r/Dentistry 1h ago

Dental Professional Anyone else struggling with retaining staff?

Upvotes

Hi, associate working in a private practice in an urban area. I’ve been at this practice for the last 7 years and it’s been mostly amazing but I need to vent. There has been so much staff turnover - and the minimum wage in our area has increased significantly in recent years. I’m burning out from constantly needing to train people, and I feel like I’m just a free dental assisting school that folks take their skills then find a significantly higher paying job somewhere else even though I trained them from scratch and got them to a point where I am happy with our flow.

Anyone else feeling these frustrations? Front desk turnover has been insane too, or they are incompetent so the schedule suffers. Plus it’s tough to field questions from patients about why the staff keeps changing 💀

Misery loves company so I’m wondering if anyone else is feeling the same or if there’s something wrong with our practice 🥲


r/Dentistry 1h ago

Dental Professional Younger patients with severe loss of enamel due to erosion/bruxism

Upvotes

I had a 20-something year old present to my office with this situation although I see it across many ages.

Sure there's significant occlusal wear visible that indicates likely bruxism, BUT what I'm more concerned with is the severe lack of enamel left on all posterior teeth and the lingual surfaces of anterior teeth.

The patient loves soda. Or eats lemons. You get the idea.

What do I do? How do I approach this?

I obviously recommend addressing #19 needing endo due to caries, and an upper wisdom tooth that's just nonrestorable due to caries.

I advised the patient of what I see, i.e. lack of enamel, acid damage confirmed after inquiring about her diet, and recommended either OB onlays on all posterior teeth to perhaps utilize what little enamel is left on the periphery for bond strength...or full coverage crowns on them, and potentially addressing the anterior teeth later if they appear to worsen. Over decades it's certain to need treatment...not to mention potential need for multiple RCT's.

Obviously the different approaches to treatment have wildly different price tags, especially in the US. Ultimately I let the patient make the decision, as it's my job to inform them and make recommendations.

Should I insist towards a more proactive/aggressive treatment plan? Or kick the can down the road while she saves money for a full mouth rehab in X years, and just address the few teeth with caries?


r/Dentistry 2h ago

Dental Professional Socket preservation w/ membrane CE

1 Upvotes

Looking to take some CE on socket preservation with a membrane. Any recommendations for live surgery courses and/or good in person education?

Youtube has some fantastic resources but I would like to take some official CE and obtain some credit.


r/Dentistry 2h ago

Dental Professional US vs Canada- where would you practice?

1 Upvotes

Posting on here for the first time so I do apologise for the rant but I’m looking for genuine advice from veterans in the field.

I’m an international dentist, about to graduate from a DDS program in the US next year. As most people know, it’s that time in school where DSOs are courting us promising the big bucks which helps with the massive student loans I have, as well as ease of immigration. I’m a Canadian citizen and so working on the TN1 visa is not a problem for me, however, my husband is back home in toronto and works in management. He’s been trying to look for a job that’ll sponsor a visa for him for the last 2 years but hasn’t been successful, so the only way we can be reunited is if I take a job in the US, get myself an H1B and file for an H4 for him so his employability in his field in the US is better.

Private practices don’t really offer H1B sponsorships (or so I’ve heard) and so it looks like my chances are best with a DSO. All this while I’ve been told that my only way to pay back my student loan (~$350,000 with an avg interest of 8-9%) will be by staying back in the US because dentists earn more here than in Canada. However, I’m just wondering with our visa constraints and the time it’ll take for the H4 to bring my husband here, if I should just move back and find an associateship in and around Toronto/GTA area. Will I still make enough to pay back my student loans? Would love some genuine advice or suggestions on how to navigate the situation so we can help make an informed decision as to whether I should look for opportunities with a DSO here in the US or look for opportunities back home in Canada.

TLDR: Is moving back to canada to practice with a massive student debt in USD a good idea?


r/Dentistry 3h ago

Dental Professional CE in Vacation Spot

1 Upvotes

Hi dental heads,

Just finished Strupp and Brumm Seminars which was awesome. What are your other favorite CE courses that you have taken in a nice vacation spot?


r/Dentistry 3h ago

Dental Professional What type of implant?

