New Dentists Stuck on Hard Clinical Cases

“Patient needs an endo on tooth 15. Today the tooth 15 looks calcified (I can’t see the full root outline) and one year ago I can see the full root outline. Does anyone know is this calcified tooth 15? Patient is only 25 yrs old. Do you think it will be difficult now to do? Please share your opinion. submitted by /u/Efficient-Bowl-3046 [link] [comments]”

“hey everyone, recent grad (2 years out). I love surgery and do all extractions except impacted 3rds. I notice that even if I do a little alveoplasty after extracting teeth that patients still get some sharp spots under the gums after healing. I’m thinking i’m not being thorough enough with the alveoplasty, any tips ? thanks in advance. submitted by /u/Dentalsnob3 [link] [comments]”

“Patient came for crown insert and distal margin was open so I resent the same scan to a different lab and they sent back a crown that was bang on. Did I waste money, was the first crown acceptable? I included the scan too submitted by /u/Used-Bullfrog-1923 [link] [comments]”

“The patient reported with pain and swelling on the lower left first molar. He has a history of RC treatment 3 years back from a different place and has been asymptomatic since then. He wants to retain his natural tooth submitted by /u/Ok-Conclusion-7676 [link] [comments]”

“The patient reported with pain and swelling on the lower left molar which has been treated 3 years back from a different clinic and has been asymptomatic since then. The patient wants to retain his natural tooth as much as possible. submitted by /u/Ok-Conclusion-7676 [link] [comments]”

“2023 grad here looking for some advice regarding immediate dentures and treatment planning. I've finally reached the point where I understand why so many experienced docs say denture patients can be some of the most challenging patients to manage. For my soon-to-be edentulous patients, I always discuss the option of immediate complete dentures and go over the pros, cons, limitations, and expected healing changes. Despite that, it feels like patients are unhappy regardless of which route they”

“Patient is 38 M, hx of carries on #15 OL. Resin done 2.5 months ago and has persistent post-op sensitivity. Had an appointment where I etched and bonded the margins in case there was a poor seal, no relief. 3 weeks ago replaced the resin, made absolutely sure that the was no saliva contamination, it's smooth as glass with a layer of fluoride varnish over it. Radiograph takes post-op confirms good fill, can't see any issues with it. Now I see he's in my schedule for tomorrow asking fo”

“recently graduated dentist here! patient came with this and was complaining of bitter taste and smell the dentist ( he did the rct) and said that there’s no issue with it but i’m not so sure? submitted by /u/diamentesices [link] [comments]”

“Pt comes in with failed implant (#10) on a 6 unit (7-12) / 3 implant (7/10/12) supported bridge - anyone have an idea what implant company this could be? Appreciate it. submitted by /u/askkordo [link] [comments]”

“Hi all, I have seen many cases where full arch crowns are indicated due to occlusal wear, I know that is indicated in certain instances. I had a patient today for a crown prep #9 due to loss of MIDFL composite - #8 was prepped and has had a crown for 7 years. I did the prep like I always do, the height was short (since he lost the MIDFL filling and has a tight bite) but measured around 3 mm. The lingual was truly the problem, he had wear above the cingulum and due to his bite being so tight, he”

“Pt had been seen by another dentist 2 years ago. These past months the tooth feel “sensitive” to Cold. 2 days ago pt noticed there is a small swollen dot above the said tooth and some pain when the swollen dot aka fistule spot when pressure applied. What I had done : Remove the gutta noticed there is a small amount of wet mixture, that feels like non setting endoseal sealer. And seems like the previous dentist packed 2 gutta inside, I took out both, it caught me off guard I thought could it be 2”

“New grad here. Limited time to type everything out today so here are some thoughts Debating what the options here are. 65F with humana. Debating doing a crown #8 and doing a P/P. I know posterior teeth have supraerupted but I’m not certain if they are too much to do a partial still? She’s getting a FMD today and going to evaluate for root caries. There is some on #6 and #8 but I find it difficult to see them on radiographs on posterior teeth. Any guidance helps. Might refer to prosth As I write”

