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3 Things They Do NOT Teach in Dental School - But They Should
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- Опубліковано 5 сер 2024
- Dental school taught me lot, but there was so much that I had to learn the hard way.
The first big thing I needed to learn was how to give painless injections. Dental school taught me to be able to deliver safe and effective anesthesia, but there was never much emphasis on making the shot painless. I'm always still learning and refining my technique.
Being able to talk to patients and make them feel comfortable is incredibly important, and I ma learning that more and more each day. In dental school, the emphasis on the fillings/crowns/root canals - the technical aspect of dentistry - but we spent very little time discussing how important it is to really relate to each patient and understand them as a person.
Another issue that I did not hear much about in dental school was how stressful this career can actually be. There are no easy answers to stress in dentistry, but know that if you are stress out, you are not alone. It did not take long in the "real world" of dentistry to understand how stressful this job can be.
Thank you so much for your likes and comments. Keep them coming!!
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Dentist with 36 years of experience. I started out working 2 part time jobs for 3 years when I graduated. Then when I opened my own practice from scratch, I dropped one job & worked 6 days a week for 10 years. The part time job gave me a steady income for about 3-4 years while building up my practice. I eventually went completely solo & enjoyed the freedom. Did very well in my solo years but there comes a time when you realize being with a group practice or having a partner or office sharing makes better financial sense. Dentistry is an expensive career getting into it starting with your education and the bills never stop - they only get bigger as time goes on. Tecnology is great but expensive & it needs to be updated periodically costing you more & more. My advice to young dentists would be to office share or join a group practice. You share the rent, the insurances, the tecnology, etc. ...Yes, it will have pros & cons but from a financial point of view, keeping your overhead down is much attainable when you share office space in some capacity. There are many solo dentists out there having trouble paying their bills & you get paid last. I have worked in 2 offices & went solo. If I had to do it all over again, I would definately be in some kind of partnership or group practice or office share. This will definitely reduce your stress level, keep expenses lower, you will have automatic emergency coverage when you want vacation time, & you have a second opinion at your finger tips to bounce off complicated issues. Another suggestion is to keep your wives out of the office. As a female hygienist turned dentist, the staff couldn't stand the owners wife bc she would come in & boss everyone around, try to make changes, question everything, then go home and complain about the staff to her dentist husband. She only added additional stress to the office atmosphere every time she came around.
Hi! I am a dentist from Toronto!!Really like your video and Totally agree that we need more patient-dentist communication/scenario in dental schools. Glad to connect with you through your channel Dr.!!
Key to atraumatic local anesthetic technique: topical, and anesthetic pathway as you advance.
A full minute with compounded topical + pressure for palatals can really help. I also use an amalgam plugger to create pressure and inject very slowly right beside it. I used to use a vibrating gadget in the past, but it kept breaking down. For pedo I do interdental after letting the first injection set for 5 full minutes.
Awesome video. Should help lots of people!
My anesthetic technique: I never liked shaking people cheeks. Like you said, it just didn't work "in my hands" lol.
What I like to do is dry the snot out of the gingiva and place a good topical covered by a 2X2 gauze to keep saliva from washing it away. I let that sit for 1-2 minutes. I remove the 2X2 and I immediately give the injection, often retracting with the same cotton tipped applicator I used for topical (I stretch tight for local infiltrations as I feel it also helps distract pt). This works well for me. Thanks again!
Thanks so much! That’s a great idea, I’m going to try that.
I have tried to really stretch the tissue with a mirror with mixed results, but I bet the cotton tip applicator would work well.
Seriously I’m going to try this.
I have always used all the tips you mentioned here. I’m a hygienist and learned anesthesia from an oral surgeon years ago who gave the same tips
My dentist definitely does a painless shot--Love him for it❤️🙌🏾 He shakes my cheek area pretty vigorously, and I appreciate his need to give me the most comfortable experience.
