The Dental Grind - #5

Have you lost your conviction in what you do? So much of our performance is dictated by what we truly believe. Do we actually believe that tooth needs a crown — or are we just suggesting it because it’s “what’s next”? Do we believe a cosmetic case can change a life, or that getting a mouth infection-free will ripple into someone’s overall health? Patients can sense when we’re just going through the motions. If you’re not convinced, neither are they. But when you speak with excitement and certainty, treatment acceptance soars. If you find your conviction slipping, it may be time to study, reflect, and rebuild your confidence — because belief is contagious, and your patients are buying into you before they buy into your dentistry.

⁇ The Question: Patients want teeth yesterday, and the technology says we can deliver. But do immediate implants placed into fresh sockets actually survive as well long-term as the traditional delayed approach? Or is there a hidden penalty for speed?

⚖️ The Evidence: Here’s where the confusion starts: many meta-analyses define “survival” as the implant is still physically in the mouth. That means an implant with 5 mm of bone loss and bleeding tissue still counts as “successful.” No wonder the reported survival rates hover around 97–98%.

But when stricter criteria and longer follow-ups are applied, the picture changes:

On the flip side, shorter-term studies in compromised sites (even with periapical lesions) show 95–97% survival if thorough debridement and antibiotics are used【BMC Oral Health, 2023】. And when it comes to gap grafting, survival rates don’t budge, but tissue stability does:

✅ The Answer: The evidence is clear: long-term survival is lower for immediate implants, especially in the posterior maxilla and higher-risk patients. Short-term numbers can mislead, but time exposes the difference.

🏠 The Application:

✅ Low-risk patients + dense mandibular bone + excellent stability → Immediate can still be safe and predictable.

👉 Bottom line: Speed is tempting, but patience usually pays off.

💰 Clean up your Chart of Accounts before it cleans you out.

Your P&L is only as good as your Chart of Accounts. If it’s a jumbled mess, you’ll never know where the money is leaking. Sit down with your bookkeeper or accountant and make sure payroll is broken down by role (admin 👩‍💼 vs. assistants 🦷 vs. hygienists 🪥), that payroll taxes and health insurance are clearly separated, and that big spend categories like lab, supplies, and marketing have their own sub-accounts. Once you can actually see where your money is going, you can diagnose problems and attack the things you control—especially payroll, supplies, lab, and marketing.

⏱️ Stop wasting time — Septocaine kicks in faster than you think.

Most dentists wait 3–5 extra minutes “just to be safe” before starting — but with Septocaine (articaine) 💉, that’s wasted chair time. Onset is usually 1–3 minutes for maxillary infiltrations, 2–4 minutes for mandibular infiltrations, and about 5 minutes for an IAN block. Don’t be afraid to test sooner — you’ll be surprised how quickly it works. And here’s a bonus tip: try infiltrating on lower first molars 🦷; evidence shows it often works better than you’d expect. Shaving minutes off every procedure adds up fast.

Check out this research article for more details!

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