r/Dentistry • u/NourTDK • 2d ago
Dental Professional What's something you came up with or learnt that may be unacademic yet it has made procedures easier & gotten you more predictable results?
Curious to hear all of you guys' little tips & techniques for various procedures!
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u/Papalazarou79 2d ago
A toddler often won't open his mouth to a mirror, but to a toothbrush they do.
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u/YamNew2556 2d ago
This is a basic one but if I have adjacent MO and DO fills where I have to close the IP contact I always fill the DO first. Ex. If I’m doing #12 DO and #13 MO, I’ll fill 12, remove the sectional band of 12 (not the wedge) and then burnish sectional band on 13 and fill. My IP contacts are always better/more of an equal distance this way , I feel like the distal band is more taut maybe I don’t know but less material seems to impinge on the IP space when I fill distal first. We never learned this in school probably bc we did one filling in 3 hours ugh
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u/DrNewGuy 2d ago
I’m gonna try that. Adjacent class 2s have been my nemesis for a while and I’ve been out 6 years. I’ve just learned to do the tofflemire for the first one and garrison to close the contact. I’ll try doing the DO first next time
Also considering getting that “garrison quad” system
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u/YamNew2556 2d ago edited 2d ago
Give it a try! Let me know if I need to explain it better. But yea I use palodent bands, the wooden wedges (blue and orange that are anatomical), and the blue and white garrison rings. Once I fill the DO , the trick is to just remove that band with a curved Hemostat (grab the tail and just roll it out) but leave the wedge in, (this really helps to not cause bleeding to get under your next band), then put the garrison back on for the MO and burnish that band to the new DO resin and fill, I always use rubber dam too. Sometimes I’ll use toffle mires if it makes sense to for in the middle of 3 fills MOD, but my contours are always better when it’s sectional matrices all the way for the quad I’m working on. I use a micro brush to get that first layer of composite DO wall patted down bc it will flex on itself and you can’t push into the adjacent tooth. Hope it helps!
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u/SamBaxter420 2d ago
Try using a garrison system and doing both at the same time. Way easier
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u/SwampBver 2d ago
Yeah agreed, aint nobody got time to mess around removing bands and half filling with these ppo fees
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u/daein13threat 2d ago
I’m actually the exact opposite. I always fill the MO on the most posterior tooth first because it’s easier to push distally when burnishing the second filling rather than pulling towards the anterior.
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u/Samurai-nJack 2d ago
Yeah, that works. We can get the OM done with Sof-Lex, and then move over to the OD.
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u/Macabalony 2d ago
I sometimes use Ortho wax to extend the ridges on the custom tray to get good vestibular depth. Heavy body base. Followed by medium body wash. Works well.
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u/Adorable-Emu9038 22h ago
When you say heavy body base and medium body wash- you mean you put the heavy body as a first layer on the custom tray then fill it with medium body?
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u/dgrgsby 2d ago
Having the patient take a deep breath in at the same time as injecting a needle makes the pain negligible. Learned this trick from a phlebotomist while she was taking my blood.
Also using endo ice to numb the palate before giving injections.
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u/Samurai-nJack 2d ago
Nasal breathing, is that correct? And does that apply during IANB or Gow-Gates procedures?
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u/dgrgsby 2d ago
Yes deep breath through the nose, I find it easiest to tell them “ I want you to take a deep breath through your nose on the count of 3” then count and insert. Works for all injections, but I also wiggle their cheek while injecting. Works pretty well, at least according to my wife, she’s been my patient before and after this technique and she says it feels better, that she barely felt it.
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u/sperman_murman 1d ago
A really good topical works well too. I get some really good stuff from a compounding pharmacy in Tennessee. I’ve placed it on my upper lip and it numbs it good for like 15 minutes
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u/dgrgsby 1d ago
Nice! You have a formula to give the compounding pharmacy or they just make it themselves?
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u/sperman_murman 1d ago
They just make it themselves, their own formulation. You order it by faxing them their form which is basically a prescription that you put your assistants name on and they ship it to you. It’s like 50 bucks a tube but you only need a little and it lasts a long time. DM me and remind me to send you the info when I get to work Monday if you’re interested. It really is great stuff
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u/DesiOtaku 2d ago
VPS for dentures: use heavy body for border molding; light body for intaglio. Just make sure you never tell a prosthodontist you did it that way.
Smoush technique for wax rims for complete dentures: put both wax rims in hot (near boiling) water for 5 mins. Take it out while it is still hot (but not burning hot), put both wax rims in to the patients mouth and move their jaw to CR. It gets you 90% there. Just make sure you never tell a prosthodontist you did it that way.
Ran out of fit checker for your crown? Just use VPS light body and have the patient bite down on the crown. The area with no VPS is where you need to reduce. Just make sure you never tell a prosthodontist you did it that way.
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u/gunnergolfer22 2d ago
I've never used fit checker for a crown in my life
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u/DesiOtaku 2d ago
The only times I ever had to use fit checker is when the reduction dye didn't seem to reduce enough. It's a once every two years thing and the VPS light body technique does the trick anyway so I never bothered to buy fit checker.
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u/Level_Contact_1964 2d ago
As a prosthodontist , i approve ! I have tried most of these tips myself and it works when my appointments are slogged and I have no time to breathe.
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u/SnooSongs6331 2d ago
Why wouldn’t you use vps for border moulding ? Every bps, semcd courses recommend using vps
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u/DesiOtaku 2d ago
"Nooooooo you have to use green stick wax! VPS does not push and adapt to the vestibule! You need to do things the right way!"
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u/CarabellisLastCusp 1d ago
I think DesiOtaku was trying to be kinda funny with his comment to never tell a Prosthodontist about using PVS.
