A miserable dental student

[AnneSoul]

Hello there
It might not be my first thread related to this topic but, I am really depressed in this year especially, D4
1)I overthink a lot and make many scenarios about how my upcoming clinics might go
2) my hand skills are not well developed yet, I still have problems with indirect vision and keep telling
myself that I am inadequate
3) I am really slow even with the simplest procedures, I always fear of doing something wrong and most of my clinics do not end well
4) always think I will not be a good dentist because I don not feel I am improving

Please, help me with your advice!

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[keep2camel]

Listen, this year took a toll on everyone. I can think of MANY people that are in your position. Luckily for us students, the schools need to crank out upcoming students, and they cant keep every D4 in the clinic. As with everything in life, it will take time to be good in something-and dentistry is no different. With every crown prep, or resto you WILL get better, quicker and more efficient, its just a matter of time.
And if you feel really behind, an AEGD or GPR will be a perfect fit, and there is no shame in doing that

 

[AnneSoul]

Listen, this year took a toll on everyone. I can think of MANY people that are in your position. Luckily for us students, the schools need to crank out upcoming students, and they cant keep every D4 in the clinic. As with everything in life, it will take time to be good in something-and dentistry is no different. With every crown prep, or resto you WILL get better, quicker and more efficient, its just a matter of time.
And if you feel really behind, an AEGD or GPR will be a perfect fit, and there is no shame in doing that

It is really stressful. Everything has an end even though I cannot imagine when I will be out ‍♀️
Many days I cannot focus at all and just spend the time crying - like today -because of the stress.
Thank you very much

 

[Saddleshoes]

Anne, you are normal!!!
Everybody dislikes D4 year, even the gunners and boot lickers.
Go in every day and give it your best shot. That's all you can do.
IF that's not good enough, that's somebody else's problem not yours!

 

[DrMarioRobles]

Listen, a lot of people play basketball, but not everybody gets to be a Michael Jordan, that doesn’t mean they’re not good basketball players. Same thing goes for dentistry and everything else in life. The more you practice the better you’ll get, try to find something you like it more and you feel you’re good at it and try to specialize on that area. Don’t pay attention to other students who seems to be awesome on everything they do, you will get there. If you don’t have one already try to build a setup at home and practice, try to improve your skills by practicing at home, use YouTube as a tool, there’s plenty of teachers teaching different techniques to achieve the same result, you’re probably gonna find out that some techniques will work better for you. Ditch the mind set that dental school is stressful because is not, dental school is chill, all you have to do is study and try to accomplish every treatment to the best of your knowledge, “most likely” you’re not dealing with barely paying bills and making ends meat, working at a super busy minimum wage job or a super dangerous and physically demanding job. You’re very fortunate to be on your last year of dental school in the U.S. the best paying country for dentists in the WORLD, and anybody here who never had to work else where you don’t know what I’m talking about. So never forget that, be happy, you’re almost done and you’re going to be an awesome dentist, trust me!

 

[schmoob]

It’s rough, man. You have reduced clinic time and half of D3 was reduced as well. You’re not getting your reps in. But don’t stress! Once you graduate and go into private practice you can apply all your knowledge that you’ve attained on your patients. You really will do more dentistry in your 1st month of PP than in 4 years of dental school.

 

[PerioDont]

Hello there
It might not be my first thread related to this topic but, I am really depressed in this year especially, D4
1)I overthink a lot and make many scenarios about how my upcoming clinics might go
2) my hand skills are not well developed yet, I still have problems with indirect vision and keep telling
myself that I am inadequate
3) I am really slow even with the simplest procedures, I always fear of doing something wrong and most of my clinics do not end well what exactly is not ending well? could it be the school's processes and instructors? try to schedule with instructors that you like and are part time private practice or retired. the academic faculty usually make do things very much by the school way which can suck
4) always think I will not be a good dentist because I don not feel I am improving if you have made it to D4, you are improving by definition. all you need to do is get through the next few months and you will be done!

Please, help me with your advice!

I would also suggest making an account on dentaltown.com and asking your clinical questions on there. you can also post your xrays and pictures and ask for feedback on your cases.