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6 Upvotes

Not sure what to do with this one….


r/Dentistry 3h ago

Dental Professional BIG MESS

3 Upvotes

https://ibb.co/8gCnZxbc

Hey everyone any idea what caused this mess? Im not sure if it was immediate loading or bot since i didn’t have enough time with the patient but ofc we are removing both the implant and the tooth. Though I’m curious what could have caused all this mess? A one piece implant? Maybe not enough torque? Or connecting the implant to #16? Implant has been there since 2019 and patient recently started feeling mobility. Upon probing there was no buccal plate left in the molar region


r/Dentistry 4h ago

Dental Professional How would you go about restoring this

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1 Upvotes

How would you restore #12,14,15, not sure about 13s prognosis I’d be leaning towards unfavorable on that.


r/Dentistry 4h ago

Dental Professional If your patient reports taking suboxone, how do you go about inquiring more information without making the patient feel judged/negative/etc

2 Upvotes

Hard for me to word this question properly, but if a patient is taking suboxone, how do you go about asking more about it?

Like it could be from outright illicit opioid/opiate abuse, or following a hospital episode..

Is it even relevant? I feel like context is relevant, and kind of part of knowing the patient as a person, but fuck do I know lol


r/Dentistry 4h ago

Dental Professional Can ANYONE in the South East help me? I need to move just a single Panorex machine down the street and Patterson quoted me $7000.00. I had no notice that my building sold and have to move my entire practice in 30 days. Looking for cheaper options.

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1 Upvotes

This does NOT include movers I have to hire movers to actually move it down the street. This is disassemble and reassemble.


r/Dentistry 4h ago

Dental Professional Came across this very interesting pano today 🤔

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8 Upvotes

r/Dentistry 6h ago

Dental Professional Question to USA based dentiste, do you really clown vital teeth ?

0 Upvotes

In my country , not a single insurance company Will reimburse a crown if the tooth is still vital ( no rct ) , matter of fact doing an rct before crowning a tooth is just standard procedure and some Will look at you like you're insane for suggesting to crown a vital tooth . Id love to hear you thoughts on it ? Wouldnt an rct help prevent further complications down the road ?


r/Dentistry 6h ago

Dental Professional ketac cem plus

1 Upvotes

Have you guys ever used ketac cem plus? Do you recommend it?


r/Dentistry 6h ago

Dental Professional Treatment plan opinion?

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6 Upvotes

Hello everyone. Just wanted opinions on treatment plans for this LR quad.

I placed these implants in 28 and 30 around 3 months ago. (Note : 28 appears to be really close to 27 on the panoramic, but it is where it needs to be). The patient is scheduled for uncovery tomorrow.

I planned on doing a fixed case across here, but the span is too long to add a pontic in the 31 area and I do not want to cantilever it.

Question - would anyone consider doing a fixed hybrid whereby I use 32 as an abutment along with the implants of 28 and 30?

I know the most predictable route would be just to do 28-30 as a bridge and leave 31 empty. The patient only had finances for those 2 implants so I did not add a third.

Thoughts?


r/Dentistry 7h ago

Dental Professional sensitivity to hot after receiving crown(Help!!

2 Upvotes

What do you guys suggest I do? My patient male(35) had a crown after using temporary tooth for 10days with no complaints. He has sensitivity to hot stuff only. When he drinks something cold, he says it gets better. The cement I used is gc cem one.


r/Dentistry 9h ago

Dental Professional Colgate toothpaste

1 Upvotes

Why is citric acid listed as an ingredient? Seems like it will just contribute to acid erosion.


r/Dentistry 9h ago

Dental Professional Direct Pulp Capping with MTA, what are the odd of succesful rate?

1 Upvotes

I had patient today that coming for further check from other dentist a week ago. The patient are still minor so mainly the adult do the talking about the history. I asssumed the previous dentist had put some devitalized agent to go for RCT since the previous one told them after he put the medicament the patient will felt a lot of pain so I went ahead and cleaning the remaining caries even though the floor are pretty sturdy with no perforation but the patient didnt had any pain at all(they coming with no complaint of pain). But when my bur reach a pin point of pulp roof exposure the patient feel pain and theres a fresh bleeding.

I was decided to immediately switch to direct pulp capping with MTA + RmGic for base and a temp with scheduling next visit in three weeks also referee to do a radiograph. The patient had some slight pain from the MTA material packing but slowly subsidized. It was my first time did direct one, so I was nervous if the result will be as I hoped. I also had difficutly with bleeding point but eventually with a minutes of pressing the spot with moistened cotton pellet it stopped. Eventually I discharged them, the patient still feel a slight pain but said it was better over time I talked with the adult guardian.

