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Is it ethical to not tell a patient about a previous dentist's obvious mistake?

New patient came in. Previous dentist did a crown on #19, and it's... bad. Obvious open margin, poor fit, probably going to fail. Patient is happy with it, doesn't know there's a problem. Do I: 1. Tell them it needs to be redone (they'll be upset, might blame me) 2. Wait until it fails (feels wrong) 3. Just monitor it (but what if it causes bigger problems?) I don't want to badmouth another dentist, but I also don't want to let a problem go untreated.

How much did your income change going from associate to owner?

Seriously considering buying a practice but terrified of the financial risk. Currently making $200k as an associate, pretty comfortable. For those who made the jump: what was the income change in year 1? Year 2? When did it start feeling worth it? I know it varies wildly, just trying to get some real numbers from people who've done it.

What's the dumbest mistake you've made that you'll never admit publicly?

I'll go first: I once prepped the wrong tooth for a crown. Patient was numb, I was distracted, and I prepped #13 instead of #14. Realized it halfway through. Had to explain to the patient why we needed to prep another tooth. I've never told anyone this. I'm so embarrassed. But I bet I'm not the only one who's done something stupid. What's yours? Let's normalize admitting mistakes so we can all learn.

Patient no-showed their SRP appointment for the THIRD time

We blocked 2 hours for this patient's SRP. They no-showed. Rescheduled. No-showed again. Rescheduled again. No-showed today. Each time they have an excuse. "Forgot," "car trouble," "family emergency." I'm done. I'm going to dismiss them from the practice. I can't keep blocking time for someone who doesn't show up. But I feel guilty because they clearly need the treatment. Am I being unreasonable?

Buy-in offer seems predatory - need reality check

Owner is offering me a 20% buy-in for $400k. Practice does about $2.5M annually, he says EBITDA is around $600k. The terms: - $400k upfront (I'd need to finance) - 20% of profits after that - 5-year buyout option for remaining 80% - Non-compete within 10 miles for 3 years if I leave This feels like a lot of money for 20% and the non-compete is scary. Am I being paranoid or is this actually a bad deal?

Finally started therapy and it's helping

After years of thinking "I should be able to handle this," I finally started seeing a therapist. Best decision I've made. Turns out the constant stress, patient anxiety, and work-life balance issues were actually affecting me more than I realized. Having someone to talk to who gets it (even if they're not a dentist) has been huge. If you're on the fence about therapy, just try it. You don't have to be "broken" to benefit from it.

Just spent 2 hours on a crown prep that the lab will probably mess up anyway

Perfect margins, perfect reduction, perfect temporization. Took me 2 hours because I wanted it perfect. Sent it to the lab with detailed instructions, photos, everything. I already know they're going to call me in 2 weeks saying "we need to remake it" or deliver something that doesn't fit. It's always something. Why do I even try to be perfect when the lab ruins it anyway?

What's your daily rate as an associate?

Trying to benchmark. What's your daily rate (or equivalent if you're on salary + production)? Include: - Your rate - Years of experience - Geographic area (HCOL/MCOL/LCOL) - Practice type (private/DSO/specialty) Trying to figure out if I'm being lowballed.

Does anyone else just refer out stuff they could technically do?

I know I *could* do that implant, or that complex endo, or that full-mouth rehab. I have the training. But I just... don't want to. I'd rather refer it out and sleep well at night than stress about a case I'm not 100% confident in. Is this lazy? Or is this actually good judgment? I feel guilty sometimes, like I'm not living up to my potential. But I'm happier this way.

Anyone actually happy at a DSO? Genuine question

All I hear is DSO horror stories. But I'm considering an offer from one and the recruiter seems genuine, the practice looks nice, and the pay is competitive. Is there anyone out there who actually likes working at a DSO? What makes it work for you? I know they're not all the same, but it's hard to find positive experiences online.

Colleague's work is consistently bad but they're a partner

I work with another dentist who's a partner in the practice. Their work is... not good. I've seen multiple cases where I would have done things very differently, and some that I think are actually substandard. Patients complain to me about their work sometimes. But they're a partner, so I can't really say anything. Do I have an ethical obligation to report this? Or is it not my problem? I'm conflicted.

5 years in, still at $180k. When do I push for more?

I've been at the same practice for 5 years. Started at $150k, got bumped to $180k after year 2, and haven't seen a raise since. I'm producing well over $1M annually for the practice. The owner keeps saying "we'll talk about it next quarter" but it never happens. I like the team and the patients, but I feel undervalued. At what point do I either demand a raise or start looking? I'm worried about burning bridges if I push too hard.

Partnership was promised, now they're backtracking

When I joined 4 years ago, the owner promised me a partnership track. "Give it 5 years and we'll talk about buying in." Now I'm approaching year 5 and when I brought it up, he said "the practice isn't in a position for that right now" and changed the subject. I feel like I've been strung along. Should I confront him directly or just start looking elsewhere? I'm pissed but don't want to make things awkward if I stay.

Hygienist called in sick for the 4th Monday in a row

I know people get sick, but this is getting ridiculous. Every Monday for the past month, my hygienist calls in "sick." I'm starting to think it's not a coincidence. I'm stuck seeing her patients or rescheduling them, which makes me look bad. The owner won't do anything because "we're short-staffed" and can't afford to lose her. I'm so frustrated. I can't run a practice like this.

I think I missed a second canal and I can't stop thinking about it

Did an endo on #19 last week. Found the MB and ML canals, cleaned and shaped, obturated. But now I'm second-guessing myself. I keep looking at the pre-op X-ray and wondering if there's a second MB canal I missed. The patient isn't having symptoms, but what if it flares up in 6 months? I'm losing sleep over this. Should I call the patient and re-treat it proactively? Or am I being paranoid?

