As a Dentist, the first years are always the hardest. You have to adjust to unfamiliar situations and people constantly. A newbie’s nerves can lead to self-doubt and hesitation whilst navigating this steep learning curve. I brought on recently qualified Dr. Saeed Cheraghi to guide you through the first few years of the ‘University of Life’.
“You come out of Dental school thinking you know things and then you go into the real world and you realize you actually don’t know that much at all!” Dr. Saeed Cheraghi.
Highlights of this episode:
- 8:31 Indirect Dentistry experience
- 10:15 Challenges in terms of treatment phasing
- 12:17 Level of support being a newbie dentist
- 15:03 Dental training
- 18:07 Overcoming lack of experience
- 30:34 Worrying about litigations
- 35:05 Importance of Health
- 39:59 Lesson from experience
If you liked this episode, you will love How to Win at Life and Succeed in Dentistry – Emotional Intelligence
Click below for full episode transcript:Jaz's Introduction: I remember my first few years out dental school extremely well, I was actually really nervous, really scared. I wasn't sure I was worrying about things like taking a bitewing. Can you believe that? The initial worry was how will I take my first bitewing? And actually remember it happening.
I’m like, ‘These are different holders to the ones I had at dental school. And this is a different unit and do I need to try to memorize the timings and the exposure and radiation?’ And just making really simple things really complicated because let’s face it, you haven’t done this a long time when your first day of the real world of dentistry comes. The other thing I remember about my first few years was CONSTANTLY DOUBTING MYSELF and not being able to make decisions because you can’t really make decisions or you struggle making decisions when you have a lack of experience. You’re constantly doubting your judgment. So, this is why it’s a very UNIQUE CHALLENGE. Being a dentist, fully fledged dentists out in the real world after dental school.
So, this episode is dedicated to those in their first few years of career, after qualifying, and all the unique challenges that you face as a newbie dentist. I’ve got someone on today, Saeed Cheraghi, who is literally just finished their first year out of dental school. And so he’s in a great position because even though I remember, he has just felt all those emotions, he’s actually literally has been through it all. So together, we share our stories and our advice. And the aim of this episode is to inspire SUPPORT GUIDE and encourage you to KEEP GOING, you’ve got this. So, I hope this non-clinical interruption because this is an interference cast. It’s very clinical actually this one, but it’s not eligible for CPD.
So, the ones that have got enough meat in terms of clinical gems, they’re the ones who are eligible for CPD and how you can get CPD is now by joining Protrusive Premium. So, if you go to protrusive.app on your web browser, or if you download the iOS or the Android app, you can actually join Protrusive Premium and actually get CPD episodes after listening or watching the episodes. Not this one though, because this one doesn’t qualify. But most of the other ones about 99%, are eligible for you to get CPD. So, straight after you listen or watch, answer some questions and get your CPD.
Otherwise let’s join Dr. Saeed Cheraghi to talk all about HOW TO THRIVE IN YOUR FIRST FEW YEARS OUT OF DENTAL SCHOOL. This episode is brought to you by Enlightened Smiles a premium brand of teeth whitening. They also run the Mini Smile Makeover course. Now, lots of dentists messaging me saying, ‘Jaz, which composite course should I do?’ One reason I recommend Mini Smile Makeover, which I went on, I paid in full before I ever started talking on the podcast is because of two reasons. I’m gonna give you two really good reasons why as a young dentist, one or two years at dental school, this will make a good course. Number one is because you can actually pay in installments. Okay, so you can actually, when I was doing courses, and I was newly qualified, there wasn’t a such thing as paying in installments for somebody that’s about 1000 pounds, because that’s kind of like the going rate nowadays for for a two-day course. So, you get to pay in installments, which is great. The other thing and this is real world, like from the heart, I’m telling you this that okay, you’ll go on this course.
But will you really be able to apply it the next day? And this can be said about any course when you’re a super young dentist, when you’re first few years qualified, it’s very difficult to apply all the things that you learn in the real world, which is why these treatment planning, history taking, basic occlusion. That’s why there’s this kind of bigger picture courses can actually be more helpful to young dentists. But the reason why I think even though you may not be able to apply the peg lateral and the multi-layering kind of stuff, and veneers and stuff straight away. The wonderful thing about Mini smile makeovers, something I’ve taken advantage of is that okay, you pay and you go once fine, I understand that. But then you get to go again and again and again. And there’s no charge the second time, the third time or the fourth time, etc. So, you get to sit at the back of the class.
Now, you don’t get through the hands-on fine, fair enough. And every time I go again, I hear Dipesh, I pick up a new gem that I just forgot from the time before. And I’m seeing the delegates threw their hands on again. I was like yes, I can visualize this. So, you get to go again the future for free, which is great. So, if you’re early in your career, and you go on it and you think, ‘I’m worried I can’t apply it.’ Then when you’re in the right environment, hey, you get to go again. And then it will be fresh in your head and you can get a second bite the cherry to apply again. So, another reason to join the mini smile makeover course.
Okay, now let’s start the main episode, Saeed Cheraghi, welcome to the Protrusive Dental Podcast, my friend. How are you?
Hello there, Jaz. Thank you so much for having me. It’s a big honor because I’m a huge fan of the podcast. So- [Jaz]
I really appreciate that man. And it’s great to have someone on because the point of this podcast is to help those who are literally has come out of dental school and they’re doing their first ever job. Now, in the UK that could be or you know, dental foundation training in the US. It would be your first job or wherever you are in the world, Australia, etc. It’s essentially your first few years out of dental school and when we’re talking before the podcast, we’re talking about some challenges. You made a lovely document for me in terms of all the challenges you faced and I was saying to you that you will remember things that I forgotten because I’m now nine years gone, whatever.
