I Interviewed a New Grad 7 Months Apart (First Year of Practice) – IC052

Protrusive Dental Podcast

The first EVER ‘Prospective’ episode of Protrusive – I interviewed new-grad Dr Triman Ahluwalia in 2023, then again 7 months later in 2024 to see how he gets on with his first year as a *real* Dentist 😉

We uncover what it feels to be a freshly qualified Dentist, the pressures and fears that come with procedures such as endo and surgical extractions, but what we can do as growing clinicians to overcome these hurdles.

https://youtu.be/9NtKCIVfMLs

Watch IC052 on Youtube

This episode is packed with lots of top tips to help you in your journey from the ground up, or as a reminder for those that have been there and done that, that we are forever learning on our journey and there’s always something out there to help us become better Dentists.

Need to Read it? Check out the Full Episode Transcript below!

Highlights of this Episode:
02:02 Introduction to Dr Triman (2023)
03:32 Experiences at Dental School
07:15 Procedures You Fear + Sectioning Teeth
11:25 Thoughts on Social Media in Dentistry
15:26 Documenting Work
16:30 Future Career Plans
18:00 Additional Comments from Triman
19:03 Back to the Future: 2024 Triman Update
21:50 Dental Photography Progress
23:08 Tricky Dental Procedures Update
27:46 The Good and the Bad of DFT
32:26 Career Path in Dentistry
34:49 Triman’s Top Tips
37:06 Wrapping Up

Don’t forget to check out the Protrusive App where you can find more awesome tutorials on becoming a more efficient and effective practitioner.

If you liked this episode, you will also like IC029 – Young Dentist Thrival Guide

This episode is not eligible for CPD/CE points, but never fear, there are hundreds of hours of CPD waiting for you on on the Ultimate Eduction Plan, including Premium clinical workthroughs and Masterclasses.

Click below for full episode transcript:

Jaz's Introduction: Welcome to the first ever Protrusive Prospective episode. You see, I interviewed Dr. Triman Ahluwalia in his first month of being a real dentist, i. e. newly qualified. I then interviewed him again seven months later to see how he got on.

Jaz’s Introduction:
Hello Protruserati, I’m Jaz Gulati, and welcome back to your favorite dental podcast. Every year we make an episode to help those who are in their first year, i. e. they’ve just qualified and they’re entering the big bad world dentistry. And this is a interesting one because I’ve never done a prospective episode whereby I’ve told the guest to wait six, seven months and then we’ll continue the recording.

Just to see if the perspective has changed. I think this is essential listening and watching for those who are literally about to enter the first year of dental school, or maybe you’re returning to work again after some time off, or maybe you just want to gain some insight into the mind of the newly qualified dentist.

Maybe you mentor some dentists, by the way, speaking of mentorships and big things, Intaglio is almost out. For those of you who don’t know, Intaglio is a new platform we’re making to allow one on one mentorship. Look, it doesn’t matter. How much money you paid to these courses doesn’t matter how many continuums or diplomas you’ve done.

When you have that specific case and you need someone to sit down with to discuss that case, step by step for a good hour or even two hours, the course organizes the diploma teachers. They are busy. They don’t have the time to do one on one, which is why we created this platform to allow mentors and mentees to connect and allow fair exchange.

Because you know what when a mentee needs help they really value it and they value that one on one time so Intaglio is coming soon and also a big update number two is I’m in my new studio I’ve now moved from reading to West London quite close to Heathrow it’s like little India it’s called Southall. I’m close now to my parents my in laws we get lots of support for family so that was a big reason I’m still working in Reading. But yeah, it’s been a crazy time with moving.

But now this is my first episode, first intro being recorded in a new studio. Wish us good luck. And now we’ll join the main episode with Dr. Triman, catch you in the outro.

Main Episode:
We can say doctor now, Dr. Triman Ahluwalia, I might feel strange to you. How are you doing my friend?

[Triman]
Yeah, I’m doing great. Big fan of the podcast. So it’s a great honor to be here and hopefully shed some light on DFT.

[Jaz]
Brilliant. Well, welcome to the Protrusive Dental Podcast, my friend. It’s so lovely to have you. And I’m so thankful, thanks so much for agreeing for the nature of what we’re doing today. It’s going to be delayed gratification. I’m going to talk to you now at the very beginning of your DF1 journey.

So those are my international audience. DF1 is basically like your first year out of dental school. It’s kind of like a bridge between dental school and like the real world. We kind of get a bit more support and things are a bit slower to start with, which is good. I definitely learned a lot, enjoy my time, but it’s not about me. It’s about you today, my friend. And so just before we delve further into the questions I have for you, just tell us a little about your journey in dentistry and dental school so far?

[Triman]
Yeah, so, my name’s Triman. I’m 23 and I graduated dental school from King’s College, London this year in 2023 And I’m currently undertaking foundation training in part of the North London scheme at Ivy House Dental and I also recently wrote an article that was in the BDJ student just looking at the preparedness of newly graduated students like myself for independent practice, which is very on topic for today’s discussion.

[Jaz]
Excellent. Yeah in case everyone’s watching the video on youtube and seeing me just slightly sweaty. Maybe the camera’s hiding it I’ve just had these korean buldak noodles. I don’t know if you ever had these before.

