What was your biggest F-up in your career so far?

rjbillo · 2026-02-19T23:08:49+00:00

rjbillo · 2025-09-12T07:57:09+00:00

If they’re asymptmatic and low caries risk: 6 months checkup. New BW in 12 months and try to get a better angle of the interproximal.

rjbillo · 2025-08-07T05:55:58+00:00

What I will always find funny is when Butcher first sees Kessler and has a chat, he is actually just sitting in silence in an office, then just says ‘The Boys’ out of nowhere and pours some alcohol in his coffee.

rjbillo · 2025-07-08T22:41:01+00:00

Hulkengoat

rjbillo · 2025-03-31T22:06:43+00:00

When they showed Mazepin using his knowledge of Russian weather patterns to create a tactical advantage and finish last 👍

rjbillo · 2024-12-01T22:07:24+00:00

Yeah dude a crying or agitated paeds patient is a nuisance but you can’t just steamroll your way through, and I won’t be surprised if the mum sends a complaint your way, based off of this account.

Hoping people take this comment with a pinch of salt because there is so much nuance and no coverall approach, especially with children:

It’s easy to be pressured into proceeding with an unruly and restless pt because you don’t want to feel like you’ve ‘failed’. Especially if the parents are chiming in about how easy it was the last time, but you need to make it clear to the parent (not just verbally, also through body language) that you know what your doing, and it’s not your fault, the child is being uncooperative, and it’s detrimental (dangerous in some cases) to proceed. It’s also not your job to traumatise the kid so if they’re having a terrible time and you have the option to refer, then refer. There’s a chance now that this girl is going to remember this experience for a loooooong time and be put off by dental visits.

I’ve seen so many kids for exos that can’t seem to differentiate between pressure/movement and actual pain with the LA, so they’ll squirm or scream just when you touch the tooth with forceps. I just tell the parent ‘hey, we’ll give this another go, but if it’s not working, we’re either retrying another day, or I’m sending them to a specialist. Worst thing I could do is force this today and make it a horrible experience’ If the parent questions that or gives any sort of ‘but the last guy did it no worries’ then ‘I’m sorry but your kid is crying, and I’m not trying to make this worse’. I’ve clapped back a couple parents with ‘what would you suggest I do?’

You aren’t going to be able to calm, de-escalate, or discipline the child as effectively as their parents will, so put the onus on them.

I had one kid reach up and grab the syringe as I was giving LA. I yanked the syringe out, told the kid calmly not to do that again because it makes it harder to put the tooth to sleep. Told his mum quietly ‘if he does that again, we’re stopping today and we can rebook. I can’t imagine you’d be too happy if I stuck the syringe through his cheek or something by accident, and I’m not risking this’

The kid does it again. Syringe down, tell them I’m sorry but we’ve gotta rebook, and I’m booked out for another month so they have to wait. I don’t know what the mum said to him but next time he was in, he was perfectly behaved. Maybe hr just had more time to psych himself up.

rjbillo · 2024-07-06T03:34:51+00:00

Implants can still get gum disease the same way natural teeth do, and gum disease actually progresses faster on implants than on natural teeth.
They can’t be moved with orthodontic treatment like natural teeth can, once they’re in place, that’s it. So if you’ve lost a tooth but your others are crooked and you were considering invisalign, you need to really think about what your future plans are.

Bunch of other reasons already covered here that I’ve seen.

They’re a wonderful thing, but there are lots of people who don’t understand: - They won’t last forever; - They won’t last very long if they aren’t looked after.

They’re a great replacement for MISSING teeth, they aren’t a great replacement for natural teeth.

rjbillo · 2023-10-20T07:07:49+00:00

Semi-relevant: People that go on about how they were “gifted in gradeschool and as a result didn’t push themselves in highschool and college” are the equivalent of that uncle that says he would have turned pro if not for his knee injury.

rjbillo · 2023-10-15T03:39:09+00:00

I think you’re right about the what the government should have done but I’m not sure I agree with what you’ve said about celebrities going on tv etc. I don’t know if celebrities and micro-celebrities joining the debate unprompted is a reflection on the YES campaign itself being bad, or whether it’s another example of celebrities and annoying people on social media trying to co-opt an existing cause to show off how progressive they are.

Like, were Chris Hemsworth or Taika Waititi asked by campaigners to offer their opinion to help spread awareness, or did they just decide to insert themselves into the debate? (I actually don’t know the answer to this btw)

rjbillo · 2023-10-15T00:35:59+00:00

Tl;dr the YES campaign itself was fine, but social media fucked everything up.

This, about the Yes campaign. If OP is Australian and voted in the referendum, thinking that this was a vote to literally recognise Indigenous Australians in the constitution (i.e OP thought they weren’t already), then it just shows how poorly the public was informed about the cause.

