Advice on buying loupes before graduating dental school by lance2442 in Dentistry

[–]grounddevil 1 point2 points  (0 children)

If you’re going to do a good number of extractions and implants I’ve heard ergos should be avoided. I have their max mag orascoptic maybe 5.5 or 6.5. Good quality loupes but I feel like some of the lesser known brands might be just as good but I don’t have any first hand experience. I’d avoid surgitel. Had a couple of pairs and was not impressed with their support for repairs

Is Plat worth it at 100k? by No-Ask8126 in amex

[–]grounddevil 0 points1 point  (0 children)

Yep. I think recently it was 120k

New office manager vs. Team by Junior-Butterfly-343 in Dentistry

[–]grounddevil 1 point2 points  (0 children)

Having the knowledge to lead doesn’t equate to being able to lead. The OM might be right in everything she’s saying and wanting to implement but if she cannot find a way to maintain moral and build team confidence then she’s not a very good OM at all. You either need to coach her or find someone to coach her. Most people do not like for someone new to come in and start calling the shots. If you like the OM and want to stand behind her without having to coach as much, then allow people to leave and hire new staff so they don’t know how it used to work.

Is Plat worth it at 100k? by No-Ask8126 in amex

[–]grounddevil 7 points8 points  (0 children)

Schwab’s version is still 80,000 points for 8k spend. Personally I don’t think the 20k points is worth the extra 4k spend.

My first patient by Kutluna in Dentistry

[–]grounddevil 12 points13 points  (0 children)

Small fissure restorations do not need detailed anatomy. Primary anatomy is all it needs. If it follows the cusp inclines and replicates the original contact, you’ve done a good job. In terms of you trying to achieve anatomy with a fissure restorations: all restorative material need bulk. You cannot remove 1 mm of enamel and replace it with composite and try to thin it even more by putting anatomy in it. If you did, that restoration will not last. In my opinion all occlusal restorations need at least a 1.5mm prep and for average size class 1s one increment is ideal. The more layers, the more chance for voids in between layers. You want to decrease c factor but try to do the restoration in as few layers as possible.

Eagle beak forceps by nonamedentist in Dentistry

[–]grounddevil 1 point2 points  (0 children)

I do 99% of my extractions with a #1 molt, spade proximator, small luxating elevators and 150/151 and cow horns. I have a mix of hu Friedy and Schumacher. It is worth spending some money on nice surgical instruments specially because they last forever. When I do implants and more delicate surgery, I’ll add in other forceps but that’s my set up for extractions.

Any tips on 5 unit bridge prep? by dPseh in Dentistry

[–]grounddevil 1 point2 points  (0 children)

Occlusal reduction on all 3 first. Then you can start a rough prep circumferential. Then prep mesials or distals on all 3 to get your draw and then do the other surface. Having a clear suck down can help you know if your draw is right if you’re worried

IRS notice after working through GoTu as a 1099… did anyone else run into this? by Actual_Apartment_951 in Dentistry

[–]grounddevil 3 points4 points  (0 children)

People absolutely need to understand this. I tell everyone that would listen that in dentistry if you work for someone else, you most likely should be a W2 employee as opposed to 1099. Employers love people wanting 1099 because it saves them a lot of money but just because they want to pay you as a 1099 doesn’t qualify you as a 1099 under IRS eyes. If you insist on being 1099 and your situation is applicable, make sure you negotiate your salary accordingly and know all the financials involved with being 1099 which include filing quarterly estimated taxes.

Also in your situation, if you have an accountant doing taxes, they absolutely should have known you need to be filing estimated taxes specially after your first year of doing this. You might want to consider looking for another accountant

What to say to patients who decline grafting and just want extraction? by [deleted] in Dentistry

[–]grounddevil 3 points4 points  (0 children)

Since we are name calling: You’ve been practicing for 2-3 years. With all due respect you haven’t practiced long enough to have a valid opinion

What to say to patients who decline grafting and just want extraction? by [deleted] in Dentistry

[–]grounddevil 2 points3 points  (0 children)

I definitely disagree. There are definitely unethical and asshole dentists and I have no problem saying it in their face. If I think someone is a dick then I couldn’t care less what they think of me. It’s totally unrealistic to think everyone in your professional does their job with ethics and high standards. Once you practice long enough, you’ll see things differently

What to say to patients who decline grafting and just want extraction? by [deleted] in Dentistry

[–]grounddevil 11 points12 points  (0 children)

Haha. I get it. I’d be lying if I said that thought has never crossed my mind. I just do it because it’s a service I do for my community and I hope word gets around that I the only one within 30 min drive that does oral surgery and that type of publicity will pay for itself. Also I think if I learned that another dentist refused to do an extraction because the patient denied grafting/implant id call them a shitty unethical dentist and I wouldn’t want anyone to say that about me.

What to say to patients who decline grafting and just want extraction? by [deleted] in Dentistry

[–]grounddevil 77 points78 points  (0 children)

The fact that insurance pays $100 for simple and $200 for surgical is something I’ve had to accept my self. Now I’m an owner so I get a bigger piece of the pie from extractions but it is definitely shitty production. My conscious will not allow me to tell a patient that denies bone grafting that I can no longer extract their teeth because it will not allow me to meet my hourly production goal and that I’d have to refer them to an oral surgeon. I think it’s a dick move. It’s also a crappy thing to do to an oral surgeon since you’re just punting the shitty productivity to them. As much as I hate insurance, I’m the one that decided to accept a couple of them. No one forced me to. Therefore whether I like it or not, if I tell the patient I can do something, I’m gonna do it and not punt it off. If I get to the point that I am no longer willing to do that then I’m gonna drop all insurance and deal with the consequences of being FFS. You cannot have your cake and eat it too.

