What are some good tips or learning tools to increasing case acceptance in the office? I have been working in the dental field for a few years now and I considered myself a moderate producing dentist. I do have difficulty converting some of the bigger cases. I usually go through the exam take IO photos and then go through everything with the patient. I really try to create a sense of urgency and we will go over things try to focus on the most problem area first in the bigger cases I have another consult that I set up with the office manager. Nothing larger seems to be coverting at the moment and I am wondering what I can do for myself to change that.

ive been working my tail off for years but can't seem to get ahead. my retirement account looks like it's doing great. but everything around me has gone up as well. i feel like my wealth is an illusion. should i invest in bitcoin? i've heard it's the best performing asset class the last 15 years. being a dentist im so used to believing only in things i can see feel or touch. does that make me an analog moron? please help. i need help with this topic. six figure salaries used to be great. i can't for the life of me figure out why they aren't anymore. i was told when i graduated i would flourish in this profession. what happened? plumbers and electricians make more money than i do right now.

Hello, we are recruiting for a *paid online panel interview* late Monday/Tuesday 4 more people. Given our timeframe, I am reaching out here as well.

Pay: 150 £

If you are interested, please comment or reach out via messages as we will need to do a 5-min screening call tomorrow. I am happy to share more project details as well to anyone interested.

Feel free to share with your dentist friends. Thank you

Title. This is both a vent and a question post.

A little back story: I'm a Turkish, 2023 grad dentist who's looking for a job at the moment. I took a gap year to study for specialist exam and failed, decided not to waste more time studying and be a gp.

I've been looking for job postings for 3 weeks and seems like 95% of the postings require 3+ or 5+ years of experience. I've sent my resume to more than 50 clinics and only one of them gave me a positive response.

The dentist lady who owns the clinic was very attentive because she graduated from the same university as me. It is an old and small clinic in a low-level neighborhood. It takes more than 1 hour to get there by public transportation. There are only 2 units. There are no panoramic x-rays, their periapical x-ray device is broken and they don't know when they will get it fixed. The dentist lady said that they have a lot of patients and they never sit idle (she works 9 hours a day including Saturdays). She said that they work very fast to keep up with the patients and that this is all she expects. (When I observed her, she started a premolar retreatment and placed an implant in another area all within 20 minutes, I was in a shock). She said that she does not make long-term treatment plans for her patients, she does whatever the patients need and completes it immediately at the first appointment, and that she expects me to work in this manner. I was in shock when I left the meeting. I don't think this is normal and ethical. When I talked with my uncle, who's also a dentist, he said "those clinics are the places you really learn how to approach to patients, learn how to work faster and you can also have a good income." I had similar approach from a friend as well which made me confused. Some of my friends also said it's stupid to work in a clinic without x-ray and I agree with them honestly.

The situation that puts me in a dilemma is this: working in a bigger and fancier clinic closer to my home and treating whichever patients they give me (patients that require simpler procedures that will bring less income) versus trying to do everything in a small clinic in a very crowded, suburban neighborhood with limited resources, without discriminating between patients.

I don't know if I can suddenly adapt myself to such a fast-paced environment. Having been away from dentistry for months keeps me from being thrown into chaos all of a sudden.

Is it too much of a utopia to want to work in a clinic with better facilities, where I can approach patients in a more ethical and multidisciplinary manner, and where there are patients with a higher socioeconomic level? Is it an unrealistic dream to work in a place like this? If I'm going to commute far from home every day, I want it to be worth it. I don't think that's selfish. I don't know what to do and noone gives me realistic ideas that matches with my beliefs.

(Side note: when i say less income i mean approx. 1200-2000 USD, high income i mean 2000-3000 USD, both per month and after tax. I know those are daily incomes of some of you, it sucks being a dentist here. Also working hours are generally 9 am to 7 pm including saturdays.)

I’m curious for those who own a practice. How do you structure your bonuses for your staff? I need to figure out specifically how much to give my Practice Manager for bonus this year.

Been looking at a practice for a couple months now. 2-doc, 6-op. Only needs a CBCT and updated software. Leased, Bread and butter office. Asking 850k rev ~1.2mil. My biggest concern is their clinic hours are 46hrs/week where 1 doc comes in the morning 7-4 and the other 10-7. I can't do those hours and I would change it to 8-5 right off the get go. My fear is I would lose their long-time staff and patients by doing that while also carrying a 110-120k/yr note on top of that. Should this not be a big a deal as I think?

1. Do impression copings need to be torqued prior to final impressions similar to the final restoration delivery, or is tightening them with a hand driver adequate?

2. Should impression copings be placed back into the final impression prior to sending to the lab, or should the lab do this themselves?

Just a PSA to anyone feeling annoyed with dentistry or its not for them, scaling down your hours even one day will make your life feel completely different. Time is our most valuable resource and of all the cons of dentistry, working less has to one of the biggest pros I slept on. A year ago I wouldn't believe that when monday rolls around, im feeling ok about doing some back to back class 2's first thing (They still suck, just alot less now)

Slow is smooth.

