Do you enjoy being a dentist?

[zammyd]

I am a pre-dent who has been considering dentistry for a while now, but am wondering whether actually being a dentist will be something I really enjoy. I shadowed a dentist as well and definitely thought it was interesting, however, I did feel that the scope of cases and procedures was quite narrow. Can any dentists provide some insight?

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[Dental Machine7]

This is the best way I can address your misconception about the narrowness of scope of our procedures:

I am a general dentist. I only refer out very tough cases. My referring specialists take me out for dinner from time to time. So I have very good relationships with them. Some of them practiced general dentistry before specializing. Why did they specialize? Because they found general dentistry to be more difficult. They found that there were too many procedures to excel. By focusing on just select few they did not have to be good at everything!

Maybe you shadowed a general dentist who prefers to refer out most cases. Or perhaps you shadowed for a small period of time where you were unable to view all the procedures.

I can be found doing a restoration or crown prep in one room, next room I have a surgical extraction, next room impressions/try-in for dentures, maybe later in the day a root canal, next checking the wire change on short term ortho that my assistant completed or interproximal reduction if needed, and many other things I do all day as a GP.

If you are serious about dentistry, I suggest you shadow a general dentist who rarely refers out cases.

 

[DaleDoback]

This is the best way I can address your misconception about the narrowness of scope of our procedures:

I am a general dentist. I only refer out very tough cases. My referring specialists take me out for dinner from time to time. So I have very good relationships with them. Some of them practiced general dentistry before specializing. Why did they specialize? Because they found general dentistry to be more difficult. They found that there were too many procedures to excel. By focusing on just select few they did not have to be good at everything!

Maybe you shadowed a general dentist who prefers to refer out most cases. Or perhaps you shadowed for a small period of time where you were unable to view all the procedures.

I can be found doing a restoration or crown prep in one room, next room I have a surgical extraction, next room impressions/try-in for dentures, maybe later in the day a root canal, next checking the wire change on short term ortho that my assistant completed or interproximal reduction if needed, and many other things I do all day as a GP.

If you are serious about dentistry, I suggest you shadow a general dentist who rarely refers out cases.

While I agree with many things you said regarding the scope of general dentistry (I think it's enormous), are you implying that specialists specialize because they think general dentistry is too hard? That's a stretch.

 

[Eli Manning]

"Why did they specialize? Because they found general dentistry to be more difficult. They found that there were too many procedures to excel. By focusing on just select few they did not have to be good at everything!"

I was under the impression that dentists specialize bc they like a certain aspect of dentistry and they want to learn more about it and practice that aspect of dentistry exclusively. But according to you specialists are those that are not good enough to be GP's and they avoid doing what GP's do by entering a specialty. what an ass

 

[zammyd]

You guys are being a bit too critical on Dental machine. From how I interpreted his comment, it seemed like he was just referring to the specialists he knew and had good relationships with, not all specialists in general. You guys need to chill out. I appreciate your comment Dental machine!

 

[Screwtape]

This is the best way I can address your misconception about the narrowness of scope of our procedures:

I am a general dentist. I only refer out very tough cases. My referring specialists take me out for dinner from time to time. So I have very good relationships with them. Some of them practiced general dentistry before specializing. Why did they specialize? Because they found general dentistry to be more difficult. They found that there were too many procedures to excel. By focusing on just select few they did not have to be good at everything!

@DaleDoback @Eli Manning How the heck did you guys interpret this into a global statement about all specialists? You guys are being crazy sensitive over one person's perspective...

 

[AlbinoPolarBear]

Let's not get into who has the bigger penis here. The specialist thinks he has the bigger penis, but all he can talk about is how big the general dentist's penis is. That's how he gets referrals. Everyone thinks they have the big penis. Everyone wins.

 

[charlestweed]

This is the best way I can address your misconception about the narrowness of scope of our procedures:

I am a general dentist. I only refer out very tough cases. My referring specialists take me out for dinner from time to time. So I have very good relationships with them. Some of them practiced general dentistry before specializing. Why did they specialize? Because they found general dentistry to be more difficult. They found that there were too many procedures to excel. By focusing on just select few they did not have to be good at everything!

