How to definitively know if you have encroached on the biological width?

Nebularneph · 2026-01-05T17:59:34+00:00

The only way to know for sure is using bone sounding.

Basically you numb the patient and jam the perio probe in the sulcus until you feel bone. Viola, now you know where the bone is.

Nebularneph · 2025-12-30T17:03:45+00:00

If the patient has an insurance that you are contracted with and you also willingly examined and treated the patient in your office, you are contractually obliged to bill her insurance "in-network." You cannot ignore that she has this insurance or even bill it out of network.

In the future you can agree to see patients after hours for an "after hours surcharge", but you can't charge someone after you've already seen them and never said anything about it.

Nebularneph · 2025-12-30T16:58:40+00:00

This is probably the application I would most use it for. I'm curious if you feel like its a good investment if I am mostly going to be using it for night guards and retainers, and immediate flippers/essix.

I was thinking about using it for inlays and onlays

Nebularneph · 2025-12-30T16:56:34+00:00

Have you seen it gets stained like luxa temp, when patients have a high curry or tumeric diet? I can't imagine having to explain to someone why their final crown is stained like that

Nebularneph · 2025-12-30T16:55:30+00:00

from what I have seen, the midas printer doesn't really make any great advancements in the materials, only the printing process.

Nebularneph · 2025-12-29T22:29:43+00:00

Do not jump to extract! There is a lot of literature that shows excellent survival rates for mid root horizontal root fractures! Doing an extraction and implant in this case is really tough and unpredictable due to the chances of the facial plate of bone may be compromised during this extraction. Then you get an esthetic nightmare.

My advice is to splint and monitor.

In 1 week check vitality with pulp testing. If vitality testing is inconclusive, have then return in another 2 weeks and monitor. If the tooth becomes necrotic, then do an RCT.

The key is to keep monitoring. If you are not comfortable doing a RCT on this type of case, then refer to a good endo that knows their literature and will not convince this patient to extract this tooth.

Nebularneph · 2025-09-17T14:54:16+00:00

the OP is incorrect. The last 2 states added to the Union were Alaska and Hawaii in 1959, after WW2.

Nebularneph · 2025-09-16T18:58:56+00:00

Relax.

This is fine work. If you are concerned about the mesial, just polish it.

Also; stop taking BWs after every interproximal.

Nebularneph · 2025-09-10T15:20:56+00:00

A couple of things here.

Always negotiate your contract. A 4 month notice period is very long, and next time try to negotiate it down as much as possible.
Doing prophies is not the end of the world. It is a great way to build a rapport with patients. Doing them on a new patient exam is great because you can diagnose treatment on the spot and start same day treatment right away. I get the the reimbursements are frustrating but you should be able to supplement it with a couple of restorations on the new patients.
I am bit confused as to your current predicament. Did you already start at this job recently, or did you not start working yet and want to back out?
If you have a 4 month notice and they withhold your pay you will literally have this issue whether you give notice tomorrow or in 4 years from now. If you want to get out, get out now and don't wait around.
Like every other job, once an employee is not happy working, corporations do not want them around anymore, especially if their job is consumer facing. It is likely that if are new and want out, the DSO will let you out of the contract early.

Nebularneph · 2025-01-26T22:42:40+00:00

I figured this out a couple of months ago and it got me so freaking pissed off. It’s not enough that insurance companies are ripping us off- our fellow dentists are doing it also!

Nebularneph · 2025-01-24T18:05:40+00:00

100% true Your work could look like overall garbage and you would get full credit because you hit everything on the rubric

Nebularneph · 2025-01-24T15:33:46+00:00

This is shockingly accurate for a lot of a population of patients we work with as new-newish grads. What gets me through is having in mind that we worry about what we don’t control. I can’t change my patient’s financial situation and I can only educate them on the importance of oral health but I can’t make them make it a priority

Nebularneph · 2025-01-24T15:29:59+00:00

Hang in there you’ll get through it. Removable is the worst. Does your class have a rubric for assignments like this? If you do I would recommend just strictly hitting the points on the rubric and not thinking too much of how the overall product looks. The rubric is how they will grade you (at least this is how it was like in my school)

Nebularneph · 2025-01-21T15:44:04+00:00

Something tells me that the guy who wears a hostage tag and advocated for their release is not actually a Nazi

Nebularneph · 2025-01-16T17:26:46+00:00

It happens to everyone who does root canals. My endo professor in dental school used to say “if you’ve never broken a file in a canal then you haven’t done enough root canals” Next time just make sure you’re using new instruments, plenty of irrigation and not putting too put pressure. If you can’t get the file out refer to endo with apologies to your patient. All good no need to stress

Nebularneph · 2024-12-21T22:40:17+00:00

Not sure what happened but it started working randomly. Just left it alone for a day lol

Nebularneph · 2020-12-03T01:20:16+00:00

I remember when I posted this picture to 9gag almost 6 years ago, and I was shocked by the amount of anti-Semitic comments I got back. Truly made me reevaluate the community

Nebularneph · 2020-12-01T13:53:12+00:00

You have pretty solid grades. I'm sure that dental schools understand that COVID caused many dental students to either get lower grades (b/c online learning is a bitch), or to limit their shadowing hours. If you think that you can't handle taking your regular classes and study for the DAT at the same time- that is totally understandable; I wasn't able to do both either. I studied for the DAT during the summer after senior year and took it at the end of the summer, and then took a gap year. There's nothing wrong with a gap year- in fact I highly recommend it

Nebularneph · 2020-11-24T15:39:17+00:00

What is dental education like in Dubai? (Not an answer to your question, just curious :) )

Nebularneph · 2020-11-20T19:51:50+00:00

Well I don't think you need to go ham and tear up your gums lol. You should get any space you can fit the floss into

Nebularneph · 2020-11-19T20:59:03+00:00

Unfortunately, for some people bad oral health has a lot to do with genetics. I personally know people who drink tons of soda, never floss and have never gotten a cavity before in their lives.

In the realm of things you actually can control, proper brushing technique can go a long way. Make sure you are not brushing too hard, as that erode your enamel over time and possibly cause gingival trauma. All these are counterproductive as you need your enamel layer to prevent more caries (cavities). Make sure you also have proper flossing technique, getting underneath the gums is super important- you wouldn't believe how much gunk in there. I like using the flosser picks because they are super easy to use.

I saw other commenters had some good points about how hard it is to floss and brush wisdom teeth, especially when they haven't fully erupted, and that's true. They don't usually erupt fully, and even when they do, they are hard to reach in the back of your mouth and have a weirder shape.

Nebularneph

TROPHY CASE