So, that you are actually the expert and you need to own that because you are the expert of being a foundation dentist because you’ve just done it and it’s fresh in your head. And so whilst all these people who are five 6, 10, 15, 20 years qualified can give advice, they are not as qualified as you are, because you’ve just been through it. So, I just wanted to say that, because any impostor syndrome that you have within you, I want to shatter it, because it’s, you know, you are definitely the expert in that. So, just tell us a little bit about yourself, where you qualified from and where you did your DFT? You don’t have to specific if you don’t want to be for obvious reasons. So, just give us a flavor of that.[Saeed]
Yeah, sure. So, life story summarized, I’m Saeed, a dentist based in the Northwest of England at the moment, I actually started off by studying Pharmacy, I gained my master’s degree in that and then completed my pre-registration, get an experience in hospital and community pharmacies. And then pretty much as soon as I qualified, I went straight into dental school. I was studying at the University of Liverpool, which I really enjoyed. And I only just graduated last summer 2021. And literally just now finished my foundation. Yeah. So yeah. [Jaz]
Where did you do your first year? Where did you do it? [Saeed]
In Blackpool. [Jaz]
Blackpool? Okay. [Saeed]
Cool. And it was a funny time because if you qualified last summer, you were one of the years significantly affected by the pandemic. [Saeed]
Definitely, anyone in my cohort, anyone in my year across all dental schools will know that we had a lot of challenges. And, coming straight out of dental school, going into your first job, I feel like I can speak on behalf of all of us, we felt a bit more underprepared than anyone else that had previously graduated. You know, coming out of it, we had a lot less experience and a lot of other people. And that was something that was worrying us when we first started working. [Jaz]
Can I ask you Saeed, and I hope not to put you on the spot. And if it’s okay, if you’re happy to reveal this, because I’m sure what you will say will reflect everyone else in your cohort is like numbers, what kind of numbers are we talking? How many root canals you do? How many extractions? How many dentures? Because, you know, I felt in all of my cohort, you asked them, we felt super unprepared as well, it’s one of those things, you’ll never feel prepared for the real world. You never will. And we could talk about how the first year went and stuff but just to reassure you never, no matter even if had like a 10 times more experience, you still would not feel prepared for the big bad world. So, talk us about numbers of you, your colleagues, what kind of numbers are people qualifying with nowadays? [Saeed]
So, I’m not sure about other dental schools, but in my dental school, a very similar levels. I had only completed two endos on human teeth in real events by the time I can’t work- [Jaz]
I’m not laughing at the number, I’m just laughing at the back that you know, the real human reference. Okay. [Saeed]
Exactly. Only two endos, no molars. So, that was definitely one thing I was very worried about beginning at work. And I told my supervisor at the start, I’ve only completed two indirect restorations. I had done maybe 12 to 14 extractions and my whole time, no retain roots. Nothing extra challenging. And I had done a cobalt chrome and a few dentures here and there. I felt okay in other things. But the more challenging aspects, I felt really underprepared as I just, you know, as you know the numbers now. [Jaz]
Well, I really appreciate you sharing that. And you know, if I was to go back, I did a ton of endo, just the way it worked out. And a good number of extractions, but for indirect, like crowns and stuff like zero onlays, one taught to me, we didn’t do them. We just had crowns. And so I did maybe around about 12, 13 crowns, qualifying. So, it’s again, not massive numbers here, right? Not 50 and 100s. So, I still felt like nervous about doing crown. So, we’ll talk about that. The biggest worry that I had to say, believe it or not, and I wonder was it just me? What do you do? Did you feel this as well? Breaking contact, just breaking the contact. [Saeed]
Oh yes! [Jaz]
That used to really, really put the fear in me. So, what aspects of indirect dentistry did you feel worried about in your first year? [Saeed]
I think when we say indirect restoration, but there’s actually so many different types involved, and each one has its own indication, and own way of preparation, own way of segmentation. So, I think I was exposed to very few numbers. So, for example, in dental school, I think I did a metal ceramic crown. And I think I did an all ceramic crown as well. But aside from that, I hadn’t done any onlays, I hadn’t done any inlays. I didn’t know about different types of materials. And when it comes to the treatment planning, you need to be aware of which situation each one is most relevant to, so that you’re able to prescribe it or recommend it. But I think- [Jaz]
And do the appropriate prep for that material as well, right? [Saeed]
Absolutely. But before you could get onto that stage, you need to see the tooth, inform the patient. Well, these are your options here. Which one would you like to go for? That was the thing that I would think the most underprepared for because I didn’t actually know what options I could present. I didn’t know. One thing I think we should get into more is how much of a challenge a restorability assessment is. When you first start is so challenging to know well, is this tooth actually restorable? If I go through all that after and you know the patient’s going through the effort as well, is it restorable or not? Do I have a highest chance of success or not? So I think that side of things was more sort of a challenge. [Jaz]
And Saeed, these borderline restorable teeth, these are the ones that need the endo. And then again, with the lack of endo experience, these are sometimes really tough endo cases, right? [Saeed]
They’re not like they’re straightforward, nice big pulp chambers in a 18 year old. These are the 58 year old with the history of large amalgam with pins and the really tough root canal treatment. So yeah, I mean, that is a tough scenario. And even like, when I was DF one, I used to get really worked up and stressed when I’d have like simple dentistry ie just someone who had God brought, lots of caries and just gum disease but which is basic, but even just to face that in my head, and like, do you do GIC first? Like, there’s some textbooks would say, do it that way, then bring it back and and mixing it into the real world and how you actually apply it to real world. Did you have those kinds of challenges as well, in terms of treatment phasing? [Saeed]
Absolutely. That was actually one of the biggest challenges I faced starting this job. It took me a very long time to become comfortable in that situation. Because I think in you know, again, something I’ve gone to dental school, you’re in such a nice little bubble where even the patients that come along to you even the challenging ones are too challenging, it seems. But even if they are you have someone right next to you, who you can call over actually, what should you here, what should you here? What should you here? And you take it in that way. But in the real world, you come across patient and for context, again, my cohort came into a situation where majority of patients hadn’t seen a dentist in two years because of COVID. Dentistry was just about getting back into the groove of things just then, around the period when we were starting foundation training. So- [Jaz]
