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Had a patient come in today on Eliquis (apixaban) with a fractured #19 that needed immediate extraction. What's your protocol for managing anticoagulated patients? Do you consult with their physician first, or follow the current evidence suggesting continuation of DOACs for simple extractions? I'd l...

I wanted to share something that completely transformed my implant workflow. After investing in a CBCT unit, my implant success rate went from 94% to 99.2% over 3 years. Here's what changed: (1) Pre-surgical planning with guided surgery software eliminated guesswork, (2) I can identify the inferior ...

I've been reviewing my SOAP note templates and wondering if I'm documenting enough. For a standard composite restoration, how detailed are your clinical findings? Do you document: pulp testing results for every restoration? Pre-op and post-op photos? Specific shade selection rationale? Isolation met...

Cracked tooth syndrome remains one of the most challenging diagnoses in general practice. I have a patient with intermittent sharp pain on biting (#14, large MOD amalgam) but no visible crack on clinical exam or PA radiograph. My current diagnostic protocol: (1) Tooth Slooth bite test on individual ...

After struggling with case acceptance for years, I developed a systematic approach that took my acceptance rate from 35% to 72%. Here's the framework: (1) LISTEN FIRST — spend 3 minutes asking about their goals before touching their teeth, (2) SHOW, DON'T TELL — intraoral photos on a 27-inch monitor...

I see a fair number of pediatric patients and behavior management is always a challenge. For the moderately anxious 5-7 year old who needs multiple restorations: (1) When do you choose nitrous oxide alone vs. oral conscious sedation? (2) What's your preferred oral sedation protocol (midazolam, hydro...

I'm finally making the jump from PVS impressions to digital scanning. The options are overwhelming: iTero, TRIOS 3Shape, Medit, Primescan. For GPs doing crowns, bridges, implant impressions, and clear aligners: (1) Which scanner gives you the best accuracy for full-arch scans? (2) How's the learning...

After completing MII's tongue-tie course and performing over 200 frenectomies in the past 2 years, here are my key takeaways: (1) ASSESSMENT IS EVERYTHING — use the TABBY assessment tool, not just visual inspection. Many functional ties look 'normal' visually. (2) LASER vs. SCISSORS — I use a diode ...

My practice is at capacity and I'm ready to bring on an associate. I'm torn between compensation models: (1) Straight salary ($150-180K) — simple but no production incentive, (2) Percentage of collections (30-35%) — aligns incentives but variable income for the associate, (3) Base salary + productio...

I'm placing implants in the posterior mandible and need to graft a 3-wall defect. What bone graft materials are you all having the best success with? I've been using a 50/50 mix of autogenous and xenograft but curious about other approaches. Specifically interested in: (1) Allograft vs. xenograft vs...