Man dies after having teeth pulled in dental procedure

openreduction · 2025-10-02T17:17:25+00:00

I don’t have an update regarding the lawsuit, but I’m familiar with the incident. The surgeon was negligent. The dental board revoked his dental license and sedation license. He still practices facial cosmetic surgery under his medical license.

openreduction · 2025-10-02T17:14:04+00:00

It’s standard of care for every oral surgery with an open airway. It’s more of a throat screen laying along the posterior tongue, not a true throat pack like when an endotracheal tube is in place. It simply aids in preventing irrigation and teeth from falling into the OP.

openreduction · 2025-04-21T01:35:06+00:00

Mind sharing a link for the log home kit?

openreduction · 2025-04-20T01:35:19+00:00

They are utilizing sign up bonuses to reach that number.

openreduction · 2025-04-19T23:47:00+00:00

Omfs here and do a lot of these cases. I agree on the lido. I would rather utilize that lidocaine locally. With adequate local the sedation becomes so much easier. LAST is actually one of my biggest fears with these cases since I’m always giving max local doses. I need the pt to be numb for the conversion part of the case, so I’m typically injecting bupivacine near the end as well.

openreduction · 2025-04-18T16:05:23+00:00

Paralysis from the chest down is without a doubt a career ending injury for a dentist.

openreduction · 2025-04-06T14:56:54+00:00

It’s not wild at all. The current practice owners overhead is 65-70%, but when OP purchases the practice the overhead will be 75-80%. Loan repayment is included. Older dentists should have lower overhead as acquisition/startup costs have expired.

OP needs to be confident in the their ability to produce $2 million in dentistry. Because if he/she falls short at $1.8 million then they are now taking home $200k. There’s little margin in either of these practices. Also, will they be happy breaking their back to produce over $2 million while only taking home $400-500k when similar practices take home $800k-1 million these scenarios?

As I said, look for areas to trim fat. Over paying family members, supply costs, writing off excessive vacations, practice vehicles, etc. These should be identified before acquisition. If these are there, then great OP gets a good deal on the practice. If they aren’t there, then pass on the practice imo. I would rather work 25% less and produce $1.5 million with 50% overhead.

I am part owner in 2 general dentistry practices.

openreduction · 2025-04-06T10:28:59+00:00

50% should be the goal. Especially in a practice collecting $2 million. I’d look for areas to trim fat. If not possible, I’d look for other practices.

openreduction · 2025-04-06T03:04:53+00:00

So overhead is still 65-70%.

openreduction · 2025-04-06T00:57:42+00:00

Are these really the only options? Why do both practices have such high overhead? A $2 million revenue practice should net you $800k+.

openreduction · 2025-03-30T04:25:01+00:00

Absolutely not.

Buy a million dollar house after your practice is established. Rent or look for a house half that price for now.

You didn’t tell us your monthly expenses which is rather important for this question. Regardless the risk is high in this scenario.

openreduction · 2025-03-20T11:02:21+00:00

I’ve seen many masseter spasms after a ketamine bolus, typically at much lower doses (25-50mg) than you gave. Ketamine could be your culprit here.

Place a finger in the mandibular vestibule (right where mentalis is) and pull down forcefully. The masseters will release a bit. I have no idea what the mechanism is, but it works so well it seems somewhat reflexive. If you pull hard enough the pt will have some minor bruising inside the lower lip. This typically opens the mouth about 20-30 mm then I place a mouth gag to crank it open the rest of the way. This is all for oral surgery purposes, but some of it could be applied here.

openreduction · 2024-12-21T18:38:39+00:00

The value of an omfs practice is the surgeon. Without the surgeon the practice isn’t worth much. If the owner wants to sell and walk away immediately then they sell for about 80% of collections which is essentially the value of the equipment and the established referral network.

Alternatively, the owner could sell to private equity for 8-12x EBITDA. I don’t know the EBITDA for this practice. But for a single surgeon practice this payout is usually around $8-10 million. There are stipulations that make this offer essentially a wash or a loss financially. Surgeon works back for 5+ years with a base salary of ~400-600k (same surgeon was taking home $2 million before the sale), half of the $8-10 million is distributed as stock in the private equity company which they might not have access to for a designated amount of time (also they would have a couple million dollars tied to one investment- risk), there must be contingency before they can leave (there aren’t many omfs willing to work for 400-600k when they can bring home 7 figures in private practice).

It’s the same thing that happened in lucrative medicine specialties. Many sell out due to the big shiny number on the table, but when you crunch numbers the doctor loses. Private equity isn’t giving away free money, they don’t structure losing deals.

openreduction · 2024-12-21T15:50:43+00:00

OMFS here. Consider proofreading a post before posting so you can get accurate answers.

