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Blogs

THE NEXTDDS Student Ambassador Blogs

Following in the Footsteps of your Family Business

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Dentistry is often a family business. When I ask my class, nearly a quarter of my classmates have immediate relatives who are dentists. I myself come from a two-dentist household—my mother is a retired orthodontist and my father is a practicing pediatric dentist. Situations like these present wonderful opportunities for up-and-coming young dentists. The relationship is already there to work with a mentor. Parents or relatives can give professional guidance that is personalized to you. The contacts they have forged throughout their careers now become useful to you for externships, residency, or dental school misery tales! With all of this being said, it is important to keep a few things in mind when you are following in the footsteps of a family member.

 

1) Their life paths are not yours. Let’s say you’re in dental school, and your family has had 3 generations of periodontists in the same office for the last 60 years. Does this mean you have to go into periodontics? Absolutely not. If you’ve come this far and made the decision to become a dentist, do yourself a favor and explore every opportunity your school gives you. Just because a family member might have fallen in love with a certain branch of dentistry, it does not mean it will be your passion as well. What path you choose will be your profession for many years to come, and it would be a shame to chase someone else’s goals instead of your own.

 

2) Explore other practices. If you do choose to follow the same path as your family member, make sure you do not immediately find yourself in their office. Learning the business of dentistry is something I touched upon in a previous blog post, and while using mentors as invaluable resources is imperative, being exposed to one office is very short-sighted. Every office has its own “personality” and implements successful, and sometimes unsuccessful, ideas. Learning what works and what doesn’t in a variety of offices will ultimately make you a better dentist and a better practice owner.

 

3) Be humble. Dental school graduation will be one of the most triumphant and gratifying experiences in your life. You will be ready to conquer the world. Unfortunately, while dental school gives you the best of the basics, it will take you some time to work up the skills and acumen of the family members who have guided you. Try and understand that any advice given is only meant to make you a more effective dentist. Like any young person, it is easy to believe we know what is best. However, this is not always the case. Be humble, appreciate the advice given to you, and implement in whatever way you feel is best. To quote the adage: “Do not bite the hand that feeds.”

The Importance of Making Relationships with Professors

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Amidst exams, preclinical work, and extracurricular activities, dental school is a grueling four years. It requires both hard work and complete dedication to the field. Unless you have parents or friends who are dentists, it is quite difficult to find a mentor in school. Approaching faculty and administration might seem daunting, but it is necessary considering the fact that we are not given a full picture of dentistry.

As a D3, I am still in La-la land because I am not nose deep in books anymore. With that being said, I see the stress that D4s are going through. The one’s who seem to be best prepared to transition are those who have developed professional relationships with faculty. By building rapport with faculty, you are setting yourself up to ask for letters of recommendation and professional advice. For the first two years, pick just a few professors to go to during the preclinic hours. Talking to them and showing your progress gives them a sense of what kind of person you are, and helps them distinguish you from your peers. These are the same doctors who will one day assist you in attending your dream residency, or sell their practice to you when they retire.

Perhaps the biggest shortcoming of dental schools is the lack of focus on the processes of business. If you ever hope to own your own practice, there is a lot to learn in order to be prepared. Even though you are entering a field with thousands of professionals across the country, you will never find a more fruitful opportunity to network. Even though clinic is constantly busy and there is always something to do, try taking the time to speak to faculty on a more personal level. Many of them are excited to share what they love about the field and what they think can be improved. Faculty has taught me everything I needed to know about overhead, staff management, and trends in the field. My school has an especially diverse population of faculty. Some have been working at the school for 50 years, and some are just a few years removed from graduation. The different experiences they have had turn into so many different lessons and tips that you can learn for your future practice. You need only ask.

In a few short years, the faculty you’ve studied alongside will be your colleagues, so it is important to remain professional and diligent in your work. Many students from my school are recruited by faculty to work as associates in their offices. Maintaining a high standard for yourself in the clinic may very well open opportunities after graduation. The faculty are there to guide your education, but many may become your greatest influences in your professional lives. Do not go through school without taking advantage of all that is available to you. The most successful dentists are the ones who use the tools around them to improve not only their hand skills, but their business acumen as well.

 

Cars, Dentistry & Our Patients

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How can we consistently engage our patients in their oral health? Why should we want to engage and involve them in treatment and prevention planning? Let me start with a simple, but true and very relevant story.

