Day in the Life of a Modern Dentist

I’ve witnessed incredible progress made in dental care options over my career, and it continues to keep my work interesting and rewarding. If I had written a “day in the life” thirty years ago it would be very different. Here is a taste of my average work day now:

My day begins as I walk into my office to a warm good morning from my staff. They know to then leave me alone as I check my emails and review my tasks for the day. Soon I am informed that my first patient is ready for anesthesia.

Greeting my first patient in a treatment room I view an xray on one computer screen and medical history summary on a second. No medical alerts are noted on the history so instantly I know there are no medical concerns that might require me to modify my standard protocol of care. My assistant has already placed topical anesthetic on the mucosa at the apex of the tooth so that when I give the injection the patient doesn’t feel much of anything. After the injection I leave the room confident that my staff follows a post-injection routine.

In another room there is a patient who yesterday had all of her top teeth extracted and four implants placed to hold a screw retained bridge. This was done by a surgeon colleague. My examination reveals that the bite and the esthetics are acceptable, and I reassure the patient that I am satisfied with the result. The patient has had a life-changing event that improves chewing ability, stops pain and infection, and that gives confidence in social settings largely because of a beautiful smile. Very satisfying. Before stepping away I direct my staff to review home care instructions and return to my first patient.

I prepare # 29 and # 30 for full coverage restorations. There was tooth loss related to caries, so using a quick bonding technique I do buildups to create an opportunity to finish ideal preparations for the restorations.  A laser was used to contour and trough the gum tissue. When done I leave while an assistant scans the prepared teeth using a 3D imaging device. No messy impressions are necessary.

In about five minutes the image is displayed and ready for me to design the restorations. Soon both crowns are sent to the in-office CAD CAM milling area. Thirty minutes later an assistant has confirmed that the crowns are ready for me to cement. These single appointment restorations are far more convenient than waiting weeks for the lab (it’s hard to miss the lab phone calls and pickups and dropoffs).  Also there is immediate closure of the operative site and the restorations are designed using my fresh clinical memory of the supportive tissue architecture, the shape of the original teeth, and the occlusal scheme. It’s a fine clinical outcome, the patient leaves happy. It is amazing how easy all this has become.

While the two crowns were being milled I checked a third patient who had a cleaning. I am presented a long term graph of a record of their plaque accumulation, gingival bleeding, and pocket depth. The graph helps me, my staff, and the patient visualize the results and effects of their home care. It is of great importance to me as I counsel patients on any immediate and future needs. I can determine what the caries and periodontal disease risk is and my recommendations are geared towards their reduction. At the end of the appointment the patient will leave with a written report of clinical findings.   On occasion, as part of our preventive program we will use a finger stick to check a patient’s blood sugar and A1c level to screen for diabetes.

Later in the morning, a fourth patient arrived for scheduled root canal treatment. This is an appointment where I use a rotary/reciprocating drill that coordinates with a precise measuring system using a CBCT xray that has been taken in advance at my office. The combination of the digital image with the rotary system and obturating system makes for an effective debridement, shaping cleansing and sealing of the root canal space. How nice it is to be able to help patients by providing the service.

Just before lunch I visited with a new patient with dental phobia and a rather complex medical history. I recommended IV sedation and rehabilitation using multiple restorations, endodontics, and periodontal care. My hygiene staff added a risk reducing preventive section to the treatment plan to make sure that we are meeting all of the known requirements for a good long term outcome. My front desk will coordinate with the anesthesiologist and present a patient care packet to the patient that covers clinical findings, recommendations, and consents. I enjoy these cases because they allow me to focus clinically and they are appreciated by patients.

Lunch – Mexican food.

After lunch there are two problem focused consults that have both fractured a tooth. When I see each patient, the information I need is present and it only takes a moment for me to diagnose the problem and let my software suggest a solution. Then I am free to visit with the patients for moving the doctor/patient relationship along towards accepting treatment.

One patient required an extraction which was easily managed and freeze dried bone plus a membrane was used to stimulate growing of new bone to replace the missing bone and prepared the site for an implant in a few months.

Other patient activities during the afternoon included a couple of Invisalign orthodontic patient checks and an adjustment of a sleep apnea/snoring device. These appointments are typically managed by my assistants and I am called in to confirm the appointment.  Another interesting service for a hygiene patient was use of a laser to decrease tooth sensitivity. Sometimes the laser is used for treating a cold sore or to assist in reducing pathologic bacteria under the gumline of a patient with gum disease.

Throughout the day I overhear plenty of conversations of my front desk staff about online patient registrations, insurance verifications, and scheduling as they are speaking with patients and checking in and out. I am reassured by how friendly they are and how they keep that up all day long.

Dentistry is a wonderful profession supported by vibrant research, competitive vendors, strong academics and collegial peers.  Overall it was a great day!

 

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