Excellent video! When it comes to anesthesia, I like to add a little psychological effect also, especially on patients that may be a bit more nervous, by taking like 30 seconds to explain the cheek shaking and why it will help make it as painless as possible. I feel like this gets them ready and expecting a better experience than they may have had before
I love this idea! I'm going to try it this morning. It makes sense to talk to the patient a little bit first and let them know what to expect.
I’ve been an assistant for 30 years and one thing that I notice is, younger dentist have a hard time extracting teeth. I’ve worked with a few older dentist in my career and they were taught an awesome technique of elevating teeth, they never pick up a forceps!
What they do is, they first use the pointed end of a Periosteal Elevator, they push on the tooth rounded en, pushing mesial to distallyand the purpose is to make it bleed as much as possible, have the gently close on a couple of 4x4 gauze. Then he would go check a pt in Hygiene, come back and use short Luxater elevator’s, and the teeth come out so smoothly! Like butter! The blood does the work for you, breaks the periodontal ligament, detaches itself from the bone every time!
It’s amazing, utilize your time and go check hygiene patients, come back and they practically jump out of the mouth! Good luck!
Thank you again for being so real with us!
Thanks so much Jack!! Dentistry is a good job, I think staying well-rounded helps a lot. I think you will really like the profession!
Spot on! Well said Dr. Adam
Julius thanks so much for checking out the video!!
I'm a DA at a clinical rotation site and one thing I find myself bringing up with preceptors is how students can tend to rush anesthetic administration when it can very often be a rate limiting step of the procedure. They may save time up front but almost always end up having to stop to administer more anesthetic periodically, which can really dissolve the patient's trust. Taking the time to not only administer slowly but thoroughly assess anesthesia before picking up the handpiece seems to ensure smooth sailing for patients and providers for the rest of the procedure.
I think you are 100% right about that. I have definitely slowed way down with anesthesia delivery from the way we did it in school!
Really nailed it on the last one, great stuff!
Thanks so much Nima!
Great topic. I agree 100%. Dentistry can be very stressful and it is our human nature to want to put our best foot forward and make it seem to everyone else that we don't have problems or stresses - or we downplay the extent of our problems and stresses. It's important to be honest with yourself and be vulnerable and open with people who can help.
Charles thanks so much for the insight, I agree completely. Part of the reason I started this channel was to be as “real” as possible about the profession especially for new grads and students and hopefully be some small voice of encouragement. Thanks again for the comment!!
@@BeyondDentistry I'm a year out from UDM and I've enjoyed your content. Keep it up!
Doc, I think you have excellent communication skills. This edition of your video log was absolutely on target and completely accurate. If you were located in Delray Beach, Florida I would choose you as my dentist. Alan Marshall ( Pharnacist retired)....
Alan thank you so much, that really means a lot!!
Thanks for the great video & frank discussion of stress. During the third year of dental school (GPA 2.05), I came down with fulminating ulcerative colitis & ended up with a permanent ileostomy. It took me 2 years to recover from the surgery. I wish I had never, ever pursued STEM, especially health science. Dentistry has ruined my health forever and I really resent it. Dental school was a trial by ordeal that I could not endure. I wanted to make a difference in peoples’ dental health, but not at the expense of my own health.
Undaunted by sunk costs, I changed majors & went on to happily earn an MBA (GPA 3.42). I went from making “Ds” to making “As.” Vindication! No Imposter Syndrome. I wasn’t a “D” student after all. The support for students was tremendous at UT Austin, both from the university and from Fortune 500 companies.
This support and encouragement was unmatched by the quagmire I faced at UT San Antonio dental school. Several times I had to answer to a professor why I had missed a lecture or a clinical appointment. I had appointments with my gastroenterologist who sometimes admitted me to hospital for IV treatments. Only my fellow students cared and offered support.
How long ago was this? 😖
@@coolpopular4life 40 years ago. I don’t think things have changed for the better.
