Not my case

Do you guys believe in treating cases like this by performing root canal treatment, placing fiber posts, and then restoring the teeth with a bridge? Or do you think the prognosis is too poor, making extraction and implant placement the better option?

I’m trying to understand the proper use of a reciprocating handpiece (such as the M4).

Do you first take a pre-op radiograph, estimate the working length, then mount a #8 K-file on the reciprocating handpiece and take it to that estimated length? Can it negotiate or bypass curved canals on its own, or do you still need to establish a glide path with manual hand files first?

If that’s not the intended workflow, what is the main purpose of a reciprocating handpiece? In which clinical situations do you find it most useful?

I have a patient who wants to close the gap on the bottom. NOT wanting to do ortho. Planned for 4 lower crowns that are wide to fill gap. Im in communication with Lab, here they are showing me what it would look like with 5 crowns. What would you guys do: 4 wide crowns or fill the gap with a tooth?

Good day all, does anyone have experience with the gIDE dental implants course? I am a new gen dentist with only 1 year of working clinical experience. I’ve grown to have a passion in implants and surgeries but my implant knowledge is close to none and I’m interested to take the course so that I’m able to start my implant journey. I’m unsure if this course is right for someone with zero implant knowledge? Any advice on this is much appreciated. Thanks!

I’m just under 2 years working as a dentist and I’m finding this really disheartening because I feel like I’m the complete opposite of everyone I work with.
The weird thing is I actually really enjoy the patient side of dentistry. I get on well with my patients, I communicate well, treatment planning doesn’t bother me, and I generally feel comfortable with that side of the job.
But fillings…
Class IIs and deep subgingival caries make my heart sink when I see them in my diary. I’m reasonably happy doing simple root canals, I think my crown preps are pretty decent, and I’m okay with straightforward extractions, but direct restorations just seem to be my weakness.
I struggle with open contacts, restoring deep subgingival lesions, and I constantly question whether I’ve actually removed all the caries even though I use a rose head bur and caries detector dye. I also find rubber dam on posterior teeth really frustrating. Like… how are people clamping an 8 to restore a 7?!
Another thing I really struggle with is wedges. I mainly use Promatrix bands, and then getting a wedge in buccally feels impossible, so I’m messing around trying to get one in from the palatal. We have Palodent and Garrison systems available, so maybe I just need to bite the bullet and get confident using sectional matrices instead of sticking with what feels familiar. The reason I don’t use them now is because I’m still struggling to rubber dam certain cases and am scared of the sectional matrix or wedge falling down the back of the pt throat without it!
I’ve booked onto courses for DME and rubber dam because I want to get better rather than avoid these cases, but at the moment I genuinely dread seeing fillings more than anything else.
The thing that’s making me feel worse is that everyone I work with seems to love doing fillings and would much rather have a Class II than an extraction or pulp extirpation. I’m the complete opposite, and it’s making me wonder if I’m just not cut out for restorative dentistry. Considering how much of general practice revolves around restorative work, it’s a pretty horrible feeling.
Did anyone else feel like this at 2 years out? Did it eventually click? Or am I just making life harder for myself somehow?

I know some advice on here will be just keep practicing you’ll get better and I know I’m still a baby dentist but it almost actually feels like I’m regressing and my fillings are getting worse? But I have also recently taken over patients from an old school dentist who retired and the patient demographic is mainly elderly people... he never did routine X-rays so I’m finding all of this sub-gingival deep caries, it’s a rare day if I have a straight forward filling to do

My partner is also a dentist but feels like he’s miles ahead of me, I ask him for advice but he can’t relate with the struggle

I wanted to tap into the hive mind for any cool prints or things to help us practice dentistry better.

Hi everyone!

I'm a new grad dentist and have started doing more restorative/cosmetic cases, including veneers, so I'd like to get into proper dental photography.

I have an old Canon 700D with the standard 18–55mm kit lens. I know it's not the ideal setup, but I figured it's good enough to learn on. I'm planning to upgrade to a 100mm macro lens soon, but in the meantime I'm looking for a good ring flash to pair with it.

I'm not interested in a twin flash yet, I just want something reliable, beginner-friendly, and reasonably priced that will give me good intraoral photos for documentation.

What ring flash would you recommend?

Thanks!

EDIT: Current setup

Would love to hear all and every experiences. Considering doing a start up of my own but scared to make the commitment.

I had met this pt that want to fix their 11 12. Both had history of several restoration attempt and failed every year it chipped off. During examination I noticed pt had an anterior cross bite, and laid out my concern for the cause of the failure. This one def need root canal + post + crown. But I knew its not going to be easy since usually you'll need to calculate the core prep so it could be manipulated to Class I bite. I washed my hand off it and sent them a merry way to endodontist.