I know nothing about cars. All I know is that I need to get mire tires rotated every 5,000 miles and my oil changed every 3,000-5,000 miles. I take my car into the shop about every three to four months, pay for the oil and tire rotation, and then pay for some of the fixes the mechanics always seem to find. Notice my language here, I have never been extremely trusting because it seems like there is always something that needs fixing. Also, I don't know any better so I always feel like they are taking advantage of my lack of knowledge. For years, I wasn't able to find one car shop that I trusted or felt good about. Until recently when I had an experience at this new car shop that changed my perception of car repair, oil change, and dentistry altogether.

After servicing my car they told me there were a couple things that I needed to consider moving forward. However, they didn't try "sell" me on any fixes because they didn't have to, they let some simple images and descriptors educate me and do all the talking. They said when you get home, you'll get an email from us with the full workup of your car, give us a call when you've looked it over. They sent me an email with a personal login to open my own portal. When I logged in I was able to see 20 images of my tires, engine, tubes, spark plugs, filters, etc... Each image included a simple descriptor that explained the deficiency shown in the image and how urgent that problem was. They provided a timeline for repair with each image. This changed how I saw car shops, car mechanics and eventually dentistry!

All of the sudden, I had a foundation of knowledge to be able to ask appropriate questions and to become engaged in the car repair process. I felt like they weren't trying to trick me into repairing something that didn't need repair. I trusted this shop and became a lifelong customer because they gave me the tools to become involved in the process. I'm hoping you've been able to see the connection between my limited knowledge about cars and how I felt, and what our patients know about dentistry and how they feel.

In 2006, United States Surgeon General, Rear Admiral Kenneth P. Moritsugu said, “Low health literacy is a threat to the health and wellbeing of Americans. And low health literacy crosses all sectors of our society. All ages, races, incomes, and education levels are challenged by low health literacy" (CDC, 2013). Kelly and Haidet (2006) concluded that doctors commonly overestimate patients’ literacy levels. So what can we do to educate, engage, and involve our patients into this foreign world of dentistry?

For starters, let’s provide our patients with the tools to OWN their oral health. Just like the car shop did for me, we should be searching for methods to engage our patients by providing them with relevant images, personalized descriptors, and an online portal they can access away from the office. Keeping terms simple, visual, and accessible online are crucial factors to our patients becoming more engaged in their treatment and prevention plans. I’ve been searching for years for an online system or software that provides all three tools for dental patients (simple, visual, personal and accessible online). The one I recommend, and enjoy the most is found at https://livesmileapp.com.

I’ve been out of dental school for just five months but I’m confident using the tools I learned at the car shop, and available through LiveSmile, has improved my case acceptance, my patient retention, and overall patient experience.

References

Centers for Disease Control and Prevention, (2013). Lead health literacy initiative. Retrieved from http://www.cdc.gov/nceh/lead/tools/leadliteracy.htm

Kelly, P., & Haidet, P. (2006). Physician Overestimation Of Patient Literacy: A Potential Source Of Health Care Disparities. Patient Education and Counseling, 119-122.

THE ETHICS OF DENTAL OVERTREATMENT ON PATIENT CARE

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      As dental students, we are constantly faced with hypotheticals, conjectural paradigms of clinical corruption, and solutions to navigate such trying situations. While countless classes are dedicated to core sciences such as biochemistry, one class in particular stood out to me among the rest. A course I took about ethics in the dental practice served as a guide to help students circumvent unethical situations and prevent unethical behavior in the future, while emphasizing the importance of prioritizing patient needs.

One major issue plaguing the world of dentistry is the inappropriate prescription of dental care. This practice has become increasingly rampant as practitioners abuse their patients’ trust for their own financial gain, offering more expensive or unnecessary treatment plans to patients who lack the ability to discern between their options. This violates the ethical principle of justice, which states that practitioners must be fair to patients.  

 

When evaluating a patient, practitioners must make a clear distinction between elective and necessary dental treatment. Patients will be able to make an informed decision once all treatment options are presented along with the corresponding risks and benefits of each plan. In an educational setting, it is simpler to negate financial biases, but the daunting list of clinical requirements threatens to provoke unethical behaviors as students prepare to graduate. As a result, students begin learning about justice and veracity in the beginning of their dental education, and are taught to truthfully explain why the prescribed treatments are necessary, along with the corresponding risks and benefits. 

