Hey everyone, I’m in the process of starting my own dental practice and was wondering if anyone here has attended Scott Leune’s Breakaway course.

Unfortunately I can’t make it to the course, but I’d love to hear if anyone has notes, resources, or key takeaways they’d be willing to share.

Especially interested in the startup side of things, like lease negotiations, buildout, financing, equipment, and running the business.

Would really appreciate anything anyone can share. Thanks!

I’m not up to date (never was) on my dental socials, besides this Reddit and dentaltown years ago.

Is there a FB group, Reddit, DT, etc that focuses on best practices to survive and thrive while doing a dental office start up in this ppo-opy climate, where everything goes up in price, minus insurance reimbursements of course (us based).

A place people can help each other in all aspects of doing a start up from pre-planning to hiring the first employee to efficient tax strategy.

Already have practice biopsy, it’s ok, want something thats ongoing and less ”pay to hear my latest marketing strategy“ vibe.

72 yo male patient
(-) smoking
(-) systemic disease
(-) pain
(-) fever
(-) abscess

Bone quality during placement: D4
Torque: 50ncm
System: Osstem Korea

Should I remove this ASAP? I hope a seasone implant dentist can guide me. This is only the 10th implant I have placed.
One implant already failed on the other side. All implants were submerged. Thank you

I got a job offer at a DSO in central Florida that accepts HMO with other PPO insurance. It’s called Sage dental. I have heard that HMO fees are terrible but the office is 20 minutes from where I live so it’s worth taking a look at. Anyone has any experience or insights with this company?

I'm sure this question has been asked a ton before, but recently I am a new grad having some problems with post- op sensitivity at one of my offices that I work at (both offices use different materials so maybe I'm not using materials correctly). I have had 2 cases of post op sensitivity in the past two weeks which really feels like more than average. For example one patient was for a class 2 which was slightly larger than normal due to caries but not huge by any means. This patient returned 1 week later with cold sensitivity and when I blew the air he had sensitivity for like 3-4 seconds. I checked the bite and it did not appear high not where there any abnormalities I could tell.

The current protocol for fillings is using clearfil universal the green/torqoise one (since it's self-etch both the other doctors at the office do not use etch at all which is what I do). Usually try to dry the prep but I don't think I'm over dedicating, maybe I am? I rub in the bond for 15 seconds. Then I air dry the bond for 5 seconds or so. Then I cure for 20 seconds. After I usually use a layer of flowable (we use simplishade bulk fill) I usually don't do more than a few mm and then final layer with sonic fill packable composite. Then adjust the occlusion as needed.

In my other office where I haven't had the problems I'm using completely different bonding agent and using SDR flowable and packable composite. Any ideas what I could be doing wrong?

Since I'm just an associate I don't really have the ability to order things and I've seen people use Gluma but I feel like the owner would be like why do you need this when none of the other doctors are having the problems I am. Please help!

Hey y’all I’m trying to improve my skills for surgical extractions. I feel pretty confident for simple extractions but I tend to struggle more when it goes surgical especially for a maxillary molar. I know you want to section all 3 roots separately but how do I ensure I’m splitting the roots evenly and I’m not making a slice too mesial or distal or too lingual? Would the best way be to cut the crown off at the CEJ to expose the roots to see how to section it? I really want to get better at these types of extractions but I find visibility and grasping the tooth difficult and I would appreciate any advice 😅

New grad here. In dental school they didn’t necessarily give a guideline on what procedures / dental pain require T3s (we were just informed what order to increase med strength eg acetaminophen to ibu to t3).

I work with different dentists who prescribe very differently (one will prescribe 20 tabs for endo pain before and even after rct completed, the other one only prescribes for surgical extractions). What procedures do you usually prescribe for? I work rural so I want to make sure I am not overprescribing as opioid addictions are very common here

Hey folks, is there anyone here that has experience with TDO and setting it up? The customer support has not been very helpful, and I have what should be a very basic question. Also, if there is a better place for me to ask TDO questions, please let me know.