Hopefully you have a group of trusted classmates and faculty at your school. sit down with each of them and talk about your issues and how you can improve.

Most people are willing to help you and give advice specific to your situation. Don't worry too much about your clinical skills etc right now as your only objective is to get out of school. consider doing a GPR/AEGD next year to solidify your skill set.

 

[PerioDont]

It’s rough, man. You have reduced clinic time and half of D3 was reduced as well. You’re not getting your reps in. But don’t stress! Once you graduate and go into private practice you can apply all your knowledge that you’ve attained on your patients. You really will do more dentistry in your 1st month week (covid) of PP than in 4 years of dental school.

our school is still at about 25% capacity, and we lost 6 months of clinic time, likely similar in many schools.

 

[AnneSoul]

Thanks a lot everyone!
Today I had 3 clinics after each other with no breaks in between, I remembered your words all, I am here to learn and I am not a specialist and still in my first steps in dentistry
Pray for me to let this year pass quickly and smoothly

Can I ask you if it is normal to struggle with some basics, such as, today I was opening an access cavity and when the supervisor came to check, she told me that there is still some caries that I missed and I honestly thought, how could a fourth year dental student not distinguish caries from dentine

 

[ronnietee]

If you think you're still gunna struggle upon graduating, consider doing a 1-year GPR program. You'll be guided into doing more complex things, get certified to do other procedures. There's a smaller batch of students in the program, so you'll get more hands-on experience.

 

[AnneSoul]

If you think you're still gunna struggle upon graduating, consider doing a 1-year GPR program. You'll be guided into doing more complex things, get certified to do other procedures. There's a smaller batch of students in the program, so you'll get more hands-on experience.

I read some opinions that these programs are not actually helpful, is this true?

 

[ronnietee]

I read some opinions that these programs are not actually helpful, is this true?

I don't know, maybe it depends on the school/program, but I shadowed the program where I live at UNLV as a pre-dent and I saw some pretty cool stuff. In the one day I shadowed, a couple different residents were doing multiple implants. I vaguely remember asking the resident why he chose UNLV, and he said it's because you get certified to do like sedation dentistry or something like that.

I think they may offer a stipend too. I just looked at UNLV's and they have a $49,500 stipend after the 1-year. (here's the link: General Practice Residency | Academics | University of Nevada, Las Vegas)

 

[schmoob]

I read some opinions that these programs are not actually helpful, is this true?

There are some GOOD programs out there and some not so good. The good ones will provide you with surgical experience, molar endo, Perio surgery, complex restorative, etc. It will provide you with confidence to tackle tougher cases.

 

[PerioDont]

Thanks a lot everyone!
Today I had 3 clinics after each other with no breaks in between, I remembered your words all, I am here to learn and I am not a specialist and still in my first steps in dentistry
Pray for me to let this year pass quickly and smoothly

Can I ask you if it is normal to struggle with some basics, such as, today I was opening an access cavity and when the supervisor came to check, she told me that there is still some caries that I missed and I honestly thought, how could a fourth year dental student not distinguish caries from dentine

at my dental school many graduate only having done 1-2 RCTs. Sometimes if there is no RCT cases, they make us do it on an extracted tooth on a typodont - really poor endo experience. This is a US school btw.

You can just use caries detector dye to see where the decay is, this is really not a huge deal. Since we do so few endos, many of my D4 classmates accidentally perf the tooth and make it non-restorable, this is WAY worse than leaving some decay and happens frequently. I would not worry at all about this specific instance

 

[TanMan]

Hello there
It might not be my first thread related to this topic but, I am really depressed in this year especially, D4
1)I overthink a lot and make many scenarios about how my upcoming clinics might go
2) my hand skills are not well developed yet, I still have problems with indirect vision and keep telling
myself that I am inadequate
3) I am really slow even with the simplest procedures, I always fear of doing something wrong and most of my clinics do not end well
4) always think I will not be a good dentist because I don not feel I am improving

Please, help me with your advice!