Oh my God .going into dental career jas ruined my health as well
Great tips Doc especially the slow shot with the sharp new needle...it not only makes the patient feel better but me too! 2nd great tip: shut up and listen to get to know your patient...people are individuals just as we are all unique. Finally ..awesome ; sleep ,eat right and exercise:-)
Yes for sure!! Eating right, sleeping and exercising are so important!
@@BeyondDentistry share what works for me and I been at it a few decades. Great advice. I enjoy your insight
Loma Linda dental emphasize so much on painless anesthesia
i love this guy
Thank you for the great content! I would love to know how your new patient appointments look like and how do you work on developing that rapport.
I have worked in offices where the dentist would block out 15-20 minutes just to have an eye-to-eye conversation with the patient and get to know them and EVERYTHING related to their dental experiences before carrying on to the comp. exam.
Other offices paid no mind to making the time to do such a thing and the new patient appointment was mainly a cleaning / screening and a comp exam, trying to get nuggets from the patient while laying down.
I would like to know what have you found more effective and efficient in the long run, through your experience within that broad spectrum.
That's something I continue to struggle with. Most kids (like 20 and under) would go through hygiene.
I have done it where a patient would be booked with me (most assistant time) for about 90 min for photos, xrays, perio charting, etc. then we would reschedule for the prophy and tx plan consult. If you have big treatment plan, that is definitely the way to do it. But so many patients just want their teeth cleaned, esp if they are coming from another office. A lot of times, with those patients I will do a hygiene appointment, and if they need more we can do a separate consult appointment.
To answer your question honestly, most of my new patients have exam and prophy at the same time because we are slammed. But I think there is a lot of value to doing the "exam only" appointment, esp. if you are trying to explain perio. I may go back to that.
You lifted up a very important topic about burnouts. May be you can give some reccomendations how to manage yourself before the work? Because some dentists are experiencing some kind of phobia and have panic attacks😬
This is one of the most important topics in dentistry, what a great idea for a video!
@@BeyondDentistry 😉will be waiting for it
Try the “Wand” - have used it for years & it’s a combination of all the things you say in your excellent video. I have patients I’ve being seeing for over twenty years who travel miles to see me simply because I can give a painless injection with this wonderful piece of kit!
That’s great, I will have to look into it, thanks!!
Do they use conventional needles, or do you have to buy separate ones?
@@traceymurphy4804 I have 2 of them. You must use their needles, as they come with tubing that attaches to it as well. I don't use it on every patient, but when it is needed? It is invaluable.
@@DrM1107 I used to use the Stabident in those situations, but they don't make it any more. I do use the x-tip, but rarely
Thank you for being so transparent. As a dental student, I'm so scared to graduate, haha. dental school was so so difficult for me.. I was hoping I'd be less stressful as a dentist, but nah, lol.
also,
Are you able to share techniques/tips on painless injections that you heard from others and it worked for them? Thank you for your own personal tips!
Loving your channel! Learning a lot.
Thanks so much! That really means a lot, and is exactly what I started this channel!!
If you are graduating from dental school, then you have what it takes to be an excellent dentist. Try to get better every single day, and when something doesn’t go right, just learn from it and don’t take it personally.
Staying well rounded with faith/family/friends/health can make transition into work a lot easier, at least it did for me.
I will plan an anesthesia video at some point, that’s a really great idea!
Nice video Doc. I would say along with painless anesthesia in hygiene school they didn't go over doing anesthesia with children other than the max carps you can deliver
I’ve learned that once a kid has it in their head you are not giving them a shot, it’s best to refer LOL. So thankful to have pediatric dentists!
Great video
Thank you!
How to properly work with Dentures from bite to finish. At least on the RDA/DA side of Dental, I've been blessed with the opportunity to learn from a very seasoned and crafty RDA vet at my office.
This is a great idea! I will see if I can convince my lab tech to collaborate.
