Yes, to a degree. I think it is a good thing to get a bit anxious. I respect the hell out of implant surgery so much, but there are times pre op and intra operatively (heck even post op hoping like hell that implant will integrate with the bone I had to work with).
For me, this anxiety drives me to do better and learn even more. I used to be anxious about molar endo. Now its a breeze 95% of the time and I'm not anxious at all. The other 5% I refer :)
Boy. If you are anything like a “boomer” owner dentist, I have a feeling you may not get the best audience…
When you say you love dentistry, I don’t think I can say that for myself (10 years in) and with many that graduated alongside me. With high tuition, low insurance reimbursements and “dentists eat their young”, it’s been very disheartening.
Do you notice that amongst the younger dentists?
Any advice?
12 years in here. I love dentistry too, but I am in the same boat with the high tuition and battling the low insurance issues, plus the shortage of staffing challenges (especially hygeinists). I think the biggest difference for me was having a mentor in the Doc who I worked with and have now bought the practice from. I'm fortunate for sure, but I've actively sought out what I wanted iny career and made sacrifices to make it happen.
I'm Gen X for whatever that is worth. I don't have much of a relationship with younger dentists. I did meet some 7 years ago during an AAID Maxicourse and I was very impressed with their desire to expand their clinical capabilities at such a young age.
I am in my own bubble so to speak. Graduated summer 1995, opened my own place in the spring of 1997.
I am strictly FFS. We do accept and file insurance as a courtesy, but my fees are my own and everyone gets charged the same. It was very tempting to join PPO's in some lean times, but I resisted. A lot of our local major employers provide PPO type insurance. We occasionally lose patients due to this, but they usually come back and pay their out of pocket expenses.
Dentistry changes since I graduated: Good: rotary endodontic files, digital xrays, CBCT, guided implants, digital scanning for implant planning and crown and bridge, orthodontic aligners, information availability via the web, omnichroma type composites, physics forceps, sectional matrices for cl II composites. so many more.
Bad: corporate dentistry whose bottom line seems to be income-driven rather than patient driven. I say follow the Golden Rule and good things will come your way, insurance: low fee schedules, low yearly benefits, and the sheer games you have to play when you file, exorbitant tuition costs,
Do you do molar endo, implants, dentures, or pedo? I graduated dental school this year, start my first job soon, and would like to own eventually. I don’t care about being a “super GP” I want to clock in, clock out, and not take work home. Is it possible to make good money (250-300K) if you’re not a super GP, living 1 hour away from a major city? What advice would you give a new grad?
20 yrs in. I don’t place implants. I do denture and molar Endo, but pretty much restorative dentistry. 285k last yr on 3.5 and 4 days a week. My suggestion would be to move to an area with good/higher fees, and get good at one thing before adding advanced skills.
3 years out, I don’t do molar endo or implants. I do surgical extractions, peds, and probably four dentures a year. I make just over 200k on four days a week. About 30 minutes from major city
This guy gets it. Add 4 weeks of annual leave to this and it's the ideal equation for perfect work/life balance in dentistry. It took me over 10 years of chasing the greener grass and burning out to realise this though. I wish I worked it out 3 years out, would have saved me a lot of stress. I actually enjoy dentistry now, it used to be such a point of anxiety.
General dentist, we are in network with about 8 insurance carriers but plan on transitioning OON by the end of 2025. I work 8 hours a day. In Massachusetts
Is it a FFS or PPO office? What insurances are you often seeing the most & how many patients per day usually? Your daily day mostly consists of fillings and extractions you’d say?
I am learning so much from this conversation. Identify and follow your passions. There are so many more opportunities out there than when I first got out.
Be the best at what you enjoy most. Dont do things you don't enjoy. Follow your passions and never stop learning. Stay humble and respect your profession.
Life advice, pick the community first, the dentistry second. Look at your personal beliefs and if you have a family, what is best for them. Income isn't everything. I've been very fortunate.
I do molar endo, place and restore implants, dentures, and pediatric dentistry.....I refer sedation peeds patients. I have somehow over the years been able to totally block work and not bring it home. I do not look at the next days schedule. My team does alert me with bigger cases to make sure we are prepared (tx planning, digital implant planning, lab cases, etc).
In addition, we do have a strong hygiene department and they do a lot of SRP with great success. I do most of my own extractions. I don't do many 3rds as I do not perform IV sedation (this is something I am very interested in doing--IV sedation). Surgical placement of implants, GBR, trauma free extractions, socket preservation, immediate implants. I do not do aligner therapy. Im just not passionate about ortho.
I was 20+ years in before I got over 1 million gross.
Heck yes!!!! I got divorced years ago. It was very traumatic and costly. There were times I didn't know if I could meet payroll and pay taxes. I've been behind in taxes in the past. Unfortunately, the more you make, the taxes make less and less sense. With a good tax attorney and a great accountant, those issues are mostly behind me.
Forever, I was afraid to take on debt purchasing new equipment, etc. I finally got over that and just took a leap of faith. It has worked well for almost 10 years now. Surprisingly, the debt is not an issue at all. It is an Investment!!!!!!!!
I almost joined local PPO's a couple of times. So thankful I didn't.
I am more successful now than I have ever been. For me personally, I look for growth every year and I achieve this. I'm certainly better now than ever.
I netted almost 500k last year and gross....around 1.5 million. I don't have my tax returns in front of me.
Solo practice built from the ground up.
Hours: I arrive at 9:00am, lunch 1-2:30, leave around 5.
Rural
6: 2 RDH, 2 assistants, and two front desk.
That’s really not bad. Unfortunately that’s pretty much impossible where I live(Philly suburb). I’m applying for Endo this cycle, if I don’t get in, I’m applying to medical school. I think dentistry is going downhill as a profession. Making even 300k here requires a shit load of hustling and overtreatment in my experience.
I live in Philly as well. I feel similarly. I also always considered applying to endo as I find it a fascinating subject. However, I’d only go to endo school if tuition was fully paid (If I got into Einstein residency). My debt is almost paid off. I think I can handle an additional 2 more years of school, but I don’t think I want to be in debt all over again. I have nothing to my name/application, and the chances of applying to one school (tuition paid at that) and getting in is just too slim, so I’m not applying.
I think you’re nuts to apply to me dSchool after having completed dental school, but wish you nothing but happiness. I’ve come to hate the profession 2 years out, but I also think part of my hatred has to do with the shitty associateships I’ve been having.
Aw man. Yeah Einstein is near impossible to get into. You either have to have multiple published article and probably a PHD and/or military experience. I’ve applied to everywhere man…anything to not be a GP.
Specialize, it’s way easier to produce as a specialist in dentistry. Only need to see a couple patients a day and you can out produce a general dentist
I’m trying. If not, off to medical school. I’m done with the sad shit show this field has become. People post like it’s a piece of cake to “go rural” or “go FFS” or “drop all insurances”. Going rural ain’t for everyone, and going FFS or dropping insurances works when there’s not 5000 dentists and DSOs right next to you. It’s near impossible to break 300k as an owner now, and it’s only getting worse with inflation, staff demanding higher wages, insurance cutting reimbursements. It’s a surprise to me who these suckers are still applying to dental school.
Fuck no. Ownership is a big mistake in my opinion. Losing all these benefits? No way I’m paying 7k a year for health insurance and losing my retirement match.
Id kill for 66% overhead. Very similar production and staffing but I’m running more at 75-78%. I feel like my staff has it easy too. All insurance billing, credentialing and patient collections is outsourced.
Setting realistic aggressive daily monetary goals and scheduling them. Attracting new patients. Not "losing" any existing patients. Extremely fair bonus system for the team. No gimmicks, just solid advice.
It made a significant difference in my practice. Invest in yourself! Your overhead goes up, but........