1. You need to replay these scenarios in your mind so much that it becomes second nature to adapt to every potential scenario that comes your way. Not run away from them.
2. Handskills take time to develop. Try doing everything via direct vision. The right way to do things is the way that achieve results. If you cannot achieve results using a "recommended" way, then do it your way. You're not inadequate, your work is "clinically acceptable" without even looking at it. If your work in your mind looks like garbage, replace that word with "clinically acceptable".
3. What you mention seems to stem from lack of confidence. You might do something wrong, but the results are probably clinically acceptable.
4. You'll improve once your perception of yourself and your work adapts to clinical reality.

I found that the faculty are a lot more amenable to clinically acceptable work if you demonstrate what's ideal and why you deviated from ideal.

Thanks a lot everyone!
Today I had 3 clinics after each other with no breaks in between, I remembered your words all, I am here to learn and I am not a specialist and still in my first steps in dentistry
Pray for me to let this year pass quickly and smoothly

Can I ask you if it is normal to struggle with some basics, such as, today I was opening an access cavity and when the supervisor came to check, she told me that there is still some caries that I missed and I honestly thought, how could a fourth year dental student not distinguish caries from dentine

Caries, infected dentin, and affected dentin are subjective. Caries detector tends to overstate caries, along with other transillumination devices. I find the spoon excavator to be the best instrument to tell you if it's caries, infected dentin, affected dentin, or healthy tooth structure. Also, take note of how your handpiece feels as you cut into healthy enamel, decalcified enamel, dentin, affected dentin, infected dentin, caries, and pulp. They all have subtle nuances of cutting and the debris that they generate.... AND they all feel different, depending on the type of bur that you use (shape/diamond v. carbide/used or new).

For the love of god, just pass and get out there in the real world. Dental school is just one long annoying hazing process. It's like a hemorrhoid that continues to get infected over and over because someone keeps poking you with a stick with an annual recurring subscription for 4 years (or more if they so choose to keep you there)

If you think you're still gunna struggle upon graduating, consider doing a 1-year GPR program. You'll be guided into doing more complex things, get certified to do other procedures. There's a smaller batch of students in the program, so you'll get more hands-on experience.

If confidence is the OPs problem and they cannot get around their self-imposed mental blocks, then, in this instance, I may actually advocate a post-grad program of sorts like an AEGD/GPR. I normally don't support AEGD/GPRs, but if there's no way around these mental blocks without outside support and rigid training, then +1 year will be needed. Main reason is that I've seen people who cannot get around their own personal hangups and end up sinking in a normally high production environment (i.e stuck @ 120k/yr if they haven't been fired already).

 

[AnneSoul]

Thank you very much guys! I really appreciate your help!

1. You need to replay these scenarios in your mind so much that it becomes second nature to adapt to every potential scenario that comes your way. Not run away from them.
2. Handskills take time to develop. Try doing everything via direct vision. The right way to do things is the way that achieve results. If you cannot achieve results using a "recommended" way, then do it your way. You're not inadequate, your work is "clinically acceptable" without even looking at it. If your work in your mind looks like garbage, replace that word with "clinically acceptable".
3. What you mention seems to stem from lack of confidence. You might do something wrong, but the results are probably clinically acceptable.
4. You'll improve once your perception of yourself and your work adapts to clinical reality.

I found that the faculty are a lot more amenable to clinically acceptable work if you demonstrate what's ideal and why you deviated from ideal.



Caries, infected dentin, and affected dentin are subjective. Caries detector tends to overstate caries, along with other transillumination devices. I find the spoon excavator to be the best instrument to tell you if it's caries, infected dentin, affected dentin, or healthy tooth structure. Also, take note of how your handpiece feels as you cut into healthy enamel, decalcified enamel, dentin, affected dentin, infected dentin, caries, and pulp. They all have subtle nuances of cutting and the debris that they generate.... AND they all feel different, depending on the type of bur that you use (shape/diamond v. carbide/used or new).

