r/Dentistry

Started a new associate position

I get along well with the owner but they have some differences practice-wise that they’ve pushed back on. For example I like doing my own detailed notes, but they have assistants do these pretty light notes.

Any tips for overcoming differences/ working well together?

What do you think?

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.

I’ve practiced in New York, California and Nevada and FMX+pano were standard on all new patients. Nevada was particularly stringent on this. Recently started a job at a DSO in TX who has told me no patient gets FMX - it’s just four BW, four anterior PA and a pano. The told me they got the ‘blessing of the board.’

Is Texas actually super lax on X-rays? They seem over the top about assistant duties, nitrous, etc. I’m honestly not comfortable diagnosing without FMX, there are a lot of details lost on a pano.

Edit - is NO FMX EVER even on active disease/caries/perio patients ‘blessed’ by the board? I get no fmx on healthy low risk patients.

I'm a new grad GP and i start my main general dentist job at the beginning of next month. I was hoping to make a little extra money before starting next month and maybe on off days once I start my new job. What do you guys think about temping and doing hygiene 1-2 days a month. From the postings I see online, the temp hygienists make around 70 dollars an hour which is not bad to see 8 patients per day with pretty low stress in my opinion. On the other hand, the temp dentist jobs look much more challenging managing whole columns of restorative with multiple columns of hygiene checks in an unfamiliar environment for pay that doesn't make it seem worth it at all. I really don't mind turning off my brain and cleaning teeth every once in a while. Also how would malpractice work with this?

Hi guys can I ask what are you’re opinions are on a principle whose hiring a new associate asking them during their first few weeks to take photos of their work- before, during prep and after restoration placed to show him so he can assess and also having to discuss with him you’re findings with patients/ describe a radiograph ect.
To me I feel like it’s a bit much- I’m qualified three years now working in private practices and I feel this ijust feels like im back in Dental School. (By the way I’m talking about routine fillings, crowns ect, not implants/full mouth rehab cases-just bread and butter stuff)
There’s also the fact many dentists will have differing treatment plans and outlooks which I’m worried may lead to friction.
Would you feel a bit patronised by this request and what would you do.

Hi all,

I hope you’re doing well and Happy Fourth! A student of mine (HS sophomore) somewhat enjoys the sciences, but really enjoys woodcarving and making small dollhouse figurines and furniture 🪑. For someone with this skillset (talented kid from what I’ve seen!) is Dentistry a pathway to explore? Should I recommend he look into it more? First student EVER who has this as a hobby and is making me think about taking it up over the summer with all the time off I have (haha just kidding!). Thanks in advance!

I'm a recent graduate working as an associate in a private clinic, and this case has been weighing on me.

No amount of RCTs I did in dental school prepared me for this. The patient had such severe dental anxiety that she would start screaming before I had even removed the chamber roof. My boss advised placing Pulpotec in the pulp chamber and bringing her back a week later. It settled her pain, but when she returned, every attempt to continue treatment had to be stopped because of pain. The pulp was still bleeding profusely.

I tried every supplemental anesthetic technique I could (the only one I couldn't do was intraosseous because I didn't have the equipment), along with an intrapulpal injection. Nothing seemed to work.

Eventually, she asked for the tooth to be extracted, and I had to respect her decision.

I'm honestly heartbroken because she's a young patient and the tooth was otherwise restorable. Her dental anxiety was such a huge barrier, which I completely understand, but I keep wishing she'd been able to give treatment one more chance.

Has anyone else had a case where, despite seemingly adequate anesthesia and multiple supplemental techniques, treatment just wasn't possible? How do you manage these situations, especially in highly anxious patients?

Been working office 2 years as associate

I am solo doc, 35% production

1099

4/5 days a week

Production like 1.2 mil a year

Overall things good. However, could be gooder. As I'm trying to ravish my student loans with the intensity of one thousand suns.

Is asking for a raise reasonable?

Even like 36/36%

I understand I'm at high end however I'm also 1099 and I feel I bring a lot to the office. I'm totally drama free make things easy for owner so much so that it's on autopilot pretty much for him.

Thoughts?

anyone tried any of the cheap eBay electric handpiece motors? Are they pretty good or loud?

thanks.

I'm a dental resident in a combined endodontics/restorative specialty program, looking to buy my first pair of loupes. I've been looking into Lumadent, Orascoptic, Zumax, and Univet but haven't decided on what to get yet.

I want to get ergo loupes to help me better maintain my posture. I have congenital scoliosis - it's a congenital spinal cord deformity where my spinal cord is curved instead of straight. So it's especially important for me to maintain good posture.

A colleague was telling me that the declination angle for loupes really matters - he has flip-up ergo loupes with a declination angle of 45 degrees and he said he feels like he has to bend his neck slightly to see certain angles when working, which causes strain on his neck and back. He said he wished his loupes had a higher declination angle.