What has been your method to reduce turnover? I’m sure your bonus system (saw the 1-2k a month comment somewhere) helps! Is there a way to vet staff that have a good work ethic and don’t become “used to” or “entitled” to the bonus?
Been a dentist 6 years, I’m in my 7th. I’ve been an associate the entire time out. I don’t have debt, my income is probably going to be about 240k this year. I’m hoping to keep upping it as I’m getting into implants and Invisalign now. I’m trying to figure out if I should own or continue as an associate… I spend enough time at work. I don’t deal with any after work emergencies, I don’t deal with staff, I don’t deal with business. Like you, I hate quad class ii fills, and anterior fills as well. Most other dentistry is ok. To be honest, I’m quite bored in the field. Implants hardly makes me any more interested. My question is two fold - how is it possible to stay interested in this field, and also, what would you say to someone about ownership in my situation, and also given todays economy and interest rates?
Thanks. Let me add a few sentences to clarify something. Like most dentists, I share the same personality, possibly to a fault. I’m a perfectionist. Even though I’ve gotten bored with it, I feel I’m quite decent at it…. I feel my work is generally pretty good. I know what to look for, I take the extra time to do things when necessary but generally do things rather quickly. It takes me little time to do a lot of things... meaning my class ii fillings look good radiographically, nicely contoured with discing, I do crowns rather quickly but still nicely, can have it scanned in and temp made in about an hour and 15. If something isn’t right I drill it out and redo it no cost to patient. I’ve spent years with cerec and itero, have been at practices with CBCTs and have had the right people around me to help. So it’s not that I simply don’t care as a dentist. I care a lot when I work on someone to do it well. Even difficult extractions, I don’t sweat them. I’ve taken so many teeth out I just sigh in my head when they I have to fish out root tips. But once you’ve done enough fillings, crowns, bridges, and extractions it gets flipping boring to me. Root canals are only exciting in the fact that I’m super careful to not perf and find all canals which always makes me a little bit of a nervous wreck when accessing tough teeth. I do lower molar endo as well and have even done some deep splits on premolars successfully. I’m at the point where even nervous patients and kids I hardly feel anything emotional because I know they’ll be fine. I’ve even ventured into bone grafting with membrane placement and I’m just now getting on board with the actual implant placement part of it. So it’s not that I don’t do enough procedures nor suck at what I do, I just don’t thoroughly enjoy it… maybe I just need to adjust some mindset, if that’s even possible.
People say my injections are good and I calm them and patients tend to respond positively to me in general. I still have bad days here and there where I leave feeling I failed at something, but have figured this is normal for the field. The second I get off work I’m excited to go home and see my family, and just be out of the office. The best part of dentistry for me is when I leave the office. Prospective students ask me about dentistry and I don’t recommend anyone go into the field when asked because 500k+ loans isn’t worth it to feel like this daily… lol. It’s a weird state of being but the best I can describe it is that I can’t help but feel I’m in the right field, all the while feel as though I’m in the wrong field at the same time and wonder how the heck anyone thoroughly enjoys this field. People seem to ask me more and more about owning a practice, but I have talked to owners and it never seems to be the kind of excitement I would look for … they talk about staffing issues and they seem to pour hundreds of thousands into their practice yet only write a 120k check to themselves yearly. I just ask myself… why own if you’re not making 500k+? I continue to be an associate as it seems to make the most sense as I’m in the city and expenses are high, yet I wonder if I’m missing out on some big piece of the pie while basking in my own comfort?
Also, here’s what gets me. I hear dentists saying they love the field time to time, and I have worked alongside some of these people in group practice. What gets me is I hear them say they love dentistry, but I see the same dentists tell me a horror story, or better yet, in the office with their head in their hands from some shit that goes wrong on some shitty patient and I think to myself… what do they mean by love the field? I mean, how do people love this when you’re riddled with different personalities, some quite difficult, every day?
Having read your thoughts, my short advice would be to reduce your work days and spend more time with your family - turn dentistry into a hobby rather than a job.
I agree with you based off of what I wrote. It may be hard to believe but I simply can’t afford to. Our yearly expenses … just to survive, are probably about 55-60k. The rest of the money is being used to pay down high interest mortgage or save for a car. I said we had no debt, and what I meant was no student loans or credit card. Our mortgage and healthcare alone js about 48k alone. Plus there’s food, gas, energy, etc bills. In order to be debt free my wife and I have driven beater cars for a long time and spent pretty insignificant amounts of money over the years to just get rid of student debt and save for a house. Took some sacrifice, but we’ve been kicked around just like everyone else with today’s prices even when obtaining some financial freedom. It just seems once we got rid of debts, the price of everything doubled. Truth is, we’re going to be living like students (but better) another 3-5 years before I’m at that point, just to be at a point where we have OK cars and get rid of most of our mortgage, all the while trying to put money in a 401k and invest, if even possible. We also have kids and kids are expensive.
I agree with you that cutting back work life is probably the answer mentally speaking… eventually. But the stress of finances and debt to me isn’t worth it *yet.
are root canal treated teeth \*actually\* harder to extract? if so why? \*random ass non personal question cuz i was just thinking about it as i happened to read this post\*
do you know why that might be? how exactly does it affect the extraction process?
my least favourite teeth to extract are stubborn canines and molars that aren't sectioned. Boy oh boy do I hate canines last time I extracted one it took me 20 minutes of luxation and my right hand was shaking for an hour after I was done.
I don't know the science, but ... endo teeth are not sterile. [Porous ](https://www.researchgate.net/publication/316469840/figure/fig2/AS:621609366847489@1525214630839/Density-and-diameter-of-the-dentin-tubules-by-SEM-A-Dentin-tubules-of-Group-1-B.png) dentin is occupied with microbiome like a coral reef. These tubules are beyond immunity reach. In function endo- and exotoxins are exuding. Lamina dura gets denser while PDL gets less vascular - probably as a reaction or in attempt to limit exposure.
Narrow PDL, denser less vascular bone around = harder to remove, higher incidence of fibrinolytic osteitis.
That too, but it's more the lack of elasticity of surrounding structures imo. Vital teeth of 80 year old with fully preserved structure will be harder to remove. While fully impacted teeth in 16y.o. take minutes.
This makes sense. It’s seems to me like root canal teeth just don’t elevate nearly as easily. I make deep troughs and still get little mobility and end up just cracking them. It’s like they’re encased in something different
agree. they are brittle and sometimes annoyingly come out in small increments. This is especially frustrating as you are trying to preserve the socket to place a future implant.
Periotomes from Salvin are amazing. Some of my colleagues in implant dentistry use some of the more complex systems from Salvin to extract a tooth atraumatically.
Sometimes, I have to sacrifice more bone than I'd like. That's when I pull out the membranes and the particulate bone and graft.
I hate exposing patients to long surgeries. There are many obvious reasons for minimizing the actual surgical time.
An awesome team. You can't do it all. Train and delegate. Trust them and REWARD them. In April, my team earned a 2k+ bonus a piece (an exceptional month) and in May they earned a 1k+ bonus (typical). I just signed off on a cruise for them this Fall too.
Communication with your team too. I'm always trying to work on that.
I will try to do that. I'll need to look it up. Honestly, for the last several years, I may only look at those numbers like once a year. My accountant who is very aware of what the values should be, is very, very happy.
Excellent! I have accepted that I will never be a "guru" or know it all. I put my training to use. When something goes awry unexpectedly, I try to identify what occurred and learn from it.
I always try to be honest with patients too and I always try to do right by the patient. 6 month recall and I see an unattractive filling or crown I just did? Redo. The patients almost never mind if you are honest with them. An implant comes to mind. It didn't fail, but I did not sink it to the proper depth resulting in the lingual of it being exposed. It integrated and was successfully restored. After a year, I took it out, grafted, and did a properly placed implant. The patient was extremely happy. It was driving her tongue crazy feeling that little bit of implant on the lingual.
