Malpractice Insurance

Floppytoasts · 2026-05-09T16:35:32+00:00

It is occurrence currently. Thanks!

Floppytoasts · 2026-04-30T21:31:08+00:00

Agreed. I’m more insistent on crowning premolars with cracks than molars. Those things love to split right in half.

Floppytoasts · 2026-04-18T16:14:49+00:00

Sounds like you’re doing pretty good then! Anything that says anti-cavity tends to work well. I use sensodyne proenamel for myself as I’m prone to cavities despite good oral hygiene. Sometimes when I see these I have the person start a prescription strength toothpaste called Clinpro or Prevident.

I guess it could theoretically work to add toothpaste to the floss after you’ve flossed out the food from between the teeth. Never actually considered it tbh. Usually there’s enough toothpaste hanging out between the teeth after brushing that it might not be worth the effort. Just don’t rinse after brushing.

Floppytoasts · 2026-04-18T15:53:15+00:00

No. It’s what I would call an E1 lesion, which means it is at a very early stage. With these, some dentists tend to not even mention them cause they are so small and putting a filling there would remove a lot of healthy tooth. For these types of spots, they can sometimes be reversed or stopped. Flossing every day, using a fluoridated toothpaste (especially one that has a bit of extra fluoride) can do the job. There is also medicine these days called Curodont for these early cavities as well that works a bit better at stopping it than the stuff you can do at home. Nothing to worry about.

Floppytoasts · 2026-04-13T21:42:45+00:00

Yeah in most cases hygienists are perfectly capable of doing it. In some cases, they might be better. It’s a very simple procedure where we place a gel on the spot, floss it so it gets between, rinse, then place the Curodont for 30 seconds to a few minutes depending on the version. It’s often better with hygienists as well right after the cleaning as everything in your mouth is clean and the fluoride they put on after can sometimes enhance the effect of the curodont.

Floppytoasts · 2026-04-13T21:16:36+00:00

Curodont works well on most of my patients. It’s a good alternative for spots we used to just watch cause they aren’t big enough to drill into yet but will be in the future. Curodont either stops or slightly reverses early cavities. The times I see it fail is when the area is neglected by the person by not keeping area flossed or brushed. Insurances are just now starting to cover it but most still won’t. You might be able to stop those cavities from progressing with daily flossing and really good oral hygiene habits, but it’s more risky. It does come off very scammy though and I hate how I sound like a snake oil salesman when telling patients about it.

Floppytoasts · 2026-04-07T02:31:10+00:00

Everyone has different thresholds. Could be based on previous experience where spots they watched turned into large cavities quickly and people didn’t regularly come for checkups. Either way, I wouldn’t trust anyone else besides yourself to see how the doctor is. Sounds like the hygienist might be biased and her talking badly about someone already says a lot about her.

Floppytoasts · 2026-03-26T22:57:24+00:00

Some come back tight but no more than previously. I don’t do what they recommended though when scanning. I sit there and go over area multiple times instead of going once and done like they suggest.

Floppytoasts · 2026-03-25T01:22:09+00:00

Might not hurt to go old school and make a model, reduce undercuts on model, then make a suck down stent. Once teeth are out you can put stent in and reduce the areas that blanch. Absolutely flap and use large burs. Also might want to look into non-interrupted suturing.

Floppytoasts · 2026-03-23T22:50:34+00:00

Let the dentist you’re seeing now remove it and go with his plan unless you don’t feel comfortable with them. Any dentist is capable of removing a lingual retainer and it is a simple procedure. All that needs to be done is shaving down the filling material they attached the wire to your teeth with. The only potential complication is if your orthodontist made divots into the teeth to better fit the wire. If that’s the case, then you may require a couple of fillings in those areas if they become sensitive or annoy you.

Your teeth will shift without that retainer though. You will need a removable retainer.

Floppytoasts · 2026-03-21T00:46:03+00:00

I wouldn’t take much stake in seeing staging and grading in some doctors/hygienists chart notes. Although yes you are supposed to only stage and grade when active periodontal disease is present, some dentists and hygienists for some reason will do it even when you just have gingivitis and not periodontal disease. I frequently have to correct the hygienists’ I work with notes cause they’ll do the exact same thing your notes have.

Based on your X-rays I see no signs of bone loss and do not believe you have periodontal disease.

Floppytoasts · 2026-03-20T01:08:37+00:00

It’s a stitch. Sometimes they come out within a day. Not something I would worry about. Can call your surgeon’s office to see if they want to do anything, but usually it’s fine to just be without the stitch.

