Posted on 30th January 2020
It’s true that the landscape of dentistry has altered almost beyond recognition. The influence of third parties such as private health funds and corporate ownership has crept in, along with new techniques, technology and materials. At its heart, though, this profession offers the same opportunities to our newest dentists as it does to our most experienced – the chance to help people.
It was heartening to hear this when ADAWA sat down with a group of dentists on a warm day in December. From experienced dentists, Drs Bernadette Pilkington, Max Trott and Owen Ferguson, to our new dental graduates, Drs Lyndon Abbott, Ellie Knight, Emily Grant and Emrik Graff, the reasons for becoming a dentist were strikingly similar. It’s this, Max says, that our younger dentists should keep at the forefront of their minds when beginning their careers.
“Times have certainly changed, but basic concepts haven’t,” Max told us. “We like to call ourselves professional people. But what is it that makes us a professional person compared to a car salesman, or anyone else?
“The answer, and my key point to make, is that people come and pay for your advice and you give treatment based on what is in their best interests.
“Young dentists are going to be faced with a lot more pressure to do what is going to make you more money, or to make the practice you are working for more money, but the key message is to be a professional person and don’t lose sight of why you became a dentist in the first place.”
For Emily, it was her experience as a dental assistant that spurred her on to study dentistry. Emrik says his choice of career can be attributed to the orthodontic work that made a huge difference to his life as a teenager.
“I wanted to do something that would help people,” Ellie explains. “I don’t come from a medical family, but my dentist was a big role model for me. She was someone that I really looked up to while I was growing up.”
“I really liked how dentistry combined science and art,” Lyndon adds. “As a creative person, I wanted to have a mix of the two. There is also a real reward to a dentists’ work – at the end of the day you are doing something to make a patient better.”
Nodding in agreement, Max continues: “For me, the most exciting part of dentistry is the people and the interaction with the patients. If you look after your patients, they will look after you and respect you – for me, that is a great reward.”
“If the patient walked in the door and walked out better, it was just fantastic,” Owen says, recalling his long and rewarding career in dentistry. “People are the most important thing.”
As a 17-year-old, Bernadette originally leant towards a career in medicine, but shifted to dentistry after working in an aged-care facility. “People kept dying, and I didn’t like that,” she laughs. “I changed to dentistry and I don’t regret that at all because no one has died on me!
“It was also the art and science aspect,” she continues. “The combination of those two things was appealing. And I still really enjoy the work and the people.”
Arguably the biggest change to the profession in recent years has been the influence of third parties on dental practice. “When we graduated, there was no practice manager telling us how many patients we had to see each hour,” Owen says. “We didn’t have to worry about health funds telling us what to do.”
Despite the pressure to be efficient and economical, our new dentists should still take their time, advises Owen.
“It’s very important to do things properly, not quickly. If you learn how to do things correctly, you can always speed up with practice. If you do something fast, you can pick up bad habits and you can’t always break bad habits.”
“Do it right for however long it takes,” Max advises.
Having said that, our older dentists also stress the importance of running on time, and not being pressured to fit in too many appointments.
“If you need an hour to do an exam, take an hour,” Bernadette urges. “Try and run on time – your patients’ time is just as important as yours.”
“During dental school you get the reassurance of having a tutor over your shoulder, making sure you are on the right track,” Lyndon asks. “How do you get that reassurance once you’ve graduated?”
In response, Bernadette suggests seeking mentorship. “You have to be careful who you work for,” she says. “You want to work for someone who will mentor you and nurture you.”
“If you are working with someone more experienced, ask them,” Max adds. “Don’t think that you know it all.”
“Don’t be over-confident,” Bernadette agrees. “I worked with someone who thought everything could be fixed, but it can’t.”
“You have a professional responsibility to do the best by your patient,” Owen says. “Your patient is the most important person in the room. It’s not you, it’s not your asssistant, it is your patient. If ever I was wondering what to do, I’d stop and think: ‘Would I do this to my mother?’ If the answer is no, you don’t do it.
“Always try to visualise where you want to end up,” he continues. “Sometimes I just couldn’t see it, so I would refer. Do not try to do everything. You are the gatekeeper for your patient. If you don’t think you can do it properly, then you shouldn’t be doing it.”
“Listen to your patients,” Bernadette says. “If they tell you what’s wrong, listen to them and address whatever it is that they have come in about. If you can see there is something on the lower left, but the lower right is what is bothering them, you need to address the lower right first. Listen to what your patient needs but don’t go beyond your scope of practice.”
“Keep to the KISS principle – keep it simple, stupid – by being honest,” Owen adds. “But by being honest, don’t say, ‘Oops, I’ve mucked up here.’
“Say, ‘This hasn’t gone according to how I planned, so this is how we are going to fix it.’ Or say, ‘I don’t feel confident enough to do this, so I am going to refer you to someone else.’ Tell the patient that is in their best interests to refer them to someone with more knowledge than you have. Explain, be honest, do not tell lies.”
Max, Bernadette and Owen are all too familiar with burn-out. They understand the temptation to run headlong into a new dentistry career, urging our new dentists to slow down and enjoy the ride.
“Don’t work too hard,” Owen advises. “When I first graduated, I was working 60-70 hours a week. I can remember putting my eldest child to bed on a Sunday night and not seeing him again until Thursday night.
“I did this until a colleague dropped dead from a heart attack at 41. After this, I cut back to working 35 hours a week, with eight weeks’ holiday a year. We even took the family around the world for three months.
“What I’m getting at it here is that it is important to have a work-life balance. Remember that dentistry can be stressful.
“When you are working, you have a patient in your lap, a nurse coming over your shoulder and a hot light coming down on top of your head. It’s very intense.”
At the start of a career, in your early 20s and with no huge financial commitments, insurance can seem like an unnecessary expenditure. Don’t underestimate its importance, our older dentists urge.
“You need insurance that covers you for both loss of income and permanent disability,” Owen stresses, citing his own experience. In August 2008 and only in his mid-50s, he experienced loss of fine control and function in his right hand. This worsened and didn’t respond to treatment, leading to a diagnosis of a permanent disability. In December 2009, Owen was forced to retire and sell his practice. After six months’ negotiations, his insurance company agreed his claim justified for permanent disability, which saw him receiving monthly benefits until February 2018.
“Make sure you are well and truly insured, especially if you are the sole income earner for your family,” Owen says. “You never know what might happen. It seems strange at your age, but things can happen.”
The years of intensive study may be over for our new dentists, but the learning journey should continue for the duration of a dentists’ career, according to Max.
“Further education is very important. From the day you graduate to the day that you retire, you should always be learning. You have only just started, and you are going to learn a lot more.”