The patient has large diastemas and refuses orthodontic treatment, preferring crowns to close the spaces. However, her teeth are otherwise healthy, and I don’t believe full-coverage crowns are justified in this case.

The lab also refuses to fabricate individual crowns for this design and will only accept the case if 6–8 teeth are connected as a single bridge. The patient is willing to proceed with this approach, but I remain uncomfortable taking responsibility for a treatment plan I don’t consider appropriate for her.

The clinic owner insists on proceeding, despite my concerns. His final decision was to refer the patient to a colleague who may be able to do this treatment without having any problem sleeping at night. (Asshole clinic owner wont refuse to do the case)

I have always been terrible at Endo. when I was a student, it took my like two hours to get the right master cones it was either too overextended or too short and my obturations always had voids in it. In my country, before leaving dental school, you have to finish a 45 day internship in each specialty. before The Endo one started, I thought that I will come out of it confident in my skills and now that it is over I realized that I just went from terrible to mediocre. Cases still take an absurd amount of time and I have no idea why even though I start each day with all my instruments prepared. I don’t face any more problems with the master cone choosing but I still face problems with obturation. Sometimes the result comes out perfect, but most times there is a problem. Short, overextended by 1 mm outside the canal, thin bec I under flared the cleaning and shaping. and the most embarrassing part of it all, I still have a hard time gaining a good access even though I know the proper location of the orifices but it is because I am petrified of perforating the tooth even though I have never done that before. Other people who did the internship with me managed to finish more cases and their work is better than mine. It is making me feel even more upset about my skills especially bec there are other areas that I perform poorly at like tooth reduction. The only things that I can really do are fillings, cleanings, and extractions. But even with those qualification, who will hire me or trust me as a provider when my Endo work is poor? Everyone can do a filling but not everyone can do a good RCT.

I graduated in 2024 and immediately bought a house and moved to start a new job. This job was one I had planned on working at since undergrad. She is a family friend and held the spot for me because she really believed in me and was excited to have me. Offers of buying the practice in the future. We were steadily busy and things were working out well. However, over the course of 2026 as the economy has slowed, the office has gotten so slow. We are in the suburbs outside of a large city with lots of surrounding competition. We are only in network with two insurances. I got cut down to three days a week from four, now I'm down to two. Currently is through the new year and I don't see me getting back to full time here since the new year is usually slow. I started at a one day a week place last week that is going through a big transitional phase. Feels disjointed, don't love it, but hopefully will only be one and then eventually two days a week. I get guaranteed hourly rate for 60 days. At the first job, the two days have been fairly busy, but I really don't see this working long term. I stupidly have a 10 mile noncompete so I'd have to go to neighboring cities to work. I'd like to think that my boss would allow me to lessen that distance or even dissolve it if they can't support me, but it isn't a guarantee.

Job search went on and finding something that isn't corporate full time, or isn't 1.5+ hour away, or the part time hours work with my current schedule feels impossible.

I'm just feeling lost. Student loan payments kicked in as soon as my hours were cut. I'm still net positive each month, but the full effects haven't been felt yet.

I hate the town I'm in. It's boring, no character, my only joy here is the house that I own and love every square inch of and that I'm only a couple hours away from my parents. My boyfriend travels for work so being close to an airport is important, and we are close.

I can feel the ship sinking and I really don't want to go down with it. I love my main job, I love my patients, I love the staff, I feel supported... but I also understand that they simply are not busy enough to support two full time docs and our owner isn't close enough to retirement to cut her hours any more than she has. I don't even know if going fully in network with more insurances would even help at this point.

Maybe I just need to hear that it's time to get the hell out, sell the house, move somewhere and rent for a while until I find the town that makes sense and works well. If I didn't own a house the decision would be much easier! Have even toyed with the idea of renting but am not sure I want the headache.

Just a new grad looking for some perspective. Feeling sad and lost. I believe in myself and I believe I'm a good dentist and know patients love working with me. I'm just ready to grow and settle and am sad that this isn't what it would be.

If I get dollar for every randomly discover possible tumor/ cyst this year , I would have 4 bucks , not a lot sure but it's kinda weird 😕 and sad , think about all the undiagnosed cases , because people don't want x-rays .

