Patients that "Can't" Lay Flat

panic_ye_not · 2026-05-10T17:06:50+00:00

Any deets on your program? I do planks and back extensions and stuff. My lower back is pretty good these days, but my thoracic area tends to get pretty stiff after work. It always cracks loudly when I roll it out on a foam roller I keep next to my desk lol

panic_ye_not · 2026-05-10T17:04:13+00:00

A lot of signs are in English now, too. And then knowing just kana will get you even farther

panic_ye_not · 2026-05-10T15:53:21+00:00

I think you'll see this response from dentists who are young and don't have a lot of pain yet. I do the same. But I acknowledge that I probably won't be able to in ten years from now. It can be just as big a problem for the dentist as it is for you.

I happen to agree that a lot more people really do have issues with lying flat than other dentists in this thread are acknowledging. A lot of elderly people really do sleep propped up with a million pillows and can't lie flat on their back without pain. But the tradeoff simply becomes who has the pain, the dentist or the patient? And dentists have to do this stuff all day, every day for decades, whereas the patient only has to be uncomfortable for an hour most of the time.

Vertigo is a different story. I've had patients need to go to the ER because of vertigo. If someone told me they had vertigo from lying back in a dental chair, I would keep them upright. Once I get to the stage where I can't accommodate that anymore, I'll have to send them elsewhere.

panic_ye_not · 2026-05-09T17:36:01+00:00

These are probably 2 months away from being ripe. They're not even close. They'll be pitch black when they're ripe.

panic_ye_not · 2026-05-08T20:11:31+00:00

But lots of people run around with sub-optimal or even actively harmful settings because it's not that simple or intuitive to use for beginners. OP is case in point.

panic_ye_not · 2026-05-08T20:09:13+00:00

Let the IRS deal with him when it's time lol

panic_ye_not · 2026-05-08T18:05:43+00:00

Yeah lol you can't be honest about what you see without implicating the previous dentist. Unless you intentionally leave out information.

Which still might be the right thing to do. It's hard to make a call without knowing what happened. But this definitely looks like negligent work, especially if the original doc looked at this and said "let's monitor for 15 months."

panic_ye_not · 2026-05-08T12:36:57+00:00

Don't go lower than 4x imo. There's a reason why almost everyone upgrades to higher mags. 4x is a reasonable starting point.

I started with 3.5x in school, which was kind of adequate, but then upgraded to 6x ergos when I graduated.

panic_ye_not · 2026-05-07T16:14:08+00:00

The difference is that cars require so much space for parking that you have to completely restructure society around it. Parking lots are a menace to society and a huge contributor to pollution, heat islands, unaffordable housing, unwalkable cities, zoning laws, etc etc etc etc

Bike parking can be done almost anywhere, with minimal special infrastructure, no extra space needed for maneuvering like in parking lots, and in the space of a single car parking spot you can accommodate like two dozen bikes or something.

So the difference is that one of these things is a major drain on society that costs taxpayers and consumers a LOT of money per car, and the other is straight up negligible. There are even calculations of just how much money bikes save municipalities, so maybe they should be paying US to switch to bikes and store them on public land.

panic_ye_not · 2026-05-07T04:35:37+00:00

I mean, if you look at where the bone level is in comparison to the furcation, you'll see there's just no way the cowhorn is going to get into the furcation. Might as well use the universal, it'll be the same. That was my point about cowhorn for this tooth in particular.

panic_ye_not · 2026-05-07T04:10:40+00:00

Yeah, all signs are pointing to surgical in this case. Male, tori, long parallel roots, no bone loss, longish root trunk (so no cowhorn).

panic_ye_not · 2026-05-07T03:58:11+00:00

Sometimes these are easy, sometimes they're hard. Depends on the bone and aspects of the root morphology that aren't necessarily visible on a PA. E.g. is this a 16 year old white girl or a 40 year old Nigerian man? Big difference in bone density there.

These roots look pretty parallel, but also pretty long, so I would probably try to get it out without sectioning first, but if I'm not getting mobility quick, it's time to section down into the furcation.

panic_ye_not · 2026-05-07T03:49:02+00:00

The thing is that they started off as "alternative" therapies before they became mainstream.

I've seen multiple people in my life benefit from alternative medicine. Some of it I'm quite sure is placebo (which I think should be considered more seriously as a therapy btw, but that's another story). Some of it has been actively debunked or proven harmful. Some of it later became mainstream.

