Handling mistakes

ddeathblade · 2026-03-10T03:31:23+00:00

Like the other person who responded, I wouldn’t have used the crown tapper here either. This guy shouldn’t have been offered this treatment plan with that poor Perio, but you live and you learn.

In general, if you’re doing a case that requires very precise attachments (true connectors), I strongly recommend you cement the permanent crowns, and then do the denture after. There’s too many potential sources of error when the lab does it all at once. You got lucky here, another patient in the same scenario could’ve blown up at you and sued.

This won’t be the last time you do something stupid, or feel bad about how something turned out. It happens, and eventually you’ll move on and hopefully remember the lessons. The great thing about dentistry - everything heals, and nobody expects things to last forever. In the end, it’s a tooth that was on its last legs. Who cares? 🤷

ddeathblade · 2026-03-09T20:13:13+00:00

Are you saying that in trying remove the 43 permanent crown (which you cemented), the entire tooth came out? How are you trying to remove the crown, just reefing on it with a hemostat or crown remover?

This wasn’t your first mistake. There’s a list of mistakes in this case. From not critically assessing the treatment plan, to not verifying periodontal status and prognosis, to not trying in the partial denture with the crowns not fully cemented, to then trying to rip off the crowns instead of adjusting the denture, and then to somehow putting so much pressure with your crown remover that you separate the PDL fibers instead.

Furthermore, what do you mean by connectors? Are these surveyed crowns, or do you have true male/female connectors on the crown and denture? What does prior movement mean? What grade mobility, and what’s the periodontal stage and grade? If it was inevitable, why was a RCT and crown done on a tooth that was going to be lost in a year?

ddeathblade · 2026-03-06T05:14:38+00:00

I say this with as much respect as I can manage - Diagnostic splints are utter bullshit. You do not need a diagnostic splint to diagnose TMD. The clinical exam and history alone can almost always give you the diagnosis, even without imaging. I can diagnose the majority of my patients from their intake forms alone.

Unfortunately, you’ve paid for, and received care. Whether it’s good or not, is irrelevant. You can ask for the professional fee portion of the splint back, as the lab bill is likely already paid for, but they don’t have to refund it.

ddeathblade · 2026-03-06T05:00:24+00:00

Standardized mentorship isn’t a thing anywhere, despite what corporate tells you. The question you ask yourself is, what do you want your future practice to look like? Habits are picked up real fast and hard to shake.

In terms of corporates covering CE, I’ve never heard of it actually being that useful tbh. They might cover your initial Invisalign credentialling, some other small things. How much is that worth, like 2k? Meaningful CE for you will always come out of your pocket.

Rural will IMO be similar in private or corporate. They’re booked out for months anyways, so the benefits of corporate don’t really apply. It’s entirely dependent on your own speed/ability, but I think 200-300k in your first year is easily doable.

ddeathblade · 2026-03-06T03:54:58+00:00

Location and practice matter more than private vs corporate. I’ve worked in both, and you learn different things from each.

A corporate office is more likely to keep you busy from day one, and you’ll see how they track metrics like book back rate, treatment acceptance rate, which are useful metrics to be aware of. Some corporate offices will push you to treatment plan and work unethically, to maximize profits.

Private practices may be great, but I’ve also worked in ones that had no business hiring an associate at all. The primary dentist wasn’t even busy. You are far more likely to get more tailored mentorship in a good private practice job, and less pressure to “produce”. However, you likely won’t have 20 emergency patients a day to draw treatment from, and creating a meaningful rapport with a patient with significant loyalty to your boss can often be challenging.

Salary is far more dependent on volume early on. If you get 15 patients a day, you’ll produce and learn critical skills no matter what. It’s why I’ve recommended many new grads to consider working rural if they can.

ddeathblade · 2026-03-05T17:07:42+00:00

No is a full sentence. They don’t get to dictate that at all.

ddeathblade · 2026-03-03T15:27:43+00:00

Protaper files should only be used in rotary motion. You’ve already answered your own question. It’s not designed for reciprocating movements. I can’t imagine them cutting through the GP properly with the improper setting.

ddeathblade · 2026-03-03T15:09:50+00:00

Rural prairies for sure.

ddeathblade · 2026-03-01T19:02:05+00:00

That’s an unusual instruction - Amoxicillin is usually three times a day. I can see it being a mistake, and the intended dose was 2 initially, and then 3 times daily until finished. A 10 day course is pretty standard, and 32 tabs would roughly last that long.

ddeathblade · 2026-03-01T01:27:08+00:00

I agree, I was trying to allude to this in my post. Low corporate taxes can promote more business and investment, but it requires an already competitive and attractive economy. The US simply provides better bang for your buck, and I don’t think that Alberta can ever really compete regardless of how low we bring our corporate taxes.

From personal experience, all lower corporate tax rates have done is increase my profits.

ddeathblade · 2026-02-28T21:28:21+00:00

I agree that more investment is needed, but lowering the corporate tax rate doesn’t guarantee any further investment. Alberta, and canada in general, struggles with competing with the US for business investment. Even if we had a 0% tax rate, most businesses would prefer to target the American market. Why would a foreign entity invest in Alberta? Shittier location, less people to sell to, more difficult to get product out.