Maybe you shadowed a general dentist who prefers to refer out most cases. Or perhaps you shadowed for a small period of time where you were unable to view all the procedures.

I can be found doing a restoration or crown prep in one room, next room I have a surgical extraction, next room impressions/try-in for dentures, maybe later in the day a root canal, next checking the wire change on short term ortho that my assistant completed or interproximal reduction if needed, and many other things I do all day as a GP.

If you are serious about dentistry, I suggest you shadow a general dentist who rarely refers out cases.

I am a specialist and I agree with everything you said here. I too practiced general dentistry (GPR and moonlighting at a private practice) for a year and then I decided to go back to school to specialize. I share the same view that many of your specialist friends have.

 

[charlestweed]

...But according to you specialists are those that are not good enough to be GP's and they avoid doing what GP's do by entering a specialty.

I don't know how other specialists feel but yes, that's exactly how I feel. I specialized because I feel I am not good enough to handle a wide variety of dental procedures. It's hard to do everything well in order to keep the patients happy. Some patients have unrealistic expectations and are very difficult to deal with.

 

[DaleDoback]

I don't know how other specialists feel but yes, that's exactly how I feel. I specialized because I feel I am not good enough to handle a wide variety of dental procedures. It's hard to do everything well in order to keep the patients happy. Some patients have unrealistic expectations and are very difficult to deal with.

I disagree, but see your point. Again, I said that I think the scope is ridiculous and tough, but that had nothing to do with my personal reasoning for becoming an OMS. I am surprised there are more people who think that way.

 

[charlestweed]

I disagree, but see your point. Again, I said that I think the scope is ridiculous and tough, but that had nothing to do with my personal reasoning for becoming an OMS. I am surprised there are more people who think that way.

I think one has to work in the real world for a while in order to understand how hard general dentistry really is. Having worked for a busy dental chain office as an in-house orthodontist, I have the opportunity to talk to a lot of general dentists. Some are new grad dentists. Some have 5-10 years of experience. Some owned a practice before but had to sell their practice because they didn't do well. The majority of them, whom I've talked to, wish that they can have my easy job.

To the OP, I don't mean to sound so negative about general dentistry. It's a stressful job but IMO, it is a lot better than other health professions and other career options. I want my own kids to go to dental school. My sister is a general dentist and she is very happy with her job. Being a practice owner, my sister is able to have a lot of free time to take care of her kids. But she still thinks that I have a better job.

Being limited to do a few procedures as a specialist is not boring. It is actually a good thing.

 

[zammyd]

Thank you for your comment @charlestweed. It is much appreciated coming from an actual dentist, and is reassuring for what my current ambitions are

 

[toothdriller2k17]

dental student here----everyone has different preferences. if you have the interest and the grades to specialize, then why not?

i know of general dentists that don't refer out and they make a killing. general dentistry arguably has one of the highest ceilings in the profession if you know what you're doing. but if one aspect interests you and you have the ability to excel in that area, specializing might be for you.

 

[Miley Cyrus.]

Can a GP who focuses really on just bread and butter dentistry, and maybe gets good at endo, be successful? Doesn't bread and butter dentistry have less variety? I mean obviously you would want a high volume to sustain yourself.

 

[Dental Machine7]

Can a GP who focuses really on just bread and butter dentistry, and maybe gets good at endo, be successful? Doesn't bread and butter dentistry have less variety? I mean obviously you would want a high volume to sustain yourself.

What is your definition of successful?

I am assuming by bread and butter dentistry, we are talking about restorative, anterior endo, fixed and removable. No full mouth rehabs, third molar extractions, molar endo, or implants.

With bread and butter dentistry it all comes down to reimbursement. If two dentists complete the same exact amount of dentistry in one day, their production will depend heavily on reimbursement. Fee for service with some PPO dentist will make considerably more than a office that has 50% medicaid patients (given overhead percentage is the same as well).

 

[Dental Machine7]

"Why did they specialize? Because they found general dentistry to be more difficult. They found that there were too many procedures to excel. By focusing on just select few they did not have to be good at everything!"

