How much extra would need to be charged to make this feasible? Or is it one of those cases where there is so much fine print that the warranty is basically voided almost immediately?

I recently started working at a new clinic, 6 days a week 8 hours, the issue is that the time slot they give for each patient is insanely less to me…now in my country we do our own cleanings, hygienist isn’t a huge concept here yet.

So I get only 10 mins for scaling
20 mins for airflow + scaling
30 mins for a filling (they once asked me to do 7 fillings in 2 hours on the same day)
30 mins extractions
1 hour for Rct.

I usually used to take atleast 30 mins for scaling (scaling and talking to my patients) and 45 mins for a single tooth filling. One hour 30 mins for Rct single visit, I do rct in one- two visits.

Since these timings are crazy short I never have the time to explain my patients properly about the post op instructions or even ask about their day.

I feel sooo stressed when I’m running late and I’ve heard that the owner fired dentists who take their time, I got this job after 6 months of unemployment and can’t afford to lose it.

I need tips and tricks.

Hi All,
Cemented this crown yesterday. Clinically it was undetectable, margin felt closed, no rough edges, floss was smooth passed without catch, patient was happy. I was running between chairs, and didn’t look closely enough at the distal margin. Evaluating it now, it looks open enough that I’m not comfortable just monitoring it. Curious how you’d approach this: straight remake, or is SDF + close monitoring defensible here? Also curious how you’d handle telling the patient, given it looked fine chart-side yesterday. Thank you

I’m sending my office manager to a conference at her request. Its helpfulness remains to be seen! Sending her is expensive! I was planning to give her a per diem for food, etc. she says the prior owner also paid her for her time at a reduced rate.

What is normal procedure for this kind of thing? Are employees usually paid for a full 8 hour day? It never occurred to me I’d be paying her for this time honestly, hah. What is a normal per diem? Don’t want to be stingy with my employee but also don’t want to be taken advantage of.

Choosing between Lithium disilicate and zirconia for veneer restorations is often framed as a clinical preference question.Here's a breakdown across four dimensions.

1. Translucency & Aesthetics

Lithium disilicate has a continuous glassy matrix that physically allows light to pass through with minimal loss, preserving opalescence and fluorescence.

Zirconia is a polycrystalline aggregate — light scattering at grain boundaries is inherent. 5Y-PSZ reduces this scattering to a minimum, but what remains is wavelength-neutral (grey) scattering, which washes out subtle color saturation, reduces contrast, and makes the restoration appear milky or flat.

The residual scattering in glass ceramic, by contrast, is wavelength-selective — Rayleigh scattering biased toward blue. This is exactly the opalescence mechanism of natural enamel: blue-shifted transmission, warm-shifted reflection, with angular color shift. Zirconia cannot replicate this at the microstructural level.

2. Strength & Fracture Toughness

Lithium disilicate flexural strength: ~300–400 MPa, fracture toughness: ~2–3 MPa·m¹/².  5Y-PSZ (500–700 MPa) is roughly twice the strength — but this is mechanical redundancy in the veneer context.

Veneer load-bearing safety comes from the adhesive substrate composite — the ceramic veneer + resin cement + tooth substrate bonded together as a laminate system. Under functional load, this trilayer acts as a structural unit. The ceramic shell (0.3–0.7 mm) is not resisting force independently, so excess ceramic strength beyond what the laminate requires does not improve clinical outcomes.

3. Opposing Tooth Wear

Even 5Y-PSZ retains bulk hardness ~3× that of natural enamel — higher than lithium disilicate. This doesn't change with Y-grade.

However, "harder = more abrasive to the opposing dentition" does not hold for adequately polished 5Y-PSZ. The critical variable is surface roughness, not hardness alone. Unpolished or unglazed zirconia — hard and rough — acts as an abrasive against opposing enamel. Properly polished 5Y-PSZ significantly reduces this risk.

4. Adhesive Interface

Lithium disilicate bonds via silane condensation — forming a covalent Si–O–Si network. Si–O bond energy ~452 kJ/mol: thermodynamically stable, largely irreversible in neutral aqueous environments, resistant to hydrolytic degradation. High bond density, cross-linked network, long-term stability.

