The Biggest Surprises After Dental School by Drs. Brad Guyton and Hope Marshall

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Dentaltown Magazine

Diastema closure made simple

by Drs. Hope Marshall and Brad Guyton

Starting out as a dentist is a life-changing event—and will be one of life’s major stressors. Building clinical skills and patient communication skills is a primary focus for gaining competence and confidence as a new-graduate dentist, but what are some of the things you may not anticipate? These two dentists, who graduated 20 years apart, have agreed that the surprises that happen the first six months out of school haven’t changed all that much over the years. Below are the top 10 surprises new-graduate dentists may encounter, along with some simple tips on how to overcome them.

Patients say, “You look too young to be my dentist.”
Dr. Hope Marshall: “I’ve had a lot of patients make comments that they were old enough to be my parent. As a new-graduate dentist, it often made me more nervous. I learned to just laugh it off and say, ‘Why, thank you!’ ”

It can easily catch you off guard when patients comment about your age or ask, “How long have you been practicing?” You should always be confident in your response; while you should never lie to patients, you can include your clinical experience in dental school and say, “I’ve been seeing patients for two years.” Always help them know they are in good and capable hands.

Dressing more professionally helps give you a better chance of being taken seriously by patients. Leave the scrubs and jeans at home and commit to the white coat.

I'm hungry.
It’s something you may not think about, but it can be very challenging to eat and drink during busy days in the patient-centric practice.

HM: “I found myself so focused on patient care that I was not drinking enough water throughout the day, and getting dehydrated. I started keeping a large water bottle that stays cold throughout the day at the same computer I use to look at patient radiographs. I constantly drink water while I’m looking at radiographs to ensure that I’m staying hydrated.”

It’s important to keep yourself fueled and well hydrated, so take the time to plan meals in advance. Have snacks that are easy to eat throughout the day and keep a water bottle full and chilled. Avoid carbohydrates and sugars to prevent quick spikes in blood sugar.

Starting out is really expensive.
The dental license costs up to $500, depending on the state, plus any fees for sending transcripts. The process can be started once you have your transcript showing that your degree is “conferred.”

HM: “I found that it was helpful to get everything together for the application in advance. As soon as my degree was conferred, I was able to submit my application to get ahead of the rush.”

You must also apply for a registration number with the U.S. Drug Enforcement Administration (DEA), which lasts three years and costs $700–$800, and obtain a National Provider Identifier (NPI) number, which can be done for free on the National Plan & Provider Enumeration System website. Lastly, signing up to become a provider with dental insurance networks can be the most time-consuming of all, because it often takes three to four months.

Down payments on new housing, insurance and student loan payments will start to kick in. Be intentional about finding a job that’s a good fit and enlist the help of a lawyer or trusted professional to review the employment agreement. It’s also helpful to have a backup plan if things don’t go as expected. And remember to double-check your paystubs to make certain taxes and fees are being withheld properly. Start saving for retirement on day one by setting aside something from every paycheck and grow your contribution when you can afford it.

I want mentorship and don’t know where to find it.
Mentors are critical in helping you build confidence and bridge the gap between what you did in school and real-world dentistry. Be hungry and humble. Find multiple mentors and set expectations of what defines success with them. Having people to bounce ideas off or to help confirm your treatment plan/diagnosis in the beginning is really helpful.

Dr. Brad Guyton: “I found that it’s best to shoot for 100 hours of mentorship and continuing education each year. For complex treatment plans and rare cases, it’s always helpful to have a second opinion. Be quick to recognize that it is your job to make mentoring easy for the mentor.”

There’s no Tinder to match dentists.
Finding a great dentist to work with is as tough as finding a great personal relationship. Ask to shadow the practice and glove up to assist the doctor if possible. Ask other associates and team members about their experiences in the practice. This helps give us a much broader perspective of the practice environment.

When interviewing and committing to jobs, be honest about your career goals. Dentistry is a small world and you want to maintain a solid reputation. In addition, you should be interviewing the employer to evaluate the fit just as much as they are interviewing you.