I was under the impression that dentists specialize bc they like a certain aspect of dentistry and they want to learn more about it and practice that aspect of dentistry exclusively. But according to you specialists are those that are not good enough to be GP's and they avoid doing what GP's do by entering a specialty. what an ass

I was providing the original poster with a view that my colleagues shared with me about their own personal career choices. I am not a specialist as such I cannot speak for the challenges faced by any one particular specialty.

"But according to you specialists are those that are not good enough to be GP's and they avoid doing what GP's do by entering a specialty. what an ass

Even when I provided my colleagues view point, I never stated that they were "not good enough" to be a GP. They are excellent clinicians as evident by their work that comes back to our office. In general, a specialist cannot avoid what a general dentist performs, as they perform the same procedures except complete it more efficiently. For example, as a GP I can complete a molar root canal. However, my referral Endodontist can complete the same molar root canal in less time.

I do not mean to look down upon you but you marked yourself as a dental student. Keep in mind that this is not a car enthusiasts message board. Please respect our profession and keep the conversation professional.

 

[DocJL]

I am a pre-dent who has been considering dentistry for a while now, but am wondering whether actually being a dentist will be something I really enjoy. I shadowed a dentist as well and definitely thought it was interesting, however, I did feel that the scope of cases and procedures was quite narrow. Can any dentists provide some insight?

I am a general dentist in mid career.



Your scope of practice is only limited by your skills, training, and experience.


At this stage in my career I am comfortable performing many procedures that are commonly referred to specialists.



As an example, today, my first pt was a maxillary edentulation from premolar to premolar, with extensive alveoplasty, and delivery of an immediate denture. Done under local with N2O sedation. I trimmed the models prior to denture processing (after wax try in) for maximum control over final shape of his maxilla. Many would refer to an oral surgeon for a procedure where you are flapping the entire alveolus, and performing extensive osteotomy/ aleveoplasty with rotary and hand instruments, and fitting the alveolus to the final prosthetic. This particular pt had large over jet and his maxilla had large buccal tuberosities and undercuts. Achieving an ideal final prosthetic result both functionally and esthetically required the experience to see the final result BEFORE we got there, and extensive planning to execute.

The next several hours were several fillings, exams, and simple extractions, and was still able to squeeze a crown prep into my 3rd chair. My last pt was a teenager who had facial trauma and splinting of his anterior teeth several years ago at another office. One of his lateral incisors was experiencing external/internal resorption, and one of his centrals was necrotic, with an immature apex. I performed the endo on the central, very easy to instrument due to the huge canal, but there was NO apex or apical stop and would have been impossible to obturate using conventional techniques. I obturated the apical 4mm with MTA, and will obturate the rest of the canal in 2 weeks. As in the above case which many would refer to OS, many would refer this to endo. I took a photo of my apical obturation and texted it to my endodontist for critique afterwards, as I have picked up many pointers from him over the years, even popping in and observing on many half days when I finished early. Then surgical extraction and socket debridement, degranulation of the lateral, with placement of a collagen based socket preservation graft, for a future implant, which I will place when the pt is older.

Pretty fun day, I would say!


This is not to say that there are not days where I seem to have 5 pts in a row for operative dentistry (fillings), which I do find very tedious and not the most fun, lol.


With all of this said, if I had to do it over again, I probably would have specialized (I graduated in the top 10% of my class, ranked 4th in my class my senior year). After many years of doing this I finally understand why most of the kids in my class who had fathers who were general dentists, ended up specializing if they had the grades to get in - general dentistry IS hard work. And you have to be married to your pts. This is great for the ones that are nice that you look forward to seeing, but for the ones that are miserable and like to inflict their mood on you and your staff, it is no fun, lol.

 

[tooth knockn]

I am a general dentist in mid career.



Your scope of practice is only limited by your skills, training, and experience.


At this stage in my career I am comfortable performing many procedures that are commonly referred to specialists.