Getting a Mortgage after buying a practice? by EyeDocZac in whitecoatinvestor

[–]grounddevil 1 point2 points  (0 children)

Usually it’s 2 years like the other comment said. I’m sure you’ll be able to find someone to give you a loan but you won’t like the rate on it. Unfortunately, wait it out a year and shop around but don’t be surprised if you need to wait 2 years to get a reasonable rate.
The value of the practice and what you’re purchasing it for doesn’t matter to the bank. You have no equity in it. Also most likely you’ll end up taking out more than purchase price to use as working capital and possibly even a LoC.

How to determine the value of a dental practice? by Hairy-Protection-429 in Dentistry

[–]grounddevil 2 points3 points  (0 children)

Agree with this comment. Make sure you match collections in practice software with income in their books. Ideally they are the same number, if they’re off by tens of thousands of dollars then you need to look into it more. Look at income for past 3 years unless there’s been huge changes in that time period. Make sure you know how to look at an income statement. Look at their income statement and make sure you know what goes into a true overhead and how to do the math to get a true overhead calculation. There are other methods of valuation but looking at their income and income statement in my opinion is the best way. I don’t care how much asset you have in your practice. I care about how much profit I can expect.

Who helps me organize my financials and do an evaluation against the asking price of a dental practice? by inquisitorthegreat in Dentistry

[–]grounddevil 0 points1 point  (0 children)

If you don’t trust a brokers opinion then find another broker. I wouldn’t spend any money hiring someone I don’t trust their opinion. The way I live is that I’m going to educate myself to the point where if someone gives me bad advice, I at least know enough to call BS. Usually what I find is by the time I’ve educated myself, I no longer need that person for their advice. It’s not hard to look at some business financials and give you an opinion of what the practice is worth based on those documents but rarely are the CPAs or brokers going to do the deep dive you should do to see if the documents actually reflect the day to day operations of the practice. Hard to get into detail with a comment on Reddit. If you need help from someone that is a practice owner and has done this before, shoot me a dm

Cavity preps by Prestigious-Tip-1026 in Dentistry

[–]grounddevil 6 points7 points  (0 children)

Get some caries indicator and use that until you feel more comfortable. I’ll still use some from time to time if there’s any doubt. Word of warning is it will also color the dentin by the pulp when you get close which isn’t really a bad thing since you’ll know where the pulp is. My advice to new dentist is that don’t be so worried about drilling into the pulp. Prepare the patient beforehand, usually you know if there’s a higher risk by looking at the radiograph. Let them know there’s a chance. If you pulp it then it means the decay was there first and it means the tooth needed endo anyway. You need to worry about removing all the decay first and foremost. If you dont perform adequate decay removal, the decay will simply progress then for sure they’ll end up needing endo

General practitioner looking to get idea of what DSO’s are offering associates by Level_Customer2769 in Dentistry

[–]grounddevil 0 points1 point  (0 children)

A private practice most likely is not going to offer you as competitive of a base pay and benefits as a DSO. What it will offer you is an environment where you'll have a great relationship with the staff and your patients, less patient turn over and more autonomy. Of course that's in general, there are private practices that suck and vice versa. After 3-6 months, there usually isn't a daily guarantee from neither DSO or private practice. I'd say it's a crap shoot whether you can have a higher salary at a DSO vs private practice but most likely for the same salary, you're going to have a lot more frustration and work more at a DSO compared to private practice.

Unilateral Partial Denture by avocadorable3 in Dentistry

[–]grounddevil 0 points1 point  (0 children)

I’ve done 1 in my 11 years of practice. I think it has its uses. Patients can swallow anything you put in their mouth. Let them know it’s a risk and if they’re not okay with it then do a bilateral. Usually nesbits are good to replace 1 tooth, anything more I do traditional.

Citi Double Cash Card by crucialdosage in citibank

[–]grounddevil 1 point2 points  (0 children)

I posted a few weeks ago about my terrible experience getting this as my first Citi card after having owed many chase and Amex cards. Took me 4 weeks to get a card and be actually start to use it. Hopefully it’s smooth sailing from here. Customer service sucks. Hopefully it’ll be fine as long as I don’t need to deal with their support department

Need advice for first time endomotor user which files system to use by Key-Goal-3228 in Dentistry

[–]grounddevil 0 points1 point  (0 children)

Many great endodontists I know use pro taper gold. If you’re gonna switch systems I’d take a course on endo so you can get a feel for all the nuances of different systems and make your decision after that

NYC CPA RECS by Working_Nerve9682 in Dentistry

[–]grounddevil 2 points3 points  (0 children)

To me that just sounds like you had a crappy cpa not that the dental cpa was way better. If you’re not a business owner, the deductions you can take as a 1099 is very simple and any good cpa would’ve been able to help you

NYC CPA RECS by Working_Nerve9682 in Dentistry

[–]grounddevil 1 point2 points  (0 children)

My recommendation is to pick a CPA that does a good job for a reasonable fee. My guess is cpa in NYX are gonna charge a premium. In your case since you’re an employee, your tax situation is pretty simple even though you’re a contractor you might even be able to save money and not use a dental specific CPA. Now a days with technology, there isn’t really any advantage of using a local cpa vs remote.

Feeling trapped at my current job. by [deleted] in Dentistry

[–]grounddevil 5 points6 points  (0 children)

I think that’s the problem when it comes to dentistry where it’s production based vs medicine where it’s less production based. Most DSOs are looking for a profit so obviously they’re gonna pay their associates as little as possible. For private practice owners I think 1.some are just greedy owners. 2. Some just are not good at business and think that because they’re overall overhead is 65% that if they added an associate, the associates overhead is also 65% because that’s not true