And I see you have a lovely beard. Do you have to wear the hood and stuff? Do you have to wear a hood? [Jaz]
That’s crazy! Like, you lack experience, you’re starting new job? And you had to wear that bloody hood as well? [Saeed]
Yes, definitely. And it was, you know, all of it together was a challenge. Everything together- [Jaz]
Really overwhelming. [Saeed]
Yeah, obviously, that’s the one word if I could summarize that initial period of starting that job, I would say overwhelming. There’s just so many issues such a huge step up from dental school- [Jaz]
And all AGPs and that kind of stuff as well. It’s definitely hard. Every year group I qualify say they will always tell you that oh, yeah, we had it really bad. But I don’t think any, there’ll be another 100 years for another cohort come out. So you have one, one thing you can definitely claim. So I mean, we’re talking about all these problems and challenges. Tell me about the level of support you got not only within your practice, but within your scheme. I imagine they had to run this scheme in a very different way. Your study days are probably very different to mine, they’re probably back to basics. How well did you feel supported? [Saeed]
Well, I would say I was very lucky, I went into a really supportive practice, thankfully. I was the first ever foundation dentist, the practice had. So, it was a learning curve for the both of us. But my supervisor was really supportive always available to help me and the other dentists in the practice were also super supportive. You know, I probably at certain points was annoying them because I was quizzing them all the time about well, what would you do in this scenario? I was showing them my cases, how would you approach this? What is your approach to this, and from each dentists, each clinical judgment, you pick up a tiny little gem that you can then apply to your own work.
So thankfully, there was a lot of support within the practice itself, the whole team was really supportive. And then in terms of the scheme, the scheme was the study days that we had what good, a lot of the study days were online, as you can imagine, because of social distancing, and everything like that, which was a little bit of a shame, because I wish I could interact with my fellow Foundation Dentists and my scheme a bit more. It would have been nice to have a bit of a, you know, social gathering as well.[Jaz]
But you were still a close knit cohort, right, in terms of speaking probably on the WhatsApp group or something like that. Right? [Saeed]
Yeah, we have a WhatsApp group- [Jaz]
Sharing with each other some cases opinions, that kind of stuff, looking after each other. [Saeed]
Now, did you have, because even I had it in my scheme as well, where some people felt as though that for whatever reason, personality clash, or just generally the way it was, they didn’t get the best support from their trainers as they wish and they really felt not as supported as you did. Did you know of people in your scheme or other schemes that work that sort of feeling? [Saeed]
Yeah, I would say not in my scheme specifically. But speaking of catching up with friends from dental school, there were some cases where like I said, it is a personality clash. And when you’re dealing with humans, aren’t you not everyone is the same, has the same method of approach in teaching everyone is slightly different in their style. So yeah, I felt like some people were a little bit under supported there and I would say for the new dentists that are just about to start their foundation training now. Just please don’t be scared of speaking to your supervisor and they’re not going to think any less of you, they’re not going to think, ‘Oh, this guy’s rubbish. He doesn’t know the basic of like caries removal.’ For example, there’s there’s no harm in that. You’re just about to start there that literally to support you. And don’t be worried. Don’t be scared to speak to someone. And if your supervisor in the practice, you feel like you’re not getting further, you can always speak to the person higher up, which is the beauty of the foundation training. [Jaz]
Well, you’re speaking directly there to all the new guys and girls coming through about to get into DF1. But let’s send the message to because a lot of DF trainers listen to this podcast, right? [Saeed]
If you’re in a position to train, I think it’s important now more than ever, to just be a little bit more lenient of your time, have a few more blocks in your diary, especially in the first few months, where your trainee will need you more. Any advice that you can give to trainers out there? [Saeed]
Yeah, I would say, firstly, please just be understanding, like, I’ve just kind of give a brief explanation, for example, someone in my year or the year below might have less experience than the previous foundation dentist that the practice has seen. So, please be understanding towards that, please be understanding towards the fact that the final year of dental school is stressful, you get a really short summer on your back straight into the swing of things into a really overwhelming environment, and everyone has their own pace of learning, you know, it’s like any other skill, some people will get the hang of things a lot quicker, but somebody will take a bit more time. It doesn’t mean they won’t get there, it just means they’ll take a bit more time. Please be understanding towards that. And like you mentioned, it’s the best thing to have those gaps in your diary, where you can go in the room and observe or just help out if the foundation that is, especially on the cases they feel most worried about. [Jaz]
Saeed, did you have any over the shoulder training ie you are doing a restoration and then your your trainer was watching you. Did you have any of those kind of you were taking out a tooth and your training was watching you did you have any of those? [Saeed]
My personal style is if I feel like I need that level of assistance then I will ask for and my supervisor was super welcoming towards that. But otherwise, I kind of feel a bit more pressure. If someone’s just watching me the whole time. I feel I would much rather, if I feel like it’s within my competence, I’ll give it a go myself. And then if there are cases where I can’t, you know, I can’t overcome it myself. That’s when I’ll ask for assistance. [Jaz]
That’s exactly how I was as well Saeed as DF1. But then something interesting happened to me when I was in DCT1, I was at Guy’s hospital. So, my oral surgery post, and I was really struggling taking this tooth out. And so this registrar came over I said, ‘Okay, I think I need some help.’ And instead of jumping in helping me she just stood by me and said, ‘You do what you gotta do. I’m gonna watch you.’ And Saeed, that was the most powerful learning experience I ever had. The way she was coaching me to hold the instruments the way she was guiding me on what to do was a super and I’m actually extracting myself with her support.