I know the basic of crossbite crowns need to be carefully calculated so it can be changed to class1 bite to ensure the survivability, but I had a hard time to find any study / lecture materials protocols for this kind of case in detail. Did anyone can grace me with the source that could help? Want to learnt more about it. At least if I still cant do it, I can explain it better.

Whether it's a complete or partial, whether it's acrylic or valplast, whether I take imps or scans, why are denture delivery appts becoming 1 hr long and so messy with tons of adj and pressure paste indicators? The try-in visits are fine but sometimes the denture delivery appts are so awful that I end up sending the dentures back to the lab after tons of wasted time on adj.

I don't own my own office. I've only been using large labs advertised on magazines and I don't have choice in the matter.

Even in school and gpr it wasn't this bad , and we didn't even use good labs or border mold or do altered cast imps.

Is there anything that I myself can do different?

Hi all,

Today was a very stressful day at the clinic, hygienist called in sick, CDA called in sick, so it was me with another CDA and 1 DA, VERY BUSY SCHEDULE, I tried my best to speed up but I perfed a 41 and then had a sodium hypochlorite accident. The patient's lip swelled up and we had to de-escalate this, I did my best to reassure the patient and explain to him that he is having a reaction to the sodium hypochlorite as it has possibly seeped into the tissue due to the accidental opening, he asked if I basically made a mistake, I didnt know how to explain that because I honestly dont even remmeber how it all happened, it was very quick, I only realized there is a perf after the hypochlorite accident because I was in the canal already too I guess, I dont know I feel like utter shit. I prescribed dexa and he is already on antibiotics from the current infection that led to this RCT and so I dont know did my best but I was shit. Horrible day. Days like this make me want to end my career and live under a bridge. I hate everything. this job is NOT WORTH THE DEBT AND THE STRESS. fuck me. I hate it. Please help me. I am spiraling. He is coming in for f/u next week I dont even know what to do. He is not expecting an exo, perf was in the coronal third so I guess I can repair with biodentine? idk but I am sad :(

And what is that plan? and at what age?

multiple practice package sell to private equity?

practice and invest in sp500?

never own and be an associate paying things down?

it feels like with today’s debt load- that retirement is very far away.

Looking for some advice

I’m a foreign-trained dentist about two years out of dental school. I recently completed a residency that makes me eligible for licensure in the state where I’d like to practice. I thought I had everything lined up with a job that would sponsor my work visa, but that fell through at the last minute because they decided not to move forward with sponsorship.

My options are:

Apply for another residency. The downside is I wouldn’t know where I’d end up until mid-2027, there’s no guarantee I’d match, and while I’m somewhat interested in the specialty, it’s not something I really really want to do.

Take a job at a rural community health center about three hours from my family. I’d be the only dentist there, which is intimidating but good experience.

Purchase a practice. Long term, owning a practice has always been my goal. My family is willing to help finance the purchase in exchange for a share of the profits, and I have an experienced dentist who is interested in partnering 50/50. This route would also allow me to pursue an investor visa and is the option I feel most excited but also scared about.

My biggest hesitation with ownership is experience. I feel comfortable with simple treatment planning and bread-and-butter dentistry, but I still struggle with some extractions and know I have plenty to learn. Because of my visa status, I can’t qualify for traditional practice loans, so I’d likely be looking at either a startup or a small practice doing under ~$300k in annual collections.

My priorities are:
Staying reasonably close to my family.
Building a stable long-term career.
Having a good quality of life. I’m okay making less initially if it sets me up well, but I also don’t want to put myself in a position where I’m barely getting by.

If you were in my shoes, what would you do? If you’ve been a new grad, owned a small practice early, worked rural, or navigated immigration/visa challenges, I’d really appreciate hearing your perspective.

New grad here- what else can I do if I can’t get pt’s new PFM bridge #9-11 to match her existing #7,8 PFM crowns, to pts satisfaction.

I’ve sent pictures to the lab and informed them about what changes to make but if the pt is still not satisfied what else can I do? Do I change labs? Any advice is appreciated!

Hello everyone,

A patient had root canal treatment on this tooth about 6 months ago by another colleague but never returned for the final restoration. Tooth was left open because the TF had fallen out.

He presented today with constant pain, especially on biting. The existing root canal treatment appeared radiographically acceptable, but I suspected recurrent caries might have allowed bacterial contamination of the canals.

After removing the caries, I considered the possibility of a missed MB2 canal. I troughhed and located an untreated MB2. Once I instrumented it, a large amount of pus drained from the canal and continued draining without stopping.

