How hard (physically) is dentistry?

[Pemulis]

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To all of you dental students and practicing dentists: how demanding, physically, would you say dentistry is? Is back pain common? How about hand injuries? Do any of you know or know of any dentists who've had to quit practicing because they've developed carpal tunnel or some other repetitive stress injury?

I've also read in a few places that dentistry requires "a lot" of manual dexterity to practice. How much is "a lot"? Is it something the average person can do? Is there some kind of test of dexterity that you have to pass to be admitted to d-school?

My apologies if any of these are stupid questions...I'm a newbie around here, and I haven't seen these answered in the other posts I've browsed through.

Thanks.

 

[DcS]

I will be a 3rd year this fall, so here is my take:

As far as manual dexterity, dentistry does require that you are competent with your hands. That doesn't mean you have to have the ability to do microsurgery w/ your hands. Dentistry is a learned skill. People, like they do in every type of class, have different learning curves. Some people pick things up quickly, some more slowly. In the end, even the slower ones eventually master skills with enough practice. The nice thing about it is that because there are so many different types of procedures, you may find yourself lightning fast at one type, and horribly slow and frustrated with another procedure.


As far as pain, I have heard of a few practitioners limited by back pain. I know for me I already have back pain occasionally since we are in clinic so much now. The important thing is to try to develop good habits now that will carry over and pay off in years time. Purchasing loupes was a huge plus for me, because it prevented me from leaning over because the focus will be lost. Clinic can be exhausting at times, but I guess it's because it's a new situation, can be stressful, and is spread over a 3 hour period.

 

[booshwa]

I have at least one teacher who is teaching because he has back problems that were developed from working...and he is fairly young, and looks to be in good shape.

One good thing is that there seems to be an increased awareness/promotion of ergonomics. Although all injuries cannot be prevented, especially with such repetitive movements, learning to do things correctly can help.

 

[simpledoc]

Purchasing loops was a huge plus for me, because it prevented me from leaning over because the focus will be lost.

hey there..can you please explain to me what do you mean by "loops"? is it effctive enough?
how does it work, and can you give me any websites or places for purchase?
i have lower back aches on and off for the past 6 years, and i also make a diligent attempt to follow the correct postures in dentistry, as well a strong attempt for good postures in my personal life too...
right now am regularly exercising and doing yoga for backache, which seems to provide some relief...
simpledoc.

 

[UNLV OMS GUNNABE]

One guy in my class caught his scrub top on fire w/an alcohol torch, so yes, I think dentistry can be dangerous 😀

 

[djsux]

Loupes are bascially magnification devices commonly used by dentists and doctors for surgical procedures. They come either already mounted through the lens or flip-down style, and they help dentists get a better view of what they are working on in the mouth without having to smell what the patient had for breakfast or lunch while maintaining better posture.

I would also highly recommend loupes, as I had back pain coming into dental school from college athletics - it makes a considerable difference being able to sit up straight and work on the mouth (please consider that I only just finished my first year, so I'm not as experienced as others using loupes on real live patients!). It will also help alleviate neck pain.

As a dental student, most of the big loupes companies do give you discounts, so ask around. The main ones that our class ended up buying were Designs For Visions (www.designsforvision.com), Surgitel (www.surgitel.com), and Orascoptic (www.orascoptic.com). I don't think you can go wrong with any of those brands. It seems like a lot of seasoned dentists like the DFV ones, but they are more expensive than the other two. Expect to pay ~$700-$900 for a new set of loupes - so start saving up!

Hope this helps!

 

[larryphrank]

I worked with 2 guys who, in their late 30's, both had to undergo a surgical procedure to correct upper back/ neck problems. I cant say specifically what they had done, but it putthem out for about 3 months.
Carpal tunnel is also common.

Manual dexterity.
Very necessary in the field.
Every procedure is, to some extent, a surgical, hands on procedure. Sure , everyone can learn to do the physical tasks. But, in the real world, these tasks have to come almost instinctual to be able to complete the tasks in a reasonable time. Not only for financial reasons, but also to build the confidence of the patient. Taking 3 hours to prep a tooth, compared to 20 minutes is significant. Sure we all have to start somewhere, but patients hate coming to the dentist, and want as little chair time as possible. So, even if those less fortunate eventually master a task, the time variable must also be mastered. And, for some people, this is impossible.

Lets think about it, how many people in your class would you actually let do a procedure on you?
I garduates with about 112 people, and maybe 5 would I let touch me.