Is this true? I thought all ergo loupes had a declination angle of around 40-45 degrees. I didn't know it could be higher than that.

I'm a new grad dentist, and I'll be starting my first associate position next week. I'm excited... but definitely a little nervous too.

For those of you who've been in practice for a while, what's something you wish you knew when you first started? It could be clinical tips, communication with patients, managing staff relationships, dealing with imposter syndrome, handling mistakes, improving efficiency. Literally anything you think would have made those first few months easier.

If you could go back and give your new-grad self one piece of advice, what would it be?

I'd love to learn from your experiences. Thanks in advance!

Over 10 years I've been doing IDBs, absentmindedly pulling my thumb back on the plunger because it's ingrained into muscle memory, and for the first time ever today saw that little red speck come back through into the cartridge.

Thankfully, my instincts and years of training kicked in and I heroically repositioned very slightly, aspirated again and all clear.

Anyone else had any minor 'firsts' this week?

It never really bothered me when patients come in wearing Meta smart glasses with the camera on. In fact, I've usually seen it as a positive. I try to be as honest and transparent as possible, so if they want to go back and review what I explained, that's fine with me.

Lately, though, I've started thinking about the other side of it. What if someone records the appointment, edits the video, posts only certain parts online, and completely changes the context? Even if you did everything correctly, a short edited clip could make you look bad or leave out important parts of the conversation.

How do you all handle this? Do you allow patients to record appointments, or do you have a policy against it? Has anyone actually had an experience where a recording caused problems?

Throwaway because I’ve got friends on here. I (23F) have been working as a general dentist for around a year and a half in a public hospital clinic in Aus. I hate it.

During uni I enjoyed most aspects of it, including placements and thought that I’d made the right decision choosing to do this degree. I even did some extra study and exams in prep for wanting to specialise into paeds.

But now I hate it. I hate doing new patient exams, I hate perio cleans, I hate fillings, I hate endo, I hate crowns, I hate bridges, I hate managing overseas implants because nobody else will take them on and patients can’t afford anywhere else. I hate having to do the really hard stuff because nobody else wants to and we’re the ‘last option’. I hate having to do cowboy dentistry. And the manager sucks too because they don’t know anything about dental so no meaningful changes are ever made, and they just blame the shortcomings on the clinicians (and in the hospital, the role is just viewed as a progression to a more senior role because the clinic produces good numbers).

Most of all though, I hate the patients. I don’t know if it’s because it’s a public clinic so it’s low health literacies, or if it’s just how people are but it is so exhausting having to constantly manage people with such complexities who are anxious and are scared of everything, while also managing their expectations of what we can and can’t do.
And the parents suck too. My service sees so many kids, and so many of these parents get so angry at the prospect of being told that they need to be brushing their kids teeth and it’s not up to their kid to brush by themselves. And they just keep getting worse.
I don’t want to be yelled at because our next available appointment is in 8 weeks, like I know it sucks and I get it. I don’t want to be told that they hate the dentist and how we’re all butchers and we must love inflicting pain on people. I don’t want to be verbally assaulted and almost physically assaulted by a psych inpatient when they’re already aggro about having a toothache. I don’t want the creepy old men making those suggestive remarks.

I’m really struggling to see the light at the end of the tunnel, because so many people talk about how they wanted to quit when they first started but they find their footing eventually, but it just feels like an infinite tunnel of darkness and there’s no way to get out. I’m losing the motivation for this career and just life outside of it. It’s a constant cycle of wake up, go to work, come home, shower, try to sleep, and repeat. And the money isn’t even worth any of it, especially when I know people who work at the shops and get Sunday rates that are equivalent to my salary.

And I feel like it’s reflecting in my work now. I do okay work, it’s not horrendous but it’s not the best. I constantly run late trying to fit in all this treatment because the patients demand it or they make a sob story about it and it feels impossible to say no. I don’t have the energy or even the urge to hang out with friends after work, or do anything really. Sometimes I find myself fantasising about being blipped from reality. But then the thought of the struggle with an already stretched patient base and the extra stress on the other clinicians just makes it feel so selfish to think like that.

I don’t feel like I can leave this profession, my parents are both in healthcare and sacrificed a lot to get me through dental school. They’re also asian.

I just want to know if it ever stops feeling like this or do people just find other ways to get by.

Any opinions or advice is deeply appreciated.

tldr: I so far hate this job and where I work, and does it ever end

I’m trying to incorporate some great hygiene upsells in my practice. We are fortunate to have a thriving hygiene department, and I want to take advantage!

I’ve already started offering adult sealants (and the hygienist gets a kickback for each sealant performed to motivate them).

Also charging $30 for fluoride treatment.

What are some other luxury upgrades I can offer patients during their cleaning???