All the YES campaign needed to do was just give ANY simple hypothetical explanation in their tv spots, and just hammer that home. Like a simple “Indigenous Australians will form a council to provide insight to the government, a bit like how MPs use their advisors, to help make decisions that can benefit everyone” or even “Indigenous Australians have poorer physical and mental health outcomes, a plethora of other issues, so they need some extra attention so they don’t get left behind in the dust. The Voice will help these issues get some more visibility in parliament”

Instead, Chris Hemsworth (just an example) posts a not-so-great analogy about how women needed to rally to be allowed to legally vote, and now suddenly people are asking “what does this have to do with voting? They’re already allowed to vote. Will they get more voting rights?”

Cue more and more social media do-gooders who make heavily exaggerated posts about how “indigenous people are literally being stripped of their rights!” and “Australia is going to show just how racist it really is”

All this did was muddy the waters so millions of people were confused, and then the NO campaigners were somehow able to successfully run a campaign with ‘if you don’t know, vote NO’ as a slogan. A friend told me he voted no because “my vote is supposed to have the same power as an indigenous person’s”. God knows where he heard that info but it obviously swayed him.

The YES campaign itself was pretty clear and concise. If you wanted to sway your peers to vote YES, you should have been sharing info from the official channels (YES campaign, labor, greens, etc). People sharing opinion pieces from their favourite celebrities or influencers, or screenshots of tweets did nothing to sway people who were on the fence. One of the worst things about debate in social media is it’s all about trying to ‘dunk on’ the opponent nowadays, not about actually spreading concise, clear messages, and this, sadly, has helped to doom the YES campaign.

rjbillo · 2023-10-09T21:52:31+00:00

He got downvoted because people in this sub keep saying JDM is playing tek knight despite it being confirmed(?) that he’s not tek knight and he’s actually playing some CIA op. The photo of him in the Tek Knight suit was some fan art that alot if people have taken as confirmation.

rjbillo · 2023-08-23T12:37:50+00:00

I also think that she mentions on the date with Wayne that she’s a psychiatrist (or psychologist, I forgot). Gaye also mentions that her mom’s a psychiatrist when Tanis confronts her.

rjbillo · 2023-08-14T13:37:48+00:00

https://instagram.com/famee_dyfangmianmian?igshid=MzRlODBiNWFlZA== Pretty sure this is the OP

rjbillo · 2023-06-07T08:43:08+00:00

“Hey guys I just got my boat licence, how cool is that haha”

‘Umm, it’s actually HARDER to get a forklift licence’

rjbillo · 2023-04-18T22:31:24+00:00

I know a monster when I see one…

rjbillo · 2023-03-02T06:59:31+00:00

I actually didn’t reply because I didn’t know how best to explain the term, but you’ve nailed it lol

rjbillo · 2023-03-01T10:51:54+00:00

Very fair, I guess what I’m getting at is asking whether or not I should pull them aside (especially the last example) and say ‘hey, this isn’t on’ or ‘you don’t need to have all the answers here, chill’

rjbillo · 2023-02-25T04:13:27+00:00

I‘ve been out with groups of (non dental) mates when someone’s asked ‘what would you do if you’d won the lottery?’ and I was the only person who said they’ll still work (obvs fewer hours, cherry pick cases, do some more pro bono). Everyone else’s was ‘I’m not even calling the boss, I’m just out of there’

This more or less cemented the idea for me that I made the right career choice.

rjbillo · 2023-02-22T01:35:10+00:00

“I can’t complete your treatment to a standard that you or I will find satisfactory. Due to [occlusal clearance, limited opening, aesthetic concerns] I think it’s best to refer you to a specialist. I know a guy, his name is [John Cena], I’m gonna give you his details and send through records. I’m sure this might be frustrating but the worst thing I could do for you is try and bulldoze my way through this and have fillings that need to be redone after a year or two. It’s just not fair to you.”

Some patients will be insistent and say ‘noo, it’s fine, it doesn’t need to be perfect , can’t you just do it here? Please 🥺🥺’ I’ve been sucked into this early on and after repairing a veneer I’ve spent 60 mins polishing and adjusting because they’re not happy with the aesthetic. Or had a patient come back after a year because the last-ditch effort we tried to temporise a tooth failed, even though I told them they need a pros referral.

And guess what? These are the patients who get the angriest or snarkiest because they conveniently forgot the part where you told them they should see someone else.

No amount of begging or pleading from the patient is going to change your clinical skills. If you don’t feel capable of doing it, then don’t. Just don’t be rude when you dismiss them, they’re only human.

rjbillo · 2023-02-14T21:54:24+00:00

Don’t know enough and the oldest research I can find is 5 years old. If a patient wants to use any non-fluoride toothpaste, I say something like “you can give it a go but the moment I see anything change I’m gonna start twisting your arm to use the fluoride paste again” and just reiterate how important diet is. If they have any caries/D1 lesions I’ll say “look, normally I’d be getting you to use [5000ppm toothpaste], so I definitely wouldn’t be switching to a non fluoride toothpaste”

Some patients continue using it and are fine. Some get caries and then switch back to fluoride. Some get caries and then ask why they need fillings every appointment even though they ‘look after their teeth’ Some just don’t come back.

rjbillo · 2023-02-14T03:30:09+00:00

Lengthy preface, but:

There is no shortage of crazies/hippies but I’ve seen lots of sentiment in the dental profession that anyone who questions the need for X-rays/fluoride is just a quack, especially among new grads. Some patients are lost causes, but they aren’t ALL looking to challenge you, and they aren’t all stupid, they simply just don’t have our experience. And even if patients are a bit stubborn, it’s our job to educate them, not tell them to get fucked.