Other dangers in the profession:
Needle sticks
every procedure --->bloody
sharp instruments (scalpel, endo files, burs..)
Many chemical products/ materials
breathing in fumes (acrylic, saliva aeresol)
Breathing in microscopic material (amalgam,acrylic,pumice...)
Mercury (amalgam)
Eye injuries ( foreign objects)

larry

 

[Pemulis]

Thanks to everybody for their replies.

Larry: after phrasing it that way, perhaps I'll just consider a safer career--like joining the marines, for example. 😀

If I can ask you something as a follow up, with regards to your comments on dexterity: one would conclude then that most Dentists are going to fail in private practice (by extension of your logic that 1) you must be quick and efficient to get and keep patients and that 2) the majority of the students graduating with you are not). Can you (or anybody else) comment on this?

Also, regarding needle sticks, does anybody have any data on how commonly dentists contract bloodbourne illnesses? I've never heard of an epidemic of hep or hiv in the dental community, but then again I suppose it makes sense that at least occsionally dentists must become infected that way.

 

[DcS]

I completely disagree with larry on this one. Preparing teeth is not instinctual. Yes it requires a certain touch and feel, but these are both things that are learned with time. When I first started in clinic in school 6 months ago, it would take me over two hours to do a good amalgam that was 2+ surfaces. Last week, less than sixth months later, I hammered out 4 restorations, a total of 9 surfaces in our 3 hour block. I made that improvement through the experience I've gained while working on patients. With 2 more years in the clinic before I graduate, I will have plenty of speed. Of course, compared to someone practicing for years, I will pale in comparison! But how do you think they get that efficient? Certainly they weren't that way since graduation, they too learned over time.

If dentistry were instinctual, there wouldn't be so much science behind it. When every one of us sits down to prepare a tooth, there is an exact science as to how the preparation should proceed. Of course, things are dynamic and there are multiple variables in every treatment, but once you learn how to do it you will always remember.

 

[Meggs]

To all of you dental students and practicing dentists: how demanding, physically, would you say dentistry is? Is back pain common? How about hand injuries? Do any of you know or know of any dentists who've had to quit practicing because they've developed carpal tunnel or some other repetitive stress injury?

Yes, back pain is very common. But like someone else said, now days more emphasis is beign made on ergonomics. Thanks god.

Hand injuries. Well, it depends. When I do a very bad perio case my wrist and tumb will sore a little near the end of the procedure or afterwards. It was worst in dental school when I wasn't allowed to use cavitron.

There is this condition caused by tight fitting gloves, I don't know the name, but I do have heard of it. But since I'm a female, and thus smaller hands, I haven't personally experienced it.

About eye injuries.... this perio teacher somehow got a piece of calculus in his eye, and the guy almost lost it. His eye became very infected and the poor guy went trough a lot. His eye never functioned as well as before of course. I wasn't present during the procedure so I don't know how it happened.

About Hep epidemics.... you're all supossed to have got inmunizations for Hep B and whole bunch of other diseases. Glaxo has this Hep B shot that last wayy longer than the regular "updates" (sorry don't know the right word), so you might want to go that route.

 

[dentaldoc]

I have heared that suicidal rate among dentist population is high
Is this true? or is it just a rumour? if true what u guys think is the reason?

 

[larryphrank]

I never said it was instinctual. But, lets face it, some people have got it, and others have not.

Sure everyone will improve over time, in both speed and quality, but only to a certain degree.

Why doesnt every baseball player bat 400?

because some have got it, and others will never get it.

Im not saying that 100+ people in my class that i wouldnt let touch me are horrible dentists. I just dont think they are or will ever be good enough to treat me or my family.

Just wait until you get out and see all the crap that comes back that u have to fix.

Most of the stuff you will be working on is not virgin teeth, but failing dentistry taht others have done in the past.

Sure, nothing lasts for ever, but when you see what comes across your chair in the future, you will understand what i am talking about.

larry

 

[Meggs]

http://www.ada.org/prof/resources/pubs/jada/index.asp

Stress, Burnout, Anxiety and Depression Among Dentists
Rada R.E.[1], Johnson-Leong C.[2]

Abstract


Background. Dentists encounter numerous sources of professional stress, beginning in dental school. This stress can have a negative impact on their personal and professional lives.