For the love of god, just pass and get out there in the real world. Dental school is just one long annoying hazing process. It's like a hemorrhoid that continues to get infected over and over because someone keeps poking you with a stick with an annual recurring subscription for 4 years (or more if they so choose to keep you there)



If confidence is the OPs problem and they cannot get around their self-imposed mental blocks, then, in this instance, I may actually advocate a post-grad program of sorts like an AEGD/GPR. I normally don't support AEGD/GPRs, but if there's no way around these mental blocks without outside support and rigid training, then +1 year will be needed. Main reason is that I've seen people who cannot get around their own personal hangups and end up sinking in a normally high production environment (i.e stuck @ 120k/yr if they haven't been fired already).

It seems like you know me for a long time! You are right, one of my main problems is the lack of self confidence. I read recently about what is called “imposter syndrome” , its when you doubt yourself in every challenge and you think that all of your achievements are due to luck only. Seems that I have it but I am trying to work on it
This sound in my head always tells me that you do not have the skills and knowledgeto do anything,and if it goes well, then this is only luck.

 

[TanMan]

Thank you very much guys! I really appreciate your help!



It seems like you know me for a long time! You are right, one of my main problems is the lack of self confidence. I read recently about what is called “imposter syndrome” , its when you doubt yourself in every challenge and you think that all of your achievements are due to luck only. Seems that I have it but I am trying to work on it
This sound in my head always tells me that you do not have the skills and knowledgeto do anything,and if it goes well, then this is only luck.

What you mention is quite common, but often kept to themselves. It is very hard to deal with what you mention because most of your colleagues are highly talented in one way or another and classmates are often pitted against each other in a battle for supremacy. Successive successful outcomes are rarely out of pure luck. We've had it all at some point in our lives. I never want to go back to my dental school for fear of them taking my degree away, lol. They changed a bunch of rules because of what I did there.

I will say that you should redirect your self-doubt to improving your clinical knowledge as much as possible so that you won't doubt yourself ever again. The more knowledgeable you are about every aspect of the procedure, the less room you'll have for self-doubt. You pretty much have to convince yourself that you are the best, you're doing what's best for your patient, and you can execute the procedure like you've done it 10000 times. The last part will require that you know what you're doing, why you're doing it, and how you're going to achieve it.

Anyway, good luck!

 

[oralcare123]

Make sure you have and use good loupes with a light. Practice on typodont, as much as you need to improve your hand skills and indirect vision. You shouldn't practice on patients - you suppose to adapt to working with saliva, cheeks, tongue and complaints . Basic skills should be present already. Stop rethinking and watching others - they struggle as much as you are, just hiding it well. Remember - you passed you practical exams, so you are good enough

 

[yappy]

A lot of people think they’re great but they’re far from it. That is true in dental school and out in practice. There are many dentists who are delusional and think their skills and knowledge are far greater than they actually are. I have seen this in dentists who are commercially successful too. At least you recognize that you need to improve so you will actually get better if you work at it. Imagine walking around thinking you’re great when you’re not?

Stick with the process: critique each patient encounter you have with the goal of figuring out what knowledge or skills you need to work on. Actually read dental texts, review case reports similar to your cases, and read instructions for use on all the equipment and materials you use. Practice indirect vision every day. If you do that then you’ll be far ahead of your peers. Most people are not willing to do the work

 

[TanMan]

I'm curious if any dentists here have read a dental textbook recently or at all after dental school?

And it's definitely true...clinical excellence doesn't necessarily translate to commercial success/profitability. There's the human factor too. You gotta remember that there's a person attached to the mouth you're working on.

 

[2TH MVR]

There's the human factor too. You gotta remember that there's a person attached to the mouth you're working on.

Based on your past posts ..... how do you establish this human connection? Your strategy appears to be predictable procedures with high ROI and spending the least amount of time with each patient. How are your patients convinced that they are not part of a well orchestrated move them in - move them out factory scenario?

 

[TanMan]

Based on your past posts ..... how do you establish this human connection? Your strategy appears to be predictable procedures with high ROI and spending the least amount of time with each patient. How are your patients convinced that they are not part of a well orchestrated move them in - move them out factory scenario?