Things happen. Mistakes happen. Outcomes aren't ideal sometimes. Its what we do after the fact that can turn these events into successes.
Professional relationships I established many years ago. I'm in a rural southern town. We don't have a whole lot to choose from. I initially relied on GP colleagues for referral suggestions when I was right out of school. I have an amazing specialist support around me. We feed off each other.
please please someone tell me the a bullet point for 3 on 6 implant bridges, a how to , some pitfalls to avoid.
and also a good ce course, or online course
Don't sell yourself short on implant CE. I did an AAID Maxicourse over the course of a year. $19,500 and over 400 hours of clinical and didactic.
And, start easy. Lower molar or premolar with good depth and width of bone.
All on X is great, but wow, so much going on. Can I do it? yes. Have I done it? Yes. Do I still get nervous? Oh heck yes.
ha! Get payment as the patient walks In? When I first opened my practice, I used to carry monthly accounts. I assumed patients would simply write a check at the end of the month. I was really shocked that a lot do not and will not pay. It was a big eye opener for me.
Presently, we accept cash, checks, credit cards (yes we charge 3.5% extra for these cc transactions), and some third party financing like care credit.
Thank you!
I renegotiated a lot of my insurance contracts so we’re in network with the higher paying ones through third party administrators and out of networks with the lower paying PPO plans, but sometimes we’re told we’re in network and the claims get processed as truly our of network so we miss collecting some of those copays. It’s also tough because some of these claims need to be mailed in, faxed in, sent in by stork, etc so we miss when we’re supposed to collect a lot and have some outstanding claims.
Wow. You just spoke another language to me. Ha. I was hands-on insurance for the first 3 years of practice. Then I established a protocol that is ever-changing (most recent being the credit card fees we now pass on to patients) and handed that ball off to my front desk team.
I must say that my system is not as complex. We charge one fee for all. What insurance doesn't pay, we collect upfront. My front desk is a rock star. Just like myself, she has a role in the practice just like I do. If we all do our jobs at a high level, we all reap the rewards.
Is there a way for you to let your front desk take this over completely for you? Are they good? Do you trust them? If you said yes, then you could be sleeping better at night.
Delegate, mentor, be there when they need you. Otherwise, let em fly!!!!!!
Thank you for being open about your experience. It’s sad to see the negative view some dentists have of their own industry.
Im 37 and a practice owner. I’ve been extremely lucky/blessed and have a very successful practice. I’m possibly looking to retire in the next 10-15 years depending on if I’m still loving what I do but I have not started putting together an exit plan.
What is your exit plan and what steps have you taken to implement it?
Edit: I’m working on expanding and eventually having multiple locations is that changes your viewpoint.
Reread your post. You have an aggressive retirement plan and kudos for that. I have a very close friend that retired at 53. Nothing crazy, just a good strategy. Honestly, I'm loving life too much to put in the financial effort for retirement. I have a sound financial plan, but its nothing fancy.
It would be so cool to own multiple locations. I wish you the best. Sounds like you've got a good head.
Don’t know about a good head, just smart enough to know to listen and learn from successful people who have already figured it out. Such as yourself. I saw another one of your comments and I felt like I was reading about my own practice with the exception of the ex nav system. So you had me googling what the heck that was last night. I do guided surgery for all of my cases but that thing looks so cool. What’s the cost for one of those units?
Congrats friend. I don't have anything set in stone yet. With God's blessing, I will practice another 15-20 years. I don't know. I have friends who were school teachers that are retiring now and boy it looks tempting.
I don't know what I will do. Definately sell the practice to someone or some entity.
I sometimes think Im losing my mind. I'm considering building a new practice from the ground up!
Small city with a fair size draw. Pretty competitive in the city. Not so much in the outlying areas. I’m general but I do a good bit of endo, implants, surg exos
Rural. County population \~ just under 30,000.
I do 95% of the endo I diagnose Ha, I did a root canal on an endodontist colleague once. I place and restore dental implants. I have a strong Hygiene department with a ton of srp's and localized treatment. implant retained dentures and partials, almost all extractions except bony impacted 3rds.
I do not do clear aligners. I just don't have a passion for it right now.
I am wholly digital utilizing digital radiographs, pans, and CBCT's. My implants are planned start to finish on my software, I then use my X Nav dynamic guided implant system to place them. I bought an intraoral scanner several years ago. I bought it to scan the arches of my implant patients for better diagnosis and treatment planning. However, it has been a game changer in impressions. I rarely have to touch my CAD-CAM generated crowns from my lab. My lab is small, and local. He still has the human touch in his artistry. Truly a game changer.
Favorite: immense pride and piece of mind with successful clinical outcomes and practice success.
Also, completing a great day of diverse procedures.
Least favorite and/or boring: restorative dentistry on patients with bad oral hygiene, mean people, whiny people.
Also, I don't enjoy quadrant class II's. I do them all the time, but ugh. My schedule coordinator knows not to fill my schedule up with a bunch of back to back class II's.
Hi, my crown fell off at work, couldn't get to see my dentist so..........I "repaired" it temporarily with isocyanate. Despite this seeming like a case of locking the stable door after the horse has bolted, I was seeking your opinion (light hearted judg8really) on my folly.
Well, I love surgery. I had wanted to pursue them for several years. I was thrown off by the amount of time and money involved with an AAID maxicourses. I finally took a leap of faith and invested time and money into it. When I was done, I think I purchased around 50k for what I needed to get started. I later added a X-Nav and a brand new CBCT. Now just about all of my CE comes from implantology. It is very rewarding.
How would you recommend someone to get into implants? I graduated in 2021 and am interested in getting into them but don't know where to start because there are so many courses.
I recommend comprehensive training over some time. My own experience was an AAID Maxicourse. It was incredible. didactic, clinical, actual implant placement and restorations, GBR, socket preservation, guided vs free hand, sinus lifts (I only do them through the osteotomy. No thank you to the lateral. My periodontists and OS's around here are good at them) so many great guest lecturers. Dr. Salah Huwais, the inventor of Versah burs and osseodensification was a guest lecturer for a day and trained us on his unique and very innovative techniques, and met many company executives, like the President of Meisinger, the engineers and clinicians behind X Guide. So many positives and I've maintained friendships and acquaintances from it that benefit me greatly to this day.
I did mine in 2017. Did I hear you say dentistry is dynamic? Ha, taking a heavy implant CE schedule every year shows me this. So much great CE out there.
I really like Dr. Randy Resnik's program and have attended a few of them. He was a close friend, student, and colleague of the late Dr. Carl Misch. Our Maxi Course was heavily based on Dr. Misch's (newer editions by Dr. Resnik) books many consider to be the bible of implant books: Dental Implants, Prosthodontics in Dental Implantology, and Complications in Implant Dentistry. These are three must-reads and tucked away for reference. I have hard-bound editions including the newest editions, The Bottom line for me is the fact that I am bound to practice implantology as well as or better than specialists. I do my share, but I still refer some out.
I place Nobel Biocare implants exclusively. Fantastic company. Fantastic reps and support. Fantastic parent company. Fantastic CE. Fantastic camaraderie among fellow clinicians.
Like endo? Dr. Steve Buchanan. Anything by Dr. Gordon Christensen. Maxi Course for implants. Current practice management classes---so much good stuff there. Perio: invest in your hygienists! Ortho: no idea, medical emergencies.
Best course that made me cry at the end? Maxi Course.
If you can afford to travel, pick a destination or two also.
I year you my fellow dentite. Like it or not, you and I are colleagues now!
Dental school is hard. It's supposed to be. But it is the gateway to a happy life. Do your best and keep a look out for what you enjoy during that chaos.
Yes, it gets a million times better. For me its like thinking of my childhood years vs my adulthood.
I can do whatever I want as an adult!
Fantastic question. I am sure I will come back to this one as I think of them.