And so sometimes maybe for those listening out there maybe to have a chat with your DF1 trainer and maybe if you struggle with extractions and you’re nervous about extraction is some really okay so what, can we do some over the shoulder training where you watch me and and this needs a special type of trainee as well that you need to accept that it’s gonna be a lot of pressure on you, when someone’s watching you. It’s not nice, I agree on that. But if your principal’s up for it, and they’re supportive and you feel comfortable to do that, then I think take up your principles on that opportunity would be a good thing because now what I want to shift this podcast towards. Yes, we’ve mentioned all these problems and all these issues. Let’s come up with some solutions. So Saeed, tell me about the kinds of things that you think helped and will help the future generation coming through in their first year to overcome this lack of experience?[Saeed]
Yeah, so in regards to the lack of experience thing, to any young dentist just about to start, what you need to do is initially don’t put any extra pressure on yourself, be understanding towards your own situation you’ve literally just at the start of your career and there’s so many things you need to learn. You think that you come out of dental school thinking you know things and then you go into the real world and you realize you actually don’t know that much at all. So- [Jaz]
So true. [Saeed]
Be understanding towards your situation. At the start, don’t get upset at yourself because you know all of us in this situation we really we’ve worked really hard to get here so we really care about what we do. We care if something goes wrong, it really does affect us. But try not to put extra pressure on yourself because at the start, you’re just figuring out the absolute basics like when I first started even taking x-rays was a challenge. I was coning everything at the start. [Jaz]
I’m so glad you mentioned this because like you people think about the crown preps and struggling with endo. [Saeed]
But I’m with you. The first bitewing I had take, I was like wait am I put this on correctly? Was it like this or was it like that? And then the x-ray machine will be different to the one that you trained with and then the settings and stuff so you’re so right actually even just taking radiographs. You need training on that all over again. [Saeed]
Absolutely. It’s the little things that you don’t think about that you think, like I remembered column about this topic I could run my column my dad once after work and I was like all my extra combat and my dad was like, ‘Wait x-rays, is that is that hard?’ I just thought everyone can just do it like all dentists just seemed like they can do it. But instead, at the start is those little things that you just don’t have any experience. And that seemed like the biggest challenge. So, don’t stress yourself, I need to do these, you know, extremely beautiful restorations or these complex cases and treatment planning at the start be really understanding towards yourself. Just learn the absolute basics, deal with the absolute basics. As times goes by, the way that you elevate your game is by keeping good records of what you do.
And at this point, I really want to recommend everyone to get yourself a DSLR camera if you don’t have one. But I think even better is to just get an intraoral camera because firstly, they’re not that expensive. Secondly, they’re super easy to take pictures with. What I was doing, I was just taking pictures of teeth. It looks like a little thicker pen. You’re just putting them out, take a picture of the tooth. Later on in the day, when I’m sat down with my supervisor, I’d be like, ‘What do you think of that? Do you think that’s restorable?’ For example, how would you approach that? Would you take up the caries? All those kind of stuff?[Jaz]
So much better than just showing a radiograph, right? [Saeed]
So much better. And so, if you’re not in a position to get a DSLR for a reason, or certainly if you’re gonna get a DSLR and when we sat in the corner, you won’t be using it, then definitely just get an intraoral camera they’re about 180 pounds nowadays, this week. 150, another 180. But it’s worth every penny. Even if you have to like first paycheck like my first paycheck, I bought a DSLR. I’m very vocal about that. So, if you’ve got an intraoral camera, it will be the best investment you make. Get it in your first month, go on Amazon now, get it, order it. Stick into USPS, plug and play. It’ll work with your software usually exact to whatever using and you need start taking photos, not only because you can discuss that with your trainer, but it’s going to really help you, the young dentist, first year out when you need to communicate with a patient. That picture is a thousands words in itself. It does half the communicating for you. [Saeed]
Absolutely, exactly that. Because for example, like I keep folders of all the pictures I’ve taken across the year and at the start if you look at my the photos I was taking on the site, it was just literally did I remove all the caries? I was just checking for myself or to show my supervisor, did I remove all the caries? This is where I started. This is what I ended my cavity preparation with all the cariers gone. Later on in the year, I was doing taking pictures of preps and I was like what did I get the right margins and everything. I think you keep track of your own work. And this is really just a tool for yourself to be able to reflect on it and be like, ‘Well, next time that this same case comes across, I want to do it differently. I want to do it this way. And that is like you mentioned. [Jaz]
Really good. [Saeed]
When you come out really apprehensive about the level of experience that you have. These are the things that will slowly, slowly get you to elevate your game. [Jaz]
And if you come across a tough case, you know, sometimes a tough case can be a single tooth problem, which is really puts you on the fence and not sure. Okay, and that can be tough. Or someone’s got a multiple teeth problem, failing bridge, and a bruxist and TMD on one side, and some perio localized as all sorts going on. Just focus on getting a records and saying, ‘Patient, there’s a lot of going on. To give you a flavor, it’s x, y, z to come up with the best plan for you, I need to sit and think about it, there’s too much going on. I will invite you back. And we’ll have a chat.’ And in that time, that’s when you speak to your trainer. And that’s where you maybe hit the books or go to some online webinars or whatever, because I’m a big fan Saeed of just in time learning. For example, imagine you want to improve your root canals of central incisors, for example, right? You’re not gonna, on Saturday evening, just like you know what today I’d like to improve my central incisor root canals and open up a textbook and watch some videos on YouTube, wherever.