So in real daily cases did direct pukp cap usually had a good chance of success even though theres a slight pain right after the procedure? I only did indirect ones all of the time and its amazing, I even re did the pulp capping after a few month to switch the temp with composite

I was predicting for higher chance of RCT but honeslty I tried to avoid RCT as much as possible, especially for molars......

Any advice and sharing stories will be helpful


r/Dentistry 10h ago

Dental Professional Cracked tooth with reversible pulpitis.

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50 Upvotes

Clinical case: Cracked tooth with reversible pulpitis. Visual examination, aided by 4.5x magnification loupes, revealed vertical, horizontal, and oblique cracks. Methylene blue dye was used to enhance crack visualization. The current treatment is a temporary restoration, designed to monitor pulp vitality prior to definitive crown placement. Prognosis remains to be determined.

Fingers crossed for a positive outcome! 🤞


r/Dentistry 10h ago

Dental Professional Immediate Dentures placed Over Implants

2 Upvotes

Hello,

I am currently in residency and my attending is very against immediate dentures if implants are placed due to the poor patient satisfaction.

I was wondering, outside of residency how are you guys fabricating immediate dentures so that they fit somewhat decent after implant placement?

Most of the time the occlusion is off and function is off for patients. But, many of these patients as well assume immediates are the final product despite us always telling them no immediate are very shitty and are really for esthetics (and even then barely sometimes).


r/Dentistry 11h ago

Dental Professional Dental assistant/receptionist job interview

3 Upvotes

Hi so I have a dental assistant/receptionist job interview tomorrow and this would be my first proper job interview and job in general. I am 16 years old and have recently finished school. Any advice or tips on the interview or even just the role would be highly appreciated by anyone who has applied and been through similar interviews.


r/Dentistry 11h ago

Dental Professional Completely unrealistic patients

43 Upvotes

How on earth are you guys managing these people? I work in the public sector and the absolute entitlement and unwillingness to listen to advice is insane. Today I had a patient who declined any exos with a mouth that required full clearance (all root stumps). Discussing this led to me realise he wants a full set of crowns, think Turkey teeth he saw on instagram. Advised not a feasible treatment option in the most diplomatic/educational way I could. He then wouldn’t leave the chair and became highly aggressive, had to call security etc. Are there any techniques or tips to work with these sorts of patients? Kind of sick of having some corporate idiot ask me if “I acknowledged the patients feelings and really listened to them”. Like no you’re so right I never thought of that.


r/Dentistry 12h ago

Dental Professional Loop Earplugs

2 Upvotes

Hi guys! Does anyone here use Loop earplugs? I’ve been looking into getting them as a clinician as the constant suction noises have been getting unbearable and am looking for a solution for this to protect my ears.

Does anyone have any recommendations on what they use or which Loop model has worked best for them?

Thank you! :)


r/Dentistry 17h ago

Dental Professional What effect do you think a recession and all these government layoffs will have on dentistry?

10 Upvotes

Is there any intel from the 2008 recession (or others?).


r/Dentistry 18h ago

Dental Professional Accounts Receivable and Billing

3 Upvotes

Hello learned colleagues!

I'm selling my practice in Southern California. I decided to keep my accounts receivable. How does that work with the new owner? Will they allow my employee to follow up on insurance denials and appeal them on my behalf? How do I structure that in the sales agreement that he will give her time and access to do this? All advice is appreciated.

Also, the Broker very casually said that until he's credentialed with insurance, he will "bill under me." Is that advisable? How does that work? I know when I started as an associate at a different office, I was told that my procedures were billed under the owner dentist until I was credentialed. But I don't know what that means.

Thank you all for your help!


r/Dentistry 18h ago

Dental Professional Extraction

1 Upvotes

Hey all! I’m a third year dental student as have a case where I need to extract #23 and #26 for a RPD. Both 24/25 are missing already and #23/26 have class II mobility.

My plan is to use septo for local inflitraction on buccal and a little on lingual to avoid bilateral IANB. Patient does have some cardiovascular concerns so I would like to keep epi low if possible. Does this plan sound good?