“This may be more of a rant or a dump than asking for actual advice but — I (the dentist) saw this 16yo new patient for a comp exam. Bitewings shown above. Their chief complaint was their front tooth (not shown but chipped with large interproximal and incisal caries in the chip) that they said they chipped while fighting because: “People make me angry”. They have a history of psychiatric care and take antidepressants, so I went in very gently saying that what’s going on with their teeth is very s”

“I’m a general dentist and just started doing bone grafts (4 walled) post extraction. I’ve done about 4 total. First time having an issue. I covered with a collagen plug and PTFE sutures which I removed at 2 weeks post op. She came in at the 4 week mark complaining of a bump that just appeared this morning. Minor discomfort when touching area. No bad odor. I drained it and mostly blood came out with a small amount of purulence. I prescribed 7 days of amoxicillin. It seems like the infection is su”

“Associate dentist here. I’m curious if anyone else did well in dental school but has struggled to find their footing in the real world. I honestly can’t figure out whether I have a dentistry problem, an associate vs. owner problem, or simply a “me” problem. For context, I graduated dental school with a 3.9 GPA and never struggled much academically. I’m a huge introvert, so I mostly kept my head down, worked hard, and got my degree. I chose not to specialize because I genuinely enjoy general dent”

“I can't see any caries while examining clinically submitted by /u/hellodoremon [link] [comments]”

“Need an opinion on this. Place two implants on LR quad Midop PA showed good parallelism and position so I went ahead to torque in a little more Closed up after 90mins surgery and took a postop PA and noticed the 2nd molar implant a little mesially tilted 2nd molar implant must have slipped into a bony defect when I torqued in a little more The lack of parallelism means restorations may be a little difficult and crown contours may not be great. Would you guys leave it alone or reposition in the 2”

“I have a patient with lower overdenture on 2 implants (24 and 26 positions). He comes in like every 1-2 months to replace the nylon plastic inserts. When I look at the nylon inserts, they don’t look worn, but they’re slightly“bent” or folding over themselves just slightly along their perimeter within the metal housing in the denture and so the patient can’t seat his denture anymore. I replace the inserts, everything is fine. He came in twice last week (replaced Monday, bent one of them, came bac”

“A patient comes in with severely decayed #10 that I recommended to ext. patient has had to pull multiple teeth in the past due to severe decay and he was obviously frustrated at having to pull another tooth especially bc it’s the front. I told him that trying to save the tooth with a root canal and even a conservative buildup, the tooth would be weak and likely break. After a lengthy discussion, pt finally agreed to extract. Cut to a week later, patient comes in to start tx and as soon as I walk”

“New patient and need to restore #18 due to that void. How can I do this? What type of restoring technique? submitted by /u/Firm-Respect6702 [link] [comments]”

“New grad here. I Did small a #9- DL on a young pt 2 weeks ago. A week later she came back saying the tooth is very sensitive to cold and air. Occlusion was good but I adjusted little more just in case and applied Gluma. Today she’s coming back she caed and said she’s still sensitive. Not sure what’s causing the sensitivity. Should I replace the filling ? Thank you! submitted by /u/toffybonsh [link] [comments]”

“Hello r/ Dentistry, Hoping someone here can help me. I want to replace patient's implant crowns at site #7/10, but she has no documentation from previous doc, and I have been unable to figure out what brand they are. #7 is obviously elongated but hopefully the full shot of #10 can help with identification. She believes they were placed roughly 16 years ago. Any help is greatly appreciated!! submitted by /u/bbrilowski [link] [comments]”

“I work in a multi dentist clinic (I’m not the owner but I’ve been there the longest of all employees - 11 years). We currently have a dentist who graduated end of 2024 who has started expressing interested in FMR and is doing a bunch of courses to pursue this. His work is fine and at the expected standard for a new grad. Only does single unit crowns - has never done even two adjacent crowns or any quadrant dentistry. I think that wanting to do FMR at that stage is getting way too far ahead and I”

