Gaining Wisdom in Dentistry (aka: getting older)

Today is my birthday. I’m 47 years old. I have been practicing dentistry long enough that my dental career could legally drink alcohol.

I have recently experienced something very interesting. I have an influx of patients coming back into my practice that left at some time in the past. Quite a few of these folks left 15 or 20 years ago when I was a much newer dentist.

I don’t remember specifically why they left. Maybe they took the change in practice ownership as a chance to try something different. I think this happens a lot. My self esteem tells me that they may well have left because they didn’t have a ton of confidence in me. That’s probably a lot of it.

Here’s the thing…I can’t really blame them. When I became a new practice owner I was only one year out of dental school. I didn’t know that much. But more importantly, I hadn’t seen that much. That’s the beauty of just plain old doing something for a long time. You cannot help but gain experience. The experience that you gain might not be the ideal experience. But if you’re paying attention at all, you’re going to learn something.

Case in point…how does one learn who might be a “red flag” patient? You know the one that walks in with a bridge temporary that’s broken and saying terrible things about the previous dentist and was pretty sure that YOU were the one that could help them? Or maybe the one that explains to you that they broke a tooth on an olive pit at a pizza place and they’ve talked to the manager who is going to pay to have all of their long decayed and infected teeth fixed?

Well, you could have a mentor or even be on social media and heed the advice that other dentists with some experience freely offer, but I was really never one to do that. Those that are willing to listen and implement based on another’s advice are miles ahead of where I was when I was young. I was pretty sure I knew better most of the time.

Sometimes you just have to ride that garbage truck all the way to the dump and gain your experience the hard way. Quite often this was the choice I ended up making, even though I didn’t realize I was making it at the time. I do have a father that is a dentist and he was always there to lend an ear, offer some advice and occasionally just plain bail me out. For that, I will be forever grateful.

I did learn some tough lessons. But I also had a lot of great patients that were patient with me and appreciative of my honesty when I wasn’t sure about things. I have found that there are times when I don’t know the answer. There are times when the best I can do is a differential diagnosis that I don’t even feel all that confident about. I’ve learned that in most cases, patients would appreciate an honest “I don’t know” or “I’m not sure” rather than me treating something that I’m really only guessing at the cause.

Sometimes it’s tempting to move ahead with a treatment because you don’t want to lose the production. That toothache patient needs a root canal because a) they’re in pain and b) you scheduled enough time. Except maybe that’s not the right answer. Maybe I need to consult with a specialist or maybe I need to adjust the bite on the crown we seated a few weeks ago under anesthesia and see how the patient reacts. Dentists are procedure driven people. Diagnosis and observation isn’t our thing. When patients come to us, we’re supposed to have answers and more importantly…treatments! Except sometimes the answer is “don’t just do something, sit there!

When I was newer and less experienced I felt like my credibility was on the line if I didn’t have the right answer at the tip of my fingers all the time. What I’ve learned since then is that patients understand more than we give them credit for. Particularly if we can explain it using simple and understandable languages. I’ve learned to use analogies that make sense. I’ve learned that some patients need a deeper explanation than others do. Some folks love their engineer patients because they’re willing to get technical with you. Some don’t like those patients at all because they feel like the patient is challenging them.

Most importantly, the wisdom I’ve gained is in reading and understanding people. I don’t claim that this happens all the time. Not by a long shot. But some of my patients have been coming to this practice for a long time. Many of them from well before I ever showed up! I’ve developed an actual relationship with some of these folks. I’ve mourned the loss of their loved ones. I’ve held their babies. I’ve written recommendations to college. These folks have given me a chance to hone my technical and communication skills on them! And they pay me! This kind of education only happens when you’re engaged and humble.

So why have those patients that left the practice a long time ago come back? I don’t really know. Maybe the dentist the went to after they left me retired and they thought they’d give me another chance. Maybe my reputation around town has improved over the years. Maybe I showed up in their Google search.

Whatever the reason, I’m grateful that they found me. I’d like to think that I can give them an experience that they can’t get anywhere else. The other thing that makes me feel good is when they tell me that they don’t remember me being the way I am now. I understand that really well, because I wasn’t. Now I have a technical skill set that’s pretty good and a “people skills” set that is excellent. My ability to communicate confidently and compassionately is at an all time high. There wasn’t any particular CE I took or book that I read to get there.

I think it has more to do with the amount of grey I see in my hair.