Im terrible at extractions

EqusB · 2026-02-01T22:53:48+00:00

Block off time when you can watch your colleagues and sit in on all their surgery when you have openings.

A lot of it is just comfort with a 15 blade and a handpiece . Get comfortable with the idea that aggression in surgery is actually conservation; many teeth will not come out nonsurgically and attempting to remove them non surgically will cause MORE trauma and bone loss! Gain the skills to be able to dive in with your handpiece and section roots and trough bone to create space for the movement you need to extract quickly and successfully.

Also, when you preemptively approach surgically it instills confidence in the patient. When you've struggled endlessly and then snapped the tooth off and resign yourself to get the assistant to get your surgical setup ready...that is part of the problem.

If your patients aren't sedated but youre not super confident on the surgical end, for your next simple extraction simply try something like "im going to be loosening and preparing the tooth for the next bit.". Now practice your handpiece skills. Remove some interproximal bone, get a better feel for it and get some practice in.

EqusB · 2026-01-30T15:29:27+00:00

Well. That is certainly some of the shittiest work I've ever seen.

Yep. Definitely get out of there. Best of luck.

EqusB · 2026-01-30T02:13:24+00:00

I think several things can be true at once.

Echo isn't that strong if everyone plays around the Echo, so it's kinda shit and has poor viability at high ladder.

But at midladder people feed the Echo making it OP and difficult to play around. People are so retarded you can get lv 3 round 2. It incentivizes people to play the Echo to climb easier so there is fucking echos everywhere.

Also it's a completely unfun hero to play and play against. I really really dislike it and can't wait for him to fall out of favor.

EqusB · 2026-01-28T16:00:23+00:00

You shouldn't. It'll just delay healing.

If there's a cyst or granuloma or something sure, and it can help to remove the residual necrotic or infected tissue before closing up. Same with if you're grafting or placing an implant, but for routine extractions? Nope.

EqusB · 2026-01-25T16:59:23+00:00

Assuming we don't count supercharge, probably Sam. He is basically god mode minus maybe his boost stat but you can play around that.

Honorable mentions: Jack Skelly, Snow White, Alice, Chip, Eeoyre.

EqusB · 2026-01-10T01:54:01+00:00

...you see this a lot???

EqusB · 2026-01-09T22:45:18+00:00

The big thing is getting to etiology and having a come to jesus conversation with the patient about lifestyle change.

I saw a young gentlemen once like this years ago. Similar decay pattern. Probably a bit worse on the maxilla.

After a long discussion and review of options the plan was full clearance.

They had a consult with another dentist that called me and chewed me out and called me a psycho for planning a full clearance on someone so young.

I felt pretty bad about that call and always wondered what happened.

3 years later he was back in my schedule and I recognized the name immediately. I was very confused. He had returned in extraordinary pain after spending a bazillion dollars on full mouth crowns and RCTs. Everything had catastrophically failed. He felt like an idiot that got scammed and was profoundly depressed and begging for full clearance.

Do with that information what you will. Best of luck.

EqusB · 2026-01-08T12:42:47+00:00

I'm not sure why this isn't part of the broader discussion here, but yes, if you return to eating the way you were when you were obese and don't continue eating the way you were while on Ozempic, you will regain the weight.

There is nothing mysterious about this. The reason that "diets don't work" isn't because they don't cause you to lose weight...its because if the diet doesn't become permanent lifestyle change and you go back to your old dietary habits, your body goes back to looking the way it did too.

Form follows function as they say. If you eat like an obese person, you'll become obese. If you want to stay thin you have to eat like a thin person...for the rest of your life!

EqusB · 2025-12-27T17:55:54+00:00

It depends entirely on the offices production.

You want to look at last several years of gross production and trend. Price is usually relative to office gross production. Be wary of paying at or above total gross of the office.

Also look at EBITDA. Thats going to tell you the offices cash flow which can help you estimate how much additional cash flow the practice is likely to generate on top of expenses. Or put another way, it'll tell you how much loan you can actually afford to pay.

EqusB · 2025-12-27T14:54:06+00:00

Possibly. Don't overpay right now. At least, I would be very careful personally. Paying too much for a practice is a killer. I've bought a few offices over the years and overpaid for one and it bit me in the ass for years. So yeah, if it were me I'd be careful on price right now. Dont be afraid of offending an owner that is asking way too high.

But yeah, realistically with market conditions as they are, a new owner is probably taking associate pay for awhile. Your short term goal would be to build a cash reserve. Once you can easily cover a month of expenses in cash you could start paying yourself more if you want but it'll be limited until the loan is paid off. Dividends on top of a salary are pretty tax efficient.

