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Pabl0, absolutely make sure you are taking FMX or Pano for your new patients if you don’t have one. This is not an upsell, you ethically need this to properly diagnose a patient. For recalls, tak...
Post Date: 08/23/25 Forum: Ideas To Make Your Practice Grow Views: 1780 Replies: 142
Then send them over at the next appointment....
Post Date: 06/09/24 Forum: Ask a Dental Consultant Views: 1870 Replies: 65
I totally agree with your last comment.  It's always a little strange to me when an owner with 3 or 4 hygienists is lamenting over possibly losing one.  We need hygiene but, it's production pales in c...
Post Date: 05/16/24 Forum: Ask a Dental Consultant Views: 1870 Replies: 65
Its time to consider shifting your focus off of a solely hygiene based practice.  Bring NPs in on Doctor side first for just exams.  Diagnose perio in that appt.  Take all rads necessary, then send th...
Post Date: 05/16/24 Forum: Ask a Dental Consultant Views: 1870 Replies: 65
How old are these patients? Are these new patients? I don't know about the patient on the left side. Lisa on the right side was a 21 year old new patient.  The point I'm trying to make is that...
Post Date: 03/20/24 Forum: Restorative Dentistry Views: 1485 Replies: 85
I work for  a DSO and have seen my share of new dentists diagnose decay on virgin teeth on my previous patients that somehow got assigned to them. I have helped out colleagues that are in PP and seen ...
Post Date: 03/05/24 Forum: Restorative Dentistry Views: 5143 Replies: 181
Since we went all OON and TPA our hygiene department is super profitable.  We get $100+ for an 1110 rather than $50, $80+ for BWs instead of $33, etc.  Hygiene doesn't need to be a loss-leader.  I t...
Post Date: 11/09/23 Forum: Ethical Issues Views: 791 Replies: 49
Take a pano or pa now. How can you adequately diagnose the case? How do you adequately protect the patient and yourself without all of the information?...
Post Date: 09/18/22 Forum: Oral & Maxillofacial Surgery Views: 766 Replies: 24
I think you're on point here. I just dropped dentemax in favor of connection dental and am now OON with MetLife and a couple other inscos as a result. I think we are going to have to keep moving in ...
Post Date: 07/28/22 Forum: Staff Management Issues Views: 843 Replies: 30
Yes. Things give at some point, esp in pt with high caries risk and heavily restored. LEts say you diagnose a crown on a pt. They say they will think about it. Well, you arent going to see them for ...
Post Date: 07/28/22 Forum: Staff Management Issues Views: 843 Replies: 30
I agree that radiograph sucks here what my bws look ...
Post Date: 06/27/22 Forum: Restorative Dentistry Views: 2040 Replies: 36
thank you so much for such a detailed response! I've made a few notations above...
Post Date: 10/15/21 Forum: Staff Management Issues Views: 761 Replies: 39
The advice from 406 resources is good. You might need a consultant, but it needs to be the right one, or else they might dig their heels in.  Looking for honest feedback on how to help my two hygie...
Post Date: 10/08/21 Forum: Staff Management Issues Views: 761 Replies: 39
Advanced Hygiene Concepts would be a great place to start on training and developing a culture of perio treatments.  Another thing we might recommend for your Hygiene department which often times s...
Post Date: 10/08/21 Forum: Staff Management Issues Views: 761 Replies: 39
This kind of reminds me of "can this marriage be saved"?  I'm not sure RDH #1 can be saved. Sounds like you’ve done all you can for her.  Like the old adage goes, “you can lead a horse to water”...
Post Date: 10/07/21 Forum: Staff Management Issues Views: 761 Replies: 39
I have thoughts but will have to wait until after work.  Too much to type ...
Post Date: 10/07/21 Forum: Staff Management Issues Views: 761 Replies: 39
Looking for honest feedback on how to help my two hygienists improve. They are both at different places in their careers and both present a different set of issues for me. I'd love suggestions on reso...
Post Date: 10/07/21 Forum: Staff Management Issues Views: 761 Replies: 39
Observe at 6 month intervals !!! Maybe forever!! Or till retirement!!...