BG: “When a candidate says that they don’t have any questions at the end of the interview, most interviewers will assume that they did not prepare or are not truly interested in the opportunity. Always come to the interview with at least 10 solid questions. Ask questions about the clinical culture of the practice and guidelines on treatment planning, case selection, and who does the treatment on which cases.”

It’s hard to get patients to say “yes.”
BG: “This is going to sound very different from what you’ve learned in dental school, but you need to meet patients where they’re at. If they leave the office without saying yes to something, you’ve wasted their time. People come to dental offices not because they want a friend, but because they either need or want something.”

Figure out a way to give it to them! Address their chief condition that day, if possible, and let them know, “I’m concerned about some other things in your mouth, and once we take care of this, I’d like to ask your permission to speak with you further about those conditions.”

When patients have big treatment plans, it can be overwhelming—especially when they didn’t think anything was wrong in the first place. Whenever possible, customize the order of treatment plans to meet the patients’ needs and wants. Avoid stereotyping patients based on what you think they can afford. Offer them the best treatment, offer them a way to pay for it, and let the finance team take over. Then focus on exceeding their expectations.

It takes practice talking with patients in a way that helps them really understand and value their treatment. Listen to their concerns; acknowledge their feelings about their condition and reservations about treatment. Listening builds trust. Help them understand how good oral health can prevent pain, discomfort, more costly dental work and problems chewing. This will keep them smiling over their lifetime.

The team expects us to be leaders!
BG: “Be ready for the challenges and joys of leading a team. Healthy teams thrive on clarity of expectations, fairness and recognition. Recognition, not incentives, breeds loyalty.”

While you don’t need to be friends with everyone on the team, you do need to be friendly. Develop a system of communication and be consistent. Develop and set expectations with team members, and always praise in public and critique in private. Leaders lead by example and are a source of positive energy.

The days of the four-hour crown prep are over.
HM: “Real-world practice scheduling is very different from dental school. I found it helpful to wear a watch to time myself in various situations and track my progress.”

You should shadow the practice owner every time one of your patients cancels, until you can complete the procedure just as well and as fast as they can.

Master the art of juggling.
It’s challenging to see multiple patients at once. Time management is critical, and the flow takes practice.

BG: “Encourage the office manager to orchestrate the day on her feet. It’s important to know our limits and set expectations for patients and procedure times, so that we can deliver on what we say.”

HM: “As a new-graduate dentist, it was difficult to estimate how long a procedure would take. I found it was best to make my best guess and add a little extra time to ensure that the patient’s expectations would be met.”

Empower great dental assistants to direct you through the day, so you’re not too focused on where to go next or worried about how long a patient is waiting.

Debt is not sexy.
Managing student debt is a big concern for most graduating dentists. Take advantage of services offered by the school and do exit counseling.

HM: “I found it was easiest to take care of everything online. You can see who’s servicing your loan on, apply for the desired type of repayment and update your contact information to ensure that the bills go to the right place.”

Set a budget that factors in the monthly payments and consider seeking help from a financial planner. Regardless of your debt load, you should start saving for retirement as soon as you receive your first paycheck.

BG: “The best way to pay off loans is always to outwork and outearn your colleagues. Continue to live like a student for the first 3–4 years out of school and watch the debt level start to disappear.”

Embarking on your career should be an exciting challenge, not a stressful one. By understanding these 10 surprises, you can take intentional steps to prepare and set yourself up for success as a new dentist.

Author Bio
Author Hope Marshall, DMD, is a 2017 graduate of Nova Southeastern University College of Dental Medicine. She is currently an owner dentist at Woodstock Dentistry, a Pacific Dental Services-supported practice in Atlanta. Marshall won the Eleanor J. Bushee Memorial Award and is a member of the American Dental Association, American Association of Women Dentists and Georgia Dental Association.
Author Brad Guyton, DDS, MBA, MPH, has been practicing dentistry for over 20 years. He serves as dean of the PDS University–Institute of Dentistry and vice president of clinician development for Pacific Dental Services. Guyton is an associate professor at the University of Colorado School of Dental Medicine and practices dentistry in Colorado.
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