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How Long Will It Last?
17 Plays2 days ago
Savanah Craig, DDS and Ronnetta Sartor, DMD are the dynamic duo behind the "Beyond Graduation" podcast. Both are practicing dentists with a passion for guiding new dentists through the turbulent early years of their careers. Dr. Craig, known for her insightful approach to dental practice and keen interest in new dental technologies, teams up with Dr. Sartor, who offers unique perspectives on dental education and practice challenges. Together, they engage in candid conversations about growth, setbacks, and the realities of working in the dental field.
Episode Summary:
In this engaging episode of "Beyond Graduation," co-hosts Dr. Craig and Dr. Sartor dive deep into the nuanced world of practicing dentistry beyond dental school. Kicking off with a humorous look at their podcasting routine and typical wardrobe choices, they transition into a more serious discussion on why dentists are hard on themselves, especially when facing complications in treatments. With engaging anecdotes and insights, the duo examines the disconnect between the idealistic dental school training and the reality of handling complex patient cases.
Dr. Craig and Dr. Sartor explore the impact of external factors like medications, patient habits, and evolving medical conditions on dental treatments. They shed light on the common misconception that A+B should always equal C in dentistry, arguing that the mouth's hostile environment creates unforeseen challenges. Their discussion extends to the importance of patient communication, especially in educating them about how lifestyle choices and medications can impact oral health and the longevity of dental work. They stress that while dentists strive to solve problems, understanding limitations and focusing on continuous learning is key.
Key Takeaways:
- Typodont Training vs. Real-Life Practice: Dental school training using typodonts differs greatly from dealing with live patients, where multiple variables affect treatment outcomes.
- Complex Interplay of Factors: Diet, medication, and other systemic health issues can significantly impact dental work, requiring dentists to stay updated and flexible in treatment planning.
- Communication & Education: Effective dentist-patient communication is crucial for managing expectations and discussing the impact of health and habits on dental care.
- Continuous Learning: Emphasizing the importance of ongoing education to keep abreast with new research and treatment methods, ensuring the best patient outcomes.
- Dentistry is Not In a Vacuum: Treatments do not exist in isolation, and acknowledging this helps manage the professional stress associated with long-term treatment failures.
Connect with Us:
- Savanah Craig, DDS: @savanahcraigdds
- Ronnetta Sartor, DMD: @dr_sartor
- FutureDentists Beyond Graduation: @futuredentistsbeyondgraduation
- FutureDentists: @futuredentists
- IgniteDDS: @ignitedds and @ignitedds_coaching
- A-dec: @adecdental and https://www.a-dec.com/find-a-dealer
- Join Dr. Craig and Dr. Sartor for a heartfelt exploration into the evolving world of dentistry, armed with humor, experience, and invaluable insights. Don't miss out on this insightful episode and ensure you stay tuned for future installments packed with more guidance and support from the field of dentistry.
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Transcript
Introduction to ADEC's Smart Start Program
00:00:00
Speaker
ADEC's Smart Start program offers first-time practice owners their deepest discounts on equipment and furniture for two years, plus other savings and complimentary services. Ask your ADEC rep for details and start smart with ADEC.
Hosts' Introductions and Recording Insights
00:00:13
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Join Drs. Savannah Craig and Renetta Sartor as we navigate life beyond graduation. Real conversations about forging our own paths in our early years in our careers.
00:00:24
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There's a reason it's called practicing dentistry. Welcome back to another episode of Beyond Graduation. i am Savannah Craig and with me as always... I'm Renetta Sartor. Good to see you guys back so the way we record these episodes is we just pick Saturday and we just keep
Why Are Dentists Hard on Themselves?
00:00:41
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going. So that's why we always look like we're in the same outfits, but sometimes we'll record...
00:00:48
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What? was going say, what do you mean? This is my podcasting outfit. Oh, you just put it on every time. This is my lucky one. i've just got a few of them and I just alternate them, you know? Your closet is scrubs and then this outfit only?
00:01:00
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Yes. In multiples. For podcasting. But sometimes we start – we have topics queued up that we want to talk about and then sometimes as we start talking, we just keep rolling into things and we figure if we're interested in it, maybe everybody else is too.
Mentor's Perspective on Treatment Longevity
00:01:20
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But so we're doing sort of a deep dive on why we're so hard on ourselves as dentists and dentists. How we face complications and why. the i was talking to one of my mentors about a treatment plan or some treatment that I did that did not work out the way that we wanted it to.
