Good morning ya radiologists,

Before we go any further, a quick reminder:

If you have suggestions, disagreements, feedback, or something cool you want to share with the newsletter…remember you CAN reply directly to this email and we’ll get back to ASAP.

Looking forward to hearing from you.

Here’s today’s show:

• 💀The Characters of Radiopacities. A review of 5 apical radiopacities that you will actually remember.

• 📷Coffee Break. Bad YouTube dental advice and your practice’s Google reviews on toilet paper.

• 🐐Disagreeing with the GOAT. We think we disagree with a big name in restorative dentistry…but want your opinion.

Let’s get it.

The 5 Characters of Apical Radiopacities

So at some point in dental school you learned all about oral radiology, right?

And when it comes to apical radiopacities, you remember everything right?

Then you’ll easily be able to tell me what’s this radiographic finding👇

Pemphigus vulg-…*whew*…we’re talking radiology here dude.

Okay, okay, it’s okay. We get it.

We’re not all young dental students anymore who can cram for an entire finals week in a weekend

Which is why these guys are helping us out…

And this cast of characters is going to do two things

1. Represent the 5 apical radiopacities

2. Actually help you remember them

So-

Radiopacity #1

This is the guy that was fun to be around during undergrad, but overstayed his welcome and still hits you up to “kick it”

• Some say he is a little dense in the head (dense bony island)

• He doesn’t believe in leg day (small, normal PDL)

• Hasn’t changed since college (generally no radiographic changes)

Radiopacity #2

This ill lookin’ sasquatch is important because he has one characteristic that makes him an outlier.

• The cold doesn’t phase him (non-vital tooth🚩🚩)

• Carries around an endo file (RCT or ext. is treatment)

• Constantly sick (response to apical inflammation)

Radiopacity #3

This is the guy that always mumbles under his breath, “kids don’t appreciate the value of hard work” and was wearing Carhartt gear before it was cool.

• Blue-collar worker (tough extractions)

• Constantly weighed down by cement (excess cementum on root)

• Carries around a watch (no treatment)

Radiopacity #4

Everyone has that friend that:

1. Has a new look every year

2. Comes across as a bit shady, but is completely harmless, most of the time

For radiopacities, this is that friend

• Changes over time (early: radioucent to late: radiopaque)

• Different look each year (varied PDL)

• Watch (yearly radiographic overview)

Radiopacity #5

And finally…the guy that thinks he is more important than he actually is.

• Nowadays, not many pirates (rare finding)

• Carries a forcep (Ext. and biopsy indicated)

• Rounded peg leg (completely obscures root)

• Causes pain (swelling)

You will notice…

That three of these characters are holding a watch, AKA it’s a finding that just needs to be monitored

But some of these watched findings can be associated with systemic disease

…Which we will dive into with a future email

Coffee Break

Some links to get you through until your next hygiene check

• 💻YouTube Doesn’t Do Teeth. Just in case you thought everything on the internet is true, some research reminds us that YouTube is VERY bad at all-on-4 information.

• 🧻Million Dollar Idea. Toilet paper with letters from your ex? Nope. How about toilet paper with your practice’s bad Google reviews instead.

• 🖼️Nostalgia. Some artifacts from the early internet

• 💵💵That's a lot of cash. A recent study shows the US loses $45 Billion dollars of productivity due to oral health problems.

Polling the Bar

Look—

We here at tipsy dentistry don’t claim to be dental savants in any sense.

We realize there are A LOT of people way smarter than us in the dental world…one of them being Gordon Christensen.

But, an article we recently read by Dr. Christensen in Dental Economics just didn’t make sense…so we want your opinion:

Dr. Christensen proposes that mechanical retention SHOULD be placed in resin composite restorations preps.

Thoughts from the editor:

If your resin composite restoration fails and it debonds, we see two scenarios:

Scenario #1: Retentive preparation

1. The restoration is retained in the tooth

2. The patient might not realize it’s debonded

3. Recurrent decay easily develops under the restoration

Scenario #2: Non-retentive preparation

1. The patient will likely realize they, “lost a filling”

2. The site is actually cleansable

3. Pt. is more likely to get it replaced sooner

The 2nd scenario makes more sense to us, but again answer the poll question and let us know.

Looking Forward to Next Week

We’re asking the question:

A dive into the literature will help us figure it out. But until then, we want to hear what you tell patients about composites (results in next week’s newsletter)

Talk to you soon,

luv u,

😘😘😘😘tipsy dentistry