The Dental Grind - #18

Being the “nice” dentist-owner feels good in the moment—but it’s expensive over time. Avoiding hard conversations, saying yes when you should say no, and smoothing over problems instead of solving them quietly drains your energy, your margins, and your authority. Teams don’t actually thrive on niceness; they thrive on clarity, consistency, and fairness. This week’s challenge: ask yourself where being liked has started to cost you leadership—and what one uncomfortable conversation would immediately make your practice healthier.

⁇ The Question: Is dental amalgam actually bad for patients because of mercury—or is this another case of internet fear outrunning the science?

📚 The Evidence:
Dental amalgam is one of the most heavily studied materials in dentistry. Large randomized controlled trials in children (with 5–7 years of follow-up) found no significant differences between amalgam and mercury-free restorations when it came to IQ, neuropsychological performance, behavior, nerve conduction, or kidney function. Yes, amalgam releases small amounts of mercury vapor—but extensive human data show this exposure has not translated into measurable clinical harm in the general population.

✅ The Answer:
For the general population, the best available evidence does not show clinically meaningful harm from dental amalgam. Recommendations to avoid amalgam in certain groups (pregnant patients, children, those with kidney disease) are precautionary, not based on proven damage.

• Don’t recommend removing stable amalgams for “detox” or health reasons—there’s no evidence to support it.
• Frame discussions honestly: precaution ≠ proven harm.
• Use alternatives when clinically appropriate or when patient preference matters—but without fear-based messaging.
• Remember: the global phase-down of amalgam is driven largely by environmental policy, not patient toxicity.

Read the key studies here >

End-of-Year Procedure Reality Check

End of year is the perfect time to run a procedures report—and most practices skip it. Look for procedures you think you do well but actually underperform on: occlusal guards, comprehensive exams, periodontal therapy, cracked-tooth diagnoses, or large restorative. Your numbers will quietly tell you where diagnosis is slipping, confidence is lagging, or systems are breaking. Fixing just one weak area in your procedure mix can move revenue more than adding new patients.

Better Contacts Start With Better Matrix Selection

If your contacts are weak, the problem usually isn’t the composite—it’s the matrix choice and seating depth. Where the matrix is burnished is where the contact will be, and too often the band is the wrong size or not seated deep enough. Slow down for two seconds, visualize the final contact, and adjust before curing—you’ll be shocked how much your restorations improve with zero extra time.

Dentistry isn’t exhausting because the work is hard — it’s exhausting because most dentists were never taught how to run a business. This course breaks down the exact systems that actually move the needle: 📊 cash flow, 📅 scheduling, 🧾 overhead control, 👥 team structure, and 🧠 decision-making without the chaos. No fluff. No corporate nonsense. Just practical, battle-tested fundamentals from someone who’s lived it.
👉 Learn more here

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