Walk in the shoes of a foundation dentist

sara misra

Sara and dental nurse Rekha

First day on the job

Finally – that moment when you have finished your dentistry degree and now you are fully qualified as a foundation dentist (FD), ready to start your career. Recent graduates and FDs can only relate to the rush of adrenaline and excitement, as well as nerves on the first day of your new job as an FD.

So my first day started with ‘meet and greet’ amongst the reception team, nurses and practice manager. I was then introduced to my new surgery – my humble abode where I would be working, seeing and treating patients.

There was computer system that was easy to follow, equipment and an order booklet should I need any other dental material/equipment. Although I hadn’t met my nurse, it did not faze me. I couldn’t help but feel happy that after all the hard work at dental school, this is what I have finally earned.

The reality sets in

Practice dentistry is totally different to university dentistry. I’ll give a basic overview of what I mean.

Suddenly cost is something you are quickly aware of. At university, materials and equipment are at your disposal but in practice, you realise these are limited, especially when it comes to prosthetics and subsequent lab bills.

UDAs also become important and I cannot speak for other FDs, but I am still in the process of trying to figure out the system. It baffles me how a root canal treatment (both single and multiple rooted) is under the same band as fillings.

Timing also becomes an issue. A check-up conducted at university would last 45 minutes to an hour in terms of talking to the patient, recording their history, charting, radiographs and then come up with a treatment plan and/or undertaking treatment which would then take another 45 minutes.

In practice, eventually you have to get yourself into a rhythm of carrying out a check-up within 15 minutes, or else face a backlog of patients.

You also need to prepare yourself for seeing at least 20 patients a day at the end of your training period to make your quota of UDAs. Whereas at university, you would usually see five patients in your final year.

Treating patients first-hand

Experiences range from the good to the bad. Some expect a ‘Hollywood smile’, but one thing you learn very quickly is the NHS is for function and not aesthetics and trying to relay this concept to patients can be very difficult.

One particular scenario, which comes to mind, is a patient wanting a posterior implant for free, despite active caries lesions, a chronic smoking habit and periodontal issues.

Despite the risk factors present that need to be tackled first, the patient was not happy that they could not have an implant on the NHS. I feel a lot of patients are not well informed about NHS dentistry in general and as an FD, we’re still getting to grips with policies and guidelines, so finding the correct answers is a challenge.

I am pretty sure at this point dental students are wondering…is this worth it? As an FD, you have trainers or educational supervisors and this is your security.

My educational supervisors have supported me, guided me and handled tough situations that I have learnt from and I applied their advice, enabling me to take control on my own.

A rollercoaster ride

The experience so far has been a rollercoaster ride. It is all a huge transition from dental school to practice, an overwhelming and daunting one to say the very least.

Despite all the ups and downs so far, there are glimpses of those spectacular moments and feelings you get that make the blood, sweat and tears so worth it.

I carried out numerous treatments on one patient that involved extractions, periodontal, caries management, immediate dentures to composite build-ups, which ended with them telling me, “you are going to be a great dentist.”

That one statement alone has been with me through some of the more difficult times, and it helps continue to ignite that passion that drives me in my career.

Sara Misra, foundation dentist

Help us be the voice of the profession

At the 2016 British Dental Conference and Exhibition, you told us that the voice of hospital dentists was not getting heard enough, so we are offering you a chance to discuss your views and share your experience.

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