3 Things They Do NOT Teach in Dental School - But They Should

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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[RG-hfet]

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.

[jakerdson]

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!

[matthewguralsky]

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.

[shannak]

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!

[n.m.]

Start with warmed 4% Citanest Plain with short 30 gauge needle and then follow-up with lido/articaine. Painless anesthesia. Warming the citanest plain and 30 gauge makes a huge difference.

[traceymurphy]

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.

[h.seanhsu]

Key to atraumatic local anesthetic technique: topical, and anesthetic pathway as you advance.

[jackhansmiles]

Thank you again for being so real with us!

[golfertex]

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.

[spunkypoop]

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

[kindofswedefish]

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.

[chelseymichelle]

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.

[nimakhosraviani]

Really nailed it on the last one, great stuff!

[mrapp]

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

[dvp]

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.!!

[michaelhuntley]

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!

[skdavidnba]

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.

[alanmarshall]

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)....

[twothbeave]

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.

[anitamasaitis]

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:-)