The injection for the anesthesia didn't bother me much only got me nervous but I really get scared now to the point where I didn't go to a dentist for a few years b/c the last time I went, the anesthesia didn't work on my gums but instead half my face and eye got numb. I couldn't blink or feel anything. The worst part, they didn't cover my eyes to protect it from the environment. They just send me home and told me to cover my eye with my hand. Never again I went back to them. Also, they were giving people root canals without needing it, a few, all in one day. I asked for a second opinion and the chief dentist told me I didn't need one for my front teeth. I don't trust dentist. I have problems with my teeth and they don't want to fix it b/c of insurance not paying. They won't even discuss the problems or how to fix it if I wanted to pay out of pocket. They just dismiss me to get another appointment for a regular check up.
Thanks for the insight as always! So I have a question about switching sides during a procedure. Do you usually stay on one side of the patient during the whole procedure, or do you sometimes switch sides to get better access?
Ergonomics has always been a challenge for me, I know I need to get better at positioning.
I'm right handed and do everything from 9:00 (the patient's right shoulder) to 12:00 (behind the patient's head). I do have people turn their head a lot. So for a #30 crown prep, I will have them turn away from me for the buccal, occlusal and interproximals, then way toward me for the lingual.
Seriously, I need to get better at ergonomics. If you know any general dentists that use a microscope for restorative, those docs are wizards with patient positioning and ergonomics.
I’m actually planing on going to dental school in a couple years after I go to college. But i can’t wait I’m so exited! Dentistry makes me so happy and exited! I’m learning so much I’m researching watching videos and planing! Anyone have any tips on like majors and minors. And goals and dat’s? Thank you so much this video was very helpful and just continues to help me make me love my dream job interested in the future! Also I have had many bad traumatic experiences when I was younger so I want to become a dentist so no one has to go through that 😊 I don’t want anyone to have to experience I had to go through. Thank you again!
That’s great, good luck!! As far as major/minor, most people do some kind of biology or chemistry, just because all the prerequisites for dental school will put you close to that degree. Looking back I might have picked something I was more interested in, like computer science. As long as you get your prerequisites done, and get pretty good grades, you should be pretty competitive for dental school.
Beyond Dentistry thank you so so much I can’t wait to start my journey to becoming a dentist 😊☺️
@@LS-cx5dg Are you in dental school now? I ask bc, as a dentist of over 22years, I wouldn't recommend this profession to either of my daughters, and the vast majority of dentists (that I know) feel the same way. The high cost of admission, coupled with insurance companies continuing to purposely be problematic......and dentistry is spiraling in a downwards direction, and i don't see that getting better anytime soon.
I was taught how to make the shot painless. I was taught to warm it b4 use ad it’s less painful. We did a tiny bit of caring 4 ppl and ppl‘s expections. Sorry I can’t spell.
Bad school...bad bad bad! Painless injections were paramount at Loma Linda. Use Citainest P. Slow. 99% of my pts feel nothing, don’t need topical. New needles are super important, use high quality double beveled BD needles. Dental school certainly doesn’t prepare you for real practice. I say it again and again, do as little of this job as you can get away with. It’s really bad for you for all the reasons you specified.... good stuff.
Nice! I use the same thing - citanest (prilocaine) with septodont evolution needles. For the block, I usually follow it with lidocaine, and on the upper I usually just go straight to septocaine.
Thanks for the feedback!
Worst thing to do is to claim painlessness, everything is relative to expectations, by claiming a no pain technique you are in a loose loose situation. Promise to be gentle, compassionate and that you would use every trick in the book to try to make the experience as comfortable as possible and the patient would be very greatful even if they feel a bit.
Your hints are very good, changing needles and injecting slowly is critical.
Agree 100% Every time I have said "you won't feel this", I have gotten burned!
Thanks for making great content! Greeting from Serbia. Do you recommend any online CE courses for prosthodontics besides the Dawson academy?
