150 Broadhollow Road

Melville, NY 11747

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5 Impulses That Lead to Bad Dentistry

I am not perfect.  Not even close.  Despite my best efforts, sometimes I give myself a barely passing grade.  Every now and then I fail miserably.

I sit down with a patient for their annual recall, check the radiographs, and see a crown with open margins.  I check the chart and realize I did that crown last year.

I am full of rage.


What happened?  I am careful taking impressions and will retake them when necessary.  At the insertion visit I take bitewing radiographs to make sure it’s fully seated before I use permanent cement.  Wow, that’s frustrating.

I’ve discovered there are many reasons why a good dentist can do bad dentistry.  Sure, nobody’s perfect.  But if we can explore the causes of us not being perfect we might just reduce the number of times we fail.

So here they are: 5 Impulses That Lead to Bad Dentistry

(1) In a Rush

You’re running behind with a patient, an emergency patient is waiting, your receptionist tells you another dentist needs to speak with you on the phone immediately, and your hygienist has been waiting for almost ten minutes for you to do an exam.

To say that dentistry can be stressful is a bit of an understatement.  We can get downright overwhelmed now and then.  Some people can handle that stress well and still perform at a very high level.  For me, I know that being in a rush will only lead to mistakes.

TIP: If you find yourself in the above situation frequently, have a conversation with your office manager about how patients are scheduled.  There will always be days where things get hectic, but efficient scheduling can help minimize those moments.

(2) Lack of Knowledge

Sometimes we do a procedure a certain way or use a certain material because we get comfortable.  I used to prep my crowns with a deep, 2mm chamfer and place the margins almost 1mm subgingival.  Why?  I couldn’t tell you.  I thought that was how it was supposed to be done.  I was over-preparing the axial reduction and threatening the biologic width.  Despite my fine education in dental school and residency, I just had the wrong idea.

TIP: Speak with mentors about your work.  If you struggle with a certain procedure, talk to your lab or a friend about it.  There are some outstanding continuing education events like the American Dental Association’s Conference on the New Dentist which I strongly encourage you attend.  You will be not only immersed in great CE, but you will have the chance to talk with dentists from across the country very candidly.

(3) Pleasing the Patient

This is the toughest one for me.

Occasionally I’ll have a patient who wants their work done faster and/or less expensively, or just has some unreasonable expectation.  In my desire to make the patient happy, I may end up compromising my standard of care.

I may skip a step because they want it done faster.  I may tackle an extraction that I would have referred to an oral surgeon because they patient wants to save money.  Every now and then, I’ll have a patient try to invent a dental procedure that doesn’t exist just so they can have things their way.  I appreciate their creativity, but that made up dental procedure doensn’t exist for a reason.

If you let a patient dictate the quality or speed of your treatment, you may be headed for disaster.  Trust me, you’ll never want to be in the position to say, “I told you so.”

TIP: Draw a line in the sand.  I’ll say things like,” I’m sorry Mrs. Jones, but we need to make sure we take great care of you.”  Find phrases that help you confidently hold your ground.

(4) Laziness

Well, this one is hard to admit.  Fortunately I catch myself in lazy thinking and immediately change my behavior.

Must. Sleep. Now.


Whether you’re tired or bored, letting laziness affect your decisions will only make more work for you later on.

TIP: I encourage my team to take naps.  Really.  I’d rather someone sleep for 15 minutes and feel refreshed for the rest of the day than be awake the whole time with a brain fog.  I will lay back in my chair, close my eyes, and set an alarm for 20 or so minues.  When I wake up, I’m as good as new.

(5) Saving Money

We all like to reduce our overhead expenses.  Sometimes there is a dental material out there that is just as good as the popular brand but is less expensive.  I certainly don’t have a problem trying out that product.  But other times there is a definite drop in quality with the less expensive item.

We pretty much would all agree that we don’t want to sacrifice quality for savings.  But that sacrifice in quality isn’t always immediately apparent!  It can take a year or longer to find out that brand new material you purchased is a dud.  So if you’re bargain shopping for budget materials, tread carefully.

TIP: If a sales representative is trying to get you to use a new product, ask for a sample!  Try it out before you invest.  Also, ask your dental colleagues what materials and labs they use.  Their experiences might save you a lot of headaches.