“With the increasing cost of residency and 3 years of losing income. Is ortho even worth it financially speaking or is GP better in that sense? Most ortho residencies are en extra 200k-300k. I heard new orthodontist do not even make much. Obviously money is not everything, but considering I already have loans for dental school, I have to consider that. submitted by /u/Hefty_Caterpillar_42 [link] [comments]”

“I do 1-2 root canals per day on most days. I'm using WaveOne Gold with matching Guttacore obturators for most cases. Here are some random cases with my current system. I hate not being able to do a conefit xray and cleanup in a small chamber takes way too long. Basically I obturate on a prayer and I leave the carrier handle on if I need to pull it back out. After 15 years I have yet to get comfortable with single cone or warm vertical. I struggle getting tugback and it never looks as nice on”

“Hello, I’m a 4th year dental student and currently dealing with a dilemma of a patient. This patient from the very beginning was angry, and very mistrusting of dentists. She barely opens her mouth, gagger, small mouth, and needs multiple rounds of instructions to get her to do something. In addition, just seeing her name stresses me out, as I have stayed the entire clinic time each appointment to match her needs. Last week we planned #2 DO. Pt multiple times demanded suction and water to the ass”

“For background, I am 2 years out of school, I did a fellowship where I did a lot of EXTs (no bone grafts) and my last job I was the OS guy and performed a few bone grafts but our pt. population was very frugal and not as interested in future implants. At the new office, the patient population is very different and much more interested in implants. However, the dentists here do bread and butter dentistry and not much else. Most don't do any EXTs. I want to start doing bone grafting here (and”

“Seemed like an easy appointment, 35,36 37. Numbed pt up no problem. Drilled the teeth and no problem. Proceeded with placement of bite block and rubberdam followed by liquid dam for better seal. Then the patient magically decides to wake up his tongue. He knocked off my ring, the clamp, etc several times during the appointment with his tongue. Tried to take off the bite block to give him more tongue space but then hes also a passive closer so he kept closing onto the clamp.. Tried putting the da”

“I shy away from a lot of extractions with sinus involvement, but would like to up my confidence with them. Any recommendations for something tough like this? submitted by /u/CoolKaleidoscope100 [link] [comments]”

“I see a lot of Medicaid and do molar endo in office so it’s an available service but I’d like to hear people’s thoughts. Early ext of 1st molar with unerupted seconds in highly compromised cases or rct. Maxillary 2nds tend to move into 1st position much easier with ortho but I’ve had ortho accomplish this with the same situation on the mand. Arch as well. Pt is 9 with extremely poor home care. I’d like to hear your decision and reasoning submitted by /u/Rum-Hams- [link] [commen”

“Can someone identify this implant? Thanks. submitted by /u/enaminal [link] [comments]”

“Hello all. New grad here. Am NOT an esthetic dentist at this moment, but curious how y’all would approach this? Patient is pretty esthetically conscious, but she is so sweet and understanding and trusts me. However I did this filling a week ago and she comes in 2 days later looking like this. She said it bled a lot when she flossed and it was tender. Obviously this overhang is messing her up, just look at the gums. The only thing is, she said she really doesn’t want a black triangle in her teeth”

“I have a regular patient who came to me and has done their RCT in Thailand. A perf was made and there was a repair done. However there’s an infection at the furcation. They’re expecting a crown to be done. How would you handle this without throwing the dentist abroad under the bus? (I’m Based in LA) submitted by /u/No-Version-8038 [link] [comments]”

“I just bought a practice and I really don't want to do removable as much, but that's the cases that have been showing up lately, and it just stresses me out. Patient want million of adjustments, and the lab fees are high/insurance reimbursement. So, can I tell patients I don't do those? Thank you!! submitted by /u/Ok_Confection5143 [link] [comments]”

