Limited/Urgent Dental Care

[dentite24]

New grad here. HOT takes here. But here is where I’m at with dentistry… I absolutely hate general dentistry. I hate restorative dentistry and comprehensive care. I’m just not the guy for it, my passion/skills is not in it. I don’t enjoy comprehensive care liability, hate class 2’s, hate crowns/veneers, hygiene checks, talking about oral hygiene, pts’ high demands, owning a practice, etc…

What do I love? Limited care. I love getting patients out of pain, I love fixing people’s little issues. I’m very good at extracting teeth, socket grafting, halcion/nitrous for surgeries, essix/flipper for temporary tooth loss, prophylactic wisdom teeth extractions, 1-2 canal full RCTs, pulpal debriding molars, replacing fillings that chip or fall out, Class 4 incisor chipped teeth fillings… I like fix it dentistry. I love helping people out with their single issue they are coming in for. I like that the pt expectations are generally lower, ppl are generally happy that you could fix their issue, and generally you are not liable for their entire dentition.

I don’t care about money (I’d rather be happy at work), I don’t want to specialize in OS/endo. I just want to be a limited care “urgent dentist.” People give me so much slack when I tell them this, but this is the where my passion is. I have skills and have a passion for it, I would love to be able to use them. I know it’s not that profitable of a market, and I’m fine with that. As long as I’m making $100k I’d be happy.

I think there’s is a market for a market for limited care dentistry and I think i can be a provide a great service for pts. My question is.. how do I get to do this kind of work only? Will there be a DSO market that pop up that’s “emergency dentist” or “urgent dental?”

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[FutureDent020]

Lol, my dad always agreed with this. He wasn’t a dentist but worked in healthcare admin. There is a need for emergency dentist and urgent dental care. I don’t disagree, but it’s kind of a complicated niche. You are going to get a pretty specific clientele and not necessarily one you want. People who have put off issues, don’t have dentists or people to follow up with. It all just sounds complicated to do full time. But hospitals can staff you or you can work in emergency dental clinics. They exist. As an endodontist, this is basically what we do 75% of the time. But I understand you don’t want to specialize. Problem with working on people in pain is it’s pretty difficult and can be complicated as you are probably aware. And if you are treating competently then you need to be well compensated, but sounds like you aren’t concerned about that.

Long story short, those clinics exist and providers are needed. They are there if you do a little searching. Maybe not in every city/ area.

 

[Thehighwind87]

Go work at a fqhc in rural area. Lots of toothaches, fix it kind of dentistry, and the pay is pretty subpar- so no issue there for you

 

[deleted1047421]

What do I love? Limited care. I love getting patients out of pain, I love fixing people’s little issues. I’m very good at extracting teeth, socket grafting, halcion/nitrous for surgeries, essix/flipper for temporary tooth loss, prophylactic wisdom teeth extractions,

My advice to you is to operate within your scope of training.

Many urgent care/emergency dentists attempt to extract teeth and get in way over their heads.
I wish I didn’t have to say this but the ones in my area do horrific work when it comes to extractions.
I see their work because their patients show up on my schedule to finish their extractions and for me to deal with their complications.

Patients are usually very upset and sometimes even file board complaints against their emergency dentist for doing botched surgery/surgical extractions. I know bc the board sometimes requests chart notes and imaging.
Just treat patients the same way you would for your own family. Refer complicated extractions out to an os.

 

[Thehighwind87]

My advice to you is to operate within your scope of training.

Many urgent care/emergency dentists attempt to extract teeth and get in way over their heads.
I wish I didn’t have to say this but the ones in my area do horrific work when it comes to extractions.
I see their work because their patients show up on my schedule to finish their extractions and for me to deal with their complications.

Patients are usually very upset and sometimes even file board complaints against their emergency dentist for doing botched surgery/surgical extractions. I know bc the board sometimes requests chart notes and imaging.
Just treat patients the same way you would for your own family. Refer complicated extractions out to an os.

Solid advice. Always practice dentistry that protects your license.

Contrary to what you think about “comprehensive care liability”- the biggest lawsuits and complaints come from extractions and root canals.

And to do them well requires experience. One messed up case with a lawsuit board complaint and you will be wondering why you just didn’t stick with doing simple class 2 fillings. In addition as a GP you are probably getting paid next to nothing for them when in reality doing a filling would of been more productive.

Best of luck though but new grads tend to be Fung ho… until they run into a real issue like paresthesia or sinus perf or something else

 

[yappy]

Do a GPR then get a job as staff/faculty. I think if you want to work in this model you will need to be subsidized by a larger entity like a hospital.

 

[Molar Whisperer]

New grad here. HOT takes here. But here is where I’m at with dentistry… I absolutely hate general dentistry. I hate restorative dentistry and comprehensive care. I’m just not the guy for it, my passion/skills is not in it. I don’t enjoy comprehensive care liability, hate class 2’s, hate crowns/veneers, hygiene checks, talking about oral hygiene, pts’ high demands, owning a practice, etc…

What do I love? Limited care. I love getting patients out of pain, I love fixing people’s little issues. I’m very good at extracting teeth, socket grafting, halcion/nitrous for surgeries, essix/flipper for temporary tooth loss, prophylactic wisdom teeth extractions, 1-2 canal full RCTs, pulpal debriding molars, replacing fillings that chip or fall out, Class 4 incisor chipped teeth fillings… I like fix it dentistry. I love helping people out with their single issue they are coming in for. I like that the pt expectations are generally lower, ppl are generally happy that you could fix their issue, and generally you are not liable for their entire dentition.

