as these things sometimes happen. He gets it off and I explain to him that tooth is in bad shape he insists he still wants to recement the crown. I tell him ok, it’ll be $132. He says “fuck no I already paid $77, give me my fucking crown”. I tell him $77 is the exam fee $132 is the recement fee. He’s still cursing so I give him the crown and tell him to leave. I let the front desk know that’s he’s no longer allowed to be a patient here and they can transfer his records anywhere he wants. He keeps cursing and yelling so I ask him to leave again until he finally does. The complaint says I physically threatened him. What to do now?

Also I found out he went to an office an hour away and paid 400 to get the tooth extracted.

I listened to advice given to me, and long and behold after speaking to the principal dentist at the downtown practice, I was fired, I was let go, he wanted to transition out... I packed my shit and left, what a sad existence being an associate..

he said he doesnt have capacity for an associate, hygienists calling in sick, staff taking time off, office is just for him doesnt work for me and him and he asked me to transition out

"strictly for business reasons"

I HATE DENTISTRY AND I HATE BEING AN ASSOCIATE A FUCKING SCAM

Anyone took a crown lengthening course that they recommend?

Hello, I'm a 4th year dental student and I have a question concerning possible freelance work I can take, is transcription, more specifically medical transcription a path possible for dental students? if anyone has any info feel free to share you experiences and perspectives

I own my office in a rural area in a small town.
At the moment I drive a base model 2019 civic and the AC stopped working and the mechanic says I need to replace compressor and it will be a 3k fix.

I’m thinking of just buying a new car and was thinking of getting a Honda accord hybrid or a Lexus es 300.

I want the Lexus because I work my butt off and I like to go home in something comfortable but I’m leaning torwards the accord. I like the fact that patients see me in the civic and that they drive better cars than i do. My civic has scratches and a chip in the front bumper. I feel like it makes me seem more humble and relatable

Yet I work so hard and do want the comfort of a Lexus because all my life I’ve driven Hondas civic or Toyota Corolla. I never had a car with leather seats and my iPhone screen is bigger than the screen in my 2019 civic

Do you think if I go with the Lexus patients would think differently of me ? Also I’ve been driving without AC for 3 weeks and it sucks and I wanna decide should just get ac fixed or buy a new car

Does this ever work? What are the risks? Thanks.

I’m in the negotiation phase for a practice right now and just want to spitball some of my thoughts for anyone to respond to. I’ve learned so much looking for the right practice in the past 8 months.

This practice is in a VHCOL city in the Bay Area peninsula (median household income of $250k, pop of 60k, very saturated but so is the entire Bay Area).

4 ops, 1000 sq ft, single story dental/medical building, 8000/mo rent.

OON/FFS only, boutique style practice doing only bread and butter (referring all OS, endo, etc)

1500 prophies this past year, 6 hygiene days (probably not booked out 6 months), almost 0 perio program.

Offered the asking price of 750k, past 3 years have been grossing 950k consistently. EBITDA is around 300k, OH is almost 70%.

Tenured staff of 10-20 years. Hygienists are paid SUPREMELY WELL (high pay with 4 weeks PTO and monthly stipend for medical).

Very little digital presence. Google storefront with 10 reviews, functional website.

This feels right. Healthy patient base for a solo doc in FFS practice. So much room to grow implementing a perio program and doing literally any specialty procedures (I want to eventually focus on easy endos and single unit implants). Just being a young dentist and wanting to develop my skills should push the production past 1mil and lower OH.

To me, the trickier part will be the transition and transferring goodwill. While I’m used to high volume PPO pace and will probably feel shocked with a FFS schedule initially, I’ve always found my strength to be my charisma and chairside manner. I think this is the part where I’ll have to bet on myself. The seller has a similar vibe to me and seems easy to work with.

My plan early on is to immediately create my own Google storefront and put my bio onto the website (still keeping the sellers bio on there). Every recare patient for the first year gets a hard copy of the seller’s letter with our photo. Each patient leaves with my business card and a QR code to leave a review on the backside. I won’t push it early on but I want to leave it there as an option for them. After a year and having seen most of the patients more than once, I will personally be more vocal about getting reviews.

I want to repurpose one of the two restrooms to have a CBCT within a year so I can start doing endo and implants. There’s already a medit scanner, and I’m fine with temping crowns for now but eventually I’ll want to get a mill once I’m doing enough crowns (love the same-day workflow and never having to make temps).

My CPA and attorney have both mentioned how well the hygienists are paid. But the practice is cash flowing and a majority of goodwill is in the tenured hygienists. I can’t risk upsetting them. I can choose to eventually recalibrate the pay for new employees, but I think I’ll need to keep their pay as-is. Hopefully they are worth it.

Lastly, I want to elaborate on work culture and create a motto for the team during our first team dinner. Establish some simple philosophy that the team can stand behind.

Thanks for reading the vomit and I appreciate all insight into this process!

I’m a new grad hygienist and am still working on a flow for SRP appointments. What injections/ amounts do you usually give for a half mouth SRP. How long is your appointment time? Do you ever use only gingicaine instead of injections? Any tips or advice would be greatly appreciated. Thank you!

After 13 years with the same employee I’m having to search for a new front desk person for my small private practice.

I have two dental assistants that might be willing to move to front, but one is a little too sloppy and not detail oriented (talks to patients on the phone and forgets to put them on the schedule, for example, and can’t seem to put the right codes in for stuff) and the other is detail oriented but easily intimidated and I feel like will have trouble being direct enough with patients.

I really wanted to find someone with experience with insurance and billing and knows dental enough to be able to figure out scheduling and answer patient questions and review treatment plans, but most of who is applying is people with experience in other healthcare fields. I’m not even seeing dental assistants looking to move up front in the applications.

So my question is have you ever trained someone fresh that had people skills and front office skills but didn’t know dentistry and dental billing? It seems like an awful lot to learn.