You would also have to accept that you can't connect with everyone and your ROI with each patient varies depending on how well you establish the connection and how quickly. Many are willing to accept that they are part of a FIFO factory; those that do not, move on. It is based on this that natural selection of a desirable patient population pool can occur. Given the volume of patients (or even a smaller volume of patients), a 100% connection rate is not feasible as not all are productive enough to justify spending significantly more time (as t -> ∞), and even then, there are some things that time cannot accomplish. Spending more time if you have the time due to lack of patients can be justified, but there are some scenarios where you just have to know when to cut your time losses and move on.

Start off by being friendly, gauge initial reaction, if hostile, get down to business, if friendly, continue friendly banter while proceeding with examination. Extract data, build upon conversations, see next visit.

 

[PerioDont]

You would also have to accept that you can't connect with everyone and your ROI with each patient varies depending on how well you establish the connection and how quickly. Many are willing to accept that they are part of a FIFO factory; those that do not, move on. It is based on this that natural selection of a desirable patient population pool can occur. Given the volume of patients (or even a smaller volume of patients), a 100% connection rate is not feasible as not all are productive enough to justify spending significantly more time (as t -> ∞), and even then, there are some things that time cannot accomplish. Spending more time if you have the time due to lack of patients can be justified, but there are some scenarios where you just have to know when to cut your time losses and move on.

Start off by being friendly, gauge initial reaction, if hostile, get down to business, if friendly, continue friendly banter while proceeding with examination. Extract data, build upon conversations, see next visit.

Can you give us a typical conversation for your NP exam?

you come into the room, and what do you say?

 

[oralcare123]

I usually introduce myself, ask them what is bothering them and state what Is the plan for today. If necessary, conversation continues

 

[TanMan]

Can you give us a typical conversation for your NP exam?

you come into the room, and what do you say?

Introduce myself, say hi, look at them, make note of something that they might be interested in (if they are wearing nice clothes, talk about how they look professional, if they just came from work or if it's Friday night, talk about if they are going out tonight), summer clothes (nice weather), basketball shorts (talk about sports), workout gear (talk about working out), matching colors (indicate favorite color), lots of entry/segways into a conversation depending on what they wear alone. If they are holding their jaw or they look miserable, act concerned, ask them how they are doing, anything bothering or causing them pain. It's the initial read that initiates the conversation. I don't go straight to dentistry unless they are in severe pain. If they are in severe pain, i'll always state that i'm gonna get them out of pain, one way or another.

That's how I build the rapport and usually the first minute will determine if I need to continue on or just get down to business. Probings are already done for me, and I just need to present the clinical findings, diagnosis, treatment options and hopefully be out the door in 3-5 minutes. If they are receptive to treatment and I can fit them in, I'll let them and my staff know that we will accomodate them and take care of them in the same day. Act like you care.

 

[Cold Front]

Introduce myself, say hi, look at them, make note of something that they might be interested in (if they are wearing nice clothes, talk about how they look professional, if they just came from work or if it's Friday night, talk about if they are going out tonight), summer clothes (nice weather), basketball shorts (talk about sports), workout gear (talk about working out), matching colors (indicate favorite color), lots of entry/segways into a conversation depending on what they wear alone. If they are holding their jaw or they look miserable, act concerned, ask them how they are doing, anything bothering or causing them pain. It's the initial read that initiates the conversation. I don't go straight to dentistry unless they are in severe pain. If they are in severe pain, i'll always state that i'm gonna get them out of pain, one way or another.

That's how I build the rapport and usually the first minute will determine if I need to continue on or just get down to business. Probings are already done for me, and I just need to present the clinical findings, diagnosis, treatment options and hopefully be out the door in 3-5 minutes. If they are receptive to treatment and I can fit them in, I'll let them and my staff know that we will accomodate them and take care of them in the same day. Act like you care.

+1.

I would add some patients are naturally super talkers and would like to take their time/stretch the conversation. In those instances, I interject with “I agree” and take control of the discussion - and move on to the bottom lines of their concerns. There are patients who just won’t let go and keep talking, and it can be very frustrating to see them drain the time allotted to them.