Smooth is fast.

Anyone have a favorite system?

Hey Guys,

I am very new to dental practice ownership but have a lot of real estate experience. I am contemplating buying a practice with a buddy of mine (who is a dentist). Since he is a clinician, and I am the numbers guy, we have a few questions on the kind of loans we can get:

1. Typically what leverage or loan to value can we realistically get? For instance if the practice is 2M and the RE is 1M, what acquisition dollars can we get on either?
2. Are these loans recourse or non-recourse? Again it's a RE thing but most non recourse loans only claim the business and have no personal recourse on the borrower. When a bank is lending to an owner, what are they underwriting to? I have to imagine the practice and experience of the clinician, ideally he has a running practice already.
3. What interest rates are you folks typically seeing in today's market?
4. Do banks lend on Capex improvements as well?
5. I hear that Huntingon and Bofa are very active in the space. Any other banks that you folks have had success with?

Many thanks!

Background: New Grad, out 2 yrs & 6 month out. Working for DSO for the last yr & half... I have a 2 yr contract with this current DSO, however, I have 6 months left on it. I have to give 20k bonus back if I wanted to leave so I don't see the point if I endured this long to not wait the 6 months.

I want to buy my own office and I've been saving for it.... My goal should be out from there to my own office.

I used to be working weekends & less days in another office, but there were issues there: most production going to lead doctor, empty schedule, disrespectful staff, now shows/calls in from assistants etc. They were expanding and it was going to be a full 5 days schedule.

They moved me to a different office and I felt so much better at first even though I went from running 3 columns to run 1 because lost the assistant soon because wasn't the right fit. Now hiring another one.

I feel I am learning a lot, I done molar endo that I've never done before and been doing more surgical ext etc. Both procedures I feel are a waste of chair space because reimbursement is very low and no worth my time so doing it for experience.

The assistants are very "peachy," and pushy, as if I am not a real dmd if I don't do molar endo because all the other docs do it, or if takes me 1hr to do a difficult #18 grossly carious surgical ext in a difficult patient, they belittle me for it. I can't basically refer anything out because oh so and so would do it, but yeah they would fully keep it all, not just that specific tx, the front desk would keep scheduling with the other docs. I can't barely see any hygiene because they patients prefer so and so, whatever fine... then when I do see hygiene and I tx plan something the hygienist adds it to the other docs scheduled not to me.

The office is run more on efficiency than in quality if you know what I mean .... I am nowhere near slow, but I like to make sure crowns preps are down well because I hate repeats, mostly all my crowns seat & look gorgeous in BW.

I like to use caries detection dye and that irks them when I reach for it.

If I want to irrigate with chlorxedine after EXT "omg now I have to open the bottle"

I have the worst impostor syndrome as well, so that does not help. My confidence goes up and then someone comes and puts it down again, like today the assistant was like saying I "traumatised" a patient bc a surgical ext, like whattt???? It took me 1hr from the time I numbed to the time I finished, maybe a little too much but I am not OS and I am not the other docs, they don't even have a proper cryer elevator for godsake.

Pt was numbed, very gross decay #18 .. had to section, and split both roots and get it out....pt was no cooperating wouldn't open, assistant would not retract far enough, etc. His tongue was going everywhere I have to keep it out the way at the same time as I was sectioning or elevating b/c they are useless as assistants.

I admit my issue was not going surgical from the get go, which is my biggest issue, & from now on I know.

They mistake me being slower, but I am just being careful. They think they know more than me at times and it annoys me, if I doing a crown prep and I need to laser "No you don't need it," then they do, "oh shit you right won't stop bleeding, excess gum tissue and crown don't seat."

It's going to be a long 6 months and my paycheck & confidence is starting to take a hit. I am at loss honestly on what to do, pay the money and leave... but that'll eat my funding for my own office.

EDIT: patient was fine wasn't crying or yelling or anything during EXT, and was fine after. I don't do many ext and I stair away but w/ holidays & patient in pain OS is booked till Jan, no medically compromised, I knew I could do it, maybe no the most gracious way... (one of the docs does ext sitting lol but he is a very big dude if he does it standing he prob would break a jaw)

Reading some of info on 1099s it seems that as a independent contractor you “set your own schedule”

Does this mean if you don’t want to come in you don’t have to legally?

If an implant drops of the carrier into the patient’s mouth as you’re about to place it what would you do?

Hi everyone,

I’m a new grad, a couple of months out of school, working at an office where 90% of our patients are Medicaid. I was wondering—what’s the typical production goal per day for you?

Right now, I’m averaging around $3,500 daily, but my practice keeps pushing for $5,000–$6,000. The issue is that we’re struggling to keep a full schedule. For example, today I produced around $3,500 despite having an empty schedule the entire morning and only seeing patients in the afternoon.