 

The harsh reality is that overtreatment is a huge disservice to patients, as enamel cannot be replaced. Over time, teeth become increasingly more susceptible to bacterial byproduct attacks and casualties from traumatic events, causing patients to require more dental treatment. When dentists overtreat, they compromise tooth structure that could otherwise have continued to serve as a masticatory device which distributes occlusal forces, withstands erosive dietary acid attacks, and maintains the patient’s vertical dimension.

 

Sometimes overtreatment may result from a lack of dental IQ when patients opt for one treatment over another. Some patients request specific treatments that they may not necessarily need and are unaware of the harm that these treatments may cause. For example, a dentist may offer bleaching or cosmetic veneers instead of esthetic crowns requested by the patient. At times, patients may turn down conservative treatment plans due to cost or expectations, and instead opt for a more aggressive treatment that accomplishes the same result. However, it is the provider’s duty to inform patients of suitable alternatives as an expert in the field and refuse to supply treatments that are not in the best interest of the patient.  

 

This is a core value termed nonmaleficence, which promotes the patient’s well-being through the “do no harm” principle. Dentists must practice ethically and provide patients with the best care and protect all patients from harm. Allowing patients to choose between alternative treatment plans and selecting a plan that they prefer is known as autonomy, or self-governance. Patients should also have the option to elect to have no dental treatment, and have the risks and benefits of refusing treatment explained accordingly.  

 

In addition, pain may play an influential role in patient preference as well. For example, if a patient feels pain, he or she may feel a sense of urgency to remove the tooth instead of treating and possibly saving it with a restoration. More aggressive treatment plans may be called for after extractions, as practitioners offer ways to replace the missing dentition and occlusion begins to change. During this process, teeth may drift or fracture due to changes in occlusion, calling for even more extensive treatments as the remaining dentition is accommodates for any changes. Overtreatment causes an array of supplementary issues, which is why it is always best to devise a conservative treatment plan, monitor small lesions, and prioritize pain so the patient’s needs are taken care of. This principle is known as beneficence, or the “do good” principle.  

 

Not all overtreatment is intentional. For example, some practitioners may not be up to date on newer practices, such as laser technology or microsurgery, which provide minimally invasive treatment modalities as in contrast to outdated protocols. This exemplifies the importance of staying current and learning about the constantly evolving field of dentistry. Research and new technology coalesce to create new advances and materials in the field, which serve to improve patient care.  

  

Instead of overtreating through elaborate treatment plans, practitioners should hold off on treatment that is not necessary, and instead inform the patient of any questionable lesions so they can be monitored. To combat overtreatment, providers can recommend more frequent patient visits in order to monitor smaller lesions, and provide conservative treatment plans, the “best-case scenario,” and explain to the patient that more extensive treatment may be necessary in the future. Any dentist who proposes unnecessary treatment is engaging in unethical conduct, and may be causing serious harm to the patient. 

The Impact of Dental Mission Trips Home and Abroad

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By Emma Guzman, DDS

I have always had a passion for going overseas and providing dental services to those in need. During my undergraduate studies, I went to Mexico on a dental mission and, while in dental school, participated in a mission to the Dominican Republic and Jamaica. Each experience was very different, but they all were extremely memorable and enriching. I think this passion stems from being a first-generation American and knowing the lack of dental literacy and access to care in other countries.

 

On all three trips, dentists, residents, students, and volunteers provided free dental care. We went to small towns and dental clinics in the local schools. We brought our own equipment and used local supplies provided to us as well. Most of the treatment performed were extractions. Our main goal was to get the patients out of pain and remove diseased teeth from their mouths. We also treated children, performed fillings, and were able to do some esthetic cases. I played a different role on each trip, which gave me different perspectives on mission trips. On the Mexico trip, I supported staff, triaged patients, assisted the providers, sterilized instruments, and translated (since I speak Spanish).

On the trip to the Dominican Republic, I served as a provider. This was only a few months after starting clinical experiences, so I was certainly nervous about providing treatment. When we walked into the clinic at the local elementary school and saw the number of patients waiting to be seen, I understood the impact that being there would make. In Jamaica, I took part in organizing the clinic, choosing supplies, providing education and, of course, treatment. By this trip, I was more confident and efficient and was able to treat more patients.