When that case comes along nd you know that you’ve got it next week, that’s when it’s actually going to stick in your head. And that’s when it’s gonna be relevant. So, just in time learning accept that okay, we don’t know very much. But as an everyday, you know, okay, today I need to focus on the wax tryin stage, because I’ve got that next week. Today, I need to focus on how to prep the distal margin of a lower molar because that’s what I’ve got next week. And if you keep doing that, by the end of the year, you will have covered a lot of ground because it’s a more focused way of learning. Did you employ that technique when like that?[Saeed]
Well, yeah, definitely did that kind of, Can I just say something that you really quickly brushed over that I think for you is now really second nature. But for young dentists in my position- [Jaz]
Was actually a big deal, which is you said about how when you speak into a patient, you could be like, well, I take these pictures that aren’t getting an answer for you next time. I know from experience this time last year, doing that was a really scary thought because I felt like I should have all the answers right now. And if I tell the patient, ‘Oh actually can I tell you next time.’ That might come across as incompetence, but I think with time you learn that that’s completely normal. That’s completely fine.
Like, that’s something my supervisor really instilled in me as well. When I was at large case with multiple different issues going on, I would be really upfront and say, ‘Look, these are the urgent things that we’re going to deal with. Here’s an answer for what we should do. But we also need a long term plan. Can I please just get you back next week for a 15-20 minute discussion by then I’ll have the treatment plan ready for you?’ So-
Yeah, that’s a really important skill that I think young lads shouldn’t be scared doing that. [Jaz]
You’re right, that you feel as though that you should know the answer. And I remember being incredibly frustrated with myself saying, you know, this is simple caries and perio case, why do I need more time? But actually to even just sit down and chart on the software exactly how many restorations appointment one appointment two, appointment three, exactly how you going to the face it, to have a think about how you can restore it and stuff, discuss costs with the patient, etc. that, aside from the examination can take a lot of time.
So, even the simple dentistry at the beginning, it’s completely okay to take those photos, deal with the urgent thing like you said, and say to the patient, look, ‘An architect will go away and give you a blueprint, I’d come up with blueprint for you. And then when I do, I will make sure that when we make this build this foundation that will last.’ And if you just communicate like that with confidence, the patient be like, ‘Okay, I’m glad.’ Because the opposite of that is what we call shotgun treatment planning, right? Someone’s got a gun to your head like, ‘Okay, treatment plan right now.’ And we feel this pressure everyday. But there’s no need for that, especially in your first year. Because you haven’t had enough failures yet to know what’s gonna work, what’s not. And so you need to have those discussions and don’t be shy. So, I’m glad we emphasize that on that a little bit more.[Saeed]
And so following on from that camera, taking a pause and then discuss with your trainer, which other strategies would you recommend to our peers? [Saeed]
I would say that the biggest skill that you kind of, throughout this entire year is learning how to manage patients and talk to patients. And that should be the bulk of the emphasis of a lot of the subsidy, especially at the start. There’s two things that you need to really be able to do. One is to truly be able to get valid consent. And by valid consent, it means explaining to the patient in layman terms, what’s going on, pros and cons of whatever you’re suggesting, and then allowing them to make a decision for themselves. Because it’s really easy for us, we have our own dental language. And it’s really easy for us to throw those things like upper right six, all these things. But a patient like, just imagine if your parents are in the dental world, they wouldn’t understand half the things you say. So, learn how to speak to patients in a really nice concise way.
The second probably the biggest skill that you can learn is learning how to manage expectations in my personal opinion, it’s managing expectations. And that’s going to save you so much pressure and stress in the future. When I deal with a patient, I’m completely honest with them, I say, ‘This is the treatment that needs to be had. This is what we need to do. Here’s are the pros and cons for this. What do you think? Would you like to go ahead with this or not?’ And then, for example, managing expectations that I’ll just give one quick example Jaz, from what I learned in dental school. In dental school, I was having a real struggle with getting nice, accurate impressions. And I was taking maybe three, four or five attempts sometimes. I’ll go to a tutor show.[Jaz]
I’ve been there. [Saeed]
Yes. Show the truth. I never like no go again. [Jaz]
Hearts and comment. [Saeed]
Yeah, I’m going back again to renovation. I was so sorry. Again. So, sorry to do it. But if one thing that someone taught me was if at the start of the appointment, I just told the patient with today’s the impression stage, I might need to take a few different impressions because I need to, I want to get the most accurate impression for you so that I can give you the best product at the end of this. Then if you go to your fourth attempt, fifth attempt, instead of them thinking, ‘Oh, this guy is taking so long.’ They’re actually like, ‘Wow, he’s really putting the effort. He really wants to give me the best.’ [Jaz]
Guys, if anyone’s multitasking and you miss that, you need to listen that again. Because Saeed has given you wise beyond his years, what he just told you is essentially what he’s changed. He’s changed the frame of the appointment. So, before the frame was apologetic, I’m sorry, I’m sorry that we’re doing this. But we changed the frame and set the tone the beginnings that, ‘Hey, we really are serious about getting high quality dentistry and to get high quality dentistry it might take me a few impressions to make sure I’m really happy with it.’ And then you’ve really set yourself up for success. So, that is a really great tip. Well shared, Saeed. [Saeed]
Thank you very much. Yeah. So, I would say genuinely there’s the whole dental side of things, the technical aspects of things. But, if you are good with communicating with patients, managing patients, because you’re going to deal with conflict is guaranteed. I mean, at some point in your career, it’s different guaranteed. I don’t know if it’s in your first year but you need to deal with conflict. You need to learn how to cope with that. You need to learn how to cope with nervous patients. The biggest shock to me, that I don’t think I was fully prepared for. It’s just how much of the population adults especially are so scared of the dentist that you know, genuinely some are petrified.
