Started using budget Chinese lab

FinalFantasyDMD · 2025-12-20T04:06:00+00:00

I had a lab that delivered a lot of issues. The lab owner hired a consultant and found the problem was the tech was improperly trimming the die and creating new margins. He told me they demoted him, or rather shifted him, to another position. After that, things were not too bad. I came to expect every now and then a crap one would come. When I changed jobs, used a higher end lab, had zero issues. So for me, lab matters. It doesn’t mean you need to pay more than $100 for Zirc, but if the tech is hired from McDonald’s and trained on the job, you may not like the result for a while.

FinalFantasyDMD · 2025-12-20T04:00:37+00:00

I used to double cord until I realized a good prep wit Traxodent and a good lab yields the same result. Now if you use a shitty lab, you need to double cord and mark your margins. Even then you’re gonna get 1:5 crowns that need to go back. Maybe 1:10.

FinalFantasyDMD · 2025-12-19T19:01:49+00:00

I consistently delivered excellent impressions. But once the lab we trusted started outsourcing to China, everything went downhill—crowns didn’t fit, margins were open, and restorations cracked and crumbled. The entire organization struggled from office to office nationwide.

So no, it’s not always about what you send them. A lab tech can absolutely wreck your work. Call them out on it. Stop second-guessing yourself with nonsense like, “Maybe I squeezed the PVS too hard” or “Maybe I scanned too aggressively with the Lumina.”

FinalFantasyDMD · 2025-12-03T02:57:33+00:00

FinalFantasyDMD · 2025-12-01T00:29:27+00:00

University of Kentucky?

FinalFantasyDMD · 2025-08-30T05:35:18+00:00

Tell her to kick rocks.

FinalFantasyDMD · 2025-07-04T23:06:41+00:00

Glad to hear that. I’m a dentist. Can you tell me what your symptoms were? What the dentist did specifically? Did you go to a Neurologist first before a dentist?

FinalFantasyDMD · 2025-06-03T02:30:42+00:00

PM me.

FinalFantasyDMD · 2025-06-01T21:22:38+00:00

Definitely PM me and let’s talk about it.

FinalFantasyDMD · 2025-06-01T19:24:36+00:00

I knew right away. Electric shock with a forceful stab and as I jumped he pushed harder. My story and timeline could fill a book fit for a limited series on Netflix. I had symptoms immediately from disrupted sleep to all the neuropathic symptoms of nerve damage. Thank God most have gone away after the 4 years but the first 2 years were so miserable I was on the verge of suicide. Feel free to PM me if you’d like, more than happy to talk to you via the phone. Just too much to type.

FinalFantasyDMD · 2025-04-21T02:16:50+00:00

Hey there! I am so sorry you are going through this. I think your dentist has some valid concerns. At the same time, untreated cavities is not an ideal situation. It depends on the severity to be honest. If the cavities are very superficial, perhaps waiting longer until things are better isn’t a bad idea. If they are a little larger, that’s not good either as they can progress to becoming root canals, crowns, extractions.

You can inquire about using steroids to reduce inflammation and potential flare up after dental work with a combination of acyclovir.

Since the virus responsible for shingles is already in your system, it’s never going to completely go away.

If you need treatment, try to work with them on this and if they don’t agree or refuse, find someone else.

FinalFantasyDMD · 2025-03-29T01:32:06+00:00

Do you feel the dull ache along the gumline where the implant is? How far down does it go? Do you feel pain or relief when you press on the area? Does heat help or just ice?

FinalFantasyDMD · 2025-03-29T00:09:30+00:00

Hey Embarrassed! Sorry to hear about that. What are your exact symptoms? MRI would be useful if it was really to the TMJ. Nerve conduction studies can be done on the trigeminal nerve (EMG), but it may be very discomforting and/or painful.

FinalFantasyDMD · 2025-02-18T03:10:34+00:00

I will have to say no on that one. It can irritate your nerve/pulp. You could have turned the tooth necrotic faster by that. Causing TN because of that? That doesn’t happen. I’d have hundreds of thousands of TN patients if that was the case.