[Triman]
No, I’ve not had them before.

[Jaz]
There’s something else, my friend. So I’m enjoying that very much. So it might get a bit hot and spicy in the discussion as well. Let’s see if it transfers through. Tell me, what is your biggest worry? Like you have been, in fact, let’s take a step back. Tell me, and I hope you’re comfortable discussing this. Tell me about your experience at dental school, generally speaking. And then also how much did you actually get to do? How much experience did you qualify with bearing in mind that you were probably partially affected by COVID as well?

[Triman]
Yeah. So this was sort of like the big question that was plaguing me towards the end of my summer holidays and I was about to enter DFT and I was actually thinking how prepared am I actually for the real world of after dental school and I think, yeah, as you were saying, COVID sort of was a big factor, especially for my year.

I know that’s like the new thing for everyone to say that my year was the worst, but I guess my year I think was the worst. But for me, I started seeing patients sort of regularly from the start of fourth year, I would say, and for reference at King’s, you sort of start seeing patients. Towards the end of second year, which was when COVID hit for us.

So I didn’t really see anybody till fourth year and it was also a big backlog as well. But so it was sort of in our heads from the start anyway, for my cohort, that our clinical experience was going to be significantly more limited compared to sort of our predecessors. And I think the Kings overall, they did a pretty good job of getting us up to speed and the amount of time that we had.

And we saw sort of as many patients as we possibly could. And I think sort of towards the end, I think me, maybe my colleagues, I think we all started developing a bit of a quiet confidence about the most final year dental students have about seeing patients, getting ready to leave and. But I think, actually, when I actually started looking at my numbers when I was about to start DFT, because when you start DFT, you have to do something called an Educational Transitioning Document.

It’s basically just where you write down, sort of, the numbers of procedures that you’ve done, and how confident you feel with them, so you can share them with your educational supervisor going forward. And, for me, I was actually looking at mine, and I was thinking, there’s not actually as much dentistry as I would like.

I mean, for example, like I did about say like 50 plus fillings or so, and that seems okay, but then when you break it down and you see that I’ve only done like two amalgams, it’s not exactly the greatest and the most brimming with confidence. And then of course, there’s also procedures that. just haven’t really touched or just haven’t really got sort of like the full depth of experience. So things like endos, sort of surgical extractions, for example.

[Jaz]
And endo wise, have you not obturated before clinically on a patient basically?

[Triman]
No, I have. So I’ve done for me anyways, I did three endos. So I did, I’ve done one incisor, canine. I think I did one molar as well. And that was sort of from start to finish, but assisted so I was quite fortunate that I got to at least a mix of sort of like 3 teeth But I think that was sort of the benchmark for most of my cohort as well. I think most people had about that much. I mean, we just had an induction day actually for foundation training and they got everyone sort of general consensus. How many endos has everyone done? I think sort of, it ranged from about one to six, so you could be anywhere on that scale.

[Jaz]
Yeah. And I mean, that is a bit like, I’ve said this many times on podcasts before when I’ve had a young guest on like yourself, which is, learning to drive, just because you’ve got the driving license doesn’t mean you actually really know how to drive.

You actually really learn how to drive once you get the license, then you’re out in the real world, and that’s when you learn. It’s a bit like that in dentistry, and that’s why it’s called the practice of dentistry. So don’t feel bad about that. Definitely start with some simpler endocases, and then obviously read up before, watch some videos of the premolar.

And when you’ve got a molar, make sure you pick the molar with the nice young patient with the nice wide canals, easy to find the anatomy, and if you’ve got anything tricky, then make sure that you book extra time and all these things. So I think, this is very, very normal for dentists qualifying nowadays, and it is what it is.

So it’s about what you do afterwards. Not a single person’s success in dentistry, I think, was determined by their totals. It’s all about, for me, I think it’s all about emotional intelligence, how you communicate with the patients, how you care for your patients. And that’s the most important thing of all the procedures and stuff that you’ve done. Is there one that you’re particularly maybe scared of? Like imagine next week you had this in your diary, would you be crapping your pants a little bit?

[Triman]
I mean, I think for most DFT students, they could probably make a little tier list of which ones they hate the most. I’ve probably got one in my mind, but I mean, everyone’s go to is, oh, I don’t want to do a molar RCT, which I won’t disagree with as well.

Cause I’m not the best of them either. But I think also surgical extractions in particular, just for me particularly, at King’s, I mean, it was sort of like a code word, if someone said that my extraction went surgical, it meant that they just had to suction for the rest of the section, because the tutor would just take over and do it, and you wouldn’t really know too much of why they’re doing it this way, so I think that would be sort of the procedure that I would be dreading the most, but fortunately, my ES (Education Supervisor) isn’t that cruel, so he’s not going to chuck me in and immediately just do a surgical extraction, but I think we’ve got a bunch of oral surgery study days coming up, so that would be nice to actually get some insight into the theory of actually, how to do a social extraction, flap design, bow removal, sectioning, all that stuff, yeah.

[Jaz]
Do you mind if we just talk about that a little bit? Do you mind if I almost, like, coach you and give some advice about extraction and stuff, right? So, what you’re saying, it holds true, in my experience, I qualified ten years before you, and when I came out, there are some extractions that, once the crown broke off, and the roots weren’t budging, It was game over for me.