A 77yo female patient. She recently started on Prolia iv and complained about diffuse jaw pain, no specific location. Iirc it's a side effect. I took an opt to rule out problems. Left lower side I noticed a sharp defined opacity. At first I thought it to be the mandibular fossa, but I couldn't find any similar images. Someone here can confirm this, or has an idea what it can be? There are no extra-oral abnormalities.

Recently started doing custom crown art, I’m having a lot of fun doing this. Would love suggestions for more designs.

Greetings, I'm purchasing machine instruments for root canal shaping for the first time. I'm trying to find good files that are also relatively affordable. I have an option to choose between Fanta's V-taper gold and Rising system. Which one would be more beneficial to purchase/which one do you find better for endodontic practice? Thank you in advance for the help and kind regards!

In the office we signed up for Dental Intelligence for texting and medical history form taking services. Interested in using it along with an iPad chairside and played around with their Modento application. For one thing it asks you to enter your name and it searches as you type for the patient name. I have a big problem with the hippa privacy issue in that a patient could inadvertently see the name of someone else in the schedule and access it. Second to that their in take form takes a half hour to fill out and I don't see any other consent forms listed. So no oral surgery consent or anything unless I am missing something. So was wondering besides paper is there a better service or option out there for using your ipad??

Thank you

EDIT: Figured it out. You have to go to the engagement section and access the patient name from the patient finder. From there you select the patient and then documents and then send the consent to the device.

Upcoming Complimentary (Free) Dental CE Webinars for the week of October 19th-25th 2026

Register Here:

From the Preparation Design to the Final Restoration
Monday, October 19th - 8pm EDT / 5pm PDT
Jean Chiha, CDT
1 Live CE Credit
Course Supporter: Medit

Porcelain Veneers: From Preparation to Cementation
Tuesday, October 20th - 8pm EDT / 5pm PDT
Dr. Mario Romero
1 Live CE Credit
Course Supporter: Kerr Dental

Emergency Drugs: Is Your Office Prepared?
Wednesday, October 21st - 8pm EDT / 5pm PDT
John B. Roberson, DMD, FACD, FICD, FICOI, FIAOMS
1.75 Self-Study CE Credits
Course Supporter: HealthFirst

Chairside 3D Printing and the Ease of Digital Workflow: Changing the Future of Dentistry
Thursday, October 22nd - 8pm EDT / 5pm PDT
Dr. Roberto Macedo, DDS, MS, PhD
1 Live CE Credit
Course Supporter: Safco Dental Supply Co.

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!

Someone just asked if we take military TRIcare insurance. is that a thing any of you take? does it pay okay? Should I look into credentialing my office with them if I have schedule space for it?

Just found out that one of the dentists in our relatively small-ish city took his own life yesterday, right out in front of his office. I didn’t know him well personally, but knew him of him as a colleague and he had spoken kindly of us to mutual patients. He had one the nicest offices (in terms of architectural style and updated equipment) in our town, and his social media always appeared upbeat and showing his latest adventures with his family. Never would have guessed something like this would happen to him. Just goes to show you never really know what someone is going thru. This job is fucking hard and so stressful in so many ways. Let’s just remember to cut ourselves some slack and also take care of and support each other however we can.

We havent seen this before and unsure what its compatibility is.

Thank you!

Patient is 45 years old. Booked an emergency visit because she had an abscess.

Tooth 14: Pulp chamber was opened at another clinic because the patient had lots of pain. When she came to our clinic, she didn’t have any pain from 14. Percussion test was negative. No pain on palpation. Endo is planned by the dentist who performed the access cavity preparation.

Tooth 15 however had an abscess. A 12mm pocket buccally. Pain on percussion. Pain on palpation. The patient was talking a lot and was very anxious so I had to calm her down and I had 30 mins for the check up so I completely forgot to check pulp vitality. I drained the abscess and did some scaling with ultrasonic in the deep pocket.

The patient will come back for a proper check up and I will do a pulp vitality test.

If you had to guess judging by the x ray (without pulp vitality test, and I KNKW that’s not ideal) do you think it’s a Perioendo lesion or endoperio lesion?

I’ve never had a case like this before. How would you treat the tooth? Prognsis? Would love some input from fellow dentists that have more experience than me.

I got spammed with texts when I registered my Group 2 NPI by the insurance credentialing service companies, but had taken care of most insurance credentialing on my own but am currently struggling with Anthem/BCBS and considering using one of these services.