“Ik some people love it and would do as many noncats or extra years as it took to do the job they love But I wana know if anyone feels it wasn’t worth the years. As a student it’s hard for me to look forward to see the future and I can only gain insight and wisdom from those before me. submitted by /u/Content_Yam_8942 [link] [comments]”

“Tooth no.19 needed RCT and it was done. Based on pre-operative X-Ray, is it necessary to do SCL or can DME be enough for the tooth to be restored? https://preview.redd.it/ins0hfxm4cmh1.jpg?width=1650&format=pjpg&auto=webp&s=9f9ecc040312d303779f56860d3f01cce8e1ebc2 submitted by /u/YamanKh90 [link] [comments]”

“I know blocks are standard in such cases, but I 'm very fearful of giving a maxillary nerve block since I didn't learn how to perform it in the dental school. Are there any alternatives? submitted by /u/UglyAndTired9 [link] [comments]”

“This patient had palatal caries on 8 and 9 and that’s how the enamel looked like after removal of caries so I thought I must break it cause it’s weak My supervisor said no So I didn’t and I placed the filling anyways Is it ok to leave undermined enamel and just fill the tooth? submitted by /u/MammothCrafty7917 [link] [comments]”

“New grad dentist and been running into this issue recently with not knowing whether I should or should not have replaced amalgam fills. Did 2 cases recently where I recommended replacing occlusal amalgams which appeared to have no recurrent decay or even be very deep on radiographs but had marginal ditching/appeared to be failing. Both turned out to have a good amount of recurrent decay under the amalgam but avoided the need for RCT. I did liner and desensitizer on the most recent one but wonder”

“Hey docs - was supposed to pull only 48 today but the pt insisted on 38 as well - anyways 48 was out in 15 minutes and then for 38 everything went well except when I went to pull out the roots after sectioning and the pt kept complaining of pain the IAN distribution. I had administered 2 blocks of lido + 2 infiltrations of articaine and the pt was fully numb. The panoramics did show that both were close to the IAN with 38 being very very close. Was it a good idea to have left 38? There was no Ca”

“Can someone explain if these one-piece implants even succeed? Why is the one on the left so long? Whats happening here? Is there someone who can explain why this is bad treatment? submitted by /u/Odd-Conversation812 [link] [comments]”

“I treatment planned this tooth for a crown due to the crack on the distal marginal ridge and lingual. Is that too aggressive? submitted by /u/Eastern_Koala_8707 [link] [comments]”

“Hey guys looking for some feedback. I’m a GP who does a few endos a week and looking to get better. Recently did #19 (Pulpal necrosis w/ SAP) and on the final PA I noticed gouging of the Pulpal floor :/ I knew it was going to be a tough access because of the thin chamber so I tried mitigating error but still occurred. Clinically everything looked good though and no perforation/bleeding which I was sad to see the final PA. Looking to always improve and would like some feedback submitted by”

“Hi everyone. I took this post-cementation x-ray of this crown that I cemented today (I cleaned the excess cement). It was clinically acceptable when I checked with my explorer, but keep on thinking about this x-ray. I’ve only been practicing for a few years now; what would you do in this situation? submitted by /u/emotionlessface [link] [comments]”

“I've been taught to use a CBCT scan prior to implant placement. However, the DSO where I work does not have a CBCT scanner in any of their locations. I've spoken to several other doctors who do place implants at this DSO and they all tell me that they simply don't use a CBCT for most cases. I wouldn't want an implant piercing the IA nerve or penetrating the sinus. Is it enough to just use the PA and pano x-rays to measure distances from important anatomical structures? Instead of”

“Hello, This patient presents with irreversible pulpitis symptoms, clinically there is no visible buccal/lingual decay. The patient is lower income, would you recommend an attempt at RCT or suggest Extraction as the first choice of treatment? submitted by /u/Long-Meet1334 [link] [comments]”

