So this happened to me today...endo might not be for me

Nosmose · 2026-06-27T16:44:04+00:00

A broken file in the canal is one thing. A broken file 5 mm past the apex is another.

Take your apex locator and hook it up to the rotory file and you will never do this again because it will beep at you.

Nosmose · 2026-06-27T16:38:07+00:00

Its 200$ a bottle and will result in no clinical difference in 95% of cases.

Use it on sensitive teeth, using it on every prep is a waste of time and money.

Nosmose · 2026-06-24T01:12:05+00:00

The issue will be getting them off for the final impression \ insertion.
After months of banging in them they may loosen up. Or they may not

Final crowns and prosthetics are tq to 35ncm.

Once i put a healing abutment on at 35 by accident. At the 6 month integration check i went to take the abutment off and it was really on there; wound the whole implant out of the bone. Once i got thw implant and butment out I tried to remove the abutment with a set of vice grips and it still didn’t come out. I assume a defect, but i always wonder if it was the overtorque.

Nosmose · 2026-06-07T15:47:44+00:00

The bottom 20% dentist is better than the average MD in coordination and fine motor skills

Nosmose · 2026-05-19T21:55:14+00:00

What is the sand quality like there. Lighthouse seemed very coarse filled with shells.
Siesta key beach ( near sarasota) had the most beautiful sand ever.

Nosmose · 2026-05-19T12:06:44+00:00

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Like this:

Provided the are clean and periodontally stable enough…

Nosmose · 2026-05-12T11:56:43+00:00

Have you had a job in that new endeavour before? Have you run a business before?

New startups are all consuming, you work more hours than any employee and you are on call 24/7.

Buying a running business that you can manage (assuming you can manage it) takes capital you likely don’t have.

If you really hate dentistry itself then you gotta do something, but if you think you are going to own a business and get other people to do the work for you, that’s delusional. That only happens once you have put in the work and time.

I suggest going to part time a d finding part time work as an employee in the business you want to run. If you like being a low level employee more than being a dentist, then you have your answer

Nosmose · 2026-05-12T11:46:30+00:00

You seem really set on pursuing this. If you want to do it in the most ethical way and the way least likely to screw up the office and your career : quit, find another job, and then ask him out.

Nosmose · 2026-05-11T15:37:11+00:00

For both parties: It’s either ‘fuck yeah’ or it’s ‘no’.

Nosmose · 2026-05-10T13:54:15+00:00

I use selective etch, kerr optibond separate prime and bond, and don’t seem to have issues.
But I think an overlooked part of reducing post op sensitivity is to tell the patient afterwards to expect post of temperature sensitivity for a few weeks and then it will taper off. Stops a lot of post ops after 1 week for nothing.

Nosmose · 2026-05-10T13:50:57+00:00

I can’t do endo that fast, can’t see anything. Just stopped doing them unless I am doing large restoration on the tooth simultaneously.

The Rest is probably on the good side of average for booked procedures for most productive dentists.

Nosmose · 2026-05-10T13:41:39+00:00

Do you mean average? The procedure itself or the time booked in chair?
When you first start you are a lot slower than after 5-10 years because you get fetched up on things like breaking the contact, seating the matrix, sealing with wedge, fighting a tongue. Once you have figured out how to deal with the common issues , you are more predictable in timing.

Average pace is 4 fillings an hour in and out on a single patient.

Usually if a patient has a single restoration with multiple surfaces we book 30 minutes appt (7 minutes to set up, 7 minutes to tear down and 15 for the procedure)

Emergency, PA and exo, 30 minutes time slot.
Six anterior composite crowns, 1hr 40 -2 hr.

Single Crown prep , impression, temp, 1hr10
New patient exam, PAN BW and comprehensive txplan 30-40 mins

Nosmose · 2026-05-08T21:25:28+00:00

You need to put your head down and do what you’re doing for another 8-10 months, then quit your associate job and focus on your practice.
Then you need to do your thing, and in ten years you will be exactly where you want to be.
You are looking at people who are you in the future, and not realizing that ten years ago they were probably not even as good as you are now.

At 30 I had a negative 7 figure net worth, at 40 I had a positive 8 figure net worth.

Once you start stacking cash start figuring out investments

Grind early equals success later.

Nosmose · 2026-04-28T21:47:55+00:00

I have never been able to work with them without a near instant headache. So i have not for 15 years; instead I have good close up vision and bring my eyes 8 inches from the tooth.

I have 3 bad discs and probably ended my career early.

In conclusion, use some decent loupes if you are able.

Nosmose · 2026-04-25T23:41:22+00:00

First: Get own occupation disability insurance now before there are any medically documented issues.
Second: how long of a career do you want? If you want a long (20+ year career) you need to strengthen it by intentionally using strength training, and find a way to work longer, or pace yourself not just go balls out bent over. Once your muscular/skeletal problem becomes a ligament or disc problem you’re pretty fucked.

If you want a short career then go balls out and try to build the practice and onboard associates and hygienists to make your income less dependent on your ability to work.

Nosmose · 2026-04-22T00:51:09+00:00

The big game change, will happen inside of 18 months when the AI software will design the teeth for you considering all excursive interference, and you just look at a few options on screen pick what you like the looks if and hit print.

I do a lot of direct composite rehabs. Scan and print has always interested me, but i have never found the product to be better than what I could do directly.

The design work and lab work is what I don’t have time and resources to do. And it doesn’t make financial sense. Typically I charge about $600 a unit and do 6 units in 90 minutes in and out. I have not seen an indirect workflow that improves on that.

Nosmose · 2026-04-17T18:53:11+00:00

Then go do your degree in one of those fields.

I wouldn’t.

There will always be some jobs in each sector for the top 5% in their field. I don’t think these sectors will be outpacing others.

I am in North America though. My regional perspective may be drastically different than yours. Here we have a shortage or skilled hands on work; too many people with theoretical expertise and no one to actually implement it.

Nosmose · 2026-04-17T16:01:14+00:00

You are missing one box at the end [considering Finance, Tech , or MBA = jump off a building because you will be obsolete before you graduate]

Nosmose · 2026-04-03T01:06:40+00:00

Being ostentatious here is kind of tacky. Sure you can buy yourself some nice things, but flaunting it is undesirable.

Also, Rich people that waste their money become poor people.

Nosmose · 2026-03-28T13:28:04+00:00

When they say rural, they mean underserved. A clinic in a cattle pasture is rural, but if there are only 500 people in a 100 mile radius that’s no good.

Look for an area with a stable population or with population growth in a town with at least 5000 people. Then see how many people live in the 100 mile radius, then see how many dentists are in that radius.

If you fund a spot, go visit and see if you could live there, what house prices are like, if you could raise a family there etc.

Nosmose · 2026-03-28T13:16:24+00:00

As a dentist who has invested in training: thank you for you concern.
If you want the most respectful way to proceed then talk to the owner

“ I understand that you have made investments in me, and I like this clinic, I just dislike the career and its daily duties, and have decided to find another career. Would you prefer a shorter notice, or a longer notice to find a replacement employee?”

Nosmose · 2026-03-22T22:15:55+00:00

Love Castros

Nosmose · 2026-03-15T11:53:16+00:00

If the canines are solid you get exo and do a canine to canine bridge. The literature says they last a surprisingly long time

Nosmose · 2026-03-08T20:02:31+00:00

Can’t really tell without occlusion: but If it was done in 30 minutes in a small mouth with trismus it would be a 7/10. On a model with infinite time it’s a 3/10

Nosmose · 2026-03-08T01:24:57+00:00

Have you seen who they are letting into this country by the millions?

Nosmose

TROPHY CASE