00:01:40
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And she said to me when patients ask her, because they always do, how long will this last? And she said, forever in a vacuum. Yeah. but Oh, I like that. your Your mouth, your body is not that environment. So i thought that was a good way to think about sort of what we've been talking about behind the scenes. so what was i thought your take was pretty interesting on why why we're so afraid of or I feel ill-equipped to handle
00:02:11
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some complications and how to talk about that with my
Dental Education: Ideal vs. Real Conditions
00:02:15
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patients. And I thought your perspective on sort of the dental education system was really insightful.
00:02:22
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Yeah. So if I'm thinking about our conversation correctly, i kind of went back to when we're in dental school and how we're we're taught, right? So before we even touch a patient, we're taught how to do dentistry on a typodont, right?
00:02:38
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And then when we go and start doing things on patients, pretty much it's more so converting what we learned on a typodont to an actual human.
00:02:49
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But I think... The typodont, the ideal patient. Right, the ideal patient. we We take classes like systemic pathology and oral pathology and that sort of thing.
00:03:02
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But I wish that there was one course that kind of put it all together, right? So, for example... Like you said, our typodont is kind of the vacuum, right? Like the typodont's not chewing every day. The typodont's not drinking sodas every day.
00:03:21
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The typodont has a perfect health history. but No tongue. Yeah, no tongue. no No cheeks, kind of. But ours were really stretchy. Right. So, you know, so you know that typodont is an ideal, you know, perfect scenario and situation, right?
Impact of Real-World Factors on Dental Work
00:03:39
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yeah When we do dentistry, it's not in an ideal situation. If we're doing dentistry, it's likely because something failed, something went wrong, and we are there to now remedy the situation.
00:03:57
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And so, you know, your mentor is very right in a vacuum. Yes, it could last forever, But if our crown and bridge work and composite restorations are continuously bathed and just sitting in a pool of acid all day long, that's not going to last forever.
00:04:20
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What are your thoughts on that? And I guess more so like just your struggles with communicating those potential complications to patients. Yeah.
00:04:33
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Yeah, I think it goes back to, i mean, part of the reason I really liked dentistry and like was attracted to this field, which is very funny now, was it felt like a plus B equals C. Tooth, too cavity, filling. And I was like, I got it.
00:04:52
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I can, I got hand skills. I can drill out that decay. i can put a new thing in and good deal because of the type of mentality. Like I got the technical skills. I can see that on a radiograph.
00:05:06
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I'm your girl. But then you start realizing how much else there is And every day there are new medications and new problems that patients have that affect the work that I do.
Health Conditions and Medications in Dentistry
00:05:22
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And no matter how perfect my crown prep is, no matter how how much I talk to my patient about diet and this and that, the medications that they're on that are keeping them alive are working against me.
00:05:36
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The habits that they have that they don't necessarily even realize are bad habits work against me. Heck, I hate to admit this one, but I'm a nail biter. I've been a nail biter my whole life. My mom is a nail biter. My grandma is a nail biter.
00:05:52
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ah come from a long line of nail biters. And I know how bad that is for my teeth. And I know that one day i am one hangnail away from chipping one of my incisors.
00:06:03
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But can't stop it. And it it's is a stress habit, you know? And so there are people out here doing things like that who may or may not know better. And so I just think we're very hard on ourselves as dentists because in school we are taught a plus B equals c And that's not the actual environment we're working in or the reality we're working in.
00:06:24
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And even the best materials we have, you know, amalgams were the standard of care forever and ever. And then we find out that... They're not perfect restorations. you know like We are doing the best in a terrible environment that's already broken with the best materials we have that are not as good as what was already there.
Patient Communication on Medications and Habits
00:06:45
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Yeah, that's very true.
00:06:47
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And how do you get bottom of some these the bottom of some of these habits or medications or stay on top of learning what things are causing xerostomy I think the the big one that I've started talking to people about is like liquid IV and those sorts of like hydration drinks that a lot of people think is healthy so i just think the world around us is making it very hard to do dentistry Yeah, I mean, it's even like not if if we take teeth out of it, right?
00:07:22
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Yeah, just about everything has sugar in it. And so like you say, even the liquid IVs have sugar in it. I mean, there are like sugar free ones, but it's still acidic. or Or impacting your saliva pH anyway.
00:07:36
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Exactly. And so I think it depends. So if it's my first time seeing a patient, you know, we look at everything. You you could look in them mouth and see signs of different stuff.
00:07:49
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sure A lot of it is paperwork that I have patients fill out. And so we have a form that they fill out once they're in a chair that's called the Healthy Mouth Baseline.
00:08:02
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And it pretty much has a list of habits or pain or just anything that they may be experiencing and they check it off. Yeah.