So this very obviously a referraloma .

What are you thought on this big boy ,

I'm thinking a keratocyst .

I’ve only done a handful of these, but my lab turn around time has been crazy slow.
What’s the average turn around time you guys have experienced for each step? It wasn’t listed in the brochure/intro of prices/turn around times. I just wanna know if I’m being impatient or it’s normal.
I’m talking 5-6 weeks per step.

I am a new owner, looking to add another hygienist to my 4 op practice. I have 2 part time hygienists but have been relying on temps for double hygiene days. I tried Indeed and talking to temp agencies for perm placement. I don't care about their placement fee. I'm just noticing a lot of them would rather temp, which is totally fair. I also have run into hygienists that prefer to have a familiar work environment with regular hours so I guess where would I find those?

I’m looking for a camera to photograph my clinical work (orthodontics and aesthetic dentistry) that is very practical and easy to use.
Ideally, I’d like something lightweight and compact, rather than too heavy or bulky.
I’d also love a camera that offers quick and seamless Wi-Fi/Bluetooth connectivity with my PC or other devices, so I can easily transfer photos, better if it’s immediate so i can show my patients.

I know flashes are a big part for good photos so anything you think is compact enought helps.

Any advices or story of bad and good experience with something you already used will help. Thank you!!!

We're currently reviewing an overdenture case for a patient in the US.

The patient previously had an implant-supported denture made at another dental office. Unfortunately, that office has since closed, and the patient has transferred to a new clinic.

The main challenge is that we don't have the original implant records, and the implant brand and system haven't been identified.

The patient would like a new overdenture but wants to keep the cost as low as reasonably possible, ideally reusing the existing implants and any compatible components.

From a lab perspective, we're trying to find the most practical way forward before committing to a new design.

For those who have handled similar cases:

1. How do you usually identify an unknown implant system when the original clinic is no longer available?
2. If an existing bar or attachment system is present, how do you identify it and find compatible replacement components?
3. Are there any US-based suppliers or specialists you recommend for identifying older implant systems and overdenture attachments?
4. Have you successfully fabricated a new overdenture using existing implant components rather than replacing the entire restorative setup?

We're trying to avoid unnecessary costs while making sure the final restoration is predictable and maintainable.

I'd really appreciate hearing how other dentists and lab technicians have approached similar cases.

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Has anyone tried Pearl to help with chart notes? My office is considering getting it so they don’t have to start after work to finish their notes and also send some of the assistants don’t write good notes at all.
The thought is that we already spend so much time after work treatment planning, writing email respondence for patients and specialists for large treatment cases that keeping up with the notes after work takes even more away from our personal lives.
I love my note templates and personally it doesn’t take me long at all on most days even though they are pretty detailed but supposedly this is supposed to make it easier? Some days I do find myself staying after an extra hour or so finishing if I had multiple consults or large treatments that day so I see why the other doctors want it but I’m also wondering if I’m going to be spending just as much time editing these notes as I would be writing my own
The rep says each operatory would get its own microphone and the AI would create the clinical note. I couldn’t find any reviews online so I’m now looking here

Ideal? No. Do I expect the patient to draw from their 401k for implant, bone graft and immediate crown for esthetics? No.

It’s ideal for where the patient is in life right now after reviewing risks, benefits and alternatives as always. Patient is returning for the crown.

I keep my DME simple, I cut my own tofflemire to the extension I need (allows it to seat better without impinging on the gingiva). I don’t do copper bands, or band-in-band method although P. Magne has great results this way. I just Teflon tape to wedge the matrix (no wedge). Burnish the heck out of it; layer composite and raise the band. Doesn’t have to look pretty as it’s getting crowned anyway. 60-90min appointment and the patient leaves pain free to enjoy their weekend.

I feel like whenever I restore an anterior filling, my contact is always so light to the point where floss barely catches. Any tips on how to get a nice, solid contact? I use a mylar strip with a wooden wedge to restore, but I just can’t seem to get a technique down where I’m getting good contact with the adjacent tooth.

Have a patient who had chemotherapy completed a year ago and needs to have #24 (lower central incisor) extracted. Oncologist cleared the pt for extraction. No history of radiotherapy.

Any thought whether extraction can be done in a regular setting? does it need to be referred to OMFS due to post-op healing concerns?