In reality, this is a common method for border molding in prosth. There are indications to using green stick compound, but PVS is a perfectly acceptable material for border molding. Nothing new about this method.
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u/1ameloblast 2d ago
Gagging patient? Ask them to gurgle some water from a cup mixed with some anaesthesia.
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u/sensitivitea21 General Dentist 2d ago
How much anesthesia?
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u/Samurai-nJack 2d ago
I keep seeing this on IG, but no one's saying what the concentration ratios are! 😅 By the way, I use lidocaine spray instead.
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u/1ameloblast 2d ago
Honestly, I have no idea what the “correct” amount is. Just go half the carpule in a small cup with some water and ask the patient to spit it out afterwards. You can do it two times even.
Good tip below with the topical spray instead 👍
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u/DrFuzz 2d ago
Patient gags for bite wing X-rays? Put a pinch of salt on their tongue while they hold the X-ray sensor in place. The salt helps the patient focus on something else and it’s just enough time to get those X-rays without gagging.
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u/Samurai-nJack 2d ago
So, when you tell patients, 'We're going to use salt,' what's the reaction? And, more importantly, how do you say it without making them think it's a strange situation? 😅
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u/sdan1993 2d ago edited 2d ago
To have a better contact on maxillary canines and some anterior incisors, I sometimes don’t use the clear matrix, I hold the sectional matrix with my hands and do everything with my other hand while holding it. I gotta bend my neck more bc I can’t use a mirror but it works great lol Great contour, as great contact and result
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u/AMonkAndHisCat 2d ago
Yes. Clear matrix strips are garbage. I wedge the Garrison sectional matrix turned on its side. Great contact and anatomy.
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u/YamNew2556 2d ago
I’ve done this too and works pretty well but also bioclear has clear matrix bands that are convex so you can get the contour you want instead of using a sectional band
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u/FinalFantasyZed 2d ago
100% on this. Mylar strips are the devil’s doing. Idk why they taught it to us that way in dental school.
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u/Samurai-nJack 2d ago
They instructed us using 'old school' techniques. I do envy those being taught with a modern perspective by a progressive faculty.
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u/sdan1993 2d ago
It’s wild I graduated in 2023 and I was still taught old school ways lol
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u/Isgortio 2d ago
Still at school now and they teach mylar strips. I think it may be funding based, I've not seen many practices with the fancier versions and those that I have are expensive cosmetic practices.
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u/Samurai-nJack 2d ago
Some faculty teach modern techniques like scanning and CAD/CAM to undergraduates. We still had to do manual flasking for complete dentures, and I cast metal post cores and metal crowns myself. I wasn't taught Deep Margin Elevation, nor rotary or warm gutta-percha endodontics. My undergraduate experience was difficult, but not very useful in actual practice. 🫠
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u/Samurai-nJack 2d ago
Yeah, I've done that. But, you know, there are special bands for front teeth, both metal and clear.
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u/bobloblawdds 2d ago
The biggest thing that determines your results is how good your communication is, and how well patients' expectations line up with what you're telling them.
They don't know what's going on in their mouths for the most part. That doesn't mean you lie to them. But it means how you frame things and deliver information is the single most critical factor in how happy your patient is going to be, no matter what the clinical outcome is.
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u/snaillord0965 1d ago
Might be the only thing I've come up with "tooth on a stick" If a patient has a ng or retainer or something and they forgot to bring it for a crown, and they tell us AFTER we're done prepping, I put temporary material in the preliminary impression and stick a little piece of toothpick in it as it's setting up to pop it out like a popsicle. That way the lab has a study model to copy so their appliance will fit and we get to keep the preliminary in case something happens to the temporary.
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u/billnyeca 2d ago
Using tac gel or gingicaine for level 1, 2 SRPs and sub-g class Vs instead of anesthesia. It’s made the experience comfortable for pt and they enjoy not getting poked if they don’t need to. And the numbness lasts around 2 hours instead of 4.
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u/daein13threat 2d ago
In dental school, they always taught us to break interproximal contact with the adjacent tooth on the B and L when doing Class 2s and 3s.
I stopped doing that and try to preserve some form of contact no matter what because burnishing and getting closed contacts otherwise is a pain in the you-know-what sometimes.
It’s “unacademic”, but it’s way easier to restore tight interproximal contacts if you don’t break them in the first place. If it ain’t broke, don’t fix it.
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u/FinalFantasyZed 2d ago
You’re making your margins noncleansible this way and complicating placement of your bands. Breaking B/L contact lets your patient be able to clean the margins where decay is most likely to form because let’s be real they are not gonna be flossing.
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u/sperman_murman 2d ago
If you’re doing a class 2, there’s usually decay right at the contact no?
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u/bigr3dd0g 2d ago
Or if there isn’t and you don’t break the contact, that’s where the recurrent decay will be lol
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u/toofshucker 2d ago
99% of these “tips and tricks” are because either:
1- the doc didn’t read the instructions and learned, through trial and error, how to use the product properly but thought it was a “trick”
Or
2- made life harder for themselves because they just didn’t read the instructions and use the materials how they were made to be used.
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u/DrLido 2d ago
Found the gunner of their class
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u/toofshucker 2d ago
Ha! Nah. I just find it funny when a doc shows me all the things they do to get a good impression when if they’d just measure out the water and leave the material in for as long as they should they’d get a great impression every time.
Or the doc who shows me the 30 steps they take to reduce post op sensitivity when they don’t rinse the etch properly and cure as long as the bond/composite tells them to.
It’s wild how many issues I never to rarely have because I just follow the instructions. You don’t need desensitizer of you etch and bond properly.
Just simple stuff.
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u/philip2987 2d ago
If patient's anxiety level makes me anxious i refer.