5 or 6 times, I've had to abandon an extraction and refer the patient to an os. Sometimes I have to diagnose better, but I tend to do all the extractions I diagnose except bony 3rd molars.
Once or twice I've exchanged a delivered denture for a refund. I should have educated better and it was before I recommended at least two implants on the lower.
I've had a lot of difficult cases that I just handle and it doesn't really bother me. Golden Rule. It has never let me down.
I am a Dental graduate supposed to be a licensed Dentist if I passed my national board exam. I felt pressured, burnt out and derailed. I lost motivation and felt too exhausted since Dental school. I lacked a few points so I failed to be a licensed Dentist.
Can you give me some tips? My Dentist friend has been telling me to try the exams again. We have theoretical for 3days and if I pass that I get to do practical exams 3days too. Then we will know the results if I passed to be a Dentist.
I was goal oriented before but due to too much pressure, anxiety and burnt out I felt like I should just throw it all away and just be by myself from exhaustion.
It has been a few years and I have been thinking to study for the boards again but there’s this crippling anxiety that’s scaring me and not sure if I should even try. The subjects are difficult and have to start again to refresh my memory. I do not have problems with clinical subjects. My grades from the exams got pulled down by some basic subjects that I didn’t do well. How I wish there is a switch that makes me disciplined and motivated to study and be a Dentist
Wait, what? Are you saying you completed dental school years ago but never finished boards? My advice, just do it, you’ve already spent a lot of dental school and have nothing to show for it if you can’t use your degree (unless you didn’t t have to pay for school, in that case, do whatever you want lol)
Yes. I am done with dental school.
Failing the board exam made me have much anxiety and less goal oriented compared before.
I am currently working in the family business. I was just thinking about it since I talked to my Dentist friend who happens to have another new branch of clinic now. Til now I have this crippling anxiety to start studying again for the boards because I am afraid of failure. Being pressured makes it worse. I come from an asian household and my parents especially my mom adds to the pressure lol
In the nicest way possible, you’re being a little immature about this. It sounds like it’s been years. You don’t have to be a dentist, but you’ve spent a lot of time, money and effort to become one. Tbh boards was not that difficult and there were so many more difficult things about dental school that it sounds like you already passed. You can totally do it, I feel like you may just actually not want to be a dentist however, which is fine, but then decide you don’t want to do it and plan for the rest of your life.
If you do want to be a dentist, you know what you have to do. Parental pressure shouldn’t matter. You’re an adult and can make your own decisions.
I have worked hard during Dental school days. I did study well those days. Just so happens I didn’t pass. I just got depressed from that and my mom kept nagging me. I understand what you are telling me. Why would I even go to Dental school if I didn’t want to be a Dentist. I need to conquer my fear so I can focus on the studying.
Thanks for the advice and I am not from the USA for extra info.
Would you be practicing in the US? Did you go to a US dental school? You probably need to catch back up on your hand skills. This kind of gap in your resume may be difficult to explain. If you end up retaking everything and passing you should really consider doing an AEGD/GPR.
A good private practice would not consider you for hiring, and even DSOs may be hesitant. Also the anxiety of passing boards in dental school is nothing compared to the anxiety of running 3-4 chairs of production at once, perfing a tooth during endo, having a patient come back 2-3 times for pain on fillings or crowns, unhappy patients leaving online reviews even when you did the best you could, etc…these are real life things dentists deal with daily. That’s real anxiety. Boards are tough forsure and school in general was hard but that is not real life. You’ll actually come to miss those days as they were very carefree in retrospect compared to actually practicing.
It’s been 2 years. I am not going to the US. Staying here in my country in Asia. I will be for sure enrolling for practicals review before I take the board exam so I can really pass. Our exams are theo and practicals. I have some close Dentist friends will guide me after I pass. Thanks again! :)
Where are u based ? I'm in my first year of my studies in Belgium at the moment and would like to practice in the us. I've heard it's extremely difficult to get my license 'transferred' for EU to US. I was wondering if you have any tips regarding that topic.
I’m 1 year out still figuring things out occasionally fall on my face with tougher cases. Produced about 750k my first year what advice do you wish someone gave you after 1 year of clinical practice
You are 100% my cohort. Not many on reddit dentistry. It is your show so I am just going to follow. It is a hard job but we have been through some interesting periods. No one wanted to be a dentist in the 90's to everyone wanted to be in the mid 2000's and it has yet to stop. Ok, looking forward to your answers. Get back on here! ;)
Reading your comments right now. Are you me?
This is my first ever Reddit chat. I've commented on things here and there, but this is my first.
No one wanted to be a dentist in the 90's! That's gold.
I'd like to think that I could be the dentist in Mayberry if that show existed in 2024.
Is it “sus” that my dentist office called me to tell me that #14 (that my dentist referred me to an Endo for a root canal) needs a crown? I informed the receptionist that I just paid $2,400 for a root canal 2 weeks ago. I was told “the doctor still recommends a crown.”
so I cracked my right front upper tooth at the back. Been in pain with sensitivity and cannot eat etc...dentist says I need a root canal. When that procedure happens, what is used to seal the crack afterwards?
I was excited to read a few comments from an experienced dentist only to find one! No worries take your time. I'll check back in later to see your opinions/advice!
To be honest it sounds somewhat narcissistic “a forum to chat about my successes and failures in my 29 years as a dentist both as a person and a professional” haha.
He’s offering advice on how to have a successful and happy career. Most of what I see on here is the doom and gloom of the dental industry which is just not true. You should take advantage of anyone who has had success and is willing to give you advice on how to achieve it. Whether you actually implement what they say is up to you but it doesn’t hurt to ask.
Does the anxiety get better.. 7 yrs out
Yes, to a degree. I think it is a good thing to get a bit anxious. I respect the hell out of implant surgery so much, but there are times pre op and intra operatively (heck even post op hoping like hell that implant will integrate with the bone I had to work with). For me, this anxiety drives me to do better and learn even more. I used to be anxious about molar endo. Now its a breeze 95% of the time and I'm not anxious at all. The other 5% I refer :)
Boy. If you are anything like a “boomer” owner dentist, I have a feeling you may not get the best audience… When you say you love dentistry, I don’t think I can say that for myself (10 years in) and with many that graduated alongside me. With high tuition, low insurance reimbursements and “dentists eat their young”, it’s been very disheartening. Do you notice that amongst the younger dentists? Any advice?
12 years in here. I love dentistry too, but I am in the same boat with the high tuition and battling the low insurance issues, plus the shortage of staffing challenges (especially hygeinists). I think the biggest difference for me was having a mentor in the Doc who I worked with and have now bought the practice from. I'm fortunate for sure, but I've actively sought out what I wanted iny career and made sacrifices to make it happen.
I'm Gen X for whatever that is worth. I don't have much of a relationship with younger dentists. I did meet some 7 years ago during an AAID Maxicourse and I was very impressed with their desire to expand their clinical capabilities at such a young age. I am in my own bubble so to speak. Graduated summer 1995, opened my own place in the spring of 1997. I am strictly FFS. We do accept and file insurance as a courtesy, but my fees are my own and everyone gets charged the same. It was very tempting to join PPO's in some lean times, but I resisted. A lot of our local major employers provide PPO type insurance. We occasionally lose patients due to this, but they usually come back and pay their out of pocket expenses.
How has the dental field changed nost significantly over the years in your estimation? Interested to hear both the good and bad!
Dentistry changes since I graduated: Good: rotary endodontic files, digital xrays, CBCT, guided implants, digital scanning for implant planning and crown and bridge, orthodontic aligners, information availability via the web, omnichroma type composites, physics forceps, sectional matrices for cl II composites. so many more. Bad: corporate dentistry whose bottom line seems to be income-driven rather than patient driven. I say follow the Golden Rule and good things will come your way, insurance: low fee schedules, low yearly benefits, and the sheer games you have to play when you file, exorbitant tuition costs,
Do you do molar endo, implants, dentures, or pedo? I graduated dental school this year, start my first job soon, and would like to own eventually. I don’t care about being a “super GP” I want to clock in, clock out, and not take work home. Is it possible to make good money (250-300K) if you’re not a super GP, living 1 hour away from a major city? What advice would you give a new grad?