DSO offered $50k signing bonus but daily rate seems low

Got an offer from a DSO (won't name which one) with a $50k signing bonus, which sounds amazing. But the daily rate is only $600/day, which feels low for my area. The contract is 3 years and the bonus is prorated if I leave early. They're also pushing me to sign quickly. Is the signing bonus a red flag? Should I be worried they're trying to lock me in with a low rate?

How do you deal with the physical pain? My back is destroyed

I'm 35 and my back is already shot. Chronic pain, can't sleep, seeing a chiropractor weekly. My hygienist is in worse shape and she's only 28. I know ergonomics matter but when you're running behind and trying to see 20 patients a day, perfect posture goes out the window. What actually helps? Exercises? Equipment? I'm desperate. I can't imagine doing this for 20 more years if I'm already in this much pain.

Patient wants me to lie to insurance. What do I even say?

Patient came in for a crown. Their insurance doesn't cover it because it's "cosmetic" (it's not, but that's what the insurance says). Patient asked me to "code it differently" so insurance will pay. I explained I can't do that, it's fraud. Now they're upset and threatening to go elsewhere. I know another practice in town that would probably do it. Am I being too rigid? Or is this just the cost of doing things right?

How do I tell my boss I'm leaving for a competitor?

I got an offer from another practice in town (not a direct competitor, but same city). Better pay, better hours, seems like a better fit. My current boss has been good to me, but I need to do what's best for my career. How do I have this conversation without burning bridges? Do I give 2 weeks? 30 days? Should I be honest about where I'm going?

Had a patient threaten to sue because their veneer shade was 'too white' (they picked it)

Patient came in for veneers. We did a shade selection, she approved the shade, signed the consent. Lab delivered exactly what we ordered. At delivery, she says "this is too white, I want it redone." I explain that she approved this shade. She threatens to sue, says I'm "unprofessional," and storms out. Now I'm worried about a lawsuit over something that was literally her choice. This is why I hate cosmetic cases.

First associate offer - is $150k base + 30% production good for MCOL area?

Just graduated and got my first real offer. $150k base salary plus 30% of production after $25k monthly threshold. Practice is in a medium cost of living area (think suburbs of a major city). I'm trying to figure out if this is competitive. The owner seems nice and the practice looks modern, but I don't have much to compare it to. Should I negotiate or is this fair? Also, they're offering 2 weeks PTO and standard benefits. No 401k match though.

Honest question: how often do you actually get perfect margins?

I see all these Instagram posts with "perfect margins" and I'm like... really? Because I feel like I'm doing well if I get 80% of my margins perfect. Am I just bad at this or is everyone else exaggerating? I know what perfect looks like, but in a real patient with real saliva and real time constraints, how often does it actually happen? Be honest. I need to know if I'm the only one struggling with this.

Got a bad vibe from interview - trust my gut or take the money?

Interviewed at a practice yesterday. The offer is $50k more than I'm making now, which is huge. But something felt off. The owner was dismissive of my questions, the staff seemed tense, and the office felt... sterile? Like no one was happy to be there. My current job pays less but I actually like going to work. Is $50k worth potentially hating my life? Or am I overthinking this?

Thinking about leaving dentistry entirely

I'm 5 years out of school, $300k in debt, and I hate this. I thought it would get better but it's only gotten worse. The stress, the physical pain, the constant pressure to produce. I can't do this for 30 more years. Has anyone successfully transitioned out? What did you do? I feel trapped because of the debt and I don't know what else I could do.

Is it normal to feel stuck 3 years into your first job?

I've been at my first practice out of residency for 3 years. The owner is nice, pay is okay, but I feel like I'm not growing. I'm doing the same procedures over and over. No mentorship, no challenging cases, just bread and butter dentistry. I'm getting bored. Is this normal? Should I be looking for something more challenging or is this just what dentistry is? I thought I'd be doing more interesting work by now.

My office manager is sabotaging me and no one believes me

I'm convinced our office manager is intentionally messing with my schedule. She double-books me, "forgets" to confirm appointments, and when I bring it up to the owner, she plays innocent. The owner trusts her completely (she's been there 15 years) and thinks I'm just being difficult. But my production is down 20% because of scheduling issues and I'm the one who looks bad. I don't know what to do. I can't prove it's intentional but I know it is.

Owner is billing for procedures I didn't do

I've noticed the owner is billing insurance for procedures that either weren't done or were done differently than billed. Nothing major, but definitely not accurate. I'm an associate, not a partner. I don't want to be complicit in fraud, but I also don't want to lose my job or get blacklisted. What do I do? Do I confront him? Report it? Just keep my head down and look for another job?

Does anyone else feel like a fraud even after 10 years?

I've been practicing for 10 years. I have good reviews, patients seem happy, but I constantly feel like I don't know what I'm doing. Every case I second-guess myself. Every complication makes me think "I should have known better." I'm terrified someone will figure out I'm not as good as they think I am. Is this imposter syndrome or am I actually bad at this? How do you deal with it?

I've been practicing 8 years and I still hate endo

I know I should refer it out, but I feel like I should be able to do basic endo. I've taken courses, I have a microscope, but I still dread every single endo case. I second-guess myself constantly. Did I get all the canals? Is the obturation good enough? Is this going to fail? I'm embarrassed to admit this, but I think I'm just going to start referring all endo out. Life's too short to stress about something I hate.

My boss is selling to a DSO and I'm freaking out

Found out yesterday that the owner is selling the practice to a DSO. He's been my mentor for 8 years and I genuinely love working here. The DSO wants to keep me on, but I've heard horror stories about DSO culture. More patients, less time, corporate BS. Do I: 1. Stay and see how it goes? 2. Start looking immediately? 3. Try to buy the practice myself (probably can't afford it)? I'm panicking. This practice has been my home.