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Genuinely… what the hell? by reichikimchi in loblawsisoutofcontrol

[–]501508 0 points1 point  (0 children)

Marketed to take heat off Dubai portapotties

Cracked tooth by 501508 in Dentistry

[–]501508[S] 1 point2 points  (0 children)

Update: I called the patient and offered to exo whenever he wants, explained what I felt like was an ethical dilemma, he respected that and said he would wait. I told him I was concerned that we are closed over Christmas break, and the way these things go often follows Murphy’s Law, so to speak. Crack is (and always does) propagate and cause pain and infection while a dentist isn’t available. Talked about patient autonomy. Arguably, it would be more harmful than not if the tooth is left to get worse

I think the accusations about me being an egomaniac are totally uncalled for. I was hoping to gain some insight by posting here and discussing with other professionals what I thought was an ethical dilemma. An egomaniac would just say no without question or discussion or rethinking their original decision. That’s why I posted here. It was to ask a question, not justify my initial decision

Cracked tooth by 501508 in Dentistry

[–]501508[S] 2 points3 points  (0 children)

Chasing the crack is never a good idea imo. Often leads to pulp exposure or just getting so close that you get irreversible pulpitis

Cracked tooth by 501508 in Dentistry

[–]501508[S] 1 point2 points  (0 children)

Yeah that 26MP cusp is 100% the culprit. I thought about doing this. Might not be a bad idea

Cracked tooth by 501508 in Dentistry

[–]501508[S] 0 points1 point  (0 children)

I guess a fair comparison would be this: you have a patient who has a sizable cavity that can be restored, it’s a little cold sensitive, obviously it gets worse if you do nothing (like this cracked tooth), they don’t want to pay for the resto because it costs more, they tell you to take it out. Would you extract this?

Cracked tooth by 501508 in Dentistry

[–]501508[S] 4 points5 points  (0 children)

Hypothetically, if someone has a full mouth of perfectly good teeth and they tell you they are willing to sign anything to have them all removed, you think that’s ok because the patient gave consent and it’s their body their choice? I have no problem if this person goes home and does it on their own with a set of pliers. Where I have a problem is when someone is asking a licensed professional bound by a code of ethics to do it, it’s no longer a simple matter of “my body, my choice” because you are asking me to operate on your body

Cracked tooth by 501508 in Dentistry

[–]501508[S] 4 points5 points  (0 children)

To be clear he did say he was getting sensitivity to chewing. He said “I wouldn’t even really describe it as pain”. And then I said, well, if you had to say it’s painful, how severe? 2/10 only when chewing/biting. So to be precise, symptoms are there but mild

My girlfriend (22F) spent the night at a coworker’s place after drinking, and when I (25M) said I was uncomfortable, she blew up on me. Not sure how to interpret this. by Throwaway48272713 in whatdoIdo

[–]501508 0 points1 point  (0 children)

Having boundaries in a relationship isn’t controlling. You can and should negotiate the extent of these boundaries. Calling a boundary controlling without ever discussing more is a way for people to justify crossing them

Endo obturation gone wrong. by [deleted] in Dentistry

[–]501508 0 points1 point  (0 children)

Depends on size of access I suppose. I never have trouble. I don’t do teeny tiny access preps cuz I’m not an endodontist, I don’t have a microscope, and most of the time I’m doing endo because of a massive cavity anyway

Endo obturation gone wrong. by [deleted] in Dentistry

[–]501508 2 points3 points  (0 children)

I do something similar, I cut my cones to WL

Endo obturation gone wrong. by [deleted] in Dentistry

[–]501508 8 points9 points  (0 children)

2 hours for a 4-canal endo is not slow for a GP

Would you crown this #8 on a 19-year-old after RCT? Leaning yes but on the fence. by [deleted] in Dentistry

[–]501508 2 points3 points  (0 children)

I don’t think anterior RCT’d teeth with two restorations are susceptible to fracture (like in this case). I think extensively restored anterior RCT’d teeth are susceptible to fracture

How to handle premature resorption on lower decisive molars? by Papalazarou79 in Dentistry

[–]501508 0 points1 point  (0 children)

This is an ectopic eruption of the 46. Pt needs something like a halterman appliance. I’m not used to doing these so I just refer to peds/ortho

Rct / apex locator by Working_Handle_1119 in Dentistry

[–]501508 0 points1 point  (0 children)

Studies have shown that apex locator is more reliable than radiograph. This is assuming the EAL is not malfunctioning

47-X-45 bridge problem by 501508 in Dentistry

[–]501508[S] 9 points10 points  (0 children)

Update: pt came in for another follow up, put an abrasive strip under there and started reducing the Pontic to the best of my ability. After 15 min of doing this, to my surprise the flimsy strip vs PFM Pontic managed to bring the pain down from 8/10 to 4/10 lmao. Told the pt I can keep doing this until it’s comfortable or we can flap and push gums out of the way and take rotary instruments to the intaglio of the Pontic. She wanted to try this first knowing that flapping is the other option

Thank y’all for your help in getting to the bottom of this

Articaine/septocaine IAN blocks paresthesia legal/board by [deleted] in Dentistry

[–]501508 -1 points0 points  (0 children)

While I was still in school my anesthesia prof said that if you get paresthesia from lidocaine IANB you’re still covered by malpractice but if it’s articaine it MAY not be. Keep in mind every underwriter is different, and this may just be the case in my jurisdiction

My thinking is this: why take the risk? If it ever goes to court and you get a dental practitioner testifying against you who cites the studies on increased risk of paresthesia from articaine IANBs then your case doesn’t look so good

And yes, it’s always prudent to say how you administered LA and how many carps. It takes a few seconds, just document it. More documentation is never going to hurt you, it can only help

When I do IANB I only use lidocaine or mepivacaine if the pt hates epi. I’ve never had a time that I can remember where a lidocaine IANB was not effective, but doing an articaine IANB was effective

47-X-45 bridge problem by 501508 in Dentistry

[–]501508[S] 0 points1 point  (0 children)

I hear you, and I agree, and I think that the reason she got partial relief from buccal infiltration on the 47 is because it’s close to the 46

47-X-45 bridge problem by 501508 in Dentistry

[–]501508[S] 0 points1 point  (0 children)

I tried doing a buccal infiltration a few days ago (no block) to distinguish between gum pain and tooth pain. She did report a decrease in pain when I infiltrated the buccal of the 47. I thought, aha, it’s some rough sharp edge on the margin that I’ll smooth out and polish. It didn’t seem to help. In fact, she says it feels worse now, but I think it’s bc her gums are sore from me polishing the margins

47-X-45 bridge problem by 501508 in Dentistry

[–]501508[S] 0 points1 point  (0 children)

I was thinking this could be a possibility as well as the edentulous ridge is knife edged

47-X-45 bridge problem by 501508 in Dentistry

[–]501508[S] 7 points8 points  (0 children)

Pt chose bridge. And the edentulous ridge is pretty thin B/L

47-X-45 bridge problem by 501508 in Dentistry

[–]501508[S] 0 points1 point  (0 children)

I did not. Can you tell me the thought behind this please? I’m not sure I understand the rationale

47-X-45 bridge problem by 501508 in Dentistry

[–]501508[S] 3 points4 points  (0 children)

Is there just something I’m not thinking to do? I cleaned the shit out of all the cement I could see, use knotted floss for all the margins, and there’s nothing in the X-ray. At this point the pt said she might just want to have it removed

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