As I get older, I have new dentists asking for my “wisdom” on practice growth and professional happiness. I would have never imagined as I was stumbling through dental school that I would be asked to share my insights. Luckily, I have had the benefit of many amazing mentors throughout my career, and I believe that has been a key to my success. So first and foremost, surround yourself with excellence. The greatest dentists in the world are always willing to share and guide. You still must do the work, but they will happily share.
As you continue your journey, here are the top ten tips for new dentists that I believe will get your career and your practice on the right path.
1. Learn Interdisciplinary Treatment Planning
In 1995, I saw Frank Spear discuss Facially Generated Treatment Planning (FGTP) for the first time. After that lecture, I spent the next few years focusing on learning the technique, building a team, and creating an office environment to support my vision. If your vision is to have a restorative dental practice that provides for professionally challenging and personally fulfilling dental cases, you must learn interdisciplinary treatment planning at an extremely high level. There is nothing in dentistry that will set you apart from your peers more than this.
Key Tip: It takes a few years to fully realize the potential of improved case planning. When things are slow because we are sending cases for surgery and orthodontics, you must continue to prime the pump with your specialists. The cases will begin to return, and you will have a constant flow after that. Be patient. Be consistent.
2. Commit To High Quality Photography
Make a commitment to high quality photography of your examinations and treatment. FGTP cannot be done without photographs. Effective lab communication cannot be done without quality photographs. Building referrals is hampered without images. Promoting yourself to colleagues and the community is more impactful with quality photos.
Key Tip: Make sure to also create a cataloging system that allows you to quickly find case examples for future patient consults (i.e., key words like veneers, dark teeth, and microdont).
3. Give Painless Injections
If a patient in your office is asked for a recommendation on what dentist to see, painless is a great selling point. From a patient's perspective, quality dentistry is extremely difficult to comprehend. How good of an injection you give is something that is absolutely discussed. There are several techniques, machines, and buffering options on the market that can help to make this a better experience.
Key Tip: For the last 20 years, I only use 28-gauge needles and I always used 4% Citanest Plain as my first carpule. It is then followed by an anesthetic with epinephrine. Citanest Plain has a neutral pH so there is little to no sting. Once the area is numb, the lower pH carpule will not be felt. Rather than having to manage buffered anesthetic daily, Citanest Plain is always ready.
4. Electric Handpieces
I purchased my first electric handpiece in 1997. I was worried about the weight and cost. The additional torque and reduced maintenance made me a convert very quickly. At that time, my practice was a family dental office that I envisioned as more of a “prosthodontic” practice. The more comprehensive care I provided, the greater the benefit of electric handpieces. I can cut off old crowns easier, remove tooth structure more efficiently, and provide my lab with smoother finish lines. I also found a reduction in repair cost.
Key Tip: Currently I am using the Forza ELXT from Brassler.
5. Join a Study Club
Since leaving my residency, I have always been associated with a study club. Routinely, I was in more than one. While some of the clubs were composed of just restorative dentists, I have found that the most valuable clubs are interdisciplinary. I love to listen to other specialists describe what they are seeing with cases. We all see the world differently and we are better when our vision broadens.
I helped run a Spear study club for a few years. We named it Meritage. That is a term that refers to a blended wine. Our club was a blend of all types of ages and practices with a common vision of comprehensive care.
Key Tip: The Spear videos provided the opportunity to share knowledge around a common case that I find most important and fulfilling.
6. Crown in 1 Hour
When I purchased my practice, the selling doctor was an amazing mentor. He collaborated with me on running a business, case presentations, and techniques that were new to me like orthodontics. One important thing he taught me was that if a patient comes in with a broken tooth requiring a crown, you never smooth the edges or pack it with a provisional material. You always prepare the tooth. His logic was that if you fix the emergency, they may never return or when they do the tooth will be in worse shape. To make this happen during a busy day, he said you must learn to complete the entire appointment in less than 1 hour. If you can do that, then you can wedge the crown into your day. That piece of advice is now 30 years old, and I still find myself monitoring my time to make sure I am being as efficient as possible.
7. Enjoy Your Time Off
I cannot remember a story, although I am sure it exists, where a dentist decided to cut time from their schedule only to later turn around and add it back because it was financially crippling. We seem to think that if our office does not provide services at convenient hours for our patients that they will not come.
Looking back, I should have given time away from the office more value. During my four years in prosthodontic residency, I went from four days a week to two days. My schedule had to be optimized to take advantage of the time I was available. Over those four years, my production almost doubled.
Key Tip: Work your office smarter and take time to breathe.
8. Cut Off Crowns with Depth Cut Diamonds
I use a KS1 for initial depth cuts. It is a parallel sided, round ended, 1.2 mm diameter diamond. I use a disposable version of this bur to keep costs down. I use the exact same bur, in my electric handpiece, to cut off old crowns, including zirconia. I have chosen to do this because diamonds cause less chatter on teeth than bur designed for crown removal. Therefore, crown removal is more comfortable for the patient.
Additionally, by using the same bur I use for depth reduction, if I get through the crown before reaching the depth of the bur, I push father into the tooth to ensure that my crown preparation has adequate depth.
9. Participate in Inspiring Continuing Education
Set aside the time and money to participate in the best continuing education such as Spear Summit. Spear does an incredible job of bringing together speakers from around the world to inform and inspire you. My career path was set when I was at a meeting just like Summit in 1995. A speaker was creating dentistry that was beyond my ability at the time. I immediately contacted him and made it my goal to be able to match his excellence.
10. Design Your Office to Tell Your Story
With your future goals in mind, walk in your office with the eyes of a patient and take the journey. Take it all in: the parking lot, signage, building, music, smells, cleanliness, design, staff attire, and art, etc. Now, describe your practice vision to the staff and have them make the same walk. Compare notes and see what warrants change. As your vision matures, your office needs to grow with it.
I hope that these tips for new dentists will be helpful in your journey. As I mentioned at the beginning, great people made it possible for me to be successful. They are all around you. If you show them your passion, they will guide you too. Good luck!
Jeffrey Rouse, D.D.S., is a member of Spear Resident Faculty.