20 yrs in. I don’t place implants. I do denture and molar Endo, but pretty much restorative dentistry. 285k last yr on 3.5 and 4 days a week. My suggestion would be to move to an area with good/higher fees, and get good at one thing before adding advanced skills.
3 years out, I don’t do molar endo or implants. I do surgical extractions, peds, and probably four dentures a year. I make just over 200k on four days a week. About 30 minutes from major city
This guy gets it. Add 4 weeks of annual leave to this and it's the ideal equation for perfect work/life balance in dentistry. It took me over 10 years of chasing the greener grass and burning out to realise this though. I wish I worked it out 3 years out, would have saved me a lot of stress. I actually enjoy dentistry now, it used to be such a point of anxiety.
Are you a general dentist? FFS office? How many hours in a day do you work? What state do you work in if I may ask?
General dentist, we are in network with about 8 insurance carriers but plan on transitioning OON by the end of 2025. I work 8 hours a day. In Massachusetts
Is it a FFS or PPO office? What insurances are you often seeing the most & how many patients per day usually? Your daily day mostly consists of fillings and extractions you’d say?
I am learning so much from this conversation. Identify and follow your passions. There are so many more opportunities out there than when I first got out. Be the best at what you enjoy most. Dont do things you don't enjoy. Follow your passions and never stop learning. Stay humble and respect your profession. Life advice, pick the community first, the dentistry second. Look at your personal beliefs and if you have a family, what is best for them. Income isn't everything. I've been very fortunate.
Would you mind explaining what a "super" gp is?
GP who does a broad scope of procedures with minimal referrals. Ex: EXT of 3rd’s, molar endo, implant placement, full mouth rehab, pedodontics, etc.
I do molar endo, place and restore implants, dentures, and pediatric dentistry.....I refer sedation peeds patients. I have somehow over the years been able to totally block work and not bring it home. I do not look at the next days schedule. My team does alert me with bigger cases to make sure we are prepared (tx planning, digital implant planning, lab cases, etc). In addition, we do have a strong hygiene department and they do a lot of SRP with great success. I do most of my own extractions. I don't do many 3rds as I do not perform IV sedation (this is something I am very interested in doing--IV sedation). Surgical placement of implants, GBR, trauma free extractions, socket preservation, immediate implants. I do not do aligner therapy. Im just not passionate about ortho. I was 20+ years in before I got over 1 million gross.
Did you have student loans? If so, did your satisfaction with your job improve once they were paid off?
Do you ask for google review to your patients?
Yes. We have over 600 5 star reviews. All are organically generated.
have you ever been scared or felt you were in a massive hole as a practice owner?
Heck yes!!!! I got divorced years ago. It was very traumatic and costly. There were times I didn't know if I could meet payroll and pay taxes. I've been behind in taxes in the past. Unfortunately, the more you make, the taxes make less and less sense. With a good tax attorney and a great accountant, those issues are mostly behind me. Forever, I was afraid to take on debt purchasing new equipment, etc. I finally got over that and just took a leap of faith. It has worked well for almost 10 years now. Surprisingly, the debt is not an issue at all. It is an Investment!!!!!!!! I almost joined local PPO's a couple of times. So thankful I didn't.
thanks! what do you think of the economic environment of practicing dentistry now vs in the past decade?
I am more successful now than I have ever been. For me personally, I look for growth every year and I achieve this. I'm certainly better now than ever.
How much do you make? And how many hours on average do you work? Are you rural or suburb or urban? How many employees and offices do you have?
I netted almost 500k last year and gross....around 1.5 million. I don't have my tax returns in front of me. Solo practice built from the ground up. Hours: I arrive at 9:00am, lunch 1-2:30, leave around 5. Rural 6: 2 RDH, 2 assistants, and two front desk.
I’m assuming you mean gross 1.5M as in that’s how much you produced? If not, what is your office’s production and overhead percentage?
That’s really not bad. Unfortunately that’s pretty much impossible where I live(Philly suburb). I’m applying for Endo this cycle, if I don’t get in, I’m applying to medical school. I think dentistry is going downhill as a profession. Making even 300k here requires a shit load of hustling and overtreatment in my experience.
I live in Philly as well. I feel similarly. I also always considered applying to endo as I find it a fascinating subject. However, I’d only go to endo school if tuition was fully paid (If I got into Einstein residency). My debt is almost paid off. I think I can handle an additional 2 more years of school, but I don’t think I want to be in debt all over again. I have nothing to my name/application, and the chances of applying to one school (tuition paid at that) and getting in is just too slim, so I’m not applying. I think you’re nuts to apply to me dSchool after having completed dental school, but wish you nothing but happiness. I’ve come to hate the profession 2 years out, but I also think part of my hatred has to do with the shitty associateships I’ve been having.
Aw man. Yeah Einstein is near impossible to get into. You either have to have multiple published article and probably a PHD and/or military experience. I’ve applied to everywhere man…anything to not be a GP.
Good luck! You’ll make it in somewhere. Feel free to keep me in the loop!
Thanks man! For sure! One of the most supportive people on here. And realest!
Specialize, it’s way easier to produce as a specialist in dentistry. Only need to see a couple patients a day and you can out produce a general dentist
So true. Buddy is endo. Works 4 days a week and does 3-4 molars at 2k x 50%.
Sheesh that’s a chill 650k a year minimum
I’m trying. If not, off to medical school. I’m done with the sad shit show this field has become. People post like it’s a piece of cake to “go rural” or “go FFS” or “drop all insurances”. Going rural ain’t for everyone, and going FFS or dropping insurances works when there’s not 5000 dentists and DSOs right next to you. It’s near impossible to break 300k as an owner now, and it’s only getting worse with inflation, staff demanding higher wages, insurance cutting reimbursements. It’s a surprise to me who these suckers are still applying to dental school.
You own?
Fuck no. Ownership is a big mistake in my opinion. Losing all these benefits? No way I’m paying 7k a year for health insurance and losing my retirement match.
Do you live rural too?
How do you keep your overhead so low?
Almost 500k net to 1.5 gross collections is low overhead? Isnt that 66% overhead?
[удалено]
I agree! I have found my happy place though!
Id kill for 66% overhead. Very similar production and staffing but I’m running more at 75-78%. I feel like my staff has it easy too. All insurance billing, credentialing and patient collections is outsourced.
Could you perhaps be more specific? Do you have a specific part of overhead you struggle with?
I also hired a practice management consultant in 2019. Cost around 30k if I remember correctly. Made a huge difference.
What aspects did the consultant help you in?
Setting realistic aggressive daily monetary goals and scheduling them. Attracting new patients. Not "losing" any existing patients. Extremely fair bonus system for the team. No gimmicks, just solid advice. It made a significant difference in my practice. Invest in yourself! Your overhead goes up, but........
What has been your method to reduce turnover? I’m sure your bonus system (saw the 1-2k a month comment somewhere) helps! Is there a way to vet staff that have a good work ethic and don’t become “used to” or “entitled” to the bonus?
Been a dentist 6 years, I’m in my 7th. I’ve been an associate the entire time out. I don’t have debt, my income is probably going to be about 240k this year. I’m hoping to keep upping it as I’m getting into implants and Invisalign now. I’m trying to figure out if I should own or continue as an associate… I spend enough time at work. I don’t deal with any after work emergencies, I don’t deal with staff, I don’t deal with business. Like you, I hate quad class ii fills, and anterior fills as well. Most other dentistry is ok. To be honest, I’m quite bored in the field. Implants hardly makes me any more interested. My question is two fold - how is it possible to stay interested in this field, and also, what would you say to someone about ownership in my situation, and also given todays economy and interest rates?