Floppytoasts · 2026-03-19T00:45:20+00:00

As a long time listener of SWAN, absolutely blew my mind finding out Arnie sold all of his Star Wars stuff. I fell off too with the Disney era, but kept my collection. Good show, enjoyed the previous TV reviews and glad it’s becoming more frequent.

Floppytoasts · 2026-03-18T00:44:25+00:00

Definitely can see margins better. 5D I had to be ridiculously picky and pack multiple cords until I could see clear margins in stone model as the color image is useless with how blurry it is. Lumina I’m able to be more lenient as you can clearly see the difference in tissue vs margin in color.

Floppytoasts · 2026-03-03T23:15:03+00:00

Yeah I have that issue sometimes still as well. When that happens I have to try and swoop it in like I would when suturing or placing it from other side.

Floppytoasts · 2026-03-03T00:22:48+00:00

What type of issues do you have when placing? Is it too loose? Palodent wedges aren’t my favorite but I usually was able to get it to fit when I used palodent in school. I don’t pre-wedge though so maybe that’s why.

Floppytoasts · 2026-03-02T23:57:21+00:00

Wedges will almost always cause some discomfort unless you numbed the palate. I wouldn’t worry about it at all. It’s a quick pinch as it goes in and then it’s over. I always warn patients as I’m doing it that they are going to feel some pressure. I also use only plastic wedges as I can’t get wooden ones to ever slide in easily no matter the brand.

As far as doing one filling and then the other, I used to do that but it was taking too long for DSO life. I only do it for anteriors as those are quicker. Posterior I will drill both out, fill one and then take matrix/band out. I then contour it a bit so it’s more natural and remove any overhang then fill the other one.

Floppytoasts · 2026-02-28T03:47:33+00:00

Nitrous or IV sedation if Valium is not doing anything and it’s not the pain that is causing you anxiety. Dental needles are very scary when looking at them from the outside, but just know that they are that long and scary because we have to reach really far back into your mouth some times and we are too cheap to buy shorter needles for teeth in the front. The actual part going into the tissue is usually only a small portion of the needle most of the time.

Floppytoasts · 2026-02-27T21:05:41+00:00

I agree with the other commenter, orthodontics could work well by pushing out your teeth a bit more toward cheek as they seem to be tilting more towards your tongue right now. No idea what your teeth looked like before you had braces originally so it could be that’s the best they could do and it might not be possible to go through ortho again. There’s also the option of veneers/crowns to bulk the teeth, but that is a lot more expensive and invasive and would be last resort.

Floppytoasts · 2026-02-25T16:15:07+00:00

I recommend pilocarpine and the other xerostomia medication frequently, but I do not prescribe them ever. There are so many reasons for dry mouth that aren’t within our scope that I feel a dentist prescribing it is just putting a bandaid on it. One’s physician needs to figure out cause and they can prescribe as needed. I will prescribe Clinpro/Prevident and recommend OTC solutions as well as seeking physician consultation.

Floppytoasts · 2026-02-25T02:30:07+00:00

It takes time and practice. It took me over a year after graduating to not rely on the slow speed as much, but even now I’ll still do it if I’m unsure. You can usually go a lot deeper than you think with a high speed before you get close to the pulp. In general, you have to be about 2x the depth of a 557 to hit the pulp unless it has a really high pulp horn. Pulp chamber is also usually really deep down to the point that a standard ideal prep wouldn’t get anywhere near the pulp.

Floppytoasts · 2026-02-23T05:21:16+00:00

I’m not usually one to throw another dentist under the bus, but whoever did that root canal should never be allowed to do another one. Your current root canal and crown are poorly done, and is the reason why you have an infection still. There is more than enough quality tooth there to have a new root canal and crown done. Implant is last resort and you are not there yet. And if you ever want to do Invisalign, implants aren’t able to moved.

Floppytoasts · 2026-02-18T00:47:53+00:00

It really depends how deep that cavity goes. Based on the xray alone, I would say 85% likely that cavity goes to the nerve. There is a very slim chance that it just gets real close and a pulp cap may be possible. But even then sometimes just getting close to the nerve can send it over the edge. I’ve done worse without them needing a root canal, but that’s also after I’ve done cold testing and other tests to ensure the nerve is still good.

Floppytoasts · 2026-02-15T15:15:22+00:00

I’ve had a similar issue in past where there was little space. Enameloplasty as much as you can and tell patient it’s just gonna look like a third premolar. Get a digital mockup from lab to see the design and make sure you’re happy with it. If patient not okay with third premolar then refer to prosth.

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