Don’t be afraid to do pulpotomies on kids this age with teeth like that. Remove the pulp, BC liner, GI, fill. It works well and is a lot quicker and can be a permanent option or buy time for them with that tooth. Can do it even in irreversible/apical perio cases and it works.
Yes. Use hypo to stop bleeding also. Not formocresol. And it’s not expected to go necrotic in any timeframe. It can be permanent treatment but don’t quote this I believe success rate is into the 90s for 5+ years.
Already plenty of folks telling you you don't have to do endo if you don't want so I'll just add a counter point. If you want to get better at endo, or even just find out if you really do hate it, treat every exo as an opportunity to do an endo - keep every tooth you extract and access them, clean and shape, obturate.
I'd choose Spear based off what you said. I'm 10 years in practice and looking for a new perspective on diagnosis/treatment planning/occlusion. I don't have any specific issues with how I've always done things, maybe just bored?
Thank you ❤️ I’m a dental student and that’s what my faculty told me lmao. I’m too much of a wuss to ask faculty for sources. I tried googling it and couldn’t find anything so I just don’t do it bc I’m scared to mess around and find out lol
Anecdotally, I do PDL injections if my IAN block isn't effective the first time for restorative treatment. I'd guess once or twice a week. I got this tip from a faculty during dental school, been doing it for 10 years. I haven't noticed any increased incidence in pulpal issues to date.
The tip is the difference, c+ are end cutting files and c files are not. I rarely use k-files anymore, c files are my go to. The reason being is k-files were my highest separation rate - jumping from size 10-15 is a 50% increase in size. C files are stiffer. Think of a size 6 c file having the stiffness of an 8 k file, 8c is as stiff as a 10k, etc. I use a lot of 6-8-10 c files on calcified canals, then move to a rotary glide path file once 10c is pretty passive in the canal.
Using college pliers to hold endo files when working on posterior teeth. Gives much more clearance than even having your fingertips on the files. Bend the file slightly and have it on a college plier and slide that baby in,
How do you do the quarter twists of the hand files with the pliers?/ do you still have enough tactile sensation? For ex to feel that its going where it should
I have my day sheet printed with my planned production totaled at the bottom. We huddle for 5-10 minutes each morning (front and back end), go over new patients, any patient particulars of importance. Some days there isn't much to clear but I think it's good to get the team focused and ready to go for the day.
I don't know anything about perioptix, but univet isn't it man. Cheap plastic frames that I broke 3 times in the first six months, the arms snap off so easily. Don't buy univet.
I’m right handed, prepping the buccal cusps of #14, I’m doing from the buccal. Have the patient close a little if needed, or if they have super tight cheeks, have them move their jaw to the left. The large tongue for mandibular can be trickier, I find using my mirror or the assistant’s mirror to retract is easier if the mirror is used as a barrier and not pulling on the patients tongue. When their tongue gets pulled on they tend to wrestle back more and it’s harder to deal with
Ever tried a crown prep with rubber dam? I typically prep with a split dam to keep tissues at bay. Remove RD at the end to verify occlusal reduction and drop margins if clamp was on the prep tooth.
Have you already luxated the roots a bit? If so, when you see them next week the PDL will be broken down due to inflammation from luxating and it'll be easier.
The comment I replied to was edited after I replied. He originally said that he thought dentists in Canada had to provide an amount of service for free each year under our licensure, but asked for a dentist to comment if that was incorrect.
I'm not sure about Ontario but there may be low income programs/centers where dentists volunteer their time to do emergency work pro bono. There are in Alberta at least (CUPS, SHINE for example). They are first come first serve so patients show up first thing in the morning and wait their turn.
Depends on the tooth. I find that most single rooted teeth that I can also get forceps on, getting a MB purchase point and working it for a minute or two is usually enough to get class 3 mobility, then I just grab it and lift it out. For stuff like more difficult canines, I'll get multiple points and work it from different angles.
Position the patient somewhere between flat and 45 degrees (closer to 45deg), the aim is to have the mandible sort of parallel to the floor (when the patient is open wide) if you want any direct vision on lower posterior teeth.
Play with it, you'll figure out the sweet spot in time. With good positioning, even indirect vision is way easier. During endo for instance, you won't have direct vision of the orifices for lower molars (unless the tooth is bombed out) so proper patient position will make accessing with indirect vision easier.
Mark Olsen in Vancouver goes over the following: Troubleshooting tips, think blockages, calcified etc Different endo systems and preserving peri cervicle dentine Economics, ways to cut down costs and where to source from for equipment You also get to practice with a microscope and teeth Everything’s in a booklet after for you to take home A little theory and lecture heavy but overall pretty good
Skinner was almost on the bench, and the guy that came on for Skinner was also right near the bench. Neither were involved in the play. It was a VERY soft call.
