After spending 4 years of my life in an academic environment surrounded by the minute details of dentistry, the transition to clinical practice can be challenging.
Difficulties Transitioning from Dental School to Clinical Practice
These aspects of dentistry have been challenges faced by every new graduate from dental school.
Technical Knowledge
It is difficult to take the technical knowledge you have spent years of your life accumulating and distill it down to be accessable for the general public.
Niche Terminology
It is a challenge to take niche terminology like caries and periodontal disease and relay it to patients as cavities and gum disease.
Treatment Planning Nuances
Additionally, it can be difficult to share risks, benefits, and nuances of treatment planning that took years to grasp, to patients with limited dental IQ and short appointment times.
Handling Patient Expectations
In today’s day in age, dentists are faced with the social media era. Patients expect social media-level results with minimal time and effort required. We are living in a society of 1 day shipping and dentistry is being viewed as more of a commodity. These trends are impacting the everyday interactions between dentists and patients.
Dealing with the Separation of Dentistry and Medicine
With the separation of dentistry and medicine, unfortunately, our society has decided to view dentistry as more of a commodity. Generally, people view dentistry as cosmetic work to achieve a “Hollywood Smile” and forget the systemic implications of poor oral health.
The oral cavity is a part of the human body and dental infections easily travel to the brain or heart via the bloodstream. Because of this separation between dentistry and medicine, it is easy to forget that dental procedures are medical care. Patients are coming to their dentist with a problem that needs to be solved.
Just like going to an orthopedic surgeon because you need hip surgery, you are asking a medical professional to evaluate your problem and provide a solution to address this problem.
Physicians and dentists are only human. They are trained to provide solutions based on the information they have in front of them. Patients are responsible for providing as much information to assist in treatment planning.
Not Every Solution is the Best for Every Patient
However, not every solution will be the best option for every patient. As a dentist, many times we are faced with a patient who is in pain, having an emergency, or has significantly neglected their dental health and we are expected to provide a solution to these long-standing chronic problems
It can be overwhelming, as the dental provider, to meet someone for the first time, understand their expectations, and motivations, and provide an individualized solution to their problem all in the first 30-60 minutes of meeting someone.
When we seek treatment from medical professionals or even lawyers, we are looking to these experts in their feel to provide us with their efforts, we are not necessarily paying for outcomes. Yes, one would hope a lawyer that we’ve hired will help us win our case, just as we hope our heart surgeon will successfully place a stent to allow proper blood flow to our heart, but these experts cannot guarantee the desired outcome. Dentists are no different.
If a patient has an infected tooth with an abscess, the dentist can recommend endodontic therapy to remove the infection from the root canal and prevent further systemic infection, but there is no guarantee this treatment will be successful.
It is important for patients to understand that they are seeking effort from their dentist. Your dentist will use their skills to address your issue and put in their best efforts to save your tooth. If the outcome of the treatment is not what you hoped for, that doesn’t mean your dentist failed. Many people need revisions of their joint replacements but we don’t always apply that same standard to dental procedures.
Unrealistic Expectations
Orthopedic surgeons and car salesmen cannot provide any guarantees for their services, so it Is unfair to expect dentists to be able to give lifetime guarantees. For some reason with teeth, if a Root Canal and Crown last 5-10 years patients consider that a failure.
However, your dentist was able to save your natural tooth and extend its life for that time frame. You were able to eat, smile, and talk with that tooth many millions of times over the course of those years and I would consider that success!
No artificial material is as good as the natural structure we were born with, so if you’ve had problems with your natural tooth structure, you cannot expect man-made materials to be better than what you were born with. It is incredibly important for patients to have realistic expectations regarding the tooth replacement options that dentists can provide.
Crowns are replacements for natural enamel that have been damaged by cavity-causing bacteria or fracture of enamel due to grinding of teeth, but it is still an artificial solution. Dentures are an alternative for edentulous patients but they only provide up to 10% of the function of natural teeth because they are acrylic objects placed into patient’s mouth. These materials have weaknesses and shelf lives that prevent them from lasting forever.
The biggest factor regarding the longevity of dental treatment and prostheses, however, is how the patient cares for these tooth replacement or repair options. If patients follow their dentist’s care instructions and post-operative instructions many dental materials can last several years. Your dentist and hygienist are not with you every day helping you to properly care for the work they have done, so patients need to take responsibility for the way their lifestyle, habits, and diet impact their dental work. Everything requires regular maintenance. Your car requires regular oil changes and new tires on occasion. Your house will require a new roof eventually or perhaps updates to your HVAC system.
Dental work is no different. If you want to extend the life of your car, you complete your regular maintenance. If you want to extend the life of your teeth, you need to see your dentist for regular examinations and complete recommended care.
Keep Reading: Lessons I Learned in My First Year of Dentistry
Photo by Robert Golebiewski