These experiences were the most memorable aspects of dental school because these patients were truly in need, having no access to dental care. They were very appreciative and it was a blessing to be able to help them. The biggest impact these trips had on me is in how I look at myself as a provider. I believe I came out of every trip better than I was before. I had to think on my feet and work in environments that were not ideal. For example, we had to work in 90-degree rooms with two fans for eight students or working on four-foot chairs when you are almost six feet tall! It takes a toll on your back (not to mention the sweating!) but every moment was worth it.

 

Nothing compares to how you feel after giving relief to someone who has been in pain for months or fixing a chipped tooth that prevented a patient from smiling. I absolutely recommend participating in dental mission trips. Don’t forget, in the United States there are parts of the country that have very little access to dental care and need our services. Do your part!

 

Third Year Thirteen: 13 Tips for Thriving in Your Third Year

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13 Tips for Thriving in Your Third Year

 

It's been said that the first two years of dental school are about learning how to stay in successfully, and the last two years are about learning how to get out successfully. Starting the third year of dental school is a huge transition for many, as students realize that a bulk of their didactic coursework is completed, the National Boards Part I is in the books, and now they are scheduling patients full time and applying their skills and classroom knowledge in a clinical setting. It is important to keep these thirteen tips in mind to make the most of your remaining time in school:

 

Get involved in interesting clubs.

As an active member of many organizations and clubs, I have acquired so much valuable information from upperclassmen and peers in different organizations, which opened so many doors for me. Some clubs open their lunch and learn events, tutorials, socials, and other events to non-members as well, so it’s worthwhile to get involved, meet new people, and learn new things.

Become a member of an organization.

In dental school, you’ll meet so many professionals, including practicing dentists, former dentists, researchers, and potential employers. It is important to establish professional connections, which may help in the future. Organizations such as ASDA, ADEA, and various fraternities—such as THE NEXTDDS—invite speakers to inform students of the many opportunities after graduation. These events teach students about understanding the current job market and what offers are available upon entering the workforce, as well as how to strengthen one’s CV and build his or her own practice.

Keep your CV/resume updated.

During my first year, an upperclassman was asked to offer new students one piece of advice, and he immediately responded with, “Log everything you were involved in, including clubs and organizations, volunteer work, shadowing, awards, etc.” Many students become busy with schoolwork and extracurricular activities during their time in dental school. Once it comes time to apply for residency and specialty programs, many forget which events they took part in and with which organizations they have membership, leaving out many achievements from their CVs. In addition, students should update their resume before submitting them to faculty members in order to take part in research or externships.

Review a procedure before the patient arrives.

This helps the student gain comfort and confidence before beginning a clinical procedure. For example, many schools require that students practice a crown preparation on a typodont and a patient’s cast before starting on a patient. This practice helps both the student-provider and patient feel more comfortable, as the provider is less nervous and has developed a systematic approach to the procedure that allows for a seamless transition from one step to another.

Establish a work-life balance.

It is important to establish a balance between professional life and personal life by making time for friends and family alongside completion of dental school requirements. It is imperative to maintain a balance of mental and physical health. I find that maintaining a planner is a good way to keep track of scheduling and to-do lists so that nothing is missed or overlooked, and I can plan the best time to take care of school-related responsibilities. I can enjoy my free time without worrying about missing important tasks!

Take advantage of your time in clinic.

At this point, many students develop tunnel vision, only looking to get requirements out of the way and work towards graduation. Many overlook the resources available and tend to refrain from getting advice or guidance from faculty while they still can. Or, they refrain from asking questions about procedures they have already completed, and often forget that it is better to learn as much as possible while faculty members are readily available. A student’s third year is the best time to learn more from faculty, gain a better understanding, get requirements out of the way, and make their fourth year less stressful.

Take advantage of your time out of clinic.

Many organizations sponsor social events that can help students unwind, network, and explore local areas. These events are not only helpful for building professional connections, but also for allowing students to take mental health breaks. It is important to take advantage of time off to catch up on sleep, be with family and friends, take part in volunteer opportunities, and make contributions to the field and to underserved communities.

Take care of your health.