00:08:13
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And so we talk about that plus medical history, plus what's seen radiographically and intraorally. And based on that, I start asking questions. I almost always ask about diet and what they drink.
00:08:30
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And then we just have real conversation on how medications or habits are contributing to certain things. And if we want the teeth to sustain for as long as we can, here are the things that I need to do as a dentist to help you.
00:08:51
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But also you have homework too every day so help me help you you, know, attain your goal of keeping your teeth for as long as you can.
00:09:03
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I like that. I think there are also just so many people unaware of what they're eating, what medications they're on. I think we talk a lot about xerostomia polypharmacy. and i had a patient the other day was was like, I don't understand. I've never had cavities ever in my life. And now
Patient Risk Factors in Treatment Planning
00:09:29
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teeth are breaking and all these things. And we got to, oh, recently diagnosed with diabetes. And now we're on these medications and this changes and stinks because you've got to keep your body healthy. But it's going to impact what we're doing here.
00:09:46
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Same thing for sleep apnea and acid reflux and antidepressants, anti-anxiety medications. You know, there, yeah, it's, you know, it's just so much.
00:10:00
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Almost all those things that we mentioned causes xerostomia. But in addition to that, you know, the SSRIs and apnea pretty much can cause clenching and grinding.
00:10:15
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And so whatever we put in there, you know, may not hold up as long as we need to, you know, but it just means that, okay, now that we know that these things are going on, it changes our treatment plan.
00:10:31
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or how we might go about it. You know, if we're doing a risk assessment and you score in the high risk category for sleep apnea, one, it's important for you from a systemic standpoint, because we want you to be here. We want you to be alive.
00:10:48
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But from a oral standpoint, there's no way that I'm doing full mouth restoration on you and until you have your sleep apnea addressed, you know, there's no way we're going to, you know, you explain it to them, know, whatever I put in here, you're to spit it back out at me until we have that addressed, you know?
Challenges in Achieving Ideal Treatments
00:11:09
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So I think a lot of it is just, I think when we're in school, we, we run to the mouth to be ready to be technical and yeah like do things and But it's more so taking a step back and seeing our patients and getting to know them, what's important to them, but also getting to know their history. Like, you know, in school they say, never treat a stranger.
00:11:36
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Yeah. Part of this, though, too, is just knowing how these things impact the dentistry. And I don't know about you, but we were taught to look at the medical history, to look at all these things.
00:11:48
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And at least for me, those were focused on safety of local anesthetics and that sort of systemic thing. But I don't think it also doesn't have the time to teach you everything, first of all.
00:12:01
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Second, for me, our occlusion lecture was like spring of our first year when I didn't know anything about anything. And so none of that made sense to me and how it was all connected.
00:12:13
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And so same thing with like pathology and medical history. If you don't know how these things, learning that SSRIs cause clenching and grinding and also impact bone. And we were talking about a little bit about implant failure and things like that.
00:12:27
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If you don't know that these things can impact bone, your dentistry and in what specific ways, you can't communicate that to your patients. And it's hard. There are new medications that come out all the time.
00:12:41
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so How do you keep up with this? You just try your best to, you know, take his as much continuing education as you can. Because honestly, a lot of it is i go to continue education courses.
00:12:54
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You know, I have friends and mentors like you and some friends that are specialists. You know, you and I both read a lot. So all you can do is do the best that you can.
00:13:07
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yeah And function with the knowledge that you have today. Like I tell patients all the time, you know, you know if something dentistry-wise that they have failed and they they want to know why and it's something that was like an older material or something like that, we say, you know, at the time, this is what we knew.
00:13:25
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yeah This was the best material, but we have now found XYZ and this is how I propose we move forward. I think that's any profession, you know, you you're just doing the best that you can with the research that you have at that time.
00:13:46
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I think that I have this conversation with my grandparents all the time. Like your doctors are just people working on what they were taught. And that can be scary to think about.
00:13:58
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Yeah, it could be. But we're doing our best and as when you know better, you do better. But also we don't know everything and we're never going
Growth and Knowledge in Dental Practice
00:14:07
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to. How do you, you've you've talked about how you've transitioned to the dentistry failed, the dentist doing the treatment didn't fail.
00:14:16
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that That conversation, i think in this talk about we're putting our work in a inhospitable environment, it's not in a vacuum. How do you let patients know? on. Did you say hospitable or did you mean hostile?
00:14:32
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Hostile. Hostile environment. Sorry. Good good catch. was about to say because it could be hospitable. and Usually not. Depending on what kind of mouth it is, but I just know. The majority. Yeah, my style. Yeah, it's pre-hostile. Thank you. it's not It's not an ideal place to be.