“Hi All, Cemented this crown yesterday. Clinically it was undetectable, margin felt closed, no rough edges, floss was smooth passed without catch, patient was happy. I was running between chairs, and didn’t look closely enough at the distal margin. Evaluating it now, it looks open enough that I’m not comfortable just monitoring it. Curious how you’d approach this: straight remake, or is SDF + close monitoring defensible here? Also curious how you’d handle telling the patient, given it looked fine”

“I’m a few months into independent practice after finishing dental school. My supervisor has been away, so I’ve been running the schedule mostly on my own, and two cases have been sitting heavily with me. I’d like some perspective from people who’ve been doing this longer. Case 1: Oncology patient, active chemotherapy, documented Grade IV neutropenia in her history, no antiresorptives. Extraction of four lower anterior teeth as infection source clearance before her next cycle, cleared by her onco”

“Hi Guys, I have a few years experience being a dentist but I started at a new clinic because I want to learn new skills and for mentorship in them. I just feel after the first few days a bit overwhelmed, new dental software that’s confusing, new equipment, staff and workflow. Strangely every patient I have had in with me has been very complicated and I feel basic stuff are hard and a bit nervous to do. I also work in a different clinic a long time a lot more basic stuff granted but im at ease th”

“If you’re truly at the final step and the implant is already placed and healed, this is actually a much simpler situation than having the entire implant procedure done . The important thing is to know exactly what implant was placed and what component/crown your dentist is quoting you for . An implant restoration is more than just the visible crown — the abutment and implant connection also have to be compatible and properly fitted. If you have a copy of your implant records, the implant brand/m”

“I recently completed an endo on #30, and this came up on the final xray. I was wondering - is this the GP pushing past the apex? or is this sealer puff? I've never had sealer puff look this aggressive before. 1st pic is zoomed in on that mesial root. 2nd pic is the final xray. 3rd pic is the cone fit radiograph Thank you! submitted by /u/implantfreak [link] [comments]”

“Hey all, I’m a relatively new grad and today I was doing a root canal on #5 with a diagnosis of irreversible pulpitis. I was able to fully instrument the palatal canal, however the buccal canal was super infected. It kept welling up with blood and I wasn’t able to fully instrument because the patient kept feeling pain. I tried intrapulpal and PDL injections to no avail. I ended up placing calcium hydroxide and she’ll come back in a few weeks. Any tips on what to do differently? I don’t want to r”

“I have this patient that I am trying to do a root banking for due to cost. How long should I wait until I take an impression for a bridge? I cut the tooth below the gum line. submitted by /u/sephirothmms [link] [comments]”

“I placed an implant today and I wasn't quite happy with the angle. However, we got pressed for time and I explained to the patient that I would like to see her again to fix this issue. She can't come in until Monday (in 5 days). My questions is, can I remove the implant readily at that time and reposition it to where I want it? Any risks? submitted by /u/Responsible_Win_9114 [link] [comments]”

“Hi everyone! Can anyone help me identify these implants based on this X-ray? I don’t have any information about the implant system or manufacturer. Any ideas or recommendations on what they could be would be greatly appreciated. Thank you! submitted by /u/woofandlove [link] [comments]”

“When I am delivering a crown and get this lip on the margin- is it an error on my part with not enough retraction with the cord/ scan not being clear when impressing/ remaining undermined enamel on the margin? See example of #15D crown seat This is not the final x ray submitted by /u/Independent_Owl_1698 [link] [comments]”

“pt says its about 15 years old https://preview.redd.it/utlxrg3k5qlh1.png?width=3213&format=png&auto=webp&s=bab6c6ec2e7f7c9b90a8d933e3fc52134122e734 submitted by /u/rossdds [link] [comments]”

i struggle a lot submitted by /u/DragonPlus21 [link] [comments]

“So yesterday I extracted this tooth on normal routine but somehow I got really distracted to construction noise at outside and forgot to clean the apical lesion then sent the patient. Would it be really problem in the future? The body can heal itself if the area is kept clean right? submitted by /u/Blutzki [link] [comments]”