One of my favorite online classes is "Fundamentals of Fixed Prosthodontics" with Dr. Lane Ochi on Dentaltown. It honestly has changed the way I practice. It's more single unit crown and 3 unit bridge though, not full mouth. I am personally looking for some good online CE in dentures.
Thanks for saying hi from Serbia, that is awesome!!
@@BeyondDentistry Thanks, I am a long time lurker on dental town, so I know for that one. Will do it next week for sure. There is one course on Dawson academy about dentures, you can check it out with free trial! If you are interested in Implants ITI- International team for implantology has a lot of great videos with a yearly subscription. Let me know if you find a good course on dentures!
@@Alexa1995ns Thanks for the info!!
Suggestion for infiltration: place the gel, rinse, then administer a just few drops and have the patient rinse. Proceed to pumice the tooth/teeth you are working on, rinse then administer the rest of the anesthesia. Patients will always say, "WOW, I didn't feel a thing!!"...lolol...... For a block - for a nervous patient or child - I will tell the patient I am going to count to 20 and then it will be time to rinse. I count out loud to 20 while administering the block, and many times patients start counting with me with their mouths wide open....lolol....I tell the kids I need for them to freeze with their mouth wide open like a lion so we can be done by be 20 & it will be time to rinse....If they wiggle, I will have to count to 25 or 30, so freeze for me and I only have to count to 20 & then we rinse...lolol...It works every time. 😅 The next time the child patient comes in, they will ask "Are we counting to 20 today & do I have to open like a lion?" 😂😂😂
I'm always a bit worried about the stress on the necks in dentistry. The dentists literally bend their neck 8 hours a day. Does it give you neck pain?
Dentistry can definitely be hard on your back, but there are some things you can do to make it better. Loupes help a lot because they can help you sit upright, especially the new ergonomic loupe designs.
Making sure to stay physically active helps a lot too, so your back muscles don’t get “stuck” in the working position.
I honestly don’t think dentistry is any worse than sitting at a desk hunched over a keyboard, as long as you try to have good posture.
Topical, topical, topical. For infiltration, we use a compounded 'super topical' for at least 2 minutes on the dried tissues. I always use a fresh needle on unanesthatised areas and I use a plain anesthetic (0.25 cc) to start as buffered anesthetic systems haven't come to Canada yet. These are what I've found make a difference.
Want to know why medical practice in the US tends to suck? Schools.
Do you have any tips on making anterior infiltration painless??
I started using x-short needles, and I feel like I have better control. I also try to really stretch out the tissue and that seems to help. But you are right, sometimes those upper infiltrations are really hard to make painless!
You can try injecting a little bit of anesthetic right after you get needle into tissue until you see a little bolus, wait at least 5 seconds before advancing the needle to the bone. I think that it helps, but just my experience.
@@BeyondDentistry Yes, you can do everything right with the topical, and some people's tissue is way more sensitive and it's gonna hurt is what I've noticed. Sometimes not much you can do, just go slower if you notice any wincing, tease the lip or cheek like he was saying in the video.
u dam are right
Prilocaine plain, then septo. YOUR WELCOME.
If you want them to absolutely "not feel" the shot, this is a great way to do it, plus they will be super numb. I personally don't block with septo, but a lot of people do and that's fine with me. I had one parasthesia (with lido of all things) that took a while to resolve, so anything I can do to avoid that, I will do!
@@BeyondDentistry I’ve blocked 99% with Speto going on 10 years. Paresthesia is mostly an issue of the needle, not the juice in your syringe. Don’t move the needle around after you inject the tissue. Straight to your target - whatever speed you want, placing a few drops before you advance - no changing positing whilst the needle has already entered the jaw.
D2, Stab lab is a week from now and I am scared of needles. I even punched a doc when I was younger. I'll make sure to tell my partner to jiggle my face like mad.
I hate needles! No joke, I started worrying about stab lab when I was in undergrad. When we finally did shots on each other in dental school, it really wasn't that bad. Hopefully you get a good partner!