As an example, today, my first pt was a maxillary edentulation from premolar to premolar, with extensive alveoplasty, and delivery of an immediate denture. Done under local with N2O sedation. I trimmed the models prior to denture processing (after wax try in) for maximum control over final shape of his maxilla. Many would refer to an oral surgeon for a procedure where you are flapping the entire alveolus, and performing extensive osteotomy/ aleveoplasty with rotary and hand instruments, and fitting the alveolus to the final prosthetic. This particular pt had large over jet and his maxilla had large buccal tuberosities and undercuts. Achieving an ideal final prosthetic result both functionally and esthetically required the experience to see the final result BEFORE we got there, and extensive planning to execute.

The next several hours were several fillings, exams, and simple extractions, and was still able to squeeze a crown prep into my 3rd chair. My last pt was a teenager who had facial trauma and splinting of his anterior teeth several years ago at another office. One of his lateral incisors was experiencing external/internal resorption, and one of his centrals was necrotic, with an immature apex. I performed the endo on the central, very easy to instrument due to the huge canal, but there was NO apex or apical stop and would have been impossible to obturate using conventional techniques. I obturated the apical 4mm with MTA, and will obturate the rest of the canal in 2 weeks. As in the above case which many would refer to OS, many would refer this to endo. I took a photo of my apical obturation and texted it to my endodontist for critique afterwards, as I have picked up many pointers from him over the years, even popping in and observing on many half days when I finished early. Then surgical extraction and socket debridement, degranulation of the lateral, with placement of a collagen based socket preservation graft, for a future implant, which I will place when the pt is older.

Pretty fun day, I would say!


This is not to say that there are not days where I seem to have 5 pts in a row for operative dentistry (fillings), which I do find very tedious and not the most fun, lol.


With all of this said, if I had to do it over again, I probably would have specialized (I graduated in the top 10% of my class, ranked 4th in my class my senior year). After many years of doing this I finally understand why most of the kids in my class who had fathers who were general dentists, ended up specializing if they had the grades to get in - general dentistry IS hard work. And you have to be married to your pts. This is great for the ones that are nice that you look forward to seeing, but for the ones that are miserable and like to inflict their mood on you and your staff, it is no fun, lol.

Would you do it all over again knowing that you will graduate with school debt no less than $250,000 and up to $500,000?

 

[DocJL]

Would you do it all over again knowing that you will graduate with school debt no less than $250,000 and up to $500,000?

No.

But I would not allow that to happen.

Even at todays much higher tuitions, I would live the same frugal lifestyle, and try to get a military scholarship (as I did). The difference being that when I went to dental schools, NONE of the services were offering a 4-year free ride, and I only got 2 years paid for by the Navy.

If you want to avoid big debt, it takes a real effort.

I spent 6 years in the Army before I went to college, so living in less than ideal conditions was nothing new for me. (I also had 30k in GI bill benefits for this service, which helped).

 

[tooth knockn]

No.

But I would not allow that to happen.

Even at todays much higher tuitions, I would live the same frugal lifestyle, and try to get a military scholarship (as I did). The difference being that when I went to dental schools, NONE of the services were offering a 4-year free ride, and I only got 2 years paid for by the Navy.

If you want to avoid big debt, it takes a real effort.

I spent 6 years in the Army before I went to college, so living in less than ideal conditions was nothing new for me. (I also had 30k in GI bill benefits for this service, which helped).

Great insight.

Thank you.


️tooth knockn likey

 

[Jalcalde]

Hey DocJL,

Thank you for your service, I am currently in a similar situation. I was enlisted for 4 years and used army benefits to get my Bachelors while I was in and then met my wife whose father is a dentist and turned me to dentistry. Currently a D2 in dental school and immediately got the army scholarship to pay for everything and also pay me the monthly stipend while I'm in. It is a really good deal. Not having to take out loans for everything or worrying about how I'm going to pay for equipment etc. It took me and my wife about 2.5 years to pay off the 20k debt I had during undergrad before I joined the army, don't' want to imaging having 200k+ in debt, on top of taking a loan out to buy a practice, possibly a house, etc. I'm feeling the future is bright right now, just gotta survive the 3 more years of dental school

 

[DocJL]

