⬇️ Below the Gumline
Is Our Empathy a Renewable Resource?
In dentistry, empathy is our superpower — but it’s also the thing that can burn us out the fastest. We can’t exactly “go solar” on empathy, but maybe we can learn how to recharge it without draining ourselves dry. Are we treating our compassion like a bottomless cup of coffee… only to discover it’s mostly empty by Thursday? This week, let’s think about how we refill that cup before it runs dry — because burnt-out dentists don’t make great clinicians.
🔥 High-Speed Chatter
🏢 Insurance giant buys dental practices. The ADA has issued a polite-but-pointed “concern” over a dental insurance company snapping up practices. Translation: everyone’s worried about the fox running the henhouse. Read More >
💸 Fraud case ends with a payout. A DSOs-linked firm settles fraud allegations — because apparently, “creative accounting” isn’t a legal business model. Read More >
📈 Delta Dental rate hike incoming. If you were hoping for some good news in your next PPO contract… surprise! Individual and family plan rates are going up. Read More >
📝 Dentist struck off for forging complaints. Because nothing says “team player” like inventing patient complaints about your colleagues. Read More >
🦒 Safari murder case twists. A wealthy dentist convicted of killing his wife on an African safari is being called a “Jekyll & Hyde.” Dentistry in the headlines… again for all the wrong reasons. Read More >
🥛 Probiotics for your gums? New research says diet changes and probiotics may help gum disease. Maybe the future of perio treatment looks more like a yogurt aisle. Read More >
☢️ X-ray shocker. A Reddit post shows the chest X-ray of a 21-year-old dental assistant after… well, let’s just say it’s a cautionary tale for PPE compliance. Read More >
🗳️ Ohio dentist runs for Congress. Because apparently, dealing with insurance companies prepares you for politics. Read More >
🦷 We might regrow teeth in humans soon. Researchers are edging closer to making your third set of teeth a reality. Say goodbye to dentures… and maybe crown preps. Read More >
🧪 The Research Says
⁇ The Question: When does a tooth actually need a crown instead of just a filling?
⚖️ The Evidence: A filling is a patch. A crown is structural reinforcement. Teeth cross the line from patchable to crown-worthy when cracks, wide preps, or cusp loss make them structurally weak. The research gives us clear thresholds:
Cracks: Crowning cracked teeth early improves survival by 98% (J Endod, 2022) and reduces the need for RCT by 80% (J Endod, 2018).
Prep Width: When the isthmus is >1/3 intercuspal distance, fracture risk skyrockets (Eur Endod J, 2021).
Endo Teeth: Posterior teeth without crowns are 6× more likely to be lost (J Prosthet Dent).
Fractured Cusps: Universal agreement — cuspal coverage is mandatory.
Risk Factors: High caries risk, multiple surfaces, and bruxism dramatically increase failure of large fillings (J Dent Res, 2014).
“Posterior teeth without cuspal coverage after endodontic treatment were six times more likely to be extracted.” (Journal of Prosthetic Dentistry)
✅ The Answer: A tooth needs a crown when any of the following exist:
It has a definitive crack
The prep/caries is >1/3 intercuspal width
It has had endodontic treatment
A cusp is fractured
And if you’re on the fence, risk modifiers (bruxism, high caries risk, multiple restored surfaces) should push you toward a crown.
🏠 The Application: On Monday morning, use this simple checklist chairside: crack, prep width, endo, fractured cusp, risk factors. If yes to any, go crown. If not, a well-placed filling is likely the better treatment.
💰 Business Bites
Pre-Payment: Your Cash Flow’s Best Friend
If you’re scheduling over an hour with the doctor, you should be getting pre-payment. This isn’t about being pushy — it’s about protecting your schedule and your bottom line. Patients are far less likely to cancel last-minute when they’ve already paid. Plus, your cash flow stops looking like a rollercoaster and starts looking like a steady climb.
🤯 Productive Pearls
Stop Scheduling Single Fillings
A single filling appointment is like driving across town for one stick of gum — it’s just not worth it. Unless you’re working them in a second chair or doing them same-day as diagnosis, the production-per-hour math just doesn’t add up. Batch your dentistry for profitability’s sake.
💉 Mental Anesthesia
🤝 Got a Question? Got a Friend? 🤝
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