Hmm works for me on mobile, but just a video showing all 7 oilers on the ice. Oilers have had some bad calls against this post season, this wasn't one.
Trick I learned from an old military dentist - after stimulating bleeding, soak a gel foam in the liquid portion of IRM (or a strip of gauze, but you have to see the patient back to remove in 2-3 days) and place in the socket. Pain relief within minutes.
I did, I covered the cost of the perf repair and the endo with the endodontist. Patient returned and paid for the crown. I'm in Canada so rules might different, but here an apology or paying for treatment is not an admission of fault or liability.
"Clear aligners" is an all encompassing term, not a brand. Any aligner training courses/programs will prepare you to treat cases with invisalign, clear correct, suresmile, etc.
What does that tell potential FA signings if we buy out our prize goalie signing after 1 year? We already have to sign FA's at a premium, we buy out Campbell after year one and they just won't sign here.
Don’t be afraid to do pulpotomies on kids this age with teeth like that. Remove the pulp, BC liner, GI, fill. It works well and is a lot quicker and can be a permanent option or buy time for them with that tooth. Can do it even in irreversible/apical perio cases and it works.
Is it similar to pulpotomy on primary molars? Will the stumps stop bleeding? And what timeline do we expect it to go necrotic in?
Yes. Use hypo to stop bleeding also. Not formocresol. And it’s not expected to go necrotic in any timeframe. It can be permanent treatment but don’t quote this I believe success rate is into the 90s for 5+ years.
Thanks for the info. Yearly imaging and vitality testing?
Already plenty of folks telling you you don't have to do endo if you don't want so I'll just add a counter point. If you want to get better at endo, or even just find out if you really do hate it, treat every exo as an opportunity to do an endo - keep every tooth you extract and access them, clean and shape, obturate.
You will love it. After the first course you will have the knowledge to do a 10 unit veneer course, second course FMR
Any insight on the online CMS vs in person? Online is half the price, wondering if its a teaser of sorts.
It’s a recording of the in person stuff. So you lose out on talking to the amazing faculty and any hands on portions. But it’s very good.
Thank you!
Imo-
Thank you, this is very helpful, I really appreciate it.
Based on my description, which would you choose?
I'd choose Spear based off what you said. I'm 10 years in practice and looking for a new perspective on diagnosis/treatment planning/occlusion. I don't have any specific issues with how I've always done things, maybe just bored?
Thank you ❤️ I’m a dental student and that’s what my faculty told me lmao. I’m too much of a wuss to ask faculty for sources. I tried googling it and couldn’t find anything so I just don’t do it bc I’m scared to mess around and find out lol
Anecdotally, I do PDL injections if my IAN block isn't effective the first time for restorative treatment. I'd guess once or twice a week. I got this tip from a faculty during dental school, been doing it for 10 years. I haven't noticed any increased incidence in pulpal issues to date.
I've heard good things, but it's usually specifically about c+ files. Not sure what the difference is.
The tip is the difference, c+ are end cutting files and c files are not. I rarely use k-files anymore, c files are my go to. The reason being is k-files were my highest separation rate - jumping from size 10-15 is a 50% increase in size. C files are stiffer. Think of a size 6 c file having the stiffness of an 8 k file, 8c is as stiff as a 10k, etc. I use a lot of 6-8-10 c files on calcified canals, then move to a rotary glide path file once 10c is pretty passive in the canal.
Using college pliers to hold endo files when working on posterior teeth. Gives much more clearance than even having your fingertips on the files. Bend the file slightly and have it on a college plier and slide that baby in,
To add to this, size 6 and 8 C files were a game changer for me in tight canals (as opposed to K files).
How do you do the quarter twists of the hand files with the pliers?/ do you still have enough tactile sensation? For ex to feel that its going where it should
Just use the pliers to place the file in the canal. After that I use my fingers.
Do you also review unconfirmed appointments and what should be production to be achieved for the day?
I have my day sheet printed with my planned production totaled at the bottom. We huddle for 5-10 minutes each morning (front and back end), go over new patients, any patient particulars of importance. Some days there isn't much to clear but I think it's good to get the team focused and ready to go for the day.
I don't know anything about perioptix, but univet isn't it man. Cheap plastic frames that I broke 3 times in the first six months, the arms snap off so easily. Don't buy univet.
I’m right handed, prepping the buccal cusps of #14, I’m doing from the buccal. Have the patient close a little if needed, or if they have super tight cheeks, have them move their jaw to the left. The large tongue for mandibular can be trickier, I find using my mirror or the assistant’s mirror to retract is easier if the mirror is used as a barrier and not pulling on the patients tongue. When their tongue gets pulled on they tend to wrestle back more and it’s harder to deal with
Ever tried a crown prep with rubber dam? I typically prep with a split dam to keep tissues at bay. Remove RD at the end to verify occlusal reduction and drop margins if clamp was on the prep tooth.