Hey DocJL,

Thank you for your service, I am currently in a similar situation. I was enlisted for 4 years and used army benefits to get my Bachelors while I was in and then met my wife whose father is a dentist and turned me to dentistry. Currently a D2 in dental school and immediately got the army scholarship to pay for everything and also pay me the monthly stipend while I'm in. It is a really good deal. Not having to take out loans for everything or worrying about how I'm going to pay for equipment etc. It took me and my wife about 2.5 years to pay off the 20k debt I had during undergrad before I joined the army, don't' want to imaging having 200k+ in debt, on top of taking a loan out to buy a practice, possibly a house, etc. I'm feeling the future is bright right now, just gotta survive the 3 more years of dental school

Likewise thanks for yours!

Congratulations - you are in an enviable position. Having a paycheck instead of signing for more loans in dental school is awesome. And having been prior service, you don't really have the "great unknown" that so many do, as to whether or not they will be able to adapt to the military. You will also get paid more when you go in, being a "mustang" (prior enlisted officer). I was on the pay scale as o3E over 10, due to time in the reserves in college, and the 2 years on my HSCP counting as active duty

Does your wife work? The only potential downside for you in going back into the Army would be if she has a high paying career, and moving to be with you to a potentially isolated post might have some implications for her career.

 

[Incis0r]

@DocJL did you enjoy your time as a Navy Dentist? Best/worst moments?

 

[DocJL]

Best AND Worst moments pretty much sums it up, lol.

I learned a lot, and the skills I picked up help me run a successful office and be more productive, but in retrospect I would probably not do it again.

Too many variables to extrapolate my experience to every persons situation though.

The amount that they paid me on scholarship (about 50k over 2 years), and salary for 4 years (at the time about 65-70k per year) was not worth the long hours (never forget that the military OWNS you), and isolated duty station I spent most of my time at, considering how easy it was to go right into practice in the late 90's, early 2000's, and immediately earn 150k plus.

 

[Jalcalde]

Nice DocJL, I will be O3E as well with 4 years. My wife is a nurse at the VA hospital which you are able to transfer to VA hospitals so just planning on having her move within the VA system to wherever I am stationed. Yes I am planning on getting out as soon as the payback is done and just use the 4 years to gain as much experience as possible. We considered the pros and cons and after being an E4 in the Army and doing a year deployment in Afghanistan, an O3 dentist should be a cakewalk (minus all the annoying that the army throws at you regarding details, mandatory bologna classes, holding your hand, etc).

 

[yappy]

@DocJL What is your recommendation today for students who are looking at a starting salary of ~90k-120k and student loan levels of 400-500k @6.8 - 7.2% interest? Is it worth the cons?

 

[Incis0r]

.

 

[Jalcalde]

If you are going to have 400-500k in debt from dental school I wouldn't consider any other option but military or any other programs that pay off the debt. I would only consider it if I knew that Dentistry was the ONLY profession I wanted to do and was happy realistically making 30-60k a year for 10 years to pay off my debt. Otherwise I would invest in a less costly profession with a comparable return in salary that I would also enjoy. I got a full ride tuition scholarship from UB and opted to still do the Army scholarship and give it to someone else as I would still have 100k+ in debt due to other fees and living that the UB scholarship wouldn't pay for.

 

[Incis0r]

@Jalcalde as someone considering HPSP, I was wondering: have you done BOLC yet? Visited an Army installation? Why did you choose Army over the other branches?

 

[Jalcalde]

I was in the army for 4 years enlisted before going to dental school. I chose the Army pretty much because I know the army. My second choice would be the Air Force. I have done actual basic training but seeing as how BOLC is a requirement I will be going this summer to get it out of the way. I have been to several Army installations, including the tropical paradise known as Afghanistan. If you have any more questions regarding HPSP or military I'd be happy to answer.

 

[Incis0r]

I was in the army for 4 years enlisted before going to dental school. I chose the Army pretty much because I know the army. My second choice would be the Air Force. I have done actual basic training but seeing as how BOLC is a requirement I will be going this summer to get it out of the way. I have been to several Army installations, including the tropical paradise known as Afghanistan. If you have any more questions regarding HPSP or military I'd be happy to answer.

See PM. Thank you!