I didn’t know what to do. I didn’t feel confident. It was very embarrassing to me. I hated it. And I took that, those emotions that I had within me. At that point, I’m just closing my eyes. I’m just really pitching myself. And that’s, I remember the patient’s face. I felt so low. I felt so disappointed in myself.

I let the patient down. And that’s what sort of drove me to really start shadowing some oral surgeons and just generally picking up as many tips. And nowadays, I can look at a radiograph, make a correct assessment, and most extractions I’m happy to do. Very few that I refer out, and nothing fazes me anymore in terms of extractions, even surgical wisdom teeth.

And I think that all of that stems from, again, something I’ve talked about in the podcast before, but it’s really important for those perhaps who are new to the podcast to hear this, is most of my molar extractions, are going to be sectioned. No flap involved, flapless, but just section from the start.

Don’t wait for the crown to break off before you section. And so the skill I was lacking to remember when I qualified was the sectioning, the ability to section confidence. But the thing I want to say to you and to all your cohort of new grads is, sectioning is just getting the biggest, baddest diamond bur you have, all the tons of carbide, and just cutting the tooth in half.

It’s really nothing more than that for a lower molar, for example, right? We did an episode around 80 something with Chris Waith about this topic, and in the comments of that section, someone towards the end of the DF1 wrote, you know, after this episode, I did my first section elevation today. I felt so good.

And so don’t be afraid of going in section elevate. Maybe you have a tutorial with your trainer, but the top tip for me is don’t worry too much about flap designs, but do spend extra energy and time and just learning how to section teeth so that that’s going to help make teeth are otherwise difficult to extract for you. For me, they were certainly were much, much more possible.

[Triman]
Yeah, definitely. I think also just having had a few tutorials so far with, by ES, I think it’s really given me a bit of appreciation of actually the pre op radiograph, as you’re saying, do I need to actually do a flap? Do I need to section the tooth? And what’s the plan going to be? Is there an ABCD plan that I’m going to have? So I think. Yeah, hopefully I’ll sort of get a bit more of an appreciation for that as I go through.

[Jaz]
Well, I’ll be sure to ask you about that in about nine months time or so. With that, I love that you said that already, and you’re wise beyond your years to say that you should have a plan. I didn’t know that you should have a plan for extraction until I was about two or three years qualified. It’s just a concept I didn’t consider. Like, extraction is like, okay, let me try this. If this doesn’t work on the spot, I’ll think, okay, what should I do next? So really, everything should be premeditated.

Like, okay, first I’m going to section. If it comes out great, if it doesn’t section, I’m then next going to do this. I’m next going to remove that furcal bone, for example. I’m next going to then use the cryers and just have some sort of a rough plan which you’re willing to change, but it’s good to go in with a plan. I 100% agree and I think you’re very good to recognize that already.

[Triman]
Thank you.

[Jaz]
What’s your biggest worry? You don’t feel particularly prepared. And that’s true, my friend, that you’ll always be that way. You’ve told me already that the procedures, surgical extraction would be scaring your cohort. Molar endos. It definitely was the same for me as well. What kind of plans and goals you have for the year? Because you’re this generation, like when I was qualifying, there wasn’t this Instagram Dentistry at that time. It just didn’t exist. Instagram was mostly for food and that kind of stuff and holidays, basically.

There wasn’t a dental home for Instagram. And now you can see all this amazing work. Tell me about your perception of the world of dentistry and what you see on social media and how that might impact you and your vision.

[Triman]
Yeah, so I mean for me, personally, I wasn’t a big social media guy. Probably before dentistry, but I did sort of, I mean, my sister just last week had to tell me how to teach me how to upload a story, which is sort of how out of the touch I am, so, but yeah, now I’m sort of getting the idea of it and the hang of it, but yeah, there’s a lot of, I think, dentistry, just sort of social media, Instagram is one of them, but, even when you get recently, some of the study days we’ve had, a lot of speakers have come in and literally they will always, always write their Instagram handle.

And these are some of the pictures that they have and they’ve publicized. I think it forms a big part of creating that sort of portfolio. And it’s something I’m sort of slowly trying to ingrain myself into as well, just to sort of catch up to what everyone else is doing, but also just to sort of see.

I think it’s nice to have, I think particularly with Instagram because it’s image based, having a actual photographic recollection of all the work that you’ve done for not only yourself but for patients and just for colleagues just to share cases as well.

[Jaz]
Totally agree. So it becomes like a portfolio and I know lots of dentists who’ve been sort of head hunted based on their work that they show me like, Hey, you look decent. Would you like to come to work for my all singing, all dancing practice? I’ve seen that happen before. So that’s one thing. But has it perhaps given you delusional sense or perhaps this worry that you’re seeing this amazing work and then when you’re looking at the very early on the journey and thinking hang on It’s not quite looking like what I’m seeing on social media It’s a bit like I guess in the beauty magazines how everyone’s airbrushed and stuff and then and then people think oh, yeah I’m not so good looking etc.

But really it’s the same applied to dentistry. You see all this beautiful, polished stuff on social media that’s been hand picked, cherry picked, the highlight reels. Have you suffered, or do you know anyone who’s been sort of having mixed feelings about that?