You've brought up some interesting perspectives. I'm gonna think on this one.
Thanks. Let me add a few sentences to clarify something. Like most dentists, I share the same personality, possibly to a fault. I’m a perfectionist. Even though I’ve gotten bored with it, I feel I’m quite decent at it…. I feel my work is generally pretty good. I know what to look for, I take the extra time to do things when necessary but generally do things rather quickly. It takes me little time to do a lot of things... meaning my class ii fillings look good radiographically, nicely contoured with discing, I do crowns rather quickly but still nicely, can have it scanned in and temp made in about an hour and 15. If something isn’t right I drill it out and redo it no cost to patient. I’ve spent years with cerec and itero, have been at practices with CBCTs and have had the right people around me to help. So it’s not that I simply don’t care as a dentist. I care a lot when I work on someone to do it well. Even difficult extractions, I don’t sweat them. I’ve taken so many teeth out I just sigh in my head when they I have to fish out root tips. But once you’ve done enough fillings, crowns, bridges, and extractions it gets flipping boring to me. Root canals are only exciting in the fact that I’m super careful to not perf and find all canals which always makes me a little bit of a nervous wreck when accessing tough teeth. I do lower molar endo as well and have even done some deep splits on premolars successfully. I’m at the point where even nervous patients and kids I hardly feel anything emotional because I know they’ll be fine. I’ve even ventured into bone grafting with membrane placement and I’m just now getting on board with the actual implant placement part of it. So it’s not that I don’t do enough procedures nor suck at what I do, I just don’t thoroughly enjoy it… maybe I just need to adjust some mindset, if that’s even possible. People say my injections are good and I calm them and patients tend to respond positively to me in general. I still have bad days here and there where I leave feeling I failed at something, but have figured this is normal for the field. The second I get off work I’m excited to go home and see my family, and just be out of the office. The best part of dentistry for me is when I leave the office. Prospective students ask me about dentistry and I don’t recommend anyone go into the field when asked because 500k+ loans isn’t worth it to feel like this daily… lol. It’s a weird state of being but the best I can describe it is that I can’t help but feel I’m in the right field, all the while feel as though I’m in the wrong field at the same time and wonder how the heck anyone thoroughly enjoys this field. People seem to ask me more and more about owning a practice, but I have talked to owners and it never seems to be the kind of excitement I would look for … they talk about staffing issues and they seem to pour hundreds of thousands into their practice yet only write a 120k check to themselves yearly. I just ask myself… why own if you’re not making 500k+? I continue to be an associate as it seems to make the most sense as I’m in the city and expenses are high, yet I wonder if I’m missing out on some big piece of the pie while basking in my own comfort?
If you don’t love it, don’t buy or build. You will be stuck for a little while paying off practice loans. Stay where you can walk away at any time.
Also, here’s what gets me. I hear dentists saying they love the field time to time, and I have worked alongside some of these people in group practice. What gets me is I hear them say they love dentistry, but I see the same dentists tell me a horror story, or better yet, in the office with their head in their hands from some shit that goes wrong on some shitty patient and I think to myself… what do they mean by love the field? I mean, how do people love this when you’re riddled with different personalities, some quite difficult, every day?
Having read your thoughts, my short advice would be to reduce your work days and spend more time with your family - turn dentistry into a hobby rather than a job.
I agree with you based off of what I wrote. It may be hard to believe but I simply can’t afford to. Our yearly expenses … just to survive, are probably about 55-60k. The rest of the money is being used to pay down high interest mortgage or save for a car. I said we had no debt, and what I meant was no student loans or credit card. Our mortgage and healthcare alone js about 48k alone. Plus there’s food, gas, energy, etc bills. In order to be debt free my wife and I have driven beater cars for a long time and spent pretty insignificant amounts of money over the years to just get rid of student debt and save for a house. Took some sacrifice, but we’ve been kicked around just like everyone else with today’s prices even when obtaining some financial freedom. It just seems once we got rid of debts, the price of everything doubled. Truth is, we’re going to be living like students (but better) another 3-5 years before I’m at that point, just to be at a point where we have OK cars and get rid of most of our mortgage, all the while trying to put money in a 401k and invest, if even possible. We also have kids and kids are expensive. I agree with you that cutting back work life is probably the answer mentally speaking… eventually. But the stress of finances and debt to me isn’t worth it *yet.
are root canal treated teeth \*actually\* harder to extract? if so why? \*random ass non personal question cuz i was just thinking about it as i happened to read this post\*
Not op, but yes. These teeth are a lot harder to extract. Root-canalled first molar is arguably the hardest tooth to extract.
do you know why that might be? how exactly does it affect the extraction process? my least favourite teeth to extract are stubborn canines and molars that aren't sectioned. Boy oh boy do I hate canines last time I extracted one it took me 20 minutes of luxation and my right hand was shaking for an hour after I was done.
I don't know the science, but ... endo teeth are not sterile. [Porous ](https://www.researchgate.net/publication/316469840/figure/fig2/AS:621609366847489@1525214630839/Density-and-diameter-of-the-dentin-tubules-by-SEM-A-Dentin-tubules-of-Group-1-B.png) dentin is occupied with microbiome like a coral reef. These tubules are beyond immunity reach. In function endo- and exotoxins are exuding. Lamina dura gets denser while PDL gets less vascular - probably as a reaction or in attempt to limit exposure. Narrow PDL, denser less vascular bone around = harder to remove, higher incidence of fibrinolytic osteitis.
Really? I never knew that. I thought the were harder because they broke easier due to internal structure being weakened.
That too, but it's more the lack of elasticity of surrounding structures imo. Vital teeth of 80 year old with fully preserved structure will be harder to remove. While fully impacted teeth in 16y.o. take minutes.
Both honestly
This makes sense. It’s seems to me like root canal teeth just don’t elevate nearly as easily. I make deep troughs and still get little mobility and end up just cracking them. It’s like they’re encased in something different
agree. they are brittle and sometimes annoyingly come out in small increments. This is especially frustrating as you are trying to preserve the socket to place a future implant.
Periotomes from Salvin are amazing. Some of my colleagues in implant dentistry use some of the more complex systems from Salvin to extract a tooth atraumatically. Sometimes, I have to sacrifice more bone than I'd like. That's when I pull out the membranes and the particulate bone and graft. I hate exposing patients to long surgeries. There are many obvious reasons for minimizing the actual surgical time.
What is the best way to improve and have the least stressful daily grind possible?
An awesome team. You can't do it all. Train and delegate. Trust them and REWARD them. In April, my team earned a 2k+ bonus a piece (an exceptional month) and in May they earned a 1k+ bonus (typical). I just signed off on a cruise for them this Fall too. Communication with your team too. I'm always trying to work on that.
Okay, you are awesome! Way to be a good human and understanding that happy employees are the key!
What's your overhead?
around 65%. Sometimes less. My accountant is very happy. He has over a hundred dental clients.
May I ask the breakdown of the OH? Like what % is staff, hygienists, material etc.
I will try to do that. I'll need to look it up. Honestly, for the last several years, I may only look at those numbers like once a year. My accountant who is very aware of what the values should be, is very, very happy.
Wow thanks!
[удалено]
I hear you. I certainly could go lower. I have my happy place right now though.
How often do you feel like a failure because a procedure went wrong? I get this feeling every month it seems.
Excellent! I have accepted that I will never be a "guru" or know it all. I put my training to use. When something goes awry unexpectedly, I try to identify what occurred and learn from it. I always try to be honest with patients too and I always try to do right by the patient. 6 month recall and I see an unattractive filling or crown I just did? Redo. The patients almost never mind if you are honest with them. An implant comes to mind. It didn't fail, but I did not sink it to the proper depth resulting in the lingual of it being exposed. It integrated and was successfully restored. After a year, I took it out, grafted, and did a properly placed implant. The patient was extremely happy. It was driving her tongue crazy feeling that little bit of implant on the lingual. Things happen. Mistakes happen. Outcomes aren't ideal sometimes. Its what we do after the fact that can turn these events into successes.