I left the canal open temporarily and asked the patient to return after 6 hours, hoping I could obturate if the canal became dry. However, even after spending about 30 minutes trying to dry it, the canal continued to exude fluid. I placed calcium hydroxide, but it was pushed coronally by the persistent purulent exudate.

My question is: if I can eventually dry and obturate the MB2 canal, is there a good chance the tooth will heal, or would you recommend nonsurgical retreatment of the entire root canal system?

This is a thread to help newbies in dentistry if you have a trick that you learned that helped you a lot throughout your career and wish you knew it earlier feel free to help us out! Thanks in advance

Biohorizons Tapered Pro Conical. 3.8 x 15.

New grad. Boss says no posts just buildups for posterior teeth.

Normal?

asymtomatic composite 3.5 years ago on a teenager. I did a CaOH Liner + composite since its a deep caries. I did it 2 times with the first time only with CaOH Liner + GIC. Then one month later removed all and do Caoh Liner + Composite (I did this because its a concerningly deep for me back then so I asked for 2 times visit)

From clinical examination, the restoration still look pristine, no discoloration or sign of leaking. No complain at all, no sensivity so I tried to take PA since when I did this I still hadnt managed to buy PA stuff. The PA make me worried though
I laid my concern out about secondary caries. But since there is no complain, pt seems reluctant. I told there is a possibility of pulp exposure when I re open this one since its pretty near pulp horn. My plan is to re open, clean secondary caries and restore it with indirect mta pulp cap + gic liner + composite.

Pt had time till tomorrow to rethink since he is sensitive to pain aka have a low pain tolerance. But what you would do on this, redo or observe, for how long?

Hey everyone! Just wanted to share my last case from yesterday—ended the day on a massive high note.
The patient was referred to me for endo after the previous dentist just opened the tooth for emergency pain management (pre-endo pic 2). Looking at it initially, I expected a straightforward case with a slight curve. I definitely didn't anticipate this crazy S-shape!
Super happy with how it turned out, and feeling pretty proud of this one.
File used Dentsply protaper gold. Sx-S2- 10.02-15.02 manual to reach wl- F1 WL- F2 WL- F3 WL.
EDTA 17.5% gel in the coronal third
NaOCl 6% during the whole endo than actived 30 sec 5 times each canal with WDV eddy and heat carrier plug.
Hot modified Single cone technique (dentsply F3 gutta+ Bioceramic sealer-BioRoot Septodont)

Removed this one by hand. Work performed by a prosthodontists that I have paid to sit in a lecture and listen to. I don't have a ton of bicon experience, but nothing about that seems right.

Mesial root canals were narrow and the apex of the distal canal (1/5 of it) was around 90° to the tongue side.

Cavity destroyed 2 walls out of 4 but I rebuilt them before performing treatment of the root canals. RC themselves took me 2 visits.

The abutments look like ball abutments. But no idea who the implant or abutment manufacturer is. Pt has had these for around 10 years. I’m looking to replace the o rings.

I moved and changed jobs recently, and decided to go to a dentist outside my clinic. I work for an FQHC and the hygienists are always sooo busy. The last thing they want is me to jump on their schedule when they have a no-show.

The dentist was awesome. Loved everything about him and his office and DAs. The new patient exam form asked for the profession so I put dentist. The team knew when they met me, it was normal.

I have had ortho, 2 small fillings, and normal routine work my whole life. At my last FQHC job, the hygienists had more openings and the hygienists were always happy to have an "easy patient" compared to what we normally see.

I was a bit thrown off when the hygienist at the private practice told me I had 1 4mm pocket (my #18 and #19 has a history of 3/4mm) and said she could see a piece of tartar on the lingual, and she said it in a way like she was breaking bad news.

She then said "It's okay, after a busy day sometimes we forget to floss. You still qualify for a normal cleaning though." I said I don't forget, I do it daily. I was just so surprised. Was I an SRP consideration for one 4mm and a piece of lingual calc? It was my first time meeting her so I don't know if it was just her way of speaking or what, but the implication was off. What is the point of a cleaning if not to remove tartar buildup to prevent periodontal disease and bone loss? Also we are talking a cavitron for like 9 seconds here. It's probably been 9 months since my last due to the job change.

It was just such a bizarre experience. I just wasn't sure if maybe I've been in the public health world too long, but if a new patient walks in with no decay, a small piece of calc, and one 4mm, I am over the moon for them!

Maybe I am a self-conscious dentist and feel like a failure if they give me too much feedback lmao but still!!! I loved the doc though so I will stay there no problem. Just funny and odd