[Triman]
I think, yeah, pretty much everyone in my year. I think, as you’re saying, yeah, I think it’s important to remember that it’s cherry picked, it’s almost a false idealization in some cases. I mean, this is them showcasing their best work. I mean, you don’t really see anybody saying, this is a case that went really badly. And then posting lots of images and how they can improve.

It’s more that this is like an amazing composite that I did. Look at it from start to finish. And this is the protocol that I use. And this sort of presented as like a gold standard. But I think a lot of micro what they, sometimes you can get down on yourself. Why is my composite not like that?

I mean, I remember just sort of chatting to a lot of my colleagues, all of them sort of say that, I’m really struggled to get the anatomy right on the composites to make it look just like it is on Instagram. And that’s sort of like a common thing, but I think also it’s important to realize as well, a lot of these are also American and they use different instruments and things.

So suddenly someone takes out some instrument you’ve never heard of in like a video that you’re watching. But I think it’s important to realize, yeah, that these are sort of their best work that they’re showcasing and they might be doing a completely different protocol to you. And also, functionally, who knows how long what they’ve put in the mouth has also lasted as well.

[Jaz]
And the saying goes, do you follow football, Triman?

[Triman]
Slightly, but not the best.

[Jaz]
Well, there’s a saying in football, right? Where if a team is doing really well, they’re winning all the trophies and they’re playing good. And then you say, but can they do it at stoke on a cold Tuesday night? Can they do it in those, in that different environment, a more hostile environment. So really. Your environment, the kind of mixed practice you might be in, for example, is completely different to what the kind of environments that people are working in. So I would encourage all our young graduates to not to get bamboozled, disillusioned by what you see.

Keep a cool head about you. And the only person to compare to is yourself. So Triman, I’d love for you to now, when we speak to you in about nine months or so, to when you look back and say, you know what, I’m looking back on my own work rather than I’m looking to Instagram as the standard, right? So my next question that leads on from that, Triman, is have you got any plans or have you been ready starting to document your work?

[Triman]
Yeah, so I think one of the first spends for my paycheck is going to be camera and getting a good one at that I think mainly not even just for the so I can post this on social media as you’re saying just to document my work see how I can improve I think it’ll be really telling just to take a picture of my first amalgam and then compare it to one six seven months down the line and see where I improved and why I can actually do better. So I think, yeah, definitely. That’s one of the things on the to do list. Once the first check cash is.

[Jaz]
I’m so glad you said that. I was kind of hoping you would say that. So amazing. Please do follow through with that. Do not get tempted by that ski holiday. I would definitely say get the camera instead is my top tip to you.

So well done for doing that. And I’m going to hold you accountable for that. So remember when you reappear on the podcast, I’m going to ask you, okay, how’s the photos going? So you better have an answer for that, right?

[Triman]
Yeah, I’ve got one already.

[Jaz]
Good man. Brilliant. So I’m glad that’s all in check. In terms of career aspirations, it’s funny when you speak to someone who’s newly qualified, they’re a little bit starry eyed and stuff. Just tell me, what kind of direction do you think you want your career to go in?

[Triman]
Yeah, I mean, this is sort of an interesting one. I mean, a lot of people at dental school, especially even when you like, even in BDS1, the first year, a lot of people will come in saying that, I want to specialize in this or this or this.

I mean, for me, I feel like, my stance right now is that, I haven’t actually done enough dentistry to figure out what I like and what I don’t like. I know that we were joking before about procedures that you don’t like to do, but I feel like I haven’t actually done enough of every single procedure to say that with a passion, I don’t like doing this.

I don’t like doing this because I just don’t think I’ve had enough experience. I think so far I quite like doing a mix of everything. There isn’t one thing that if I would sort of say I’d really love to specialize in this because I don’t think I’d be able to choose right now. I think. I enjoy doing a mix of everything, just familiarizing myself with all the different sort of specialties that dentistry have to offer and just sort of, yeah, I think in terms of a plan, I think right now, I think my plan is just to become really good at all of the basics and I think that in time would hopefully make me become a lot more efficient and effective.

[Jaz]
Well said. And I think, the saying goes, you have to kiss a lot of frogs before you find your Prince Charming, right? So, you have to do, you have to experience this, you have to experience failure in endo, failure in extractions, and then you might be inspired on a course one day and then go delve deeper into perio or wherever it could be.

So I’m really glad you’re keeping your options open. Again, I’ll ask you again in the future, see, perhaps you’ve niched down, maybe you said, maybe you’ve decided that you never want to do an endo ever again or whatever. Let’s see. It’ll be interesting to see what you say then. Those are all the questions I had for today, Triman.

Is there anything else? Anything else that you want to add in this first of two parts when I catch you again nine months to see how you’re getting on? Anything else you want to add to this? Maybe it’s like a time capsule thing, a message to yourself for the future.

[Triman]
Yeah, I mean, I guess I think if there’s any future advice for future Triman, it would be just to, I think. I think the message is sort of the same as it was for me in dental school. Just try and learn as much from as wide array of clinicians as there is as possible. I mean, we’re very fortunate that we can have our ES at our practice. There’s other dentists at the practice. There’s a wide variety of study day speakers who’ve so far been really good.

And I think the same thing at dental school, I think there’s always something that you can take away from every dentist that you see. You might not agree with everything that they’re doing, but if there’s even just one thing, as simple as, oh, I like the way they did that child examination, I might do that next time.