I don’t care about money (I’d rather be happy at work), I don’t want to specialize in OS/endo. I just want to be a limited care “urgent dentist.” People give me so much slack when I tell them this, but this is the where my passion is. I have skills and have a passion for it, I would love to be able to use them. I know it’s not that profitable of a market, and I’m fine with that. As long as I’m making $100k I’d be happy.

I think there’s is a market for a market for limited care dentistry and I think i can be a provide a great service for pts. My question is.. how do I get to do this kind of work only? Will there be a DSO market that pop up that’s “emergency dentist” or “urgent dental?”

I hear you. Only you know what you like and what you're good at. As long as you're getting your bills and loans paid, it's nice not having to care about money. USAF paid for my DS and my house was paid off early last year. If I don't accummulate tens of millions, I'm not going to lose sleep. What good is money when you can die of a heart attack or painful death from cancer any time after enduring work stress and neglecting your health? (Your wife can remarry and along with her new husband can enjoy your money).

I find limited exams to be my relaxing/break appts. I've been practicing for 25 years and occasionally I run behind on crown preps, RCTs, fills, etc. I usually catch up doing limiteds. I think limiteds can be fun. However, maybe it's just me, but I don't produce consistently with them. A lot of times it is like treating canker sores, and playing Dr. House with cases like primary herpetic stomatitis, or stomatitis from cinnamon products. I see a lot of teeth pain from grinding/clenching and maybe one can sell custom night guards and Full Contour Zirconia crowns. One time I saw this lady 3 times for pain upper molar (#14). I didn't see anything wrong and referred her 3 times to get her sinuses checked. She came back the 4th time saying her ENT said her sinuses are fine and to go back to her dentist (me). We ended up doing the RCT. I noticed she had vital hemorrhaging (light bleeding upon pulpal access) and found MB3 canal after ultrasonic and under magnification. She came back shortly after complaining of the same pain and I referred her to another ENT. They found sinus problems with imaging that the first ENT guy didn't do.

We have a few Emergency Dentistry Clinics, but they all do general dentistry to supplement production. On the medical side, I see a lot of urgent care clinics pop up like weeds. Maybe that is the trend for dental? Maybe you can obtain extra training like IV sedation and market yourself as "Emergency Sleep Dentist."

 

[FutureDent020]

Solid advice. Always practice dentistry that protects your license.

Contrary to what you think about “comprehensive care liability”- the biggest lawsuits and complaints come from extractions and root canals.

This is true, but you know what’s interesting? Endodontist have lowest litigation rate. Not sure if it’s because of our consent form, discussions with patient, willingness to refund, how we handle treatment, or what. But while root canals can have wild outcomes and don’t work roughly 10% of the time, patients don’t tend to file lawsuits. Maybe it’s also because if handled properly, worst case scenario is losing the tooth. And in those cases, if it happens timely after treatment, we often refund. Even if it’s not our fault. Not sure why we refund, but we do. If you get diagnosed with cancer and spend thousands on chemo/ radiation therapy that doesn’t work you don’t get refunded. Nothing is guaranteed. But patients have a hard time understanding this with dentistry.

 

[Thehighwind87]

This is true, but you know what’s interesting? Endodontist have lowest litigation rate. Not sure if it’s because of our consent form, discussions with patient, willingness to refund, how we handle treatment, or what. But while root canals can have wild outcomes and don’t work roughly 10% of the time, patients don’t tend to file lawsuits. Maybe it’s also because if handled properly, worst case scenario is losing the tooth. And in those cases, if it happens timely after treatment, we often refund. Even if it’s not our fault. Not sure why we refund, but we do. If you get diagnosed with cancer and spend thousands on chemo/ radiation therapy that doesn’t work you don’t get refunded. Nothing is guaranteed. But patients have a hard time understanding this with dentistry.

Endo and specialists are held in a different standard then a GP doing rct or ext.

For example if a GP can’t find mb2 and gets sued- any lawyer can say well if they went to endodontist they would have found it.

But if endo does the root canal and can’t negotiate the mb2 then- it is what it is. GP are held to the same standard as a specialist- and usually specialists are given benefit of the doubt because it’s your speciality. Any new grad gp doing a molar endo and screws up is easy case for a lawsuit.

Granted I know many gps that do molar endo or exts- at the end of the day it’s your call.

 

[Saddleshoes]

What do I love? Limited care. I love getting patients out of pain, I love fixing people’s little issues. I’m very good at extracting teeth, socket grafting, halcion/nitrous for surgeries, essix/flipper for temporary tooth loss, prophylactic wisdom teeth extractions, 1-2 canal full RCTs, pulpal debriding molars, replacing fillings that chip or fall out, Class 4 incisor chipped teeth fillings… I like fix it dentistry. I love helping people out with their single issue they are coming in for. I like that the pt expectations are generally lower, ppl are generally happy that you could fix their issue, and generally you are not liable for their entire dentition.

I would suggest you look into working in a correctional center. You might like it.

(I did it part-time for over 20 years and it kept me sane in this profession.)