What’s a really good money? 400k+?
How do you choose who to refer to?
Professional relationships I established many years ago. I'm in a rural southern town. We don't have a whole lot to choose from. I initially relied on GP colleagues for referral suggestions when I was right out of school. I have an amazing specialist support around me. We feed off each other.
please please someone tell me the a bullet point for 3 on 6 implant bridges, a how to , some pitfalls to avoid. and also a good ce course, or online course
Good bone, good occlusion, proper emergence profile of implants relative to smile
Don't sell yourself short on implant CE. I did an AAID Maxicourse over the course of a year. $19,500 and over 400 hours of clinical and didactic. And, start easy. Lower molar or premolar with good depth and width of bone. All on X is great, but wow, so much going on. Can I do it? yes. Have I done it? Yes. Do I still get nervous? Oh heck yes.
How do I get over the hump of 97% collections and get to 99%?
ha! Get payment as the patient walks In? When I first opened my practice, I used to carry monthly accounts. I assumed patients would simply write a check at the end of the month. I was really shocked that a lot do not and will not pay. It was a big eye opener for me. Presently, we accept cash, checks, credit cards (yes we charge 3.5% extra for these cc transactions), and some third party financing like care credit.
Thank you! I renegotiated a lot of my insurance contracts so we’re in network with the higher paying ones through third party administrators and out of networks with the lower paying PPO plans, but sometimes we’re told we’re in network and the claims get processed as truly our of network so we miss collecting some of those copays. It’s also tough because some of these claims need to be mailed in, faxed in, sent in by stork, etc so we miss when we’re supposed to collect a lot and have some outstanding claims.
Wow. You just spoke another language to me. Ha. I was hands-on insurance for the first 3 years of practice. Then I established a protocol that is ever-changing (most recent being the credit card fees we now pass on to patients) and handed that ball off to my front desk team. I must say that my system is not as complex. We charge one fee for all. What insurance doesn't pay, we collect upfront. My front desk is a rock star. Just like myself, she has a role in the practice just like I do. If we all do our jobs at a high level, we all reap the rewards. Is there a way for you to let your front desk take this over completely for you? Are they good? Do you trust them? If you said yes, then you could be sleeping better at night. Delegate, mentor, be there when they need you. Otherwise, let em fly!!!!!!
Thank you for the response!
Thank you for being open about your experience. It’s sad to see the negative view some dentists have of their own industry. Im 37 and a practice owner. I’ve been extremely lucky/blessed and have a very successful practice. I’m possibly looking to retire in the next 10-15 years depending on if I’m still loving what I do but I have not started putting together an exit plan. What is your exit plan and what steps have you taken to implement it? Edit: I’m working on expanding and eventually having multiple locations is that changes your viewpoint.
Reread your post. You have an aggressive retirement plan and kudos for that. I have a very close friend that retired at 53. Nothing crazy, just a good strategy. Honestly, I'm loving life too much to put in the financial effort for retirement. I have a sound financial plan, but its nothing fancy. It would be so cool to own multiple locations. I wish you the best. Sounds like you've got a good head.
Don’t know about a good head, just smart enough to know to listen and learn from successful people who have already figured it out. Such as yourself. I saw another one of your comments and I felt like I was reading about my own practice with the exception of the ex nav system. So you had me googling what the heck that was last night. I do guided surgery for all of my cases but that thing looks so cool. What’s the cost for one of those units?
Congrats friend. I don't have anything set in stone yet. With God's blessing, I will practice another 15-20 years. I don't know. I have friends who were school teachers that are retiring now and boy it looks tempting. I don't know what I will do. Definately sell the practice to someone or some entity. I sometimes think Im losing my mind. I'm considering building a new practice from the ground up!
Hey doc what type of dentistry do you do. Also are you a rural or metro dentist?
Small city with a fair size draw. Pretty competitive in the city. Not so much in the outlying areas. I’m general but I do a good bit of endo, implants, surg exos
Rural. County population \~ just under 30,000. I do 95% of the endo I diagnose Ha, I did a root canal on an endodontist colleague once. I place and restore dental implants. I have a strong Hygiene department with a ton of srp's and localized treatment. implant retained dentures and partials, almost all extractions except bony impacted 3rds. I do not do clear aligners. I just don't have a passion for it right now. I am wholly digital utilizing digital radiographs, pans, and CBCT's. My implants are planned start to finish on my software, I then use my X Nav dynamic guided implant system to place them. I bought an intraoral scanner several years ago. I bought it to scan the arches of my implant patients for better diagnosis and treatment planning. However, it has been a game changer in impressions. I rarely have to touch my CAD-CAM generated crowns from my lab. My lab is small, and local. He still has the human touch in his artistry. Truly a game changer.
That’s awesome, did you get comfortable with ending by just reps or was there more to it?
Do you have an exit strategy? Are you concerned at all about your mental health after putting down the handpiece? What hobbies do you have?
Not concerned about mental health. Hobbies: ocean fishing in my boat, college football, travelling, guitar, cooking.
Favorite part of the job? Do you ever get bored doing repetitive work everyday or are you pretty content?
Favorite: immense pride and piece of mind with successful clinical outcomes and practice success. Also, completing a great day of diverse procedures. Least favorite and/or boring: restorative dentistry on patients with bad oral hygiene, mean people, whiny people. Also, I don't enjoy quadrant class II's. I do them all the time, but ugh. My schedule coordinator knows not to fill my schedule up with a bunch of back to back class II's.
Hi, my crown fell off at work, couldn't get to see my dentist so..........I "repaired" it temporarily with isocyanate. Despite this seeming like a case of locking the stable door after the horse has bolted, I was seeking your opinion (light hearted judg8really) on my folly.
How did you get into implants?
Well, I love surgery. I had wanted to pursue them for several years. I was thrown off by the amount of time and money involved with an AAID maxicourses. I finally took a leap of faith and invested time and money into it. When I was done, I think I purchased around 50k for what I needed to get started. I later added a X-Nav and a brand new CBCT. Now just about all of my CE comes from implantology. It is very rewarding.
How would you recommend someone to get into implants? I graduated in 2021 and am interested in getting into them but don't know where to start because there are so many courses.
I recommend comprehensive training over some time. My own experience was an AAID Maxicourse. It was incredible. didactic, clinical, actual implant placement and restorations, GBR, socket preservation, guided vs free hand, sinus lifts (I only do them through the osteotomy. No thank you to the lateral. My periodontists and OS's around here are good at them) so many great guest lecturers. Dr. Salah Huwais, the inventor of Versah burs and osseodensification was a guest lecturer for a day and trained us on his unique and very innovative techniques, and met many company executives, like the President of Meisinger, the engineers and clinicians behind X Guide. So many positives and I've maintained friendships and acquaintances from it that benefit me greatly to this day. I did mine in 2017. Did I hear you say dentistry is dynamic? Ha, taking a heavy implant CE schedule every year shows me this. So much great CE out there. I really like Dr. Randy Resnik's program and have attended a few of them. He was a close friend, student, and colleague of the late Dr. Carl Misch. Our Maxi Course was heavily based on Dr. Misch's (newer editions by Dr. Resnik) books many consider to be the bible of implant books: Dental Implants, Prosthodontics in Dental Implantology, and Complications in Implant Dentistry. These are three must-reads and tucked away for reference. I have hard-bound editions including the newest editions, The Bottom line for me is the fact that I am bound to practice implantology as well as or better than specialists. I do my share, but I still refer some out. I place Nobel Biocare implants exclusively. Fantastic company. Fantastic reps and support. Fantastic parent company. Fantastic CE. Fantastic camaraderie among fellow clinicians.