I think it’s a good thing to be able to just sort of try and amalgamate as much experience as possible from everybody and, sure, make yourself become a more well rounded dentist overall.

[Jaz]
Amazing 2023, Triman. I really appreciate chatting to you today. I look forward to speaking to you in 2024, Truman. Okay, Truman, I’ve lost count of when we recorded. It’s been many months, maybe five months, seven months, I don’t know. But whenever it was, I’m eager to know, okay? In the order. Did you buy a camera?

[Triman]
So the straight answer is not yet, but planning to going to. So the reason is just because as part of DFT, the practice part of the training equipment list is to have a DSLR camera. So I’ve been using that throughout the year. And the main reason is really, because I wanted to just get a better feel as to what settings were best for me before I just blindly bought something just because it was on like a recommended list. And I think doing so has been really useful because it’s given me a better idea as to what settings I’m most comfortable with, what kind of interface I like, so now I sort of have a better idea of what kind of camera I want to go to.

[Jaz]
So it was like a training ground. You were just perfecting the technique, getting used to it. Tell me this, where, where was the camera actually kept? Like, was it in your surgery? Was it in your principal surgery? Different place?

[Triman]
So I’m quite fortunate that my ES had given me my own sort of dedicated camera. So it was only me who was using it. I just bought my own SD cards. It was pretty much in my surgery the whole time. So no one else aside from me used it. So I was able to really wear the thing out and sort of get as much practice as possible with it. And so figure out that, I like the Nikon interface, for example, I’m using like a hundred millimeter lens.

I’ve got a ring flash currently, but I might experiment with like a twin flash in the future. So it’s given me a good foundation. For getting started with dental photography, because it’s really something that you’re not really taught a lot at university. I mean, I remember when I was at King’s, I mean, for my case presentation, there was just, there’d be one big camera on the whole floor and they’d just hand it to you.

And it’s probably like a 2000, 3000 pound camera, but there was no one there to tell you how to use it. You’ve just got to sort of hold it and hope to God that it works. But now that we’ve actually have study days as well on photography in London, so there’s a lot better understanding of actually understanding what the specific settings actually mean.

And they give you a prescribed set of things that are settings that they would like you to use. But it’s very different for everybody because people, some people are shorter, some people are taller. Some people will go closer up to the patient some than others. So, it’s a good starting point, but you find that rather you have to adjust some settings accordingly, just how you practice really. And so that’s what I’ve been doing.

[Jaz]
The most important thing is that you’ve been taking photos, right? So that’s the most important thing for me. The reason I’m asking you whether it’s in your surgeries, because top tip is make sure for anyone out there, make sure it is in your surgery and make sure it’s fully set up.

Like the last thing you want to do is, oh, I need to take a photo, but actually you need to now attach the lens to the body and then attach the ring flash. You’re never going to get photos that way, right? So that was just a reminder to everyone to make sure that yeah, fair enough, you have a camera, but if it’s not set up and ready to go, it really has to be in your surgery, set up. Any shots that you struggle with, any shots that you find difficult to take?

[Triman]
So originally I would say at the start, I was probably struggling the most with taking the occlusal views and I actually watched one of your videos on taking occlusal views. And I actually just screenshotted the positioning on the screen and used that as a reference point.

And it’s been going pretty well since then. So I think mainly because I was at the start being trying to DIY it do it all myself. And actually I wasn’t making use of the patient, my nurse who was next to me and once they taking a set of 90 percent of the positioning was just a matter of focusing, positioning myself how I wanted to, to capture sort of the full extent of the teeth, which is what I was sort of missing out on at the start. So I think now I’m a lot better.

[Jaz]
It’s a classic, it’s very tricky to get the occlusal shot. So glad you watched that video. And the top tip for everyone is this is where all photography is make sure you get a setup light enough. There’s two options, really get a setup light enough. They can hold with one hand or hit the gym really hard.

So your one hand becomes really strong so you can pick up your camera. So one of two options, one is easier. So everyone just make sure you actually assess the weight by holding it in one hand, then with the other hand, having the mirror. You don’t even need a nurse then, the patient can just use a retractors.

[Triman]
Yeah.

[Jaz]
So that helps massively. So yeah, good. I’m glad. I’m just so pleased you’re using photography. Next question is, you told me, Triman, that molar endo and surgicals were a fear procedure. We all have fear procedures, right? Has that changed? Has that gone deeper? Has it changed for one or both? How much experience have you had of each?

[Triman]
So I’d say, yeah, definitely. It has changed for being specifically, fear procedure, like you say, I mean it’s definitely both, I still consider very difficult procedures in general, which i’m sure most dentists will but I think the main reason it was more of a fear procedure was because of the limited experience that I generally had coming out of dental school, you know partly due to covid etc I think I probably did about three endos in total coming out of university and I did more than that in like my first month of DFT.

So there’s a really big sort of learning curve, but you sort of trial by fire. You really sort of pick up a lot, just doing a lot more. And on my particular scheme, I was fortunate enough that they had like four endo study days throughout the year. So it’s a really, drill it into you and they give you a more of a definitive protocol study as well to use, which is really useful.