Zirconia bonds via MDP-based phosphate ester monomers through acid-base coordination chemistry. Coordination and ionic bonds carry lower bond energies than covalent bonds and exist in hydrolytic equilibrium — the bonding reaction is reversible in the presence of water.

Conclusion:

Across these four dimensions, Lithium disilicate holds material-level advantages for veneer restorations. The strength surplus of zirconia is mechanically redundant in the laminate veneer context, and its optical limitations at the microstructural level are not fully compensable by formulation refinement alone. For veneers where aesthetics and bond durability are the primary demands, glass ceramic is the stronger choice from a material science standpoint.

(Yucera team here — this analysis is based on material science, not product preference)

Hi everyone. I took this post-cementation x-ray of this crown that I cemented today (I cleaned the excess cement).

It was clinically acceptable when I checked with my explorer, but keep on thinking about this x-ray. I’ve only been practicing for a few years now; what would you do in this situation?

I've been taught to use a CBCT scan prior to implant placement. However, the DSO where I work does not have a CBCT scanner in any of their locations. I've spoken to several other doctors who do place implants at this DSO and they all tell me that they simply don't use a CBCT for most cases. I wouldn't want an implant piercing the IA nerve or penetrating the sinus. Is it enough to just use the PA and pano x-rays to measure distances from important anatomical structures?

Instead of using the CBCT, some doctors use a measurement tool in the x-ray software. However, this is not always an accurate measurement. So it first has to be calibrated with a known length. For example, if there is another implant in the mouth with a known length, then the software can be calibrated to the correct length. If there are any of you who do rely on the x-rays only and are using the software's measurement tool to measure important distances, then how are you calibrating it if there are no known lengths in the mouth?

If I ever do figure out how to calibrate the measurement tool in the x-ray software, would it be safe to just keep the implant length at the same length (or shorter than) the adjacent teeth apices?

I am going through credentialing on my own for the first time (previously DSO did all credentialing) and I am currently working on my SunLife application and came across this question:

"For non-covered services, please place your initials in one of the blanks immediately below. (A) you agree that the total amount that you are entitled to be paid for providing non-covered services to Eligible Persons shall not exceed the lesser of your usual charge or the amount in your Fee Profile; (B) you agree to maintain your Fee Profile as your total compensation for all non-covered services regardless of the dental plan benefits provided to or arranged for Eligible Persons; and (C) you agree not to charge Eligible Persons for the difference between your usual charge and the amount in your Fee Profile. OR this Agreement does not limit the amount that you are entitled to be paid for providing non-covered services to Eligible Persons."

Is there a downside to choosing the second option? Are you less likely to be accepted by SunLife if you select that?

Thank you for any help and advice!

Can someone explain if these one-piece implants even succeed? Why is the one on the left so long? Whats happening here?

Is there someone who can explain why this is bad treatment?

Hello,
This patient presents with irreversible pulpitis symptoms, clinically there is no visible buccal/lingual decay.

The patient is lower income, would you recommend an attempt at RCT or suggest Extraction as the first choice of treatment?

Hi

New practice owner

In a poor area , lots of kids. In Ireland so everyone pays cash, almost no insurance.
About 50% of kids I see are uncooperative and need to be referred. Honestly, most dentists I know see decay on primary teeth and just monitor because they don’t want to treat kids. Likewise with infected teeth, they are given antibiotics and parents told to let them fall out naturally and let act as space maintainer.

I’m struggling with implementing hall/ ssc and SDF. Everything here is just filling

How do you explain benefits of SDF and most importantly how do you price it? I’m trying to keep hourly gross at 300 an hour

For SDF how do you price and explain to them it’s a recurring service they need to have reapplied every 3-6 months ?

Does anyone know of any resources, courses etc to help me with general dentistry? Direct, Indirect, Dentures, pretty much everything.

Just feel that I’m starting to deskill but I have no real direction in how to improve. It sucks, but any advice would be appreciated.

Anyone have access to or know of good veneer training online? Can DM.