00:14:51
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How do you communicate that, especially as people age and their medical history changes? And how do you bring that all together? You know, i think a lot of it is patients just want know that you're concerned, right? so for example...
00:15:06
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Just, I think I was telling you about a couple of patients I had this week where, you know, they came in for their hygiene appointment. We had some things that we were monitoring or things that we had saw or treatment plan and they just hadn't gotten around to having it done just yet.
00:15:23
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And, you know, with our intraoral photos and stuff, we showed them, Hey, you know, these areas have worsened and we have the talk about, you know, the medications and everything we're fighting uphill battle.
00:15:38
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We're doing as much as we can with what we have to try to keep them around for as long as we can. And in some situations you have to let them know what the reality of the situation is.
00:15:50
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The reality is you may end up losing all of your teeth. Yeah. Yeah. Because of it. Okay. Now that we've had this discussion, what are next steps? You know, they can go home and think about what that would mean to them and how they may want to move forward with it.
00:16:10
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And then, you know, we are here to help them get to, you know, whatever goal would be achievable for them based on what their significant, what their situation is, if that makes sense.
00:16:22
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Absolutely. I do think with the idea of polypharmacy and complex medical history, all of this is also always in flux. And at the moment at the time when you did that work, that may have been the best thing or it was working then, but now they're diabetic. Or i mean, even you think of like a lot of crown and bridge work and people go through life things where maybe there's been like family loss or depression and they weren't caring for things. And now we've got recurrent caries. And I think, like we said, it's not a vacuum. And knowing that there are just so many factors, there are more factors working against me than like me.
00:17:10
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I think the important thing, like like you said, like it's so many things going on is making your patient aware of that. expressing concern for not only what's going on with them systemically, but what's going on in the oral cavity, but just making them aware so that they can have a conversation with their primary care doctors.
00:17:32
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And then together we can decide what the best course of action is to be able to help them. Yeah, and a lot of talk of prevention. And i mean, sometimes it's just we'll maintain this as long as we can. And it is it is what it is. But I don't think we're taught enough about the potential complications or how to deal with them when they arise in dental school because we're not seeing things very long term either.
00:18:02
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I think that's been the beauty of like, I mean, I was in my associateship for four years. So I got to see some things work well and I got to to see some things not work very well, but it gets you to start asking the questions, you know?
00:18:19
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Yeah. It's questioning, asking yourself the question, but also asking the patient questions because they live in their body. Their mouth is attached to them, you know, every day. So we don't, you know, I can only know what I see when you come in for your appointments.
00:18:36
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Yeah. Yeah. i tell patients a lot. and'm I'm not coming home with you, so I can do my part here, but you got hold up your end of the bargain to the best of your ability. But I think, I don't know why dentists, we want to be the heroes and like solve all the problems. And sometimes you just can't slap a composite in there and fix it. You know, does that make sense?
00:18:58
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And I think this this that shows growth, right? Yeah. In your journey in dentistry, of when you know that you can't fix everything, and just because you can do something doesn't mean that you should.
Engaging with Listeners and Social Media
00:19:12
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Yeah.
00:19:13
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That's heavy, though. I think we want to be problem solvers. Again, I went into this because I thought cavity, filling, I did it. And man, is it more complicated than that. Oh, yeah. It's a whole web.
00:19:26
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But everything's connected and everything. And so it's, you know, it's a fun time to be alive for sure. And being a profession, there's so much to learn. I mean, it never gets boring.
00:19:38
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For good or for bad. ah Yeah. Better or worse, right? Yep. So we'd love to hear your take on our topic here. i'm sure you all have lots of experiences and lots of things to share.
00:19:54
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So reach out to us. You can find me on Instagram at Dr. Sartor and you can find Savannah at at Savannah Craig DDS.
00:20:06
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We'll catch you next time. Thank for joining us for this episode of Beyond Graduation. If you enjoyed this week's episode, be sure to share it with a friend. Connect with us on social media at Savannah Craig DDS and at Dr. Sartor.
00:20:22
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And remember, you are not alone on this journey.
Affordable Dental Equipment Options
00:20:25
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ADEC certified pre-owned equipment is a sustainable, affordable choice that makes genuine ADEC equipment available to every doctor. Each package is sold on a first-come, first-served basis. So if you see one you like, contact your dealer. For more information, go to www.adec.com backslash findadealer. Thank you for listening to Beyond Graduation brought to you by Ignite DDS and Future Dentists. This episode was sponsored by Ignite DDS Coaching. We build self-determined futures. For more information, please reach out to the Ignite DDS team.