But I think the main thing that has really reduced the fear associated with the procedure for both of them is just understanding the reasons behind why I’m doing certain things in the protocol. I mean, in university, you’re often just given a protocol and you expect it to sort of just blindly follow it really.

But it’s nice actually having an understanding as to why I’m doing certain things for like an example with the access cavity in university, or maybe like told, okay, these are the specific shapes that you need to get. These are cut through. But now, I mean, sort of in our early study days, we’re sort of more told to create like an initial pilot hole and then chase the overhangs.

And then, it will naturally achieve that same shape that you’re being told to make, but it’s a lot more conservative and that makes a lot more sense when, especially when things go wrong, like they’re not able to find canal, you can angle, your BP probe, and you can search for areas where you need to get that straight line access.

And it is a lot more helpful than just blindly doing like a rhomboid shape and thinking where the canals. So it’s really has been a lot more useful doing just understanding the reasoning behind stuff. And similarly with surgical extractions, having a better understanding of the preoperative planning behind doing even just a routine extraction and having that ABC plan to fall back on.

So now if I’m taking out like maybe a heavily broken down tooth, for example, I’ll have a little bit of a better idea of how to appraise the preoperative radiograph. And my plan a might be to look, say maybe use smaller elevators to reduce the risk of fracture, maybe use a cow horns, because the tooth is quite broken down.

If that doesn’t work, I might be able to split the tooth in half with the cow horns, or I might need to section it and then elevate the roots out. Or I might need to then, if that doesn’t work plan C, then do an access flap, maybe draw some bone and elevate the roots out separately. But it’s nice having that understanding of what can happen if things go wrong. And that’s made it less of a fear procedure, but not, so much as an easy procedure, but definitely less of a feared procedure.

[Jaz]
Well, it definitely sounds like you’ve developed and gained some experience, which really is the magic sauce, right? You get the experience and then you gain so much in that year that you have with your educational supervisor, interesting thing you said about having a plan.

I love that you recognize that everyone should have a plan for every extraction. Just now I finished a tricky extraction. I knew that I was going to section because there’s tricky molar, root field, gold crown, vertical root fracture. So I spit the gold crown off first, that came out fine. Sectioned the tooth in half straight away, preserved the bone.

Mesial root, which had the vertical root fracture, came out very easily because it was all infected. Distal root was an absolute bugger and it kept chipping away, kept chipping away. The main takeaway that I can share with everyone while we’re talking about this is by switching the suction. So you know, that little, the suction, the microsurgical suction tip?

Zoe was using it and helping me out, but it just wasn’t good enough. So after about a few minutes, I said Zoe could just switch the suction. I think maybe it’s blocked. And then she got the new suction out and boom, suddenly I could see and then you know exactly where to put your Luxator.

And so the reason I mentioned this is because it reminds me of another tip, which people on Protrusive Guidance, our app, they are often saying that this is the number one tip that they gain from the podcast. It’s not even my rule. It’s a rule I picked up from like third degree from someone, which is the six second rule. Are you familiar with the six second rule?

[Triman]
No, not particularly.

[Jaz]
Okay, the six second rule. No one knows why it’s exactly six seconds, but it’s just got a nice ring to it. Basically, if you’re doing something when it comes to an extraction, anything, right? And you do that thing for six seconds, and nothing’s really changing or improving, go to the next step.

Change it. So if you’re using a luxator for six seconds and literally nothing is happening, okay, think what can you do next? Get a big luxator, get a different instrument, change your angulation, whatever. And that has helped me because sometimes you’re doing the same thing over and over again.

And you’re not achieving anything. So the six second rule has been quite a hot one on Protrusive Guidance in terms of people saying it’s their favorite one. So great. I’m glad you’re feeling more confident in Molar endo, Surgicals. You told me already about the camera. Now tell me, overall, what have you enjoyed about your DF1 experience and what have you not enjoyed?

[Triman]
Yeah. I mean, I would say, I think probably the biggest change is coming from university. The thing I’ve enjoyed the most is actually just the change in pace. From the very long sessions that most people are accustomed to in university, which is, you have one big morning session, one big afternoon session, you do as much sort of treatment as possible.

And I think actually having that broad range of patients and just slowly becoming that change of pace and being a bit more quicker and actually being a bit more efficient with the time, I would say is the best way to put it. It’s been a lot more fruitful and it’s well, it makes it a lot more enjoyable, the dentistry rather than there’s a lot of lost time in university, waiting for the tutor to come over and then they’ll agree with the treatment plan. It might change.

[Jaz]
I used to hate that. I used to hate that so much. I’m making a small talk with your patient. That was the worst thing ever.

[Triman]
With like a 30 minute wait.

[Jaz]
Yeah, exactly.

[Triman]
So now I think having the clinical freedom to actually make use of the time effectively and just call my ES. If I’m struggling with something and they won’t take 30 minutes to arrive, hopefully then it’s been a lot more enjoyable in that sense.

I think that’s probably the biggest enjoyment in terms of like particular procedures. Again, I would say actually root canal and extractions and also indirect restorations, like resin bonded bridges and on lays in particular, which I didn’t really get to touch upon at dental school a lot again, for the same reason of, I just have a better understanding of the procedures.