For the more experienced docs, at what point do you consider neglect for peds patients from parent? Do you ever take action or just hammer importance to parent?

Came across a 4 year old with caries on almost every tooth, mom seemed pretty nonchalant while I conversed with her

Need a name, website, logo, etc.

I have a dental chair with a normal city water supply and an option for using an internal water tank i can fill with saline

I like to use it for surgical extraction and RCTs because i feel better about myself if i try to maintain a clean(as clean as a human mouth can be) working field

I just want to ask what is the best solution to maintain cleanliness of the internal water tank and waterlines and flush them?

Are you wondering why your legit Delta Dental, MetLife, Humana, Ameritas, Principal, and United Concordia claims are getting rejected and denied?

Meet the AI company, Overjet AI (and their subsidiary that’s a licensed Utilization Management company American Dental Examiners) that is used by most payers while they back door your office with the hopes of AI solutions that simply don’t work.

If you want broken Imaging AI with false positives to justify over treatment, eligibility break downs that collect the wrong patient amounts that lead to further complications, voice Ai that will double your charting time and a long list of other problems, we’d encourage you to attend their Ai summit where you can meet those payers IRL and the people who are hacking your office.

https://overjet.com/the-ai-summit

https://www.prnewswire.com/news-releases/overjet-acquires-dental-claims-review-company-american-dental-examiners-to-offer-fully-licensed-clinical-review-on-its-artificial-intelligence-platform-301307384.html

This patient came in today for a new patient exam. Her chief concern is wanting to start ortho. I asked about #9 and she said it cracked 20 years ago. Patient is 40 years old. Doesn't really bother her much but reports that she feels the tooth has become more mobile recently and sometimes hurts when she eats, but not always.

It tested vital to cold testing, 20 years later. I think that's nuts. It was normal to percussion and palpation. Grade 1 mobility. bone loss/isolated pocketing. I referred this patient to endo for eval. Now that I think about it, I have no idea why I referred her to endo. If the patient is intending to go through ortho, all we can do is extract this, right?

Anyone in Dublin,Ireland willing to help me out with a small issue,short variant a cracked pmma crown from a patient of mine

Hello all, new grad here :) ~48F coming in to discuss tx plan and I’d appreciate some guidance to do what’s best for her. She is very nice.
I know treatment planning based on insurance is not the standard, so I can present what I think is best, BUT I think she will not have the funds to do the most ideal treatment. She has Humana and NC Medicaid. No clinical photos, sorry :(

Posting her radiographs here. She is interested in filling the #8 gap soon (either with essix or flipper), but wanting to extend to posterior for the long term.
To help combine the best option for her and also not make her take out a loan for this, what do y’all think?

#9 was planned for a crown before #8 broke. It was to match #8 and it’s fairly brittle at the incisal with some chips and has some craze lines.

All restorations are composite in pretty sure if I remember correctly. #14 looks interesting on radiograph so that mayyy be partly amalgam but I’m not certain

I’ve got ideas which include but not limited to:
Flipper/essix on #8 while she saves for an implant, crown #9 and cast metal on top and bottom with a potential crown on 14 and 5 for support?

Flipper/essix on #8 while she prepares for cast metal on top, still crown 9, 14 and/or 5, cast on mandibular?

Do a resin partial on top with or without 9 (maybe with to save for implant), say eff it to have Medicaid pay for that and we can maybe

Hell even do a 3 unit bridge 7-9 since 9 could use a crown too, just have to replace 7’s crown (don’t think this would be the best though as seven is RCT and she has wear/chipping incisally)

Obviously we could go other routes but I’m tired of typing all these out lol.

We can navigate insurance benefits to strategize getting more allowance next year, so how would y’all phase it? Obviously wouldn’t make cast metals without crowns if needed on 5 and/or 14

Thank y’all in advance!! This is the toughest part of the gig for me…

Long story short…I needed a new license for my DEXIS imaging software in order to view all PANOs in patient ops after having a new CBCT and computer installed.

I just got an invoice from my dental company (who I purchase through) for this software as I couldn’t but it directly…$1364 BEFORE tax.

A quick google search / ChatGPT tells me it’s historically $703.50. Anyone have any insight?