Post Date: 08/20/21 Forum: Digital Radiography Views: 6054 Replies: 112
I've been in this situation in a multi-location private practice (owner aspired to be like aspen). As a young grad, it's really easy to feel the imposter syndrome and feel like we are doing somet...
Post Date: 08/18/21 Forum: Digital Radiography Views: 6054 Replies: 112
It's nice to hear many dentists on here who share same conservative philosophy. It's what I would want if it were my mouth. I've been in trouble before in a prior associateship where I opted to mon...
Post Date: 07/27/21 Forum: Digital Radiography Views: 6054 Replies: 112
I would treat 18,19,30-O, maybe 15-O( distal looks like there's caries). I wouldn't touch the interproximals, very agressive tx plan you have.OHI, prevident 5000, re-eval in 6 months....
Post Date: 07/27/21 Forum: Digital Radiography Views: 6054 Replies: 112
I would only do 18-O, 19-O, and 30-O if they look cavitated.  Watch all interproximal fills.  Either me or hygienist or both of us reinforce diet/OHI and then take new BW's in 1 year to compare to bas...
Post Date: 07/25/21 Forum: Digital Radiography Views: 6054 Replies: 112
I would not treat any of those interproximals with fills.  Agree with reinforcing hygiene, diet and prevident.  Also important to see this kiddo regularly.   I have many of these lesions that have hav...
Post Date: 07/22/21 Forum: Digital Radiography Views: 6054 Replies: 112
I totally agree with your dx. There is alot of decay in there. It's not getting better.  18 o should be a no brainer...
Post Date: 07/22/21 Forum: Digital Radiography Views: 6054 Replies: 112
I am not sure what the ICON system is, but is anyone treating these lesions with glass ionomer as per the GIC/ Dental Duct Tape CE here on dentaltown?  ...
Post Date: 07/14/21 Forum: Digital Radiography Views: 6054 Replies: 112
With my student loans : fill 3 4 5 and watch the rest.  IF  3 4 5 end up being huge, re evaluate and may fill some others.  Without my student loans : only fill what looks cavitated with my eyeball...
Post Date: 07/13/21 Forum: Digital Radiography Views: 6054 Replies: 112
Why overwhelm the kid and parents.  Treat 3,4,5 maybe 13.  Check the other lesions in a year if they are progressing....
Post Date: 07/13/21 Forum: Digital Radiography Views: 6054 Replies: 112
X-ray qualities aside, if this was my daughter, I would probably treat zero of these right now. In fact my daughter does have a couple of these that have looked exactly the same on BW for 15 YEARS!  O...
Post Date: 07/13/21 Forum: Digital Radiography Views: 6054 Replies: 112
In my observation most patients that use a Sonicare Electric Toothbrush present with inadequate sulcular plaque removal and bleeding when probed or when they are instructed in sulcular brushing using ...
Post Date: 07/13/21 Forum: Digital Radiography Views: 6054 Replies: 112
OHI and prescription fluoride 5000 ppm definitely a part of my treatment plan when I have a patient that suddenly has a mouthful of caries and/or suspect interproximal lesions. Fillings where indicate...
Post Date: 07/11/21 Forum: Digital Radiography Views: 6054 Replies: 112
Ya, I’ve seen most of my “watches” stay the same for over a decade. But that’s because I am sitting still in one location and choosing the right patients to watch and they show up every 6 months.   T...
Post Date: 07/11/21 Forum: Digital Radiography Views: 6054 Replies: 112
In my career of 25+ years—many many times.   It takes patient effort and change in habits but it can and does occur. Jumping in on every incipient decay is not necessary and overly aggressive. Thin...
Post Date: 07/11/21 Forum: Digital Radiography Views: 6054 Replies: 112
I always wondered when someone put a "watch" on treatment options.  What are you going to watch it do, get bigger?  Kind of like telling a patient with cancer that they have a few cells in their liver...
Post Date: 07/11/21 Forum: Digital Radiography Views: 6054 Replies: 112
Digial radiographs are not as sharp as the old "analogue" methods.  We need help to identify these lesions. I have been using CariVu from Dexis for about 6-7 years as an adjunct to BW's.  What an eye ...