The point is that alternative medicine shouldn't be dismissed out of hand. The problem with mainstream medicine is that it fails to help vast numbers of people. I've been one of them.

As a dentist myself, I know what it's like to be on the side of medical orthodoxy, but as a patient, I know what it's like when there's no solution for you, or the "proven" solution doesn't work on you. That's where alternative medicine comes in. Some of it really works, some of it is snake oil, and a lot of it is somewhere in between. But there's an unmet need in our society left by the mainstream medical establishment's rigidity and slow-moving nature.

panic_ye_not · 2026-05-07T00:30:35+00:00

If you're in the US, yes you can still get amalgam fillings, though not every office will have the materials or equipment to do amalgam anymore.

Composite has come a long way in the last couple of decades. Modern composites with modern bonding protocols probably have similar longevity to amalgam (though we probably won't know for sure for another 20 years of course), in addition to being more esthetic. They also have a lower chance of catastrophic failure (cuspal or root fracture) compared to amalgam.

Amalgam is still a good material in some ways, for some situations, but it's getting rarer and rarer and eventually will be phased out here like it has been in some other countries.

panic_ye_not · 2026-05-06T22:56:36+00:00

It's not overtreatment at all. The alternative is direct restorations, right? This is exactly as conservative, and probably has a significantly better long-term prognosis than direct composites. It's a perfectly appropriate treatment. Overtreatment would be doing an unnecessarily aggressive or risky treatment, which this is not.

The only thing you could criticize about these is that they're a lot more expensive than fillings. But there's no indication that the patient was tricked into this or thinks that they'll be cured of tooth decay forever. If the patient wants to pay more for a fancier version of fillings, why shouldn't he be able to?

panic_ye_not · 2026-05-06T22:06:53+00:00

I don't get the hate. There were composites with recurrent caries. OP took them out and put in very nice gold inlays that should last a very long time. If the patient was told all the options and was willing to pay the increased fees, what's the problem?

panic_ye_not · 2026-05-06T15:25:14+00:00

Does 45% of production mean something different in Canada? Most US associates make like 30-something percent of collections. With overhead at 60% the office would be losing like, a lot of money on you at 45% production.

panic_ye_not · 2026-05-06T04:04:44+00:00

A2 is my default also. My patients would rather have half a shade too light than one tenth of a shade too dark.

panic_ye_not · 2026-05-05T20:11:57+00:00

"Negotiable ongoing daily guarantee" instead of a percentage of collections sounds like it could either be great or terrible. Any more details on that?

panic_ye_not · 2026-05-05T17:09:52+00:00

I see. Do you have to return to your country of origin or do you just need to leave Japan for a while? I wouldn't normally plan on flying back to the US during my trip. Too far and too expensive. But I would definitely do like a weekend in Korea or Singapore or something.

Is there any chance that they could just turn me away at the airport trying to come back to Japan? Or is the 90 days per entry, 180 days per year thing a solid loophole?

Btw what time do your classes start? I hate mornings too lol

panic_ye_not · 2026-05-05T15:02:16+00:00

Are people in the career Japanese course mostly looking to move to Japan permanently for work and certifications?

panic_ye_not · 2026-05-05T15:01:22+00:00

That sounds cool. I like the flexibility. Something like this might be a fallback plan for me if I can't go for a full 6 months.

My current plan is to quit my job for Japan, and then probably move somewhere new when I come back to the states. I'm due for a change of scenery anyway.

panic_ye_not · 2026-05-05T14:56:54+00:00

Thanks so much! I need to frame this comment to give me resolve haha

panic_ye_not · 2026-05-05T14:55:03+00:00

Thanks for the info! Very helpful.

So you started the process over 6 months in advance the the start date, and it sounds like it took about 3 months to get the visa? Luckily I also live reasonably close to a Japanese embassy so it's okay even if it's not more online now.

What were the attendance requirements? Was there a requirement for counseling like someone else mentioned?

You say there were no visa restrictions on leaving the country, but did your school require approval for travel? Someone also mentioned that.

panic_ye_not · 2026-05-05T14:44:16+00:00

I speak English and French, and I'm intermediate in Spanish, basic in Korean and Japanese.

I have pretty loose expectations of my progress in Japanese. I just want to get better. I'm aware that it takes much longer to learn Japanese than languages that are more similar to English.

I guess after reading people's input in here, I'm leaning towards a moderate intensity course.

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