There’s certainly a lot of pressure in dentistry to scale up. People argue that without EBITDA, you don’t own a business you own a job.

I understand that argument, but here’s my rationale for not scaling.

Dentistry is inherently stressful and taxing. I don’t want to take on more staffing and HR issues or worry about how my associates practice dentistry.

I’d rather keep my practice roughly 50% PPO and 50% OON. If I scaled up, I might need more new patients, which could mean signing up for more insurance plans.

A bigger office means a bigger mouth to feed, with more rigorous KPIs to monitor and tighter targets to meet.

I don’t know. Maybe this sounds bad, but can’t I just run a small, well-oiled machine with a small team I enjoy working with and be content?

Our schedule is booked for the next two weeks, with some room for same day emergencies. We offer a broad range of procedures, including molar RCTs, remos , and immediate implants.

I want to go home feeling less exhausted, (I wanna feel more free psychologically from the office) even if that means leaving some money on the table.

My goal is to work hard at a sustainable pace for the next 10 years, without continually adding more, and hopefully become financially independent.

I’m not sure why expansion seems to be the default goal: bigger offices, more staff, larger marketing budgets, more turnover, and potentially thinner margins from greater reliance on PPOs.

One very obvious downside of being a solo practitioner is that you can’t take a long vacation. However even my colleagues with multi offices worry about their offices during their long time off.

Maybe I’m missing something here.

new dentist and did my first molar endo today. i thought my working length was great and looked awesome on master cone but the final looks so far out the apex on distal:(
Feedback/advice for next time would be appreciated.

I am an associate dentist and newly pregnant. Question for the women in dentistry - how did you handle nausea and vomiting as a dentist or working in dentistry?
This is not my first pregnancy, but I have never experienced morning sickness in the past. Im kind of feeling like it’s slowly coming on. I’m wondering how other women in dentistry have handled it, as we deal with all sorts of smells and potential triggers all day!
I also would like to avoid telling my work as I experienced a second trimester loss previously. Should i carry around a zip loc bag? Do you just run off in the middle of a crown prep of you need to vomit?

Thank you all.

Hello all,

I recently found Dr. Ferris Nazeri on YouTube, an endodontist who posts great POV clinical videos among other cases and tips.

Are there any other recommendations for similar videos in other specialties/ types of dentistry?

(I realize the Microscope lends well to this format ,so Endo may be common)

Thanks

I've been out of school for 5+ years, worked for 2ish part time and took 3 years off(non consecutive) due to mat leave. Due to the long gaps I have lost confidence to do exos and dentures and even my restos aren't great- sometimes good other times look like shit in recalls. I keep thinking to invest on CE but will that do anything? Isn't it all about repetition? I haven't taken out a non-mobile tooth in years and I sometimes feel like I need to dental school again. I am always nervous about patient reviews and outcomes and dread the days I have to work. I feel like this isn't for me and wish I could fo something else. I don't know what am I asking for, perhaps suggestions or encouragement. But when and how can I get better if I am only working twice a week.

Fairly new grad here, and one area I still struggle with is determining restorability when treatment planning RCT + crown.
I’ll see teeth with extensive interproximal caries, and sometimes the decay appears to extend close to the crestal bone. When it’s borderline, I struggle to determine whether it makes sense to proceed with RCT and attempt a crown, especially when crown lengthening might be needed.
I also find that removing the decay to fully assess restorability and then deciding whether to proceed with treatment or refer for extraction/endo isn’t always the most efficient workflow. Sometimes I worry about investing time into a tooth only to realize afterward that the prognosis is poor.
For these borderline cases, I’ve been telling patients upfront that crown lengthening may be necessary, but I’m still trying to get better at predicting which teeth are predictably restorable before starting.

File separation in apical third of MB Canal. How to approach this guys?

Don’t want to refer this case.

Any leads from an experienced dentist/endodontist?

What steps to take for bypassing the file?