How do you deal with that kind of patient? How do you deal with children? How do you educate patients? How do you provide the information in a way that’s concise, and they can understand it, so that when they go away and come back to you in three, six months, that I will actually I’ve been doing the interdental brushes, like you explained, for example, those I think this year, there’s a lot to learn dentally. But these, if you can develop these skills this year is going to set you up for the rest of your career, it’s going to have the biggest impact,[Jaz]
Very true. And building rapport. And having conversations with patients is just the most, I think, if you just master that in your first year, or try. I don’t thing you ever master it. But if you really put some attention and energy towards actually conversating with patients and communicating in the best way possible in a concise and clear way, that’s going to really give you a leg up for the for the rest of your career. So, when you are speaking with your patients, I would say actually, just I’m gonna backtrack. Now I’m gonna say you mentioned and I picked up on it, about when it comes to speaking to patient, you said that how important it is.
And obviously, it’s important because of consent, as you mentioned, and you mentioned about good record keeping, did you in your first year, worry about litigation? Because now that you’re qualified, it gets drummed into us that in your first few years, you get litigated so many times over. Was that a concern for you? Or were you just focused on learning in dentistry that actually that was in the back. That wasn’t really at the front of your mind. How did you approach that?[Saeed]
I was listening to your podcast with Lincoln Harris recently. And he mentioned about how the last lecture you have before finishing dental school is someone coming from like these defense organizations saying, ‘By the way, you’re gonna get sued.’ So, it’s impossible to not think about it, I think it’s something definitely that’s in the back of all of our heads. And it was definitely something I was aware of. Now, I can’t prepare myself, because I don’t know what the real world is like, that’s where the experience of someone a lot more experienced than you will help you along with that. So for example, my supervisor was showing me cases, for example of complaints that have happened, or people are making claims. And he would tell me about, well, this happened because of these reasons. And these, this is how you avoid it. And then he would, for example, give me pointers on what to definitely include, in my record keeping.
The conversations that I’ve had with patients, make sure you mentioned this, make sure you inform the patient that for example, that they have something called gum disease called periodontitis. These are the consequences of it, that could happen later down the line, you know, we live in, unfortunately, we live in that kind of, well, there’s no escaping it. It’s just something that we need to learn to deal with. Because God forbid, if it does happen to us, then that’s when the real stress comes. But if you’re already aware of it, and then you can always try and protect yourself in the long term.[Jaz]
Well said. And it was just must been so tough, you know, already coming out with less experience and trying to learn but the same time with this knowledge that actually you got a little bit defensive what you do. So yeah, I mean, kudos to you for making it through. One lesson I can share with those listening is a lesson that is not my own original lesson. It’s a lesson that I picked up from I think was a book and was a chap called, Amen Armenian, very well known dentist and he wrote something really fantastic. He said, ‘The secret to not being sued’. And this is, who knows, is evidence based or not, but it really resonated with me, he said something really great. The secret to not being sued is there’s three things which you need to do. And if you do two of those three, well, then you’ll be okay. Right? So the three things are the following. Be nice to your patient. Okay, be likable, be nice. Okay.
Number two is picking the appropriate and appropriate treatment plan. And three, executing that plan well. So, even if picked the wrong plan, not a good plan, but you did it really well. And you know, the quality of dentistry is really good. Okay, that counts. So, if you do two of those three really well, you’re probably gonna be okay. And that’s always stuck with me, right? So sometimes, you know, because of lack of experience, you might not pick the best treatment plan, but you did it to the best of your ability. And the patient liked you and you’re nice. And I’ve always loved that. And I think if you extrapolate further from that, you can always be nice to your patients. That’s an easy one we can do. And you know, just if you get the other one of the other two, right, you’re gonna be okay. Have you heard about one before?[Saeed]
Actually I haven’t. That’s a really good way of summarizing. And I think in regards to the like you said, you can always be nice that’s for free. You don’t have to put in the extra effort or money into it be nice is always free. The second thing, the final thing you mentioned the quality that is something that will hopefully improve with time, you can’t always guarantee it. But I think if you genuinely, in regards to the second point, if you genuinely have the patient’s best interest at heart, even if the final result, you come to the end of and you actually like I wish I did it differently.
But if you go put yourself in the first instance and you tried your best like I’m doing this out of pure good intentions, I think that this is the best course of treatment for you. Then you know a patient will always read they will understand that you tried your best that you didn’t do something that benefits you as a dentist you tried your best to do something that benefits the patient. And I think a lot of them really understand that and appreciate that.[Jaz]
Very good. Any more on your list in terms of trying to cover one or two more themes here in terms of interest time. So, what other tips? So, you mentioned already about the intraoral camera about getting good at communicating, we tackled a lot about, you know, preventing litigation and how that should be the back your mind, managing expectations, I love the frame that you taught everyone. That was wonderful. What else? [Saeed]
So, again, I’m not gonna go specifically into dental things. But this is a topic that I think deserves a lot more attention that I don’t think we get enough attention about. And that is the health is our health. What I mean by that is both physical and mental health. This isn’t a mental health, yes, there’s a bit more awareness towards, especially physical health, I don’t think a lot of attention is placed on it from training in dental school, or our schemes or work or social media or anything like that, in every single profession, you need to protect the tools of your trade, in order to be able to have a, you know, a nice long career, hopefully, for example, footballers, they need nice healthy legs to be able to have a living to have an income.
If they get injured and they can’t play, then that’s the income done, it’s finished. It’s kind of the same for us, we have a very physical job, which means that we have to be able to protect the parts of the tools that allow us to work our hands, our eyes, our backs shoulders. Next, there’s not a lot of emphasis that’s placed on this, which I think is a shame, because what is it that provides you longevity in your career is if you can keep your body healthy, and get it to a point where you can keep continuing to work. Otherwise, that’s the income then. So some of-[Jaz]
Did you have a epiphany moment in your training that you made you realize this, or is this something that you have a background in? Because you have to do a degree before? What makes you compelled because it’s wonderful advice. But what made you realize this? And then also, what have you been doing to practice this? [Saeed]
Yeah, really good question. So, I was younger, I used to play a lot of football or a pretty decent level. So I was taking football really seriously. And the lessons that I learned from there, I’ve kind of started to apply for the rest of my life. That’s football as a career just like dentistry, for example. And into and when I first started working, I think I have kind of like an old man’s body because I was in a lot of pain from my neck, my shoulders, my back, when I first started to the point, sometimes we’re sleeping in certain positions was painful that night, I was actually struggling about at the start.