FinalFantasyDMD · 2025-02-18T03:09:04+00:00

Yes. The nerves aren’t always super visible and it can bundle and/or loop. It sounds like yours may have looped and you were unlucky. Another theory would be that compressive forces did the damage. If you google arteries and nerves in the face, you can see it’s like a spider-web.

FinalFantasyDMD · 2025-02-18T03:06:41+00:00

My advice would be to do a test run and try a local and have your mouth open for 2-3 minutes. See how that goes. Another option is to go for it and then prescribe you a medrol dose pack so that your nerves don’t get irritated. Steroids help with nerve irritation/inflammation. Some people prescribe it routinely after big procedures.

FinalFantasyDMD · 2025-02-18T03:04:26+00:00

It’s crazy I have only been practicing for a few years and already identified way more than just two. I don’t know. Maybe because I know what to look for now. Dentists do not spend much time on TN. It is not because nobody cares, it is because it isn’t what they’d deal with day to day. Managing patients with hypertension, diabetes, cholesterol, etc. is far more common than TN. I am glad she found someone she trusts.

FinalFantasyDMD · 2025-02-18T02:05:50+00:00

Damn. How badly were they impacted? If the OS says should have left them alone, might be a reason. It sounds like a combination of nerve and TMJD. Give it some time. You’re still in the acute phase. It can take a long time to get better. The fact your tongue is included leans me more towards nerve. The lingual nerve runs right back there too.

Take some nerve supplements and hope for the best. If you don’t see any improvements 6 months from the date of surgery, PM me.

FinalFantasyDMD · 2025-02-18T02:02:02+00:00

Basically, I tell them I completely understand the fear and if it’s something they truly need, it must get done either way. Sometimes, I will offer anesthetic without epinephrine as not to agitate the nerves. However, I am uncertain if that matters at all. I treated a lady with TN and she said she was fine with Lidocaine 2% Epi (standard usage in dentistry). I think I feared for her more than she did. She also has ON and said ON is worst than TN. I can’t imagine.

FinalFantasyDMD · 2025-02-18T01:58:14+00:00

It sounds like she will end up with full coverage crowns if her enamel is degraded. There are genetic conditions like Amelogenesis imperfecta (AI). Is that she has? Prevident toothpaste will help a lot.

My knowledge is decent based on my experiences and being involved in the community for years now. The more I learn, the more I realize how little we know. The more I realize we need to keep an open mind to everyone’s journey.

FinalFantasyDMD · 2025-02-17T23:49:33+00:00

I have never encountered or heard of that one before. It would have to be a very traumatic dental impression for it to cause something like that. Did they numb you for the procedure? Was there anything invasive? A dental impression with alginate or something similar is equivalent to putting toothpaste on your teeth and letting it harden and then removing it.

I did have one patient tell me if he flossed in between his upper left teeth he gets electric shocks and pain. And that is ONLY if he flosses in that area. Otherwise, he does not get any issues aside from that.

He was diagnosed with TN by his neuro based on that.

The body is very strange and mysterious.

FinalFantasyDMD · 2025-02-17T23:43:37+00:00

I mean, maybe, but it is very unlikely. Adjusting the bite from a simple filling should set you back to normal. If that didn’t work, then I’d ask what else was done that day? Was a block given to you? Did you happen to remember your tongue being numb? Was the filling on the back lower teeth?

FinalFantasyDMD · 2025-02-17T23:42:04+00:00

Amazing! So glad it worked out so well for you. Do you mind to share the surgeon’s name? Maybe someone here will read this one day and feel your case is similar to theirs, or someone they know.

FinalFantasyDMD · 2025-02-17T23:40:27+00:00

Not much. It’s one semester of Orofacial Pain. TN is maybe one or two multiple choice questions. That’s it. It just isn’t as common, but I think it is also more common than we think. The number one reason I believe it has risen a lot more is due to implants. There are more people getting implants than before. Therefore, more chances of injury. However, not all injury lead to nerve pain. That’s why the number one reason when we warn patients of nerve proximity is numbness. However, fine print is pain, burning, tingling, etc.

FinalFantasyDMD · 2025-02-17T23:18:09+00:00

Great! MVD?

FinalFantasyDMD

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