As a “boomer” dentist with four decades of dentistry behind me and with just a few years to go, I have offered in this article to reflect on how I most usefully expanded and upgraded my skills from graduation.
Many senior or employer dentists perceive that new graduates to the profession are tending to restrict the range of dental procedures which they are carrying out. Whether they are constrained by the limits of their undergraduate university training, by the warnings from risk management personnel or indemnifying insurers or their own cautiousness, it is not clear.
This article seeks to illustrate how one senior dentist, typical of many, has achieved the skills and confidence to carry out some ‘difficult’ but safe procedures. It is hoped that those new graduates may themselves follow this pathway and safely perform a broad service to the public within general practice.
I don’t claim to be anything other than a GP dentist who tries hard and sets myself high standards – like most of my professional colleagues – and who has sought to keep up with evolving techniques and knowledge.
In the beginning
On graduation I really only knew the fundamentals of being a dentist. My undergraduate course had taught me firstly the sciences that back dentistry then progressively under the supervision and guidance of academic staff and clinical tutors, I developed manual and interpersonal skills along with the carrying out of basic clinical treatment on patients.
So with a handful of extractions (none surgical), a few crowns and dentures, a bridge, a good number of routine restorations and a couple of “perio” patients, I graduated and was registered as a dentist to work on the public.
My first couple of years were busy and exhausting. The demands of every day practice, although perhaps simpler than today, were enormous as a new graduate. I was lucky to have worked in a practice where the senior dentist was an active mentor and this facilitated patient management and my introduction to “dental business”. In addition I worked with another young dentist with whom I was able to freely interact and together we learned off our respective daily experiences.
Carefully we expanded our treatment range but it was clear that we had to build on those rudimentary skills.
Along the journey
A couple of years after graduation I was invited to be a clinical tutor in paedodontics. It was clear that I urgently needed more knowledge; revisitation of basics, attendance at a couple of courses and interaction with fellow tutors all combined to allow me to hopefully be useful to those students over several years.
As a GP dentist I knew that I had to upgrade all the other aspects of my practice. So began more frequent participation in short courses, attendance at meetings of the ADA which had guest lecturers and more organised interaction with fellow dentists through a study group.
Courses then were less frequent in the 1970’s and often overwhelmingly technical but somehow the contemporary developments, for example the introduction and refinement of early composite resins, found their way successfully into our daily practice.
Courses – Short and extended and CPD
In the mid 1980’s I was persuaded to attend a week long extended perio course which commenced with revisitation of basics and contemporary theory then moved to interactive discussion and finally clinical work. This extended course offered greater depth to a lecture only format and resulted in a more confident expansion of my range of treatments. Subsequently I attended extended courses in the other main facets of my dental practice. These have had the biggest single impact in my delivery of dental treatment.
About this time I commenced attending ADA Congress. Not only are these an opportunity for social interaction with colleagues but they are invaluable in keeping up with the latest developments, mostly minus the commercial “hype”. Foundational knowledge is refreshed and techniques and equipment can be explored. Presentations on dentistry in a community and epidemiological perspective, along with HR and risk management, are all vital components to successful practice covered in these congress programs.
At a pivotal stage of my practicing years I undertook an extensive personal development and motivation course entirely outside the dental realm. For me, this was an invaluable aid and personal reinvigoration which I would strongly recommend to colleagues.
Universities and associated Foundations along with some ADA Branches hold lecture programs and utilize clinical facilities to enable theory to practice experience for attendees. Many of these courses are extended and offer the invaluable assistance that I have mentioned above.
There has in recent times, been a proliferation of commercially presented courses and with the obligatory Continuing Professional Development (C.P.D.) required under the new National Registration Scheme there will probably be more. Many will be very good but the real skill will be to determine which will be of best value.
Publications – print and electronic
Whilst paper and print has been the backbone of information dissemination there is a steady progression towards electronic sources.
The Australian Dental Journal with its sharper articles in recent years has long offered practitioners that steady stream of contemporary research, case reviews and technical evaluation. A scan of the abstracts of each article will tell you of the relevance to your interests.
Other Dental Association, Societies, specialist groups, and even PI insurers publish excellent work which fills in the various niches of other information required for operating in these complex times.
‘Dental Files’ of course are ADA initiated CD’s which enable a convenient way of picking up snippets of information.
Therapeutic Guidelines produced by the ADA in 2007 is another indispensable resource which I most commonly use and always keep in my surgery.
The Internet equally has found a place in my knowledge resource bank with authoritative websites on medications, disease presentation, PI and safe practice issues and so much more.
Looking Back
The relentless changes to materials and the way that dentistry is practiced must be faced if a dentist is to remain relevant and contemporary in the care of their patients.
Your graduation skills are just the beginning. Not only in the past but now by legislative regulation under the new National Registration arrangements, there is an obligation for all practitioners to be demonstrably involved in attending courses and other learning exercises. (Mandatory C.P.D.)
This should not be seen as a burden.
There is a range of ways in which you can continue your life long learning and in case it helps you, I have outlined what has been of greatest help to me.
- Extended courses
- Congresses and specific topic courses
- Participation in student training where practical
- Ongoing back up with print articles and guidelines
- And now – a plethora of online and information sources
I still enjoy doing dentistry and accept the challenge of new learning until the day I finish.
Bruce Noble
General Dental Practitioner
Chairman Guild/ADA Liaison Group.