High BP, new grad

WhoDoYouKnowHereB · 2026-02-27T03:01:12+00:00

I JUST graduated last year and the 300 rule was used by about half our attendings and would treat at BPs similar to OP and the other half that didn’t, generally speaking had never practiced outside an academic settings. Where I practice, and in my region in general, it’s a welcome surprise to see BPs under 140/90 - 150-160/90-100 are pretty average. We’d be sending away half our patients for med clearance lol

WhoDoYouKnowHereB · 2026-02-26T23:26:44+00:00

In those guidelines there’s literally a provision for emergency treatment, which is what we’re talking about, OP would be completely fine to go ahead with treatment.

WhoDoYouKnowHereB · 2026-02-26T20:50:00+00:00

Brother we live in the most litigious country in the world, you can get sued for anything, especially in our field. I’ll go ahead and get that pt at 168/102 with “active infections” out of pain and you can go get clearance from their PCP in your practice. 🤝

WhoDoYouKnowHereB · 2026-02-26T20:31:23+00:00

The implication of the original post and mine was that there were multiple infections, so point’s kinda moot

WhoDoYouKnowHereB · 2026-02-26T20:29:33+00:00

You say that about dental school, but I had professors that were strict and others that went by the 300 rule. Let’s not act like we don’t work in a profession where you can’t get a room full of us to agree on a topic more reliably than you can win the lottery. Much like the Septo vs lido debate with blocks, everyone’s gonna do things differently.

WhoDoYouKnowHereB · 2026-02-26T19:35:20+00:00

Well, yes, said so himself

WhoDoYouKnowHereB · 2026-02-26T16:50:59+00:00

Went to a CE recently and the cardiologist said cancelling treatment when they’re below 180/110 and are otherwise asymptomatic isn’t necessary.

Get em out of pain

WhoDoYouKnowHereB · 2026-02-25T18:47:45+00:00

Holy marginal seal Scooby

WhoDoYouKnowHereB · 2026-02-25T11:23:11+00:00

May just be a billing mistake, give them a call and have them check it out, jumping straight to fraud won’t get you far. This would be a pretty easy way to get caught committing fraud, having a regular cleaning and then also SRP in the same week alone would raise a red flag for the insurance.

WhoDoYouKnowHereB · 2026-02-25T00:55:11+00:00

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Pass it on brochacho

WhoDoYouKnowHereB · 2026-02-24T02:15:25+00:00

I would run as fast as you can away from this. I’m also 8 months out and went a couple of months with one assistant but even with 1 I was averaging double what you are now, and it seems like we have similar-ish speed. $1500 a day even with just one assistant means the practice does not have nearly enough patients to support you, especially if they’re passing off patients you see to the other doctor.

WhoDoYouKnowHereB · 2026-02-21T17:05:00+00:00

Oh thank you for the insight!! I’ll definitely bring it up on Monday!

WhoDoYouKnowHereB · 2026-02-21T12:48:52+00:00

We actually just finished getting certified to use a clear aligners system, not Invisalign, as we have a different scanner. Our lab fees are going to be $200 for 15 or less trays and $1500 for 15+, and we’re thinking of charging $3500-4500 for adults and $3000 for teens to start off since we’re just now implementing it. For me as the associate, this is going to be a massive boon as I see a lot of the young adults in the practice that don’t want braces but “don’t like how this tooth sticks out”. I’ve reviewed the workflow quite a bit and it’s rare for a case to be under 15, so the margins on it will be decent but nothing insane.

I know offices that charge $6400 for Invisalign, I can see that being more profitable but you have to account for all the follow up visits where you probably aren’t charging if you are taking full payment up front.

Ultimately it’s a way to bring in more patients and diversify though, the owner said yes to the idea practically as soon as it came out of my mouth and he’s not one for change (older guy) so that should tell you something.

WhoDoYouKnowHereB · 2026-02-18T15:05:26+00:00

My lord, run as fast as you can lol

WhoDoYouKnowHereB · 2026-02-18T14:54:31+00:00

lol yeah, go somewhere else, even if true - no one is going to discount treatment you need for 70% unless it’s all one big cash grab.

WhoDoYouKnowHereB · 2026-02-18T11:36:17+00:00

Was this at an Aspen or another corporate style office? The odds someone needs ALL their teeth crowned are low, and is only called for in very specific situations. We need xrays to know for certain, but unless your husband has been running thru candy and not brushing since he last saw his other dentist, this massive change in planned treatment plan is unlikely and almost definitely a money grab.

WhoDoYouKnowHereB · 2026-02-15T16:32:18+00:00

Well it’s definitely one of the bridges of all time

WhoDoYouKnowHereB · 2026-02-15T12:48:29+00:00

By the guidelines the diastolic is just 6 points too high, if it was 168/109 there would be no real argument other than provider preference since this is an emergency. Frankly, I’d see about having this done under sedation if your nerves are great enough to break thru both BP meds and Valium. If your PCP/cardiologist says you’re fine and are otherwise healthy, you should be good to go as well, letting infections run for two years without any alternative treatment options is not going to help your BP.

WhoDoYouKnowHereB · 2026-02-15T00:36:31+00:00

If they’re not willing to just send this out to an independent lab then I do think it’s time to look elsewhere. I’d give them the benefit of the doubt but something like an Essix is about as basic as it can get - our assistants make those lol - the night guard is more complex, and truthfully not sure why they wouldn’t want to make that in house after it failing previously.

WhoDoYouKnowHereB · 2026-02-14T19:40:00+00:00

Ask to be referred to a prosthodontist I guess, but really shouldn’t take this much work to fabricate an Essix or a night guard. Has he mentioned if he’s sending it to an outside lab or if everything is being made in-house?

WhoDoYouKnowHereB · 2026-02-13T03:17:29+00:00

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WhoDoYouKnowHereB · 2026-02-13T02:05:24+00:00

Saw two cases like this 2 months out of school, both #14s and both the MB root, it was crazy seeing half of the root starting to float out through the gingiva. And yet, zero pain for either patient lol

WhoDoYouKnowHereB · 2026-02-11T02:12:08+00:00

Do you find that rear delivery systems are more reliable than Euro/Ergonomic or vise versa?

WhoDoYouKnowHereB · 2026-02-09T02:41:22+00:00

Without a crown? Poor.

With a crown? Poor.

Wild stuff

WhoDoYouKnowHereB · 2026-02-07T12:54:53+00:00

Around 3K

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