So, that’s what really got me into it to focus a lot more into it, look into it, research and see what works best for me. And I’ll share some of the things that have worked for me in terms of physical health, and what number one thing that’s made, the biggest difference is regular routine stretching, I stretch, I do a full body stretch before work before I go into work. And I do want at the end of the day as well. And I stretch all the muscles in these areas that allows me to just loosen up, get some recharged again for the next day.
Number two is I started going to yoga lessons at my gym. And yoga was again, another really helpful tool that I found. I do weight exercises in the gym as well we strengthen those muscles that I need for work. And swimming, I found to be really helpful as well. So everyone might have a different style of doing things. But I would just recommend everyone to really put some more emphasis into your bodies, to allow you to hopefully have a nice long career. Otherwise, maybe by the time we get to the 40s, 50s you don’t want to carry on and well because you’re in pain. And then if we step aside from the physical body, in terms of mental health, that is also a huge part. Because when I’m at work, I’m operating a hyper focus level all day every day because I’m at the start of the career and I don’t have that much experience, it doesn’t feel second nature to me, I can’t just do things without thinking too much about it. Which means that I’m hyper focused on thinking about every single decision I make every single action that I do everything I say to the patient, everything they say to me, so my mind is like full throttle all day every day, which can tire you out it can that’s what leads to burnout in my opinion.
So, the way I’ve learned to deal with that, which I hope could be useful for this to listen to, is what I did was I created like a mental barrier in my mind of which separates my professional life and my personal life. And that mental barrier was the physical building of the practice. And what I mean by that is when I’m within the practice itself when I’m physically in the practice that’s me say the dentists, you know, really on top of it with work, taking things really seriously. Any responsibilities to do with work such as admin work, record keeping, portfolio referrals, anything to do with dentistry, that’s when I do it in the building, which meant that a lot of the times I was leaving the practice an hour or two after work had finished because I was just, I wanted to get all my responsibilities done. Because the moment I stepped foot after practice that saved the dentist. And that’s not to say that dentists anymore, that’s just mean almost normal Saeed. And that is what allows my mind to kind of recharge. Because if I take work home with me, I’m always in that mindset. And I’m don’t ever get a chance to recharge, refresh, get ready for the next day.[Jaz]
Very good. I think like I said, why is beyond your years, my friend, very good. Just to wrap up the episode, let’s talk about one experience, each that you remember from your DF one year, your first year out, that you found like a real challenge. And then what lesson we can draw for that. So, I’ll go first give you an idea of what would the angle I’m taking. It was Christmas Eve of my first year in work. So, DF one for us. And the volume of patients I saw that day, in pain, tomorrow is Christmas, you got to get them out. It’s just really, really, really was a challenging day for me, I just felt so physically destroyed and burnt out on that day. So yes, all the advice that you gave there. But when it comes to those scenarios, you just have to really keep your composure.
And obviously, because you see if there wasn’t much support available for me on that day, you have to keep your composure and give your everything, to that one patient that’s there who’s put their trust in you. And so you’re gonna have these days that you have just a huge volume of patients. But the show must go on. And you have to have to have to give every single patient your best. So, it’s kind of like showbusiness, even though you’re like destroyed inside, you have to give your best, present your best self to your patient, and you have to care. So, like you said, put your best patient’s best interest. That’s, you know, the classical way to say it, but you’ve just have to actually care, care with a capital C-A-R-E. So, that’s my sort of memory of having a really tough experience, do you have an experience that you want to share either isolated incident, or just generally?[Saeed]
If I can cheer, can I give two quick examples. Som the first incident is a bit of a lighthearted one. In my, I think my first or second week, literally just about to start seeing patients, just for some context, I was taking on the patient cases from the previous practice owner who’s semi-retired. So, these patients had seen the previous dentist for like 20, 30 years, some of them, they were really used to that previous dentist. I remember seeing this 78 year old, I think it was 78-ish gentleman he came in, and I was going through the same history taking that I learned at uni, you know, everything risk assessment, every tiny little question detail. I was asking everything. At one point, he looks at me and I could tell it was losing him. At one point, he looks at me and he goes, ‘Look, kid, can you just look at my mouth so I can leave?’ And I was like, ‘Yeah, sure, of course, I was just about to do that, I should just quickly do that.’ And the lesson that I learned from that is you have to be adaptable as well, you know, I have my own style, the previous dentists had their own, but you have to be adaptable, you have to kind of know your audience, and know how to approach each patient in their own way.