And so I really enjoy now actually being able to do them because I have a better understanding of what might happen if things go wrong and there’s a bit more of a problem solving element. Which is sort of I think the main enjoyable part of dentistry really having, when you understand something, it’s really useful and it makes this procedure a lot more enjoyable because you know that, okay, if this doesn’t work, then I’ve got the problem solving, skill set at least to resolve it.

Whereas that a lot of those fear procedures is just you being stuck on something for a long time. So that’s probably the thing I’ve enjoyed the most really. And in terms of, less enjoyed. I mean, I’m probably quite easy, easy to please. And I enjoy a lot of everything. I think probably the most uncomfortable thing that I’m probably not as good at and confident at yet is probably discussing costs or so with patients.

I would say, particularly around private treatment. And this was sort of one thing I mentioned in one of the recent articles I’ve published in BDJ in practice about being prepared as an associate for next year, as a DFT, because of the nature of the contract, you have to do, I think 95 percent NHS work and a lot of the patients you see up high needs.

And so a lot of them are exempt as well. So there’s not a lot of discussion around costs. And so gaining more experience and just being able to naturally communicate these are the sort of the different treatment options available. These are the private treatment options available. And then having that discussion of costs without coming across as too forceful or too passive as well is something I think I would like to gain a lot more experience in just because I haven’t been exposed to it as much.

[Jaz]
You’re so right. I totally imagine myself back in DF1 and that’s a great point you made and you definitely need to keep practicing and try and get it out of your mouth. That whole neuro physical connection, basically being able to say the price and know how things are supposed to be priced to make sure that your practice is running profitably, to make sure that at the end of the day, we love what you do, but we still need to pay the bills, put food on the plate.

So therefore we need to be able to have that skill. And you’re right in DF1, because you’re doing so much of that type of work with the patients who are exempt, you don’t get to practice that as much. So it’s important to be comfortable in your own skin, be proud of your skills and procedures, and be able to also just for transparency and clear communication, the patient needs to know the price, you know who are really bad at telling you the price and stuff, doctors, in my experience, private doctors, and they will just do all sorts, but they’re just terrible.

And then the worst thing is you actually speak to the practice manager or the people who are like their secretaries. And I say, by the way, how much will this cost? They’re like, I can’t say, I’m not sure yet. And really the price list that we have for a crown for endo in the medical world, in my experience, that really doesn’t exist.

And so, especially in the insurance world, it’s really, really complicated. So I think let’s not be like those doctors. Let’s be really clear with the price. And so that’s a great point you made. And you’re going to gain that experience as you go along. And it’s also the top tip I can give here is when you are communicating the price.

It’s really important to be confident when you say it. It’s really important not to look away because just like you said, and I only say this because when you are new to talking about money and not talking about price, a lot of dentists will lack confidence. I certainly did. Okay. I come from a type of background where it made it very, very difficult for me to talk about the cost of dentistry.

And so, common mistakes as people, dentists look away or their voice changes a little bit or it cracks or whatever. So to have that practice and conviction, and that’s a great point you made. And so Triman, last question is, did you find a niche or are you happy to still want to experience everything and enjoy all aspects of general dentistry? That’s what you said. You like the idea of general dentistry. Have you found a little passion within dentistry or are you still looking? Are you still searching?

[Triman]
Yeah, I think probably the one answer that’s probably stayed the same since we last spoke is me probably wanting a bit more experience again, trying to find out which disciplines I really like more than others. And I know I’ve gained a lot of experience throughout this year, but I was still quite new to dentistry in general. Foundation year, no pun intended has lived up to his name and providing me with a good foundation to start sort of building my career as a dentist. And so when I finished dental school, there was quite a lot of gaps in knowledge, which a lot of people have, and DFT really just helps sort of bridge those gaps and close them off.

So you now sort of have a nice base to work with. And I feel a lot more well rounded now as a dentist. So I think I’ve dipped my toe in a lot of different disciplines, but I don’t say there’s one thing in particular that draws me in particular to, I think I need to now delve further into areas that I’m interested in.

For example, I’ve booked like the composite course this weekend, which I’m going on. So that’s something which I’ve developed the fundamentals on throughout the year, which has been really useful, but now I’m sort of looking to really delve further into that topic. And I think that’s where dentistry goes from being that science to more of that art form and which as well.

Patients are going to be paying the premium for the art form part of the dentistry that you’re doing. So I think right now I’m enjoying general dentistry and I’ve sort of got a good hold on certain areas, but now I think it’s just figuring out what I like and maybe going through different courses, maybe doing something else and just sort of exploring topics a little bit further. So, and then figuring out sort of how I progress from that. So right now, somewhat of an interest in lots of different areas, but we’re really sort of exploring.

[Jaz]
Well, whatever you do, make sure after the composite course, you have someone to implement whatever new skill they’ve learned. It’s really important to do that. Otherwise it becomes lost. There are some courses out there which teach you a very specific technique or a very specific way of doing things. It might take you six months to find a patient. And by then you’re like, Oh my goodness, how do I implement this? It’s human nature, right? So make sure you implement straight away.

And so the last question I have, Triman, is, what’s the number one tip you can give someone who’s made it all the way to the end of this episode, listening to you, this little interesting feature that we had six, nine months apart, wherever it’s been, seeing your journey and stuff, and very encouraging actually to anyone, maybe to start a foundation here to hear the story that you’re sharing. What’s your top tip to give to them?

