New Practitioner Insights
By Priscilla L. Carpenter, DDS, MS
The American Association of Endodontists defines endodontics as the branch of dentistry dedicated to the study and practice of the dental pulp and periradicular tissues. It’s a specialty that delves into the biology of the pulp and addresses the diagnosis, prevention, and treatment of pulp-related conditions.
For me, endodontics represents the most captivating yet challenging dental field. A specialty that allows us to rescue teeth that may appear beyond saving while providing top- notch patient care. This specialty brings relief to patients, allowing for the resolution of their anxiety and pain, yet occasionally presents its own unique set of challenges. It demands precision, empathy, and an in-depth knowledge of dental pulp, anatomy, microbiology, and literature. Endodontics has taken me to the highest of highs and the lowest of lows. Making the victories incredibly rewarding and the setbacks equally intense.
I was fortunate to graduate from what I believe is, in my completely unbiased opinion, one of the nation’s best endodontic programs: the University of Florida. Now, in the “real world,” I’m even more grateful for the support of my dedicated faculty, both those who were always present and those who traveled far to impart their wisdom in the clinic and the classroom.
At my interview, I expressed my eagerness to be a sponge. I made good on that promise, dedicating every spare moment between patients and classes to observe, listen, and ask questions. I was ready to dive in, yet also keen on learning from those who preceded me. In my final months of residency, a consistent question I had was, “What do experienced endodontists wish they had known as new graduates?”
As I navigate my seventh month post-graduation with an equal mixture of happiness and healthy anxiety, I find myself frequently acknowledging the invaluable advice I received during and after my residency. I consider these insights crucial for new practitioners and strive to apply them in my first year as an endodontist.
“You have to go slow to go fast.” Efficiency is important, but rushing can lead to problems. If you run out of time, temporize and reschedule. Remember that each case is unique, and challenges can arise. When I’m feeling down on myself for not completing a case in one visit, I remember how there was no visible canal on the scan prior to access or that the roots were completely curved and in different planes. I try to give myself grace that I was able to get into the tooth, clean, shape, and place medication.
“Set expectations with your patients ahead of time.” Inform your patients about potential complications, such as possible crown fractures, instrument separations, or perforations, based on their specific case. This sets clear expectations and helps you manage any unforeseen issues. Set the expectations ahead of time, so that if a complication arises, you’ve already discussed it and if it does not, you’re the hero.
“Don’t be afraid to try new things.” Be open to experimenting with different supplies, files, and dental materials to find what works best for you. There is no one right way to do something, and different tools may work perfectly in one set of hands, but horribly in another set. It’s okay. Find what works for you, and do not be afraid to switch it up.
“Be prepared to train assistants your way.” Training your assistants early on can make the entire process smoother. Building a strong working relationship with your team takes time and patience. I had the unrealistic expectation that having an assistant throughout the procedure meant that everything would immediately go smoothly. It is a learning experience, and I am still learning – but I am also taking it one day at a time.
“What we do is hard; give yourself grace.” I had a faculty member who would constantly tell us this. He reminded us that no one but you knows how difficult it was to get the result that you did. I am so grateful for that, and it consistently replays in my head at least once a day. Understand that endodontics is a challenging field, and not every case will go perfectly. Learn from the tough cases and stay positive.
“Time is the ultimate teacher.” Reflect on your progress at the six-month and one-year marks. Things often become clearer with time and experience. I have consistently heard from more experienced endodontists that this really “clicked” for them at the five year mark. I try to remember this on my hardest days and take comfort in it.
“It’s all about relationships.” Nurture relationships with your patients, referring doctors, and staff. These connections are essential for a successful practice and require ongoing care and attention. What you do not water, will not grow and what you do water, will flourish.
“Try not to be too hard on yourself.” As an endodontist, being a perfectionist is practically embedded in our DNA. It’s challenging to accept that not every case will look perfect. Learn and grow from your mistakes and remember that each day is an opportunity to grow, learn, and to become better versions of ourselves.
“Go where you can grow.” Seek opportunities to work with experienced colleagues who can mentor you and help you develop as an endodontist. While I felt confident coming out of my residency, I still yearned to be in an environment with at least one experienced endodontist. I wanted to have the ability to bounce cases off of, pick brains, and be taken “under their wing.” I was blessed to land in a place that fit that criteria to the tee. The doctors in my group are kind, thoughtful, understanding, and have a wealth of experience and information that they do not hesitate to share with me. You don’t know what you don’t know, but I know that I am grateful for them.
It is my hope that incorporating these insights can help other new endodontists navigate the challenges of our profession and build successful, fulfilling careers – or at least, that’s what I will continue to tell myself. 🙂
Dr. Priscilla L. Carpenter is a member of the AAE’s Resident and New Practitioner Committee.