Have you already luxated the roots a bit? If so, when you see them next week the PDL will be broken down due to inflammation from luxating and it'll be easier.
[удалено]
The comment I replied to was edited after I replied. He originally said that he thought dentists in Canada had to provide an amount of service for free each year under our licensure, but asked for a dentist to comment if that was incorrect.
Perfect! Thanks for that clarification. I don’t know where that even came from. Removed the wrong info.
I'm not sure about Ontario but there may be low income programs/centers where dentists volunteer their time to do emergency work pro bono. There are in Alberta at least (CUPS, SHINE for example). They are first come first serve so patients show up first thing in the morning and wait their turn.
Depends on the tooth. I find that most single rooted teeth that I can also get forceps on, getting a MB purchase point and working it for a minute or two is usually enough to get class 3 mobility, then I just grab it and lift it out. For stuff like more difficult canines, I'll get multiple points and work it from different angles.
Appreciate you, thanks for the info.
No problem. Remember they're sharp and you are pushing on the king axis. Take steps to ensure you aren't sliding off the bone.
Thanks. One more question - for molars do you luxate before sectioning or go straight to a handpiece?
I'm a dentist that went through UofA dentistry, and as of writing this you don't have any other answers, so I can speak a bit to the DH program.
If the tooth is this far back in the mouth, in this position would it be possible to see with direct vision or would you need indirect vision?
Position the patient somewhere between flat and 45 degrees (closer to 45deg), the aim is to have the mandible sort of parallel to the floor (when the patient is open wide) if you want any direct vision on lower posterior teeth.
Awesome thanks! Yeah I struggle with patient positioning which is why I’m interested in learning the most efficient ways to work
Play with it, you'll figure out the sweet spot in time. With good positioning, even indirect vision is way easier. During endo for instance, you won't have direct vision of the orifices for lower molars (unless the tooth is bombed out) so proper patient position will make accessing with indirect vision easier.
Mark Olsen in Vancouver goes over the following: Troubleshooting tips, think blockages, calcified etc Different endo systems and preserving peri cervicle dentine Economics, ways to cut down costs and where to source from for equipment You also get to practice with a microscope and teeth Everything’s in a booklet after for you to take home A little theory and lecture heavy but overall pretty good
Second mark Olsen. Every file system is available to practice with. Awesome course.
Skinner was almost on the bench, and the guy that came on for Skinner was also right near the bench. Neither were involved in the play. It was a VERY soft call.
https://twitter.com/HockeyDaily365/status/1653979225207058432/mediaViewer?currentTweet=1653979225207058432¤tTweetUser=HockeyDaily365
Just a heads up I think your link is broken, it just leads to that Twitter "could not be found" page.
Hmm works for me on mobile, but just a video showing all 7 oilers on the ice. Oilers have had some bad calls against this post season, this wasn't one.
Trick I learned from an old military dentist - after stimulating bleeding, soak a gel foam in the liquid portion of IRM (or a strip of gauze, but you have to see the patient back to remove in 2-3 days) and place in the socket. Pain relief within minutes.
Are you in the US or Canada? There are a few good foundational courses I've taken that will set you up to do basic cases with invisalign:
What else did you do to sure to make it right for patient? Did rescue cost to the pt when you sent them to ur endo?
I did, I covered the cost of the perf repair and the endo with the endodontist. Patient returned and paid for the crown. I'm in Canada so rules might different, but here an apology or paying for treatment is not an admission of fault or liability.
That endodontist is an absolute buddy for showing the patient their own perforated case. Acts like that are honest and serve the whole profession.
He earned himself referrals for life with that.
you have already met him although briefly, but just read on you will know with the reveal.
Just read it, I was maybe 5 pages away when I posted this. Thanks so much!
I suggest continue to read
Thank you!
Molis coaching is a good foundation.
Would you say there is reciprocity between the systems? Like if I’m trained say in Invisalign, I’ll be able to use Clear Aligners for treatment?
"Clear aligners" is an all encompassing term, not a brand. Any aligner training courses/programs will prepare you to treat cases with invisalign, clear correct, suresmile, etc.
Canada, invisalign, $5000 for comprehensive (includes retention).
I hope we just buy him out this summer. It's only a 1.5 Million cap hit, from what I understand.
What does that tell potential FA signings if we buy out our prize goalie signing after 1 year? We already have to sign FA's at a premium, we buy out Campbell after year one and they just won't sign here.
Was the second person average in experience or personality or both?
Only two that has come through. Last time I was searching it was very very thin. So I feel lucky to just get these honestly.
That's a good plan, if the pickings are slim I'd go with the better personality.