Under the constant stress of exams and clinic, it’s easy to neglect one’s personal health. It is important to set aside time to go for walks or go to the gym to maintain physical health, maintain a healthy diet, and visit the doctor when necessary. Just as physical health is important, taking breaks to unwind and maintain mental health is another consideration. When stress piles up, remember that a lot of people are going through different hardships and many have trouble managing stress. Find someone to confide in and voice concerns. Many schools offer complementary confidential therapy sessions to help students cope with both school and life stresses, promoting student wellness.

Go to conferences.

Attending conferences can help students make professional connections while learning more about current events and innovations in the field. By attending association and research conferences, students can learn more about the profession and explore the field to learn more about their particular interest in dentistry and how they can contribute in the future.

 Get involved in research.

By becoming involved in research, students can contribute to advances in their own field with novel technologies and materials that can help make dentistry more efficient and beneficial for patients. Through research, we can discover new ways to solve oral health issues and help patients prevent future issues through evidence-based research and oral hygiene techniques.

Make professional connections.

Dental school is a great place to meet professionals, and after graduation, professors become colleagues, and classmates can become partners. It is important to talk to practicing clinicians and former clinicians to get a better idea of what to expect as a licensed dentist in the working world. The more students speak with experienced professionals, the more prepared they become for future success. Professors, guest speakers, and other leaders in the professional world can offer invaluable advice that can be very difficult to obtain without experience. Making professional connections can help in the future when one is in need of advice, or looking to expand business prospects.

Get enough sleep.

A majority of students do not get enough sleep. According to the National Sleep Foundation, studies show that people in their 20s need an average of seven to nine hours of sleep per night. During my first two years in dental school, my peers and I would get an average of about six hours of sleep per night We generally compensated for lack of sleep with coffee to maintain our attention for early classes, or stay awake to study late at night. Sleep deprivation has devastating effects on the body, and long-term caffeine abuse is detrimental to the body as well. Get enough sleep to maintain focus in class and perform better on exams.

Have fun!

Make the most of your time in dental school. As tough as it is to get through the journey, it can pass in the blink of an eye. With more than half of a doctoral degree completed, it’s easy to forget that many peers and classmates may move to other locations to begin their professional career alongside family, or wherever their path takes them. “Match” programs are difficult to predict as well, so make the most of your time with classmates and peers, explore dentistry, travel, and make the most of your time in dental school!

The Benefits of Being a Dental School Commuter

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As a student of Rutgers School of Dental Medicine, I am offered living accommodations a mere 100 yards from the front door of the dental school. The allure of such a situation is enticing, but instead, I have spent the last two years commuting about 40 minutes to and from school. After spending a considerable portion of my day in a car over these past two challenging academic years, I would recommend it to anyone considering dental school.

 

 

Going to school in Newark, NJ, I have truly grown accustomed to the concrete jungle. Other than a small courtyard, my school environment can only be described as very… grey. Living at home opens the opportunity to spend time amongst nature. Thanks to my parents, I live in a part of the state that is surrounded by green. As someone who is passionate about the environment, it has been an absolute blessing to leave the dreariness of the city each day. My mental wellbeing is rejuvenated whenever I return home.

 

No matter where you end up going to dental school, the reality is that there is an incredible amount of debt for any student.  An often-overlooked aspect, however, is the cost of everyday living. In addition to rent, the expenses of food, entertainment, laundry, and school supplies add up quickly. If given the opportunity to commute to school from a short distance away, I encourage anyone to jump at it. Living with your parents, while not so cool on paper, will be worth it in the long run. This situation is obviously not available to everyone, but it’s a fantastic way to cut down on the exponential costs of dental school.

 

Another aspect of commuting that has become an important aspect of my daily routine is the free time I am forced to take whenever I am in the car. “Dental school guilt” is an incredible phenomenon that students often feel when they are enjoying free time but remember they should probably be studying for something. I value my life and therefore do not study and drive! Instead, I catch up on music, make phone calls to loved ones, and enjoy the quiet parts of my day. I can reflect upon a rough time I had in preclinic or recognize something positive I accomplished during the day. Time is a commodity that’s hard to come by in school, and commuting affords a student valuable time that might otherwise be spent in less advantageous ways.

 

When I was applying to dental school, many of my mentors said that dental schools in “worse” geographic areas are often best because of access to a large patient pool. If given the chance, I would suggest that a dental student take advantage of the best of both worlds—access to patients and the opportunity to commute from nicer areas. Often, being outside an urban environment is markedly cheaper, and the time spent away from other students and school work is much needed.