u/Odd-Conversation812

I’m fed up with my clinic. We constantly have generator and electricity problems, and the AC barely works properly. We’re not allowed to lower the AC temperature because the generator shuts off from high electricity usage, and they even remove the batteries from the remote controls so we can’t adjust it ourselves. Ive had problems with my door for weeks and they still haven’t fixed it.

The clinical work is becoming increasingly frustrating. There are poor preparations, caries are sometimes left behind during preps, and in some cases they only remove caries, take a scan, and leave the tooth without completing the restoration. I’ve seen bridges placed over mobile implants connected to natural teeth, retained roots left in place with bridges made over them, and hopeless teeth being treated simply so a bridge can later be placed.

We’re also overworked, often working 8–9 hours a day under these conditions. It takes about a week just to get a functioning turbine, and other materials are also delayed. We’re expected to keep working regardless. They don’t even provide basic things like snacks, coffee, or anything for staff.

The patients add another layer of stress. Many are rude, demanding, and unwilling to follow the correct treatment plan because they want quick treatment and immediate results.

What frustrates me most is seeing treatment that I genuinely don’t feel confident in. With Hollywood smile cases, I’d estimate that around 8 out of 10 develop chronic gingival problems within a year, and many return needing endodontic treatment under crowns. I do the endodontic work, but deep down I often feel that simply doing the endo is not solving the actual problem, rather should the whole bridge be taken off, because there are caries under it.

I reached the tip of the iceberg, and I’m finally switching to another clinic.

Hello everyone. Any tips on improving outcomes with deep restorations? I’m pretty confident about my isolation, so I’m not sure where the issue was.

I had a 13-year-old patient with an asymptomatic lower 6 who had been referred for endo, but I wanted to give the tooth a chance. I did selective caries removal and I don’t remember whether I placed a liner, but I’m certain there wasn’t any pulpal exposure.

The restoration itself went really well and looked great. However, the patient came back a month later saying that from the very day I placed the filling, the tooth became symptomatic. She reported pain to cold that lingered for around 2 minutes.

What confuses me is that it didn’t become symptomatic after some time — the symptoms started immediately after treatment. Any thoughts on what might have happened or what I could improve in similar cases?

What a shitty situation at the clinic today. I gave an infiltration for an upper premolar before a filling, and the patient had extremely severe pain during the injection. I’ve honestly never had that happen before with any patient. She immediately got out of the chair, became upset, and went to my colleague to complete the filling instead. Later I was told she had been crying hysterically as well. I’m still trying to process what happened because the reaction felt completely unexpected.

Does bond and composite differ a lot between major brands like Dentsply, Tokuyama, and GC compared with cheaper Korean brands that cost around half as much, particularly regarding leakage and polymerization shrinkage?

I’ve done multiple anterior restorations around 3 years ago with follow-up, and they still look great. However, with the cheaper materials I’m using now, I’ve noticed that after only a week to a month there can be discoloration at the composite–tooth interface, especially palatally in Class IV restorations.

Could this be due to differences in bond quality and composite properties between brands, or is it more likely related to technique?

A lot of the comments seem to assume I had complete freedom to remove the bracket and archwire and place a rubber dam however I wanted. I didn't.

I work under an orthodontist and a clinic owner, and I was specifically instructed not to remove the bracket and archwire before treatment. If I had ignored those instructions, I could have lost my job, since its so easy to replace me.

People also need to understand that finding another position isn't as simple as saying "just quit" or "just do what you think is right." Where I work, most other jobs pay very poorly, and this is the first decent-paying position I've had. I'm not willing to risk being fired because I went against direct instructions from the orthodontist and clinic owner.

Would I have preferred to use a rubber dam? Yes. But I was working within the limitations I was given.

A lot of you seem to assume that finding another job is easy, or that any new job will provide a decent income. That's not the reality everywhere. Where I'm from, good-paying dental positions are limited, and many available jobs pay very little. This is one of the first jobs I've had that pays reasonably well, so simply saying "ignore your boss" or "find another job" isn't as practical as some commenters make it sound.

I've also had previous disagreements with the clinic owner over treatment decisions. For example, I was pressured to restore a “cavity” that I believed was arrested rather than active caries, and my job was put at risk over that disagreement. So please don't assume I have complete autonomy to do whatever I think is best in every situation. The reality is that some of us work in environments where going against instructions can have serious consequences.

Upper 6 endodontically treated and ankylosed. Sectioned and removed the mesial and distal roots after a long procedure, but the palatal root remained. Tried for another 30 minutes without success, so I called a senior colleague, who removed it in 5 minutes. I tried elevating in the same area he did, but I was too worried about fracturing the cusp subgingivally, whereas he wasn’t hesitant. Made me feel like shit.

For difficult molar extractions, do you guys prefer removing some interseptal bone after sectioning rather than putting heavy force on the buccal plate?

My thinking is that creating internal space for root delivery may be less traumatic than excessive buccal expansion that could risk cortical plate fracture.

Also when elevating, I feel like a lot of force ends up being transmitted to the mesial bone as well.

I’m also curious if there’s any evidence that conservative interseptal bone removal actually causes more post-extraction ridge resorption/recession, or if preserving the buccal plate is the more important factor.

I’m working in a clinic where the owner does a very high volume of cases daily—around 5 “Hollywood smile” cases (full crown treatments) and 5–10 implants per day.

A large percentage of patients—probably around 70%—come back with gingivitis, bleeding, and general dissatisfaction. One issue I keep noticing is that instead of placing individual crowns, he often splints multiple teeth together as bridges, which seems to make hygiene much harder for patients.

On the implant side, many cases appear to fail over time. When patients return with complications, they’re usually redirected to us to prescribe mouthwash and perform scaling and polishing, rather than addressing the underlying problem. As a result, there are frequent complaints and even arguments with patients.

From a clinical perspective, I’m also concerned about the quality of tooth preparation. In many cases, caries are removed but no core buildup is placed, and crowns are seated directly on compromised tooth structure.

I’m struggling to understand how such a high daily volume is maintained given the apparent complication rate and patient dissatisfaction. I’d really appreciate hearing others’ perspectives on this kind of workflow and whether these approaches are considered acceptable or if I’m right to be concerned.

How are you supposed to restore class 2 cavities with palatal caries extension on upper molars? There would be a gap between the band and the wedge obviously so how do you restore the class 2 and the palatal extension together?