Is $5,000 a realistic goal for someone fresh out of school, especially in this kind of setting? Or does it seem like they’re expecting too much?

Hi, I (37m) am contemplating moving to Australia from Singapore. I have a MDS from NUS (Singapore). I am wondering if anyone had any difficulty in getting their Masters recognised in Australia? Thanks for your help in advance.

Edit: I should add that I obtained my bachelor's in Australia, so I am able to register as a general dentist.

Do you guys use dental dam while applying composite? What are some expirences/tips with composite veneers that made you good at making the gumline cleansible.

I’d like opinions on corporations. Is it a bad idea to join one after graduation? What are your thoughts on PDS? Do their compensation and benefits seem reasonable? Also, which corporations do you think are better to work for?

I am doing a rct on #25 with a PARL and has a crown that is stained reddish. I want to do the internal bleaching following rct, however, I am not sure what material to use. My office has the Henry shein natural elegance whitening system. My question is can I use the Henry shein bleaching system for internal bleaching or does it require a completely different system?

Thank you so much for your feedback!

I am a receptionist at a dental office and one hygienist has come to me twice recently asking I schedule more production on specific days that have low production. Our doctor’s schedule is only ever 1.5-2 weeks booked out. The doctor himself has never complained to me about the schedule. I keep every day full and have everyone confirmed. I don’t understand how the arrangement matters when the same amount is going to be collected at the end of the week. Our doctor is very honest and does not over treat that is why the schedule is only booked out a week or two. Is there a reason I should be spacing out treatment or is the hygienist being bossy? I don’t want to talk to the doctor about this and make a big deal out of it because I am perfectly capable of ignoring the hygienist if it’s just a her problem.

Hi, my girlfriend is currently a D4 trying to specialize in peds, and for the holidays I wanted to get her a nice gift. The problem is I’m not a dentist so I don’t know what’s good or what would be useful to her. My budget is roughly $100-150, but if it’s an absolute must by I can swing closer to $200.

Any advice is appreciated :)

Edit: thank you all for your suggestions! Seems like a massage/spa day is the way to go lmao

Hi, I’m working on this patient. I was thinking of extracting his 45and placing a bone graft then doing a bridge from 44-46. As for the rest of his Dentition bridge 14-16 and crowns on 17, 47 ,34 , 37 26(electiverndo?), 27.

I told him his other teeth might need work but these are the most impoetant ones.

Is this an appropriate treatment plan. All are zirconia

https://imgur.com/a/33DPn3h

Hello what’s the best and cheapest dental scanner? Thanks

I ran an annual procedure report and I was kind of surprised at how few are actually surgical. Sitting at about 9%.

There's so much new dental software popping up, especially in AI, and a lot focused on the front office team and manual processes.

If you could wave a magic wand to remove manual process for your front office team, what would that be?

Do you even care about optimizing this?

Sometimes I just think it's part of the job description...

Does horseshoe major framework work for upper cast metal partials?

We have had a patient in our practice for the last couple of years that always requests an interpreter for her appointments. Financially it is coming out to a loss twice a year for her perio maintenance appointments. We pay an interpreter $160 every time she comes in and we collect $107 for her cleaning. (Then there's overhead and paying my hygienist an hour.) Post ops, crown placements and other short/no fee appointments we are still paying $160 for her interpreter. What are other offices doing? We have to stay compliant with Affordable Care Act, but is there something we are missing? Do we start taking classes in sign language? Or do we just put it in the category of a hit we take that comes with the territory?

Hi, Have you personally ordered from any Chinese dental labs? Would you recommend it? And if you would, what lab did you use?

We are working through a PPO revision firm, Unitas, to help try and increase PPO rates.

We would go FFS but right now in the process of practice buyout and transition and it doesn’t seem like the right time. Our patient base is typically reliant on insurance to pay for all their treatment if not most of it.

Unitas proposed joining Zelis, which is an umbrella policy.

We are apprehensive about joining an umbrella due to being roped into insurances we don’t really want to deal with in the future. But this might be the only option as other bigger PPOs (UHC and Delta) aren’t increasing fees so we might have to dip into this.

What have been owners experience with working with Unitas to get into umbrellas?

Thanks!

https://www.nytimes.com/live/2024/12/04/nyregion/brian-thompson-uhc-ceo-shot

Not to make light or suggest this is ok, but I'm kind of shocked this doesn't happen all the time to the heads of these major insurance companies that screw literally everybody over all the time.

Dollars to don't nuts this will come down to United refusing to cover treatment for somebody's spouse, or grandma, or something like that.

I work for a FQHC and we do our insurance credentialing in-house. I’ve had to learn this myself as the person who did it before retired and didn’t leave any information. Does anyone have resources they’d be willing to share? A CE course, conference, example of processes, honestly anything to help.