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Selective etch or self-etch for posterior composites?

Curious where everyone lands on this. I was taught selective etch (etch enamel, self-etch dentin), but I see a lot of people going full etch or full self-etch. What's your go-to for routine Class II composites?

Guided bioprint mock-ups for ridge preservation

Sharing our latest ridge preservation case where we co-designed a printed scaffold with the lab so that soft tissue sculpting happened chairside, not after the fact. Includes STL, tissue photos and patient journaling prompts. **What was hard:** Getting the emergence profile right on first try—we ended up doing two iterations with the lab. **What I'd change:** Start the digital design conversation earlier, before extraction.

The wedge trick that fixed my Class II contacts

Was getting open contacts on ~20% of my Class II composites. Tried everything. **The fix:** Place the wedge BEFORE the matrix, not after. Wedge first → then adapt the matrix → then place the ring. Immediate contacts improved. Now maybe 5% need adjustment. Sounds obvious in retrospect, but no one taught me this in school.

Rubber dam isolation for posterior composites [4:32]

Quick video walkthrough of my rubber dam technique for Class II composites. **Covers:** - Punch pattern for 2-tooth isolation - Clamp selection (I use 14A for most molars) - The "invert and tuck" technique - How to deal with tight contacts **Why I made this:** New associates kept struggling with dam isolation. This is the exact sequence I teach them. No fancy editing—just real-time with voiceover.

Implant dashboard built in Notion + RayFace

We finally merged CBCT screenshots, soft-tissue photography and recall scripts into one workspace. Dropping the template plus the automation that pings coordinators when torque values drift. **Problem it solved:** We were losing track of implant torque values and follow-up dates across 200+ implant patients. **ROI:** Freed up ~2 hours/week of coordinator time chasing records.

One phrase that changed how I handle anxious patients

Instead of: "Let me know if you need a break" I now say: **"Raise your hand anytime and I'll stop immediately. You're in control."** The difference: First version puts the burden on them to interrupt. Second version gives them explicit permission and control. Noticed way fewer white-knuckle patients since making this switch.

Crown didn't seat and I almost cemented it anyway

Honest debrief of a near-miss last week. **What happened:** Final crown on #14, seemed to seat clinically. Patient wasn't numb (their preference). I was rushing because we were behind schedule. **The catch:** Something felt slightly off. Took a PA "just to confirm." Crown was sitting 0.5mm high—not fully seated. **Root cause:** Small nodule of cement on the internal surface I missed. Cleaned it, reseated perfectly. **What I learned:** 1. Never skip the PA, even when it "feels right" 2. When I feel rushed is exactly when I should slow down 3. The patient being unnumb isn't a reason to skip steps Could have easily cemented that high crown and caused a fracture or perio issue down the line.

30-day growth guidance sprint kit

Prototyped a parent-facing kit with snack swaps, nasal breathing games, and mood check-ins. Kids annotate it with stickers and voice notes. Looking for 5 practices to test in March.

Do you take CBCT for implant planning? (Single tooth)

For a straightforward single-tooth implant in the posterior, do you always take a CBCT? I know the guidelines say it's case-dependent, but I'm wondering what people actually do in practice.

Field notes from 120 ultrasonic sessions

Tracking which acoustic settings ease anxious patients, plus how we narrate biofilm disruption in plain language. **What we tracked:** - Power setting (1-10) - Patient anxiety level (self-reported 1-5) - Water temperature preference - Which phrases helped **Findings:** - Power 3-4 is sweet spot for sensitive patients (lower = more time, not less pain) - Warm water made a noticeable difference - "I'm using vibration to break up the sticky film" > "This is scaling" **Includes:** Playlist we use + chairside cards with patient-friendly explanations.

Molar sectioning technique for surgical extractions [5:15]

Step-by-step video of how I section lower molars for easier extraction. **What's covered:** - Bur selection (I use 702L surgical) - Finding the furcation (hint: it's more apical than you think) - Vertical vs horizontal sectioning patterns - Protecting the lingual nerve **Key point at 3:20:** How to know you've cut deep enough without going through the roots. Recorded on my last extraction case with patient permission.

Parametric smile systems in the wild

A look at how our studio templated 18 veneer cases without losing soul. Shared Figma board + lab call recordings. **Key insight:** The template isn't about copying—it's about having a starting point that speeds up the unique customization for each patient.

Digital wax-up workflow for full-mouth rehab

Documenting our process from intraoral scan to 3D printed try-in. The key was getting the lab involved early so we could iterate on occlusion before committing to final materials. **Timeline:** 3 lab iterations over 2 weeks before final approval. **What broke:** First try-in had inadequate posterior support—caught it before final.

Counting teeth out loud for nervous kids

For kids under 7 who won't open: I tell them I need to count their teeth and I'll tell them how many they have. "Let's see... one... two... three... WOW you have a lot of teeth..." They get curious about the number. Mouth stays open. I get my exam done. Works about 80% of the time. Way better than "open wide please."

Peri-implant tissue photography protocol

Standardized lighting and positioning for consistent soft tissue documentation. Here's our exact setup and the checklist we use at every recall visit. **Equipment:** - Ring flash (we use Godox MF12) - Black contraster - Cheek retractors (medium + large) - Mirror #5 for lingual shots **5-Point Checklist:** 1. Retract → dry tissue → contraster behind 2. Facial straight-on (flash at 1/4 power) 3. Occlusal view with mirror 4. 45° mesial and distal angles 5. Probing depth documentation shot **Settings:** f/22, 1/200, ISO 200 (adjust flash, not camera) **Naming convention:** [PatientID]_[Site]_[Date]_[View]

Clear aligner troubleshooting protocol

Common issues we see in the first 3 months and how we address them. Includes patient communication scripts and when to pause treatment. **Week 1-2 Issues:** - "They don't fit" → Check seating, have patient bite on chewie 5 min 3x/day - "I can't get them out" → Demo pull from posterior, provide ortho key **Month 1-2 Issues:** - Tracking lag on canines → Add precision cut, consider auxiliary - Attachments popping → Check bonding protocol, may need to rebond with longer etch **When to pause:** - >2mm tracking discrepancy - New decay identified - Patient wearing <18 hrs consistently **Script for tracking issues:** "Your teeth are moving, but not quite at the pace we planned. This is common and fixable—we have a few options..."

Calm cleaning kit for anxious patients

Putting together a take-home kit with ultrasonic tips, desensitizing paste, and a simple tracking journal. Testing with 20 patients this month. **Kit contents:** - Sensitive toothpaste (Sensodyne Pronamel) - Soft-bristle brush - Desensitizing gel (MI Paste) - 1-page "what to expect" guide - Simple tracking card (pain level 1-10 each day) **Cost:** ~$15/kit wholesale **Hypothesis:** Patients who do this for 2 weeks before SRP have less anxiety and sensitivity. Will share results after the pilot.

Material selection for anterior veneers

Comparing e.max, zirconia, and feldspathic porcelain for different clinical scenarios. When we choose each and why. **Our decision tree:** - High translucency needed + minimal prep → feldspathic - Bruxer or edge-to-edge → zirconia - Most cases → e.max (best balance) Sharing our actual lab communication template.