How many of your patients are walk ins vs referred by someone/online marketing?
Would you rather get an practice with 7ops that’s tucked away in a building, currently has barely any reviews but owner has been there for almost 10+ years, or a practice with 4ops that you’re able to see while driving, next to a paint shop/cafe?
Is it worth it to pay 1.5x more in rent for a smaller and potentially more foot traffic office?

The patient booked with me for exo and I was seeing him for the first time. Tooth lingually tilted, with buccal decay sub-g. Male of African descent. Very strong tongue. Tried to create purchase point on the mb of tooth no movement and due to caries buccal was breaking off. Even tried on the mesial lingual (very hard since tooth lingually tilted and patient’s tongue was so strong). I wanted to open a buccal flap and trough bone but I just gave up and didn’t do it. Feel like a failure. Also I know it’s hard to see but what do ya’ll think of the roots is there 2? Are they ankylosed? Should I have taken a CBCT?

I haven’t had to do a single root canal in six years since I graduated dental school. The current office I’m at was fine letting me refer cases to the other doctor or the endodontist. However I want to improve. But it’s been so hard trying to find something that will teach me like I’m learning it from scratch. I want to feel more comfortable doing them but don’t know where to start since it’s been so long

I’ve been seeing a lot of interest in in-house 3D-printed veneers and mockups. I understand some of the benefits, but I’m curious whether the advantages justify the time spent designing and producing them.

1. Same-day mockups
I see the value of letting patients try a mockup the same day, especially while they’re excited about treatment. But you still have to design and print it. Is having the patient return a week later really that much of a downside?

I know there’s software that automates parts of the design process, but how reliable is it? How well does it account for occlusion and excursive movements, and how much manual adjustment is typically needed?

2. In-house printed veneers versus lab-designed and printed veneers

I understand the appeal of lower production costs, and I’ve heard printed veneers described as more forgiving of prep design and marginal discrepancies. But designing veneers can still take a considerable amount of time.
Why not outsource the design and fabrication to a lab, whether you’re choosing printed veneers? Some labs offer composite restorations.

Beyond same-day delivery and potentially lower costs, what makes doing everything in-house worthwhile?

For those using these workflows regularly, how much doctor or staff time goes into each case? Are the biggest benefits turnaround time, control over the design, patient acceptance, or something else?

I’d love to hear your experiences. Maybe I’m missing something about the value of in-house printing.

Looking to connect with dentists in Maryland who are looking for an associate. I’ve tried everything from Facebook, indeed, MSDA website, etc. but it seems like all I can find are offices that aren’t actually busy enough for an associate or aren’t looking at all.

So here I am lol. Anyone in Maryland looking for an associate? 😅

Comment and I’ll dm you! Please include general location if you don’t mind.

Hey everyone,

I’m a new graduate placing implants on my dad under supervision of principle dentist. Wanted to hear what you guys recommend for the flap design for 2 implants at sites 8 and 9. Should I do an envelope flap? Specifically a mid crestal incision from the mesial of the 10 to the mesial of the 7 and a sulcular incision buccal and lingual at the 7 and 10 then reflecting the flap?

Thank you!

Hey everyone,

I did an rct and crown prep on the lower left second molar 6 weeks ago because it was infected with a sinus tract. I seen him 6 weeks later and the sinus tract is still present. I popped it and pus came out. Does this mean the rct didn’t work? I took a PA with a GP cone twice. I took a scan and told the lab not to make the crown yet in case the tooth doesn’t heal. What should I do? Do I give options of referring to specialist or extracting the tooth?

I sold my practice a while ago for health reasons. As it happened rather rapidly, I did not get the chance to focus as much on A/R as I would have liked. The buyer and I had an agreement that he would attempt to collect my A/R for a given period and he would receive a percentage. That period is ending soon and there is still a significant A/R. I do blame myself for not doing better when I owned the practice. I do need the money as I cannot practice chairside due to my health. One idea I had was to pay a former employee (still working with the buyer) to attempt to collect outside of office hours. I could pay her a percentage of collections. I guess I would pay her as a 1099. What would be an appropriate percentage to pay (high enough to incentivize her but not too high to make it not worth it)? Thanks.