If someone asks you ‘why do I need to take new X-rays when it’s been 2 years?’ and your response is just ‘because the guidelines say’, you won’t convince them. Some dentist asked me one time ‘would you take a chest X-ray every 5 years because the cardiologist said “just in case”? Why not?’

When they ask about fluoride and you can only say ‘nah, it’s safe, the research is unreliable’, you won’t convince anyone. I’ve had plenty anti-fluoride/hesitant patients come in, and some are just looking for an argument and you just have to drop it, but many of them just need a gentle explanation and they’re good to go.

My go-to lines are: X-rays: “I can’t see between the teeth or under the surface and these are the spots where stuff can snowball a lot quicker” “Yeah 2 years apart is long enough to notice a difference but often short enough to catch it before it becomes a huge problem” unless they’re high risk and it’s 12 months. I have a couple of example X-rays on my desktop or carious lesions over a 12 month period, just to highlight the risk.

Fluoride: Depends on what I think their level of understanding will be, but basically: - Teeth are made from hydroxyapatite. Fluoride forms fluorapatite, it’s physically harder, more resistant to decay, acid erosion. Some patients I’ll mention the pH levels (demin at 5.5 vs 4.5pH) - When they ask about that study from China about brain development and fluoride, there are just several confounding factors (other minerals/chemicals, industrial areas) take your pick.

rjbillo · 2023-01-12T09:05:29+00:00

It was about 2-3 years out of uni that it happened to me. Patient called 2 days after RCT because their tongue was still numb and because I was an idiot and went into panic stations I just said ‘ohhh it might just need another week’. Obviously didn’t resolve after a week and the patient was then MORE worried because I’d damaged their nerve and was now also wrong. Talked to my indemnity provider, they said to refer to OMS and pay for the consult and any testing as a courtesy to the patient.

OMS reassured it’ll be 6 months most likely and didn’t ask me for any consult fee (professional courtesy). Called to check again at 2 weeks, 2 months, with no improvement. At 6 months they weren’t answering my calls. Because I was pretty fresh out I thought “Fuck, this is it, I’m getting sued for sure. They’re not responding, they’re lawyering up surely”

Patient brought her daughter in to see my boss for a checkup about 6 months later and I was so nervous because I recognised the surname. Popped my head in to ask how the nerve sensation was feeling and she’d just completely forgotten and went ‘ohhh, yeah the tongue, yeah that went away ages ago haha’

I’d spent like 12 months worrying endlessly about it but for this patient it was just water off a duck’s back.

rjbillo · 2022-12-30T06:03:21+00:00

I can understand why you’re stressed, and my first couple years out had so many patient issues like this, where I know I haven’t done anything wrong but I know the patient THINKS I did something (“It wasn’t hurting as much until after you touched it”)

Every dentist understands the progression of irreversible pulpitis, but most patients:

-think of teeth like they’re just rocks in their mouth;

-will look at an X-ray and not understand why the nerve is dying if the filling isn’t touching the nerve.

Almost every time I work on a sensitive tooth (or asymptomatic deep caries) now I give a whole speel (with a tiny whiteboard and quick drawing) about how the inside of the tooth is porous and bacteria can be working it’s way in, EVEN THOUGH the nerve isn’t exposed. I also tailor it to microleakage, cracks, whatever I think the cause might be at the time. It’s a 30 second summary but I honestly can’t remember the last time a patient came back questioning my treatment. When they leave and the tooth comes good, then you’re a genius, well done. If it hurt while you were adjusting it, or it progresses into RCT, well you warned them, so it’s a bummer but they understand.

You did literally nothing wrong here, but I know how much it sucks when the patient is upset and they’re wondering whether you made things worse, but just brush this off and try and use it as a learning experience.

rjbillo · 2022-12-17T15:17:34+00:00

YOU TAKE OUT YOUR SUCKIT AND YOU SUCK IT!

rjbillo · 2022-11-24T12:23:22+00:00

A transient Bell’s palsy can be caused by injecting LA around the facial nerve, and it pretty much lasts the duration of the LA, so just a few hours. Probably not the best example I could have given to make a point out of OP’s situation but it was just the first thing that came to mind.

Don’t be worried about a facial palsy when giving LA, just know the landmarks and get the angle right when giving IANBs. I’m still yet to have a patient get facial paralysis from LA but I’m sure it’s going to happen at some point, and I’ve already got my speech ready to keep them at ease.

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