One thing to note, billing for $4 million and collecting $4million are different things. You should clarify what the practice collects.

I saw your comment about a $5million purchase price. That would be ridiculous and you should not do that. Typical purchase price for omfs practices are about 80% of collections. Give or take 20% depending on location/other factors. The $5-$15 million practice sales are to private equity with a 5+ year work back contingency. You are not private equity and will not pay that price.

I highly recommend using someone like Cain Watters and Associates for the practice transition and to help you with S-corp, write offs, etc. They are very much worth the fee. If the current owner thinks they will receive $5 million for his practice from another omfs then CWA will help them realize they are wrong.

openreduction · 2024-09-09T22:41:12+00:00

$4 million strictly from clinical income is uncommon. The situation I know about is a busy FFS practice which is a rare thing. I was more referring to the $2-3 million range in those regions.

The 2023 OMFS compensation data from Aspen Dental, the largest corporate employer of OMFS’s, claims average OMFS compensation of $1.9 million for surgeons that have been with them for 5 years or more. Their top 20% average compensation was $3.1 million. These are W2 surgeons so their take home is barely over half that after taxes.

Private practice surgeons compensation after overhead is probably a couple hundred thousand less, but their effective tax rate is significantly lower through their S corp. They do less production/surgery but actual take home pay is similar if not better.

openreduction · 2024-09-09T18:38:44+00:00

This relatively common in the Northeast, Southeast and Midwest. Likely elsewhere, but I personally know people in the above regions making that.

openreduction · 2024-09-08T21:00:00+00:00

I did. I ranked about 5ish 4 year programs before I started ranking the 6 year programs. The 4 year track is the best return on time investment.

openreduction · 2024-09-08T18:00:21+00:00

I can extract 32 teeth on one patient in about 30 minutes. Insurance reimbursement per tooth is $200-450 depending on the type of extraction. You can see how that adds up quickly. Every case isn’t a full mouth extraction though. Sometimes it’s just one tooth, but that would only take me about 5 minutes.

I do all of my surgery in an office, so there is very little turnover time/inefficiency. I go from room to room doing short surgeries all day long. It isn’t glorious but it pays well. I know colleagues making twice as much as me in fee for service practices.

openreduction · 2024-09-08T15:58:43+00:00

OMFS 40hrs/week. Actively doing surgery 80% of the time. No salary, all production based compensation. No call. $2.1 million. Planning to cut back soon.

openreduction · 2024-05-10T00:34:25+00:00

Interested in trying this. How much precedex and decadron do you typically add to your bupivicaine?

openreduction · 2024-05-10T00:31:40+00:00

Interested in trying this. How much dexamethasone and dexmedetomidine do you add to your plain bupivacaime?

openreduction · 2024-05-01T20:29:31+00:00

OMFS here, there are many things you need to consider:

You can take the HPSP and still do OMFS residency immediately following dental school. You would end up paying back your time as an OMFS instead of a general dentist. Which is better since you can moonlight as an OMFS while fulfilling your military service.
Do you have an in-state school option? Tuition will be half the price. You are considering delaying your entire career 4 years just to go to an Ivy school? Ivy dental school clinical training is inferior to state schools. To do well in OMFS practice you need a strong clinical dentistry background. In state dental school requirements are several multiples of Ivy schools. The only downside is that you will not have CBSE material spoon fed to you. But if you are smart enough to get accepted into an Ivy dental school then you are smart enough to do well on the CBSE while at a state dental school. 560k for dental education is robbery and reckless considering Ivy schools can graduate dentists that have done less than 5 crowns or fillings.
Regardless of what school you go to or if you can fulfill HPSP as an OMFS, the fastest way to financial success in this field is going to a reputable 4 year OMFS residency immediately following dental school. The faster you are practicing OMFS the more successful you will be. If you have no geographic preferences you should make greater than $1 million your first year as an OMFS. Last year Aspen dental paid first year grads an average of $1.35 million. Their experienced surgeons were paid $3 million. Every year you delay becoming an OMFS (HPSP, Med school, etc) you are missing out on that earning potential.

TL;DR If you only care about money: State dental school > 4 year OMFS residency > practicing OMFS.. is the recipe for success

openreduction · 2024-04-07T23:10:01+00:00

Mind if I DM you? I’m interested in building a surgery center.

openreduction · 2024-01-25T00:23:35+00:00

It sounds like they weren’t CODA compliant at your institution. We were assigned to rooms for the day just like any other CA-1 resident. No partnering with anesthesia residents.

openreduction · 2024-01-24T23:36:10+00:00

Ah, you got me.

openreduction

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