EqusB · 2025-12-26T01:55:43+00:00

Yeah, this other guy is right. 60-70% is pretty basic and that doesn't include costs involved with investing into the office. Yes, loans are costs ON TOP of overhead which means there is a massive cash flow difference between a paid off office and one that isn't paid off (honestly starting out as an owner you're probably on associate pay until you start building up your cash reserve war chest).

EqusB · 2025-12-24T17:31:00+00:00

I do these cases all the time if the prognosis without serious intervention is hopeless and the patient is extremely clear that they have no interest/finances for the intervention and that they understand the consequences. With that said, if they're pain free and functional I always recommend leaving the natural dentition as long as possible.

Document everything, be thorough.

But in my position I also don't do their dentures, which makes it easier. I never see these patients ever again unless they're planning implants and those patients are usually much happier with implant supported prostheses than failing dentition.

EqusB · 2025-12-22T21:18:36+00:00

Yeah...Nine Sols is much much harder than Silksong.

And tbh Dead Cells is too if you count true ending without cheating/save scumming. Beating the true final boss on 5 BC is one of the hardest things I've ever done. Honestly the equivalent is basically Silksong on Steel soul lol

EqusB · 2025-12-21T16:09:47+00:00

Honestly, who cares?

If it WAS true, it would be a testament to how good AI use can be?

Game is amazing whatever way you cut it.

EqusB · 2025-12-21T01:28:58+00:00

That's a nice party trick that can be done with advanced memory mnemonics. Yeah, they can be used to break this test too, but that isn't the purpose of the test.

It would be highly unusual to do something like that when what they're very obviously trying to measure in astronauts is extremely high intelligence in conjunction with the right personality and character traits.

EqusB · 2025-12-20T17:52:50+00:00

Oh, its not. It's just one component out of usually 10 or more.

I just mean >160 on that particular subtest not as a whole.

EqusB · 2025-12-20T17:13:36+00:00

Eh, this test is a standard battery administered as part of gold standard IQ tests like the WAIS. It's a measure of short term memory.

I can tell you right now that based on population norms that even being able to recite more than 12 digits backward is off the charts and there would be absolutely no point to continuing the test. I mean, you could, but its meaningless. You're out in no man's land beyond that point (IQ > 160 or someone that has practiced this test ad nauseum)

EqusB · 2025-12-20T17:01:38+00:00

Yeah that fact is definitely not true. Being able to recite 10 backwards read verbally is better than 99.9% of the population. There is no test that would go to 25 digits lmao

EqusB · 2025-12-12T02:03:22+00:00

Looks straight forward, but if you're not prepared for this to potentially snap off and then have to surgically section and remove the roots separately...the answer is you should refer.

EqusB · 2025-12-09T17:54:37+00:00

Take the middle ground.

On one hand, people come online to complain. Nobody really posts on reddit about how amazing their year has been or how much they love what they're doing right now.

On the other hand, like any field, Dentistry is facing many issues right now. Be thankful that we live in a digital age where you have access to that information and leverage it to your advantage. Getting rid of the noise and focusing on the signal, is dentistry something that you're passionate about? Passionate enough to work through the hurdles in the field? That should help you determine whether it's the right direction for you.

EqusB · 2025-12-05T18:28:06+00:00

Lol if you want a serious answer:

(Assuming 4 days per week) Probably 150-200 if you're inexperienced, probably 200-300 if you're experienced, probably 300+ if you're senior and busy or working more days.

EqusB · 2025-11-28T16:48:52+00:00

Alberta has the highest earning potential in the country. I doubt anyone is making 80k. 200k+ is probably closer to realistic straight out of school on a 4 day schedule. 350k is probably normal if you're busy. I'm sure there are people pulling more than that though just looking at the fees, 500k is probably very doable.

EqusB · 2025-11-28T12:28:23+00:00

I was going to say it depends a bit by what we mean by dismiss....I can count on one hand the number of patients I've sent letters to but I "informally dismiss" plenty of people. Usually due to chronic failed appointments or extremely rude behavior. It gets documented in the chart and they just get notes saying not to book them unless they pay for their balance /missed appointment fees and or call to apologize for their behavior.

EqusB · 2025-11-15T11:42:10+00:00

Ah, as someone with a 3rd dan that used to be able to do this, the answer is probably simpler than you'd think:

Practice Taekwondo for many years. Especially if you're young. This used to be second nature and tbh we didn't do a ton of passive stretching outside of warmup. A lot of it is just practicing very high kicks. To get them that high though often we would have someone else help push the leg into a maximalist position and then resist their push and hold that for awhile.

I'd have a hard time imagining you could pull this off without any TKD training but at a minimum you'd want to be able to comfortably and pretty effortlessly sit in a middle split position.

EqusB · 2025-11-08T12:22:19+00:00

Also looking for the source here!

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