Post Date: 07/11/21 Forum: Digital Radiography Views: 6054 Replies: 112
Plus 1...
Post Date: 07/10/21 Forum: Digital Radiography Views: 6054 Replies: 112
Don't forget to emphasize grazing.  I  am seeing a lot more of this due to people being bored during pandemic.  Kids who are virtual learning have access to food and beverages all day long at home whe...
Post Date: 05/20/21 Forum: Digital Radiography Views: 6054 Replies: 112
In Miami there's plenty of dentists who would restore ANY etched spot or stain.  It's amazingly bad....
Post Date: 05/20/21 Forum: Digital Radiography Views: 6054 Replies: 112
How often do hygienists use a rubber dam or an isodry for isolation when placing sealants? Are hygienists allowed to use a fissure otomy bur or a flame shaped diamond to thoroughly cleanse the pits ...
Post Date: 05/20/21 Forum: Digital Radiography Views: 6054 Replies: 112
^^^This! I would leave most of those alone and retake BW's in 1 year. Highly doubt they will turn to RCTs in 1 year....
Post Date: 05/19/21 Forum: Digital Radiography Views: 6054 Replies: 112
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Post Date: 02/13/21 Forum: Restorative Dentistry Views: 883 Replies: 25
Usually yes. Of course, a PA needs to be taken at a correct angle.  Please note that the correct x ray to diagnose decay is always a BW, at the correct angle. Sometimes, due to overlap issues, and ...
Post Date: 02/04/21 Forum: Restorative Dentistry Views: 883 Replies: 25
Has your office discussed bringing new patients into hygiene first?    Hyg takes BWs and perio chart very first to provided the necessary steps to accurately diagnose perio....
Post Date: 12/29/20 Forum: Periodontics Views: 502 Replies: 11
Please post xrays.... Explain that the decay that you have noted is between the teeth, very common in patients with braces. It is difficult to detect early in braces due to metal etc making interpr...
Post Date: 10/30/20 Forum: Restorative Dentistry Views: 88 Replies: 2
About 11 months ago a patient in full brackets presented in hygiene.  Looking at the notes from that day BWs were taken but of course they were not diagnostic. The patient was diagnosed with occlusal...
Post Date: 10/30/20 Forum: Restorative Dentistry Views: 88 Replies: 2
Well if there were to be some kind of extra special xray I suppose or maybe im in the minority of docs who take BWs on my pts annually. Hygiene is taking them, Im not. Im certainly the one responsib...
Post Date: 08/28/20 Forum: Staff Management Issues Views: 6340 Replies: 128
I’ll almost guarantee this was the scenario. They heard ‘we need to take xrays’ (bw’s of course needed, but parents stuck on ‘we already had them’ )  to make ‘treatment plan’ which they interpreted/...
Post Date: 07/28/20 Forum: Pediatric Dentistry Views: 728 Replies: 26
Front desk at Pedo office- Sir/Madam- Looks like we will have to do a new set of Bws and this is the charge.  Parents- but GP dentist did the x rays and sent them to you. I don't have to pay twice.  ...
Post Date: 07/28/20 Forum: Pediatric Dentistry Views: 728 Replies: 26
We also have the Vatech Green used mostly for pans and CBCTs...I can't speak for most people but I hate EO BWs. I think it's just a less useful pan. Sometimes I can see interproximal lesions but most ...
Post Date: 06/18/20 Forum: Digital Radiography Views: 337 Replies: 5
This is not a stain doc. It is an obvious clear as day progressing cavity, which has reached well into dentin. It started at the surface at some point and it got to the point where you are practically...
Post Date: 03/03/20 Forum: Restorative Dentistry Views: 1168 Replies: 94
I hear ya. IMO, more severe stuff shows up on the PA's than the BW's. At any rate, typically we do 4 BW's and 3 anterior PA's every year. We find a ton of PARLs  and resorptions on virgin anterior t...
Post Date: 01/13/19 Forum: Ethical Issues Views: 1266 Replies: 45
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