Conclusions. Dentists are prone to professional burnout, anxiety disorders and clinical depression, owing to the nature of clinical practice and the personality traits common among those who decide to pursue careers in dentistry. Fortunately, treatment modalities and prevention strategies can help dentists conquer and avoid these disorders.

Practice Implications. To enjoy satisfying professional and personal lives, dentists must be aware of the importance of maintaining good physical and mental health. A large part of effective practice management is understanding the implications of stress.

 

[ItsGavinC]

Im not saying that 100+ people in my class that i wouldnt let touch me are horrible dentists. I just dont think they are or will ever be good enough to treat me or my family.

I feel a bit the same. We aren't in clinic yet, but the work that some of my classmates crank out in the simlab is atrocious.

 

[DesiDentist]

I feel a bit the same. We aren't in clinic yet, but the work that some of my classmates crank out in the simlab is atrocious.

I agree with Gavin. One should develop good techniques now before clinic or you will suffer a lot. I've been constantly drilling 6-8 hours a day and my wrist is feeling it. 👎

DesiDentist

 

[DcS]

But, in the real world, these tasks have to come almost instinctual to be able to complete the tasks in a reasonable time.

Just so you didn't think I put words into your mouth, it was said above.

 

[larryphrank]

Maybe poor choice of words, but , in reality, from what ive seen over the past 10 years, some people got it, and some dont.

 

[DcS]

I agree with you larry. I think anyone can gain enough skill to be competent enough, but really some people do good work and some never do. It's evident in dental school who fits into each category. It amazes me to see some of the work licensed dds do on my patients before they come to the school. I can do much better barely into my clinics, it's a scary thought that people have no idea about what constitutes good dental work. Other than no pain and good esthetics, that's about it. Dentistry is a unique profession in that there is little quality control other than on an office basis. In fact, I was told numerous times by an old dean here at UNC that as a profession we need to step up and determine some sort of accepted quality control measures before the government forces them upon us w/out an idea of what's necessary.

 

[larryphrank]

Its true about the quality, but actually, sometimes you are forced to do crap, unacceptable work due to circumstance. I had a guy with severe diabetes, on coumadin, liver problems, dialysis...recent heart attack (within months). The guy had multiple failing maxillary bridges. Recurrent decay, mobility, chipped porcelain...anything that could be wrong was. Ideal Tx was full mout h exo & immediate upper. Problem, unable to get medical clearance due to significant medical issues. so, i was faced with the situation of trying to stabalize this piece of crap in his mouth. So, with a little creativity, acrylic, composite, ortho wire, what ever i could find, I kept this relatively stable for about 6 months. It kept breaking, and i kept repairing. But, finally after 6 months he got clearance, sent him to an OS, full mouth exo, inserted denture, and 2 months later the guy died. I didnt even charge him for the work i did on his existing bridges, because i was ashamed of the quality work i did. But, i noted in the chart that i had no other choice but to do this. the patient was very appreciative. I felt I did nothing wrong, but what i had to do to buy time. So yes, there are exceprions to the rule, when you have to do crap work.

larry

 

[DcS]

Larry,

Your post above is a prime example why one dentist should never criticize another's work to the patient or anyone else. Who knows what circumstances it was completed under, not to mention it's very unprofessional.

 

[aphistis]

Larry,

Your post above is a prime example why one dentist should never criticize another's work to the patient or anyone else. Who knows what circumstances it was completed under, not to mention it's very unprofessional.

I agree that you shouldn't criticize another dentist's work to the patient...but to turn a completely blind eye to it? I think that's unethical and unprofessional.

 

[larryphrank]

I agree that in most cases, dont criticize another dentists work. But, in my example above. It was clearly documented, and for good reason I did what i had to do. Also, It was explaind to the patient that I was doing something, technically inferior, but it was my only choice.

On the other hand. When a patient comes in from another office, just had a few crowns put in months ago. Large open margins. Decay on these teeth. Perfed posts.....There is no acceptable reason for this. There are also no circumstances that would justify this.

Sure, as mentioned above, there arer certain circumstances. But, you cant confuse the two.

Also, I dont make it routine practice to point out others crappy work, but. You must document everything that comes in, prior to touching it. never work on a tooth with out a radiograph. You never know what the last dentist did. And guess what. if they perfed an endo, and u didnt check, and u restored it, guess whose partially liable??

Every one has their day. Weve all perfed, weve all exposed a nerve, we've all had failing endos, fillings... It happens.

larry