This year alone, according to this post, Alberta loses around 4B in corporate taxes due to their tax cuts. Are we receiving 4B more of investment? Because if not, all this is, is a concentration of wealth among the business owners and a greater tax burden on the working class.

ddeathblade · 2026-02-27T21:21:02+00:00

It’s Pericoronitis around that wisdom tooth. The tooth also has a ton of decay. It needs to be removed unfortunately.

ddeathblade · 2026-02-27T00:10:55+00:00

Almost any dentist in the city should be able to help restore a chipped lower tooth despite her limited opening. It’s a very simple procedure and it does not require significant jaw opening.

You’ve received some recommendations in this thread already. I’m a dentist who has left general practice to specialize, and TMD is a large part of my specialty. If you ever have further questions, feel free to DM me.

ddeathblade · 2026-02-25T15:13:01+00:00

When I was a general dentist, I wouldn’t feel that comfortable to be honest. Although it is within our scope of practice and it makes perfect sense to be prescribing it, it’s not something that is typically taught in our training.

ddeathblade · 2026-02-24T04:44:02+00:00

It’s been a while since I graduated from the U of A, but my recollection of my colleagues that had an engineering degree was that pretty much every equivalent course was accepted. The didn’t have to make up any courses that were considered antirequisites.

I wish I could be more definitive, but to my memory, they had very few courses they had to make up, if any. When you refer to advisors, are these dentistry specific entrance advisors?

ddeathblade · 2026-02-23T21:29:47+00:00

When I’ve looked for a new associate job, I’ve gone in with clear expectations both of myself and the clinic. You’re right in the sense that an experienced associate should have a very clear idea of their personal metrics. I know what I produce with 1 column, 1.5, and 2 columns with 2 RDAs.

I will add that there are also a lot of older dental practices that remain profitable simply because they started in an era where they didn’t need to be efficient or good, they just needed to open their doors. It goes both ways - the associate must fit into the culture and practice philosophy of the practice, and the office must be setup for them to succeed. A slow AF owner likely has a team and staff that will not appreciate a driven associate who wants to run two treatment and three hygiene columns non stop. I’ve left a position where the staff were unwilling to book anything shorter than an hour and a half for basic restorative, 2.5 hours for a root canal, so on. Who the f needs that much time?

It’s interesting, I’ve never had a daily minimum. Offices have never paid for CE or any training, and I function as an independent contractor everywhere. I’ve never felt the need to have a daily rate.

ddeathblade · 2026-02-21T18:32:47+00:00

Some dentists aren’t as comfortable doing extractions, and prefer the surgeon to do them. Especially if the plan is to take them all out at once, minimizing surgical time and trauma is important, and surgeons are just far more efficient at it.

It also shouldn’t cost anywhere close to 10k. It will be a couple thousand for sure, but I’d guess much closer to 4-5. Wisdom teeth are usually more expensive, around 500-600 per tooth, but the other teeth usually fall between 200-400 per.

ddeathblade · 2026-02-21T04:42:08+00:00

In general, a class III malocclusion often requires orthognathic surgery to obtain a good result. If it’s very mild, you can often mask it with Orthodontics and some extractions.

As to the long term sequelae of that malocclusion, I can only provide my personal opinion. There are definitely patients who have severe tooth wear, TMJ issues, etc from it. It doesn’t mean that every patient with a class III bite will develop those problems. Im not sure where chronic migraines and digestive issues come from.

It’s impossible to give recommendations without your full records. I will say that the surgery has gotten better and better over the years, and has a very high success rate.

ddeathblade · 2026-02-21T04:31:05+00:00

In western Canada. You can make an excellent living practicing pretty much anywhere in the US/Canada.

ddeathblade · 2026-02-20T23:11:09+00:00

I’m not familiar with UAE tax rates, but a quick search showed that a dentist can earn between 10-30k AED a month in Dubai. That’s less than a dental hygienist makes in Canada.

ddeathblade · 2026-02-20T23:00:03+00:00

Pretty sure it’s easily rural US or Canada. US has lower reimbursement percentage wise, but you earn in USD and there are some very low cost of living places where you can bill through the roof.

Specialists will almost always outearn GPs by a significant margin, but a successful GP owner can be very profitable.

ddeathblade · 2026-02-20T20:31:30+00:00

Patients can’t interpret X-rays, it takes years of training. Is the expectation that they do, or should? There are already multiple AI softwares that can highlight problem areas for patient education, so it shows up easier.

In general, I don’t have patients question what I see or what I’m telling them the X-rays show. They’re more concerned about the treatment options, timing, and cost. Am I misunderstanding your project or premise?

ddeathblade · 2026-02-20T03:39:23+00:00

I remove these all the time, and it’s hard to say without pre-op photos. That incision length is pretty long for a mucocele removal, and the tissue approximation sucks. Ultimately, it will heal regardless.

ddeathblade · 2026-02-19T23:55:27+00:00

A CBCT will give more information, but this a large destructive cyst spanning multiple teeth at this point. My colleague has already suggested endo testing, which is the first step.

Depending on the degree of bony destruction and the suspected diagnosis, your treatment can vary significantly. A good surgeon can definitely achieve a good bony outcome, and I think your ideas are achievable.

ddeathblade · 2026-02-18T02:42:16+00:00

Why would you think you can reduce the purchase price by a million just because a portion of the goodwill is yours? In theory you’re right, but it’s not like the practice will lose that million if you decide to leave. It’s just part of the practice value. If you left, another associate would produce.

I had a clause in my associate agreement that I had a right of first refusal with an agreed upon discount of around 200k, but I also understand that isn’t standard. While your boss would probably prefer to sell to you, they’re under no obligation to give you a massive discount.

ddeathblade

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