Because that’s when you can kind of win their trust, and be able to provide good treatment. And on a more challenging one, there was this lady who hadn’t seen a dentist again, for two years, you know, there was a lot going on her mouth, a lot of retain root, a lot of unrestorable teeth. And she came to me and she said, ‘Could you just please, like, whatever you do, just please fix my mouth so that I look presentable for my daughter’s wedding. That’s all I want to do. We’re on the top table, everyone’s gonna take pictures, please just make me look presentable.’ And what I said before you always try to manage expectations, and you never try and make promises. But in that case, I said, ‘Look, I can’t promise anything. But for you, I’m going to try my absolute best.’ And I went through the stages, you know, we did some extractions. And each stage I was going along with a denture stages as well. And it got to the point where we were just about to fit it where the patient had a lot of post operative swelling, and abscess from the area, which was something I couldn’t predict because we were under a time pressure. We had to kind of speed things up, we had the same amount of time that could give to allow healing to take place. And it really, because you get emotionally invested yourself in this situation, it can have an impact, it can have an impact on you. And by the end of it, she couldn’t wear her top denture unfortunately. She could only wear her low one. It was enough to kind of take pictures with. But I think the main takeaway that I could take from it is, like you said, care as much as you can. But just know that some scenarios are just out of your control, no matter of how much of a good intention you have, how much you try your best. Sometimes you just can’t achieve it out of things, out of your control.[Jaz]
Saeed based on that, I mean, great lessons you shared there. And I think some things to remember is you’re not a pizza, so you can’t make everyone happy. You have to care. You have to care. But ultimately you can’t take your patient’s problem and own that. So, I think it shows that what a sweet and caring dentist you are that you feel emotionally invested. And I, for the first four years, like I was in bed thinking, oh my god, I just did an extraction today, what if my patient has a dry socket? And what if they’re in pain and I used to be emotionless of myself, it was silly. You know, I always teach now, don’t own the patient’s problem and don’t take their problem home with you. But that’s different from not caring, I’m saying care, still care about the patient, but you can’t own their problem. We have enough problems in our own lives. We don’t need to start carrying all our patients problems.
So that’s, that’s really important. And then yes, the other lesson there is, if you don’t talk about stressful dentistry, you talk about dentistry under a time deadline. Oh, my goodness. So, these are the cases where anyone if anyone ever says there’s a time deadline, okay. And even if it’s a decent time deadline, you always, always, always have to put that frame on that. Listen, anything can happen. We cannot guarantee anything and try your best be like but listen, this is unrealistic to put any sort of time pressure, because we want to get the best outcome here, not a rushed outcome. So just be careful in those scenarios. Saeed, thank you so much for giving your time. And you know what Saeed, I really respect you. Because you’ve made yourself vulnerable, you reveal a few things about your experience levels and the annual training and stuff, which I really appreciate. Because a lot of people will be able to listen to this, oh my god, it’s not just me. I’ve got someone out there who’s who’s who’s been through it just and I can do as well. So, that’s really great. Tell me what you’ve got planned over the next year, what kind of things you want to learn? What’s on your personal development plan? What kind of feelings that you’re having in the real big, bad world of associate life?[Saeed]
So, in regards to dentistry itself, at the moment, I’m really just enjoying kind of getting a taste for every little tiny pocket of dentistry there is. I’m enjoying that it’s sneaking my head through through the door. I mean, ‘Oh, this is what oral surgeries like, this is what endos like.’ So, at the moment, I don’t have a clear set plan. I’m kind of just finding my feet. And then with time, hopefully whatever feels right for me, I can pursue. But one thing that I’ve always known that I want to get into in the future is I’d hopefully like to get to education. And whether that’s in the form of being a clinical tutor at university or becoming a supervisor for foundation dentists or even like setting up courses like you do. And teaching others I know that’s hopefully something I want to get into in the future. And the reason why I kind of came on here to share my stories is because I want others to know that what you’re going through isn’t unique completely to you. You know, I wish the kind of stuff I know now, a year ago, which is kind of why what gave me the idea to come and share my stories with others and people should know that you know, this is a hard job. This is an overwhelming job. For a lot of cases it might be the most difficult graduate job straight out of uni coming to your first ever full time job. This might be the most difficult one out there if you compare it so don’t feel bad about it, be understanding towards yourself. And definitely with time you’ll get better because experience is the best teacher in life. [Jaz]
Man you are so wise beyond your years and I think you’ve got a great career ahead of you just your attitude, your mindset, everything’s just seems perfect to me. And I think keep doing what you’re doing. I think you’ve definitely got your head screwed on right? So, it must be saying about these postgrads you know postgrad dentists are always just on the ball always finding something you know about having a prior degree already. So, I always find you guys are so much more mature. So, that probably explains why you are so mature despite being so young. So, that’s amazing. And I wish you all the best with that. [Saeed]
Thank you so much. [Jaz]
Please tell us how we can follow you on the socials. [Saeed]
Yeah, so Jaz, I’m sure you’re going to tag me on the social but I’ve got a dental page. It’s D-R Saeed, drsaeed_dental, is my Instagram tag. Any young dentists out there if there’s any help or advice that you think that I could give, any help at all, don’t hesitate. Find me on social media, get in touch. If I can help I’d be more than happy to do so. Just before we wrap up, Jaz, I really need to thank you not just for inviting me on here today but also for the huge amount of inspiration that you provide not just for me but anyone that listens to the podcast. I have learned so much from listening to your podcast that I’ve been able to apply to my work and I just hope that you keep doing it and you achieve bigger and greater things hopefully with time. [Jaz]
Amazing. Well, I appreciate you being part of the Protruserati and you’ve done us proud. You made us proud of this episode. You should be really proud, I think you’ve handled everything you get. So many gems that will be really helpful to all those new events coming through. Saeed, all the best for your career. I’m gonna keep an eye out for you, buddy. I wish you all the best. [Saeed]
Thank you so much as much appreciate it.
Well, there we have it guys. Some real well themes covered there in terms of just how difficult it was for me to break contact, right? Like breaking contact is a thing that we don’t talk about as being tricky but it is, especially when you haven’t got the hand-eye coordination because you haven’t done enough preps because you haven’t gotten enough muscle memory yet. And so I really appreciate that Saeed shared his sort of numbers with us and they’re probably very similar to you listening right now. If you made it all the way to the end of this episode, so kudos to you Saeed for making this happen. Thanks so much for supporting all those young dentists listening here. And whether you’re a seasoned practitioners, just want to get a feel for what our younger colleagues are going through at the moment then thanks for sticking around to the end. And if young dentists you’ve just discovered Protrusive Dental Podcast thanks so much for joining me. You’re officially now a Protruserati, so hope you enjoyed that episodes and I’ll catch you in the next one guys.