[Triman]
Yeah, I would say I’ve actually had a quantity of people messaging me recently for tips on DFT, going into my practice. So I’m well equipped for this question. So I would say that the main thing I would say is actually just try and learn as much from everyone around you.

I know in DFT, it’s easy to just click on to your ES only, but it actually, in my practice as well, specifically, there’s lots of different associates there who are willing to help you, especially, if you’re fortunate enough to have specialists in your practice as well, like in my case, I have an oral surgeon who comes once in a blue moon or so, but whenever he’s there i’ll always take the opportunity to show him an extraction I’m doing that day where I’ve got planned because he’ll provide him with so many small useful tips. Just from you know his wealth of knowledge and I think it’s really important to just make use of everyone that you have in the practice as well whether that be nurses reception as well and just yeah, general other general dentists there aside from just your ES who is going to be able to help you because it’s really good to gain knowledge from a bunch of different places.

And in fact, one of the good things that both my ES do is that they will actually say, you know what? I’m not super skilled in this area with like bridges, for example. Let’s go ask one of the other dentists here who does a lot of resin bonded bridges, for example. And they’ll even learn with me as well.

So it’s good to, I think, gain knowledge from a lot of different areas. And so definitely make the most of your practice as a whole, and not just the single ES that’s there. Try and make use of everything and everybody that you have.

[Jaz]
And that’s a great tip, by the way. And I would say, don’t get frustrated by the fact that the four dentists in your practice will all give you four different treatment plans and four different bits of advice and they may contradict each other.

And instead of focusing on seeing that as a negative, see it as a positive that you know what, you could pick any of those paths and you’ll probably be right. And so if you convert that negativity into a positive thing, trust me, you’ll be well placed the rest of your career because it used to really frustrate me, Triman, you know, all these, ah, why isn’t there just one way of doing things?

Why’d that, why’d that have to be 50 different ways? Why is one, two to tell me one thing? Why different to it, tell me a different thing. It used to frustrate me, but I’ve learned to see the beauty of it. Actually, either way, whichever one resonates with me on that particular day where I’m making the decision, I’ll go with that and I made peace with that.

I think that’s very liberating. So, Triman, thanks so much for sharing those many months apart. It’s been really nice to hear about your journey. What you got planned for next year? Are you thinking about applying for jobs or?

[Triman]
Yeah. So I’ve actually taken up sort of two associate positions at two different practices next year. So are we making the transition into sort of full finalists?

[Jaz]
How did you find them? How did you find the associate job?

[Triman]
So I went on a couple of different job searching website. I think indeed, BDJ jobs, those kinds of areas. And there’s a couple of licensing, not the very licensing agents, but a recruitment agencies that are on those websites.

So even if you apply to one job, the recruitment agency will get hold of your info and you’ll see a stream for them in coming afterwards. There’s also lots of different avenues to sort of once you search one place, you’ll end up finding a lot of different places and it’s such a high turnover that you see so many different ones posted every single day.

So it’s really just sort of a matter of looking and then calling the practice and seeing if your ideals meet really, that’s sort of how I went about it and eventually I ended up finding two that were in good proximity to me. I had good reviews. I really enjoyed seeing the practice and that kind of thing really. And it was, I think the best sort of way to go about it.

[Jaz]
Triman, I wish you all the best with your next year. It’s good that you’ve survived DF1. Well done. And you definitely come out, stronger, better for your dentistry, which is great. And I’m excited for your composite course and also for your future, my friend.

Keep in touch with the Protruserati. Hope to see you on Protrusive Guidance. It’d be great for you to post a few cases now. And again, that’d be nice to see in your progress. It’s we’re all kind of invested in it now. So we’re rooting for you Triman. You keep going, sir.

[Triman]
So yeah, thank you so much, Jaz. Really nice speaking to you.

Jaz’s Outro:
Well, there we have it, guys. Thank you so much for listening all the way to the end. Hopefully that was useful insights, especially if you’re entering the real world of dentistry. I’m very impressed with Triman’s attitude. I think he’s going to go very far. I think he’s got his head screwed on. I’m very excited to follow up his progress in his career.

If you found this prospective episode useful, if you found the library of protrusive episodes helpful, would you mind leaving us a review? We’d really appreciate that. That’s how we grow. There is a team behind us. We have Erika, the producer. We’ve got Krissel and Nav on the notes. We’ve got our CPD queen, Mari.

This episode isn’t eligible for CPD, but if you’re a dentist, by the way, and we are now PACE approved. Oh my God. Okay. So I need to do a big announcement about the PACE approval. So probably not many people are going to hear this one, but there’s a big announcement coming PACE is basically like the US governing body for quality controlling education.

And it was a long and arduous process, but we are now officially PACE approved. So the US docs can now get official accreditation. So we’re literally this month sorting that out as well. For those episodes that are eligible, but for the rest of the library, which is eligible for CPD or CE credits, that’s on Protrusive Guidance.

That’s our app. You can actually scan. If you’re watching this YouTube scan, the QR code below, join us on the iOS or Android, or if you’re like a laptop kind of guy like me, hit protrusive.app in your browser, check out the community of the nicest and geekiest dentists in the world. Thanks so much for listening all the way to the end.

I’ll catch you same time, same place next week. Bye for now.