Query Builder quandary in livewire component

Problem: how to get results from a query and then search only those results

I have a treatments table but want to display only the treatments assigned to a particular dentist.

I am using mount() to bring in the logged in dentist's user ID like this:

public function mount()
{
    $this->dentist_id = Auth::id();
}

I verified that the ID is being passed successfully.

This works:

public function render()
{
        $query = '%'.$this->search.'%';

        return view('livewire.treatments-table', [
            'treatments' => DB::table('treatments')
                ->join('users', 'users.id', 'treatments.patient_user_id')
                ->join('patients', 'patients.user_id', 'treatments.patient_user_id')
                ->join('dentists', 'dentists.user_id', 'treatments.dentist_user_id')
                ->select(
                    .....
                )
		->where('treatments.dentist_user_id', $this->dentist_id)
                ->where('treatments.status', 'like', $query)
                ->orWhere('patients.first_name', 'like', $query)
                ->orWhere('patients.last_name', 'like', $query)
                ->orWhere('dentists.name', 'like', $query)
                ->orWhere('users.email', 'like', $query)
                ->orWhere('patients.state', 'like', $query)
                ->orderBy($this->orderBy, $this->orderDirection ? 'DESC' : 'ASC')
                ->paginate($this->perPage)
        ]);
}

Except, when I hard-code a different dentist ID in the first where clause like this:

public function render()
{
        $query = '%'.$this->search.'%';

        return view('livewire.treatments-table', [
            'treatments' => DB::table('treatments')
                ->join('users', 'users.id', 'treatments.patient_user_id')
                ->join('patients', 'patients.user_id', 'treatments.patient_user_id')
                ->join('dentists', 'dentists.user_id', 'treatments.dentist_user_id')
                ->select(
                    .....
                )
                ->where('treatments.dentist_user_id', 34)
                ->where('treatments.status', 'like', $query)
                ->orWhere('patients.first_name', 'like', $query)
                ->orWhere('patients.last_name', 'like', $query)
                ->orWhere('dentists.name', 'like', $query)
                ->orWhere('users.email', 'like', $query)
                ->orWhere('patients.state', 'like', $query)
                ->orderBy($this->orderBy, $this->orderDirection ? 'DESC' : 'ASC')
                ->paginate($this->perPage)
        ]);
}

it returns all records instead of only the records of the dentist where ID == 34.

When I remove the additional where clauses like this:

public function render()
{
        $query = '%'.$this->search.'%';

        return view('livewire.treatments-table', [
            'treatments' => DB::table('treatments')
                ->join('users', 'users.id', 'treatments.patient_user_id')
                ->join('patients', 'patients.user_id', 'treatments.patient_user_id')
                ->join('dentists', 'dentists.user_id', 'treatments.dentist_user_id')
                ->select(
                    .....
                )
                ->where('treatments.dentist_user_id', 34)
                ->orderBy($this->orderBy, $this->orderDirection ? 'DESC' : 'ASC')
                ->paginate($this->perPage)
        ]);
}

it correctly returns the records for Dentist where ID = 34.

I have attempted a number of query variations with no success.

In SQL, I am trying something like this:

SELECT * 
FROM `treatments` 
JOIN()
JOIN()
JOIN()
WHERE treatments.dentist_user_id = 1
AND patients.first_name LIKE %$query%
OR patients.last_name LIKE %$query%
OR
OR
etc
. . . .

If anyone can help me understand where my error(s) are, I would greatly appreciate it!

For reference, here's the entire component:

<?php

namespace App\Http\Livewire;

use App\Models\Treatment;
use Illuminate\Support\Facades\Auth;
use Illuminate\Support\Facades\DB;
use Livewire\Component;
use Livewire\WithPagination;

class TreatmentsTable extends Component
{
    use WithPagination;
    
    public $search = '';
    public $perPage = 10;
    public $orderDirection = true;  // DESC = true
    public $orderBy = 'treatments.id';
    public $dentist_id;
    public $status;

    public function mount()
    {
        $this->dentist_id = Auth::id();
    }

    public function updatingSearch()
    {
        $this->resetPage();
    }
    
    public function render()
    {
        $query = '%'.$this->search.'%';

        return view('livewire.treatments-table', [
            'treatments' => DB::table('treatments')
                ->join('users', 'users.id', 'treatments.patient_user_id')
                ->join('patients', 'patients.user_id', 'treatments.patient_user_id')
                ->join('dentists', 'dentists.user_id', 'treatments.dentist_user_id')
                ->select(
                    'treatments.dentist_user_id AS dentist_user_id', 
                    'dentists.id AS dental_practice_id', 
                    'dentists.name AS dental_practice_name', 
                    'dentists.phone AS dental_practice_phone', 
                    'dentists.dentist AS dentist_name',
                    'dentists.address1 AS dental_address1', 
                    'dentists.address2 AS dental_address2', 
                    'dentists.city AS dental_city', 
                    'dentists.state AS dental_state', 
                    'dentists.zip AS dental_zip',

                    'patients.user_id AS patient_user_id', 
                    'patients.first_name AS patient_first_name', 
                    'patients.last_name AS patient_last_name', 
                    'patients.phone AS patient_phone', 
                    'users.email AS patient_email', 
                    'patients.address1 AS patient_address1', 
                    'patients.address2 AS patient_address2', 
                    'patients.city AS patient_city', 
                    'patients.state AS patient_state', 
                    'patients.zip AS patient_zip', 

                    'treatments.id AS treatment_id', 
                    'treatments.status', 
                    'treatments.treatment', 
                    'treatments.amt_presented', 
                    'treatments.amt_accepted',
                    'treatments.created_at AS treatment_date'
                )
                ->where('treatments.dentist_user_id', $this->dentist_id)
                ->where('treatments.status', 'like', $query)
                ->orWhere('patients.first_name', 'like', $query)
                ->orWhere('patients.last_name', 'like', $query)
                ->orWhere('dentists.name', 'like', $query)
                ->orWhere('users.email', 'like', $query)
                ->orWhere('patients.state', 'like', $query)
                ->orderBy($this->orderBy, $this->orderDirection ? 'DESC' : 'ASC')
                ->paginate($this->perPage)
        ]);
    }
}