Has anyone used one of the credentialing service companies before and would you recommend them?

Okay so i have 2 pairs of loupes. Both Orascoptic. I’ve had one pair since 2020 and the next pair since 2025.

I just sent in the first pair bc the hinge from the glasses to the arm broke. My second pair that i hate bc they’re so heavy, just did the same thing. I have it taped but it’s driving me crazy- tape works for 30 minutes.

Is anyone else experiencing this with Orascoptic, is there a way to connect them back to each other or did it snap off? This is getting ridiculous.

Looking for a decent intraoral camera. My DSO makes us buy these mouthwatch cameras and even when we treat them like glass they still break after about 1-2 years of use. Prices have tripled from what we used to get them for. I want something good that I can actually count on without a massive pricetag. I just want something affordable that doesn't need thrown out as soon as the cord breaks.

We bought a practice back in June (me & my mom), she is the one currently working as I am pregnant, and I very close to be due (next week lol). Anyhow, we've been unlucky with assistants.

We live in a state w/ EDDA's so with expanded duties, however the previous owner was paying an assistant as EDDA, but had no cert etc. We helped her w/ all that because we like things "legal," but she also left as she was having a baby too and is not planning on returning. We hired someone else, a new grad and this one gosthed us after 1 month.

My mom is foreign trained dentist and used to be an EDDA before getting her license so she is very comfortable working alone w/o Assistant, and we have Isolite. She believes is a good thing to not have an assistant for now, ramp up savings, pay off expenses from the purchase etc.

I am just worried we won't growth. The office is breaking even, and we could be paying ourselves if it weren't for the old/ new one time expenses. We both have savings to live on, plenty, and my husband makes enough for me to stay home.

My question is could we go w/o an assistant? Or is that something I have to have asap? I know from liability stand point we def must have, but it's nice to save payroll.

Thank you!!!

Looking into the possibility of a milling unit for the office. I am more familiar with cerec but the prices are bonkers & I have my reservations about DS. I’ve seen mostly positive stuff about the glidewell mill but was hoping for some first hand insight. I believe they’re bundling it with the Medit900 or 700 based on what package you choose.

How do you differentiate between hypoplasia, hypomineralisation and hypo calcification? In uni we learnt about the way they differ in terms of etiology, however now that I’ve spent a while in practice I can never differentiate between them (but can obviously tell between this and white spot lesions) - am I just super dumb ?

I'm designing All-on-X implant-supported overdentures/prostheses and have been using tapered screws for long-term provisional prostheses, with the prosthesis screwed directly onto the multi-unit abutments (MUAs), without titanium bases (Ti-bases).

My question is whether Normal Flat screw could be used as an alternative to tapered screws for this type of direct-to-abutment connection.

Neodent also offers direct-fit screws with a longer shaft, which made me wonder whether they could be suitable for this application.

For those with experience in this workflow:

• Have you used standard flat screws with printed provisional prostheses connected directly to MUAs, without Ti-bases?
• Is there a concern about insufficient material thickness around the screw channel or potential fracture of the printed prosthesis under functional loading?
• Are there any specific considerations regarding screw-head geometry, screw-channel design, or the required material thickness?

I'd appreciate hearing about your clinical or laboratory experience with this approach. Thank you!

New grad here. I work at a rural clinic where we see a lot of patients who do not care much for oral hygiene (they present only when pain is present and continue to neglect OH after tx). I’ve encountered many tx plans at the office where incipiences are planned for restos - the logic given to me is “they are high risk so it will develop into a cavity” (though I sense the real reason is because the insurance provider for these pt cover essentially all tx). What are your thoughts on this justification? The environment at the office is not the best as I often feel pressured to treat according to these tx plans made by the principle dentist.

Also, how would you approach cases where a tooth has both DEJ and incipient caries (eg 36 mesial incipiency and distal caries)? I was told that since the insurance only covers one resto per tooth per year that it is best to treat both the incipiency and the real caries so that the pt does not come back complaining that the same tooth is now hurting (though I do not necessarily agree with this). What are you thoughts on this and how would you personally approach cases like these?