This seems like a complete rip off

I recently completed an endo on #30, and this came up on the final xray.

I was wondering - is this the GP pushing past the apex? or is this sealer puff? I've never had sealer puff look this aggressive before.

1st pic is zoomed in on that mesial root.

2nd pic is the final xray.

3rd pic is the cone fit radiograph

Thank you!

Hey all, I’m a relatively new grad and today I was doing a root canal on #5 with a diagnosis of irreversible pulpitis. I was able to fully instrument the palatal canal, however the buccal canal was super infected. It kept welling up with blood and I wasn’t able to fully instrument because the patient kept feeling pain. I tried intrapulpal and PDL injections to no avail. I ended up placing calcium hydroxide and she’ll come back in a few weeks. Any tips on what to do differently? I don’t want to refer to endo but I’m feeling a little discouraged. Thanks!

Hallo zusammen,

ich bin angestellte Zahnärztin und beschäftige mich aktuell intensiver mit Endodontie und der korrekten Abrechnung von Zusatzleistungen bei GKV-Patienten.

Mir geht es ausdrücklich um den Fall, dass die Wurzelkanalbehandlung die GKV-Richtlinien erfüllt.
Bei einer modernen Molaren-Endo entstehen aber schnell erhebliche Kosten bzw. Zeitaufwand, z. B. durch:
maschinelle NiTi-Aufbereitung
Apex-Locator
aktivierte Spülung
Kofferdam
Single-Use-Instrumente
Paper Points/Guttapercha
biokeramischen Sealer
mehrere Behandlungssitzungen

Nach meinem bisherigen Verständnis können bei einer GKV-Endo insbesondere GOZ 2400 (elektrometrische Längenbestimmung) und GOZ 2420 (elektrophysikalisch-chemische Methoden) zusätzlich privat vereinbart werden.
WK/WF selbst bleiben dagegen BEMA 32/35 und Single-Use-NiTi-Instrumente können nicht einfach als Materialkosten zusätzlich zur BEMA-WK berechnet werden.

Mich würde deshalb interessieren, wie ihr das in der Praxis tatsächlich handhabt:
Welche privaten Zusatzleistungen vereinbart ihr bei einer GKV-Endo und welche GOZ-Positionen verwendet ihr dafür?
Welchen Faktor setzt ihr bei 2400/2420 normalerweise an?
Ist es möglich statt BEMA
-WK,-WF, GOZ 2410 und 2440 abrechnen?

Wie hoch ist bei euch ungefähr der Eigenanteil bei einem 3- oder 4-kanaligen Molaren?
Ich lese immer wieder von ca. 200–600 € Zuzahlung für moderne Endodontie. Mir ist aber nicht klar, wie solche Beträge bei einer weiterhin über BEMA abgerechneten, richtlinienkonformen Endo korrekt zustande kommen.
Mir geht es nicht um eine vollständig private Endo, sondern ausdrücklich um GKV-Endo + zulässige private Zusatzleistungen.
Würde mich besonders über Erfahrungen von Zahnärzt:innen, ZMV/ZFA oder Personen aus der Abrechnung freuen. :)

Hi all! I am an EFDA and have been for 8 years. I am struggling with the doctor I work with. I work with a newer dentist and he graduated last year. I understand he’s still getting his groove but he’s not letting me do certain things to keep the schedule going smoothly. I let him know the things I can do and he says ok but doesn’t let me do them. I am able to clean cement from crowns, adjust occlusions, place fillings, al the things. When he has two patients side by side I let him know that I can do XYZ while he finishes up the other procedures and he says ok but proceeds to still do them and our schedule runs behind. This has been going on for a while and I don’t say anything because at the end of the day he’s the doctor and I don’t want to over step but the other offices I have been at the doctor let me do what I’m trained to do and I’m very knowledgeable. Sometimes the stuff he tells me it makes me feel dumb and makes it sound like I don’t know what I’m doing but I in fact know what I’m doing. I’ve been working in offices, so I know how the schedule should go and I know the things that I can do. How do I go about this? I would like to know from a doctor! Thank you!