I work at a dental clinic where the owner plays games with my pay by constantly increasing and decreasing my salary. We originally agreed my pay would be lower if I stopped doing certain tasks, but I am still doing all of them, including cementation of 10+crowns, scaling and polishing. Despite this, he refuses to restore my original salary. To make matters worse, he forces mandatory overtime and pushes us to perform treatments we don't want to do. I plan to leave once I find a new job, but I want to give only a two-day notice because I know he will retaliate by withholding my salary if I give longer notice. Given his toxic behavior and breach of our agreement, is quitting with a two-day notice justifiable?

Has anyone else seen this public docket site circulating (dsodentalattorneywhistleblower.com)? It has a signed consulting agreement showing a DSO attorney taking $2,500/mo retainers and 1% stock options in dental vendors to introduce them to DSOs and put them on conference stages. Is it normal in the DSO space for legal counsel to hold undisclosed equity in the software vendors they recommend to clients?

I’m curious with what other peds providers do. For young children with primary dentition or early mixed dentition, what x-rays do you take and what do you bill to insurance for those x-rays? I take mostly PAs (small mouths can’t really bite down on BWs). I’m hearing stories though from other offices of claims getting denied because of a PA “not showing the root apex.” Are you guys seeing this? Honestly, I’m just happy to get an image on some kids!

Curious to know what everyone is using in regards to referral tracking. And if you’re sending CBCTs or multiple radiographs, how are you sending them?

Specialists: how are you tracking incoming referrals? Do you like getting emails and Drive links? Do you have concerns with HIPAA compliance with those avenues?

I currently work with FQHC and have in the past. I find that most offices have used Sheets for tracking or just uploaded referral into patients chart and moved on. For X-rays, we’ve just given paper print outs, but I very well knew that radiographs were going to be retaken at the specialist.

How is everyone else handling this?

What is your protocol when a patient walks in with a loose screw on an implant you weren't involved in? You don't know what type of implant it is, don't know what size wrench you need and what final torque to use to re-tighten it?

Upcoming Complimentary (Free) Dental CE Webinars for the weekend of October 23rd-25th 2026

Register Here:

Weekend Sessions | Interproximal Reduction: Principles and Advances in IPR
Dr. Michael Florman, DDS
1 Self-Study CE Credit
Course Supporter: EverBrands, Inc.

Choose your session:
Friday, October 23rd - 9am EDT / 6am PDT
Friday, October 23rd - 12pm EDT / 9am PDT
Saturday, October 24th - 9am EDT / 6am PDT
Saturday, October 24th - 12pm EDT / 9am PDT
Sunday, October 25th - 1pm EDT / 10am PDT
Sunday, October 25th - 4pm EDT / 1pm PDT

Please visit our website for more live and on-demand complimentary CE courses:
Dental Learning

Join our Reddit community here: https://www.reddit.com/r/DentalLearning/

Thank you and enjoy!

All night you have the chills and barely get any sleep.
Do you go to work that day?

Hello all. I am planning on purchasing my first practice in the next 3 months. I am wondering if a “dental” CPA is a must? Is a CPA a must? If so, any recommendations on one? I have been give. A few quotes are they are around 1200$ per month. Is that normal?

Hi everyone,
I am working as a dentist at a FQHC. For class II we use tofflemires. I am trying to find the best and most efficient way to complete back to back class II or kissing lesions.
Currently I am doing one tooth at a time. But after removing one tofflemires I run into few issues: uncontrollable heme, the other tofflemires doesn’t fit and overextended restorations.
What would be the best way to resort back to back restorations when only have tofflemires available.

I've been having issues with my front retiring after 2-3 years and having to go through the same old song and dance of finding someone that can do everything in the front in one package.

Because I'm a smaller office, I hire one experienced person who handles everything: insurance billing, EOB posting, AR, denials, scheduling, and treatment presentation. The problem is that truly competent people are expensive, hard to find, and you can become overly dependent on one employee. Even someone commanding a high wage can make costly mistakes with missed claims, incorrect write-offs, or neglected AR. So not only do I become 100% dependent on them, I also have to pay an arm and leg (its worth it when its worth it...but there are alot of job applicants that say they can do it- and end up making costly mistakes while also wanting high pay)

I'm considering hiring a solid generalist at a lower hourly rate to handle patients, scheduling, and daily workflow, while using AI software like Lassie or remote billing to automate insurance posting and reconciliation.