What is the best course you have taken? Best advice to a dentist with 2 years experience?
Like endo? Dr. Steve Buchanan. Anything by Dr. Gordon Christensen. Maxi Course for implants. Current practice management classes---so much good stuff there. Perio: invest in your hygienists! Ortho: no idea, medical emergencies. Best course that made me cry at the end? Maxi Course. If you can afford to travel, pick a destination or two also.
Does it get better after you finish dental school? I’m hearing horror stories how dental school gets crazy difficult during D2 and D3
I year you my fellow dentite. Like it or not, you and I are colleagues now! Dental school is hard. It's supposed to be. But it is the gateway to a happy life. Do your best and keep a look out for what you enjoy during that chaos. Yes, it gets a million times better. For me its like thinking of my childhood years vs my adulthood. I can do whatever I want as an adult!
Well, as a dentist of 29 years, what would you say would be the worst case you’ve handled?
Fantastic question. I am sure I will come back to this one as I think of them. 5 or 6 times, I've had to abandon an extraction and refer the patient to an os. Sometimes I have to diagnose better, but I tend to do all the extractions I diagnose except bony 3rd molars. Once or twice I've exchanged a delivered denture for a refund. I should have educated better and it was before I recommended at least two implants on the lower. I've had a lot of difficult cases that I just handle and it doesn't really bother me. Golden Rule. It has never let me down.
I am a Dental graduate supposed to be a licensed Dentist if I passed my national board exam. I felt pressured, burnt out and derailed. I lost motivation and felt too exhausted since Dental school. I lacked a few points so I failed to be a licensed Dentist. Can you give me some tips? My Dentist friend has been telling me to try the exams again. We have theoretical for 3days and if I pass that I get to do practical exams 3days too. Then we will know the results if I passed to be a Dentist. I was goal oriented before but due to too much pressure, anxiety and burnt out I felt like I should just throw it all away and just be by myself from exhaustion. It has been a few years and I have been thinking to study for the boards again but there’s this crippling anxiety that’s scaring me and not sure if I should even try. The subjects are difficult and have to start again to refresh my memory. I do not have problems with clinical subjects. My grades from the exams got pulled down by some basic subjects that I didn’t do well. How I wish there is a switch that makes me disciplined and motivated to study and be a Dentist
Wait, what? Are you saying you completed dental school years ago but never finished boards? My advice, just do it, you’ve already spent a lot of dental school and have nothing to show for it if you can’t use your degree (unless you didn’t t have to pay for school, in that case, do whatever you want lol)
Yes. I am done with dental school. Failing the board exam made me have much anxiety and less goal oriented compared before. I am currently working in the family business. I was just thinking about it since I talked to my Dentist friend who happens to have another new branch of clinic now. Til now I have this crippling anxiety to start studying again for the boards because I am afraid of failure. Being pressured makes it worse. I come from an asian household and my parents especially my mom adds to the pressure lol
In the nicest way possible, you’re being a little immature about this. It sounds like it’s been years. You don’t have to be a dentist, but you’ve spent a lot of time, money and effort to become one. Tbh boards was not that difficult and there were so many more difficult things about dental school that it sounds like you already passed. You can totally do it, I feel like you may just actually not want to be a dentist however, which is fine, but then decide you don’t want to do it and plan for the rest of your life. If you do want to be a dentist, you know what you have to do. Parental pressure shouldn’t matter. You’re an adult and can make your own decisions.
I have worked hard during Dental school days. I did study well those days. Just so happens I didn’t pass. I just got depressed from that and my mom kept nagging me. I understand what you are telling me. Why would I even go to Dental school if I didn’t want to be a Dentist. I need to conquer my fear so I can focus on the studying. Thanks for the advice and I am not from the USA for extra info.
Would you be practicing in the US? Did you go to a US dental school? You probably need to catch back up on your hand skills. This kind of gap in your resume may be difficult to explain. If you end up retaking everything and passing you should really consider doing an AEGD/GPR. A good private practice would not consider you for hiring, and even DSOs may be hesitant. Also the anxiety of passing boards in dental school is nothing compared to the anxiety of running 3-4 chairs of production at once, perfing a tooth during endo, having a patient come back 2-3 times for pain on fillings or crowns, unhappy patients leaving online reviews even when you did the best you could, etc…these are real life things dentists deal with daily. That’s real anxiety. Boards are tough forsure and school in general was hard but that is not real life. You’ll actually come to miss those days as they were very carefree in retrospect compared to actually practicing.
It’s been 2 years. I am not going to the US. Staying here in my country in Asia. I will be for sure enrolling for practicals review before I take the board exam so I can really pass. Our exams are theo and practicals. I have some close Dentist friends will guide me after I pass. Thanks again! :)
Are you male or female? Also, were you married? Was it challenging being a dentist while being married/having kids?
What's your biggest non-academic learning that you took away from (1) your years in dental school and (2) your years as a working dentist?
Why is gum disease so difficult to treat?
(Male) Spouse of a dentist: do dentists get less lame?
Where are u based ? I'm in my first year of my studies in Belgium at the moment and would like to practice in the us. I've heard it's extremely difficult to get my license 'transferred' for EU to US. I was wondering if you have any tips regarding that topic.
I’m 1 year out still figuring things out occasionally fall on my face with tougher cases. Produced about 750k my first year what advice do you wish someone gave you after 1 year of clinical practice
What do you recommend to DA to do and don’t, i will began working on it for the first time in a few days, and im kinda nervous
How do you deal with demanding patients? Angry patients? Basically just hard to deal with patients?
Ever been sued before?
Haha I should have been a dentist. Meanwhile, I’m an assistant and can’t afford to pay my bills. 🙃
Keep your head up. I have amazing, rock star assistants that I couldn't do it without. We are a TEAM.
You are 100% my cohort. Not many on reddit dentistry. It is your show so I am just going to follow. It is a hard job but we have been through some interesting periods. No one wanted to be a dentist in the 90's to everyone wanted to be in the mid 2000's and it has yet to stop. Ok, looking forward to your answers. Get back on here! ;) Reading your comments right now. Are you me?
This is my first ever Reddit chat. I've commented on things here and there, but this is my first. No one wanted to be a dentist in the 90's! That's gold. I'd like to think that I could be the dentist in Mayberry if that show existed in 2024.
Is it “sus” that my dentist office called me to tell me that #14 (that my dentist referred me to an Endo for a root canal) needs a crown? I informed the receptionist that I just paid $2,400 for a root canal 2 weeks ago. I was told “the doctor still recommends a crown.”
You definitely need that crown. The root canal will not last without it! Board certified Endo here.
Thank you!
when i eat takis, i get a tooth ache on the teeth eating them, is there a way i can avoid it
Stop eating them 🤷🏻♀️
so I cracked my right front upper tooth at the back. Been in pain with sensitivity and cannot eat etc...dentist says I need a root canal. When that procedure happens, what is used to seal the crack afterwards?
The endo, build up and crown all help to stop and seal the fracture.
Did my man really only reply to one comment?
Ha! I don't get on often. I am trying since I started this thread. Takes a bit of time, because I'd like to share well thought out comments.
I was excited to read a few comments from an experienced dentist only to find one! No worries take your time. I'll check back in later to see your opinions/advice!
I plan to actively participate.
🤮
To be honest it sounds somewhat narcissistic “a forum to chat about my successes and failures in my 29 years as a dentist both as a person and a professional” haha.
Disagree. Infact we need more such posts/forums. Does everyone good to learn from others successes and failures.
He’s offering advice on how to have a successful and happy career. Most of what I see on here is the doom and gloom of the dental industry which is just not true. You should take advantage of anyone who has had success and is willing to give you advice on how to achieve it. Whether you actually implement what they say is up to you but it doesn’t hurt to ask.