The goal is to reduce overhead, minimize human error, and make the practice less dependent on one person's knowledge.

For those who've tried this:

• Does AI actually handle insurance workflows reliably?
• Can a less experienced employee manage the front desk effectively with the right systems?
• Does the software genuinely save money, or do hidden costs and exceptions eat up the savings?
• Would you take this approach, or pay more for an experienced employee who does everything?

I'd appreciate honest feedback from owners who've actually implemented these systems.

I've done the math and if I were to hire someone that can present treatment plans, schedule patients, and know the "basics" of insurance- that with AI platforms posting/reconciling- I actually end up SAVING money- over hiring a all-in-one employee that does everything.

My biggest thing is I'm NOT a fan of recurring fees...like software...but if it truely does a good job and I can basically not RELY on one employee anymore....I'm willing to change up my office.

How do y'all handle recurrent decay under work you did? Any sort of time frames? Just curious.

Hi Everyone,

Our clinic based in Ontario, Canada will be transitioning from AbdelDent to EPIC Wisdom. Apparently our team can make decisions how our Wisdom can look like. So building the layout that will benefit our clinic.

Are there any layouts /functions you love about EPIC Wisdom that should definitely be on there?

For those who have used Abeldent or other software , are there functions you wish EPIC Wisdom could have , but do not?

TIA

Hey yall.

I've been using Lumadent's Ergo Max 7.0x for months to do restorative work and it's been working great for most cases.

But I noticed when working indirectly on lower back teeth, it is significantly more difficult, with any type of loupes not just ergo. I often have to work directly.

I have to re-do a #18 MO (#37 FDI) since last time I just couldn't see shit. Can't figure out a way to actually use a mirror. It feels like there is no space or angulation for a mirror.

I feel I must be doing something wrong with patient/operator positioning.

Any advice is welcome.

RAP allows for minimal monthly payments the first couple years out of school as it is based on AGI. It also waives any unpaid interest. For example, if my loans accumulate $2,000 a month in interest, but my minimum required payment is only $500, the $1,500 I did not pay is waived and not added to my total principal. Because of these two aspects, there is an interesting repayment strategy I've been working through, but want to see if there's something I'm missing with the strategy's logic.

If I make my minimum required RAP payments and invest the rest of the money I would have paid if it were a traditional loan monthly payment plan, that money will grow in the market and reach a lump sum that I can use to repay my loans faster than paying traditionally.

EXAMPLE:

Principal is 500K. Traditional payments would be ~6K a month for 10 years. The first two years, my required payment is $10 then ~$1K respectively. The first year, I will invest 6K a month instead of paying a traditional payment to the loan servicer. Year 2, I pay 1K to the servicer and invest 5K By the third year, RAP requires I pay ~2K a month. I pay the 2K and invest the other 4K in the market. Even at 7% return, I would reach 500K in this portfolio in under 8 years. If the market does well, I could pay off the loans much faster. Then, I am just paying taxes on the capital gains that year or wait until the portfolio grows enough to cover the taxes as well.

Advantages I see to this strategy: Faster payoff. Money in assets for more financial flexibility down the road. Keeping the money in my pocket instead of the bank's.

Disadvantages: Paying higher interest than refinancing (though with the interest waiver, this isn't as much of an issue). Risking that the market will grow, and relying on that growth to reach a payoff date. The market could downturn in year 7 or 8, which would push my payoff date to year 9 or 10 (In my eyes, that would end up being a wash, for the chance to pay off sooner).

I should also mention, the plan is to invest in an index fund. Not trying to beat the market here, just mimic it for more "predictable" returns. Also, as I approach the 8 year target date, I will de-risk and move more money into more stable assets.

Am I missing something here?

Has anyone started on RAP loan repayment immediately out of school/grace period for the interest subsidy and then switched to standard repayment when income was larger/more stable? I looked at white coat investor but most of them have 3-5 year residencies and we can make the “big bucks” right out of school. Any input appreciated :)

How are they different in terms of what is taught? They are about the same in terms of financial and time commitment so just wondering how they differ.