The frustration of the dentistry we ve been taught


When I started attending courses I think that the word that represented better my feelings was frustration .

At the beginning the frustration was easier to accept cause it was related to a lack of technical skill…

“I just had to exercise exercise, struggle for a while and i will succeed” …that was my inner voice motivating me along the journey.

So I started my journey learning to place properly the rubber dam, learning to use sectional matrices, learning to layer composites….I attended many courses in order to improve my technical skill and after some time I was getting quite good….yet frustration was always there …

My cases were seldom similar to the cases I was looking going at courses and congresses.

In these places most of the cases were ideal cases …crowns fully erupted, teeth aligned, cervical margins easy to isolate with the rubber dam cause never subgingival, abundant enamel on the cervical margin .

My cases, my everyday ones …were much more challenging…wide inter proximal spaces that no matrix was able to cover, subgingival margins making the isolation so tough and, there after, the never-ending fight between the matrix unable to seal and the wedge deforming and collapsing the matrix. 

Time was also an issue cause layering was a complex procedure and time consuming.

So if the frustration of my early stage was easy to overcome, the later was tougher …

Cause it was related to the kind of patients and teeth I had in my office …

My scenario was never the ideal one I was doing at my perfection courses..

My feeling after a while was that even if my “ideal “ technical skill was good, the daily “field “ was damned…

I had the feeling like a F1 driver forced to drive in a street full of holes…unable to express his potential and skill….literally stopped by a battered road..

Being short daily frustration was the norm ….the distance between my daily work and what I was expecting was wide .

I spent years in this kind of scenario….before solving this unpleasant state….

The first step I did in improving my emotions was a day when i was looking at an olympic athlete training in an average day .

He was a weightlifter and he was training his lifts…but he was lifting much less than his actual maximum..

I started getting curious about how professional athletes train and I understood that they NEVER perform at a top level always…they train themselves at, let’s say, cycles of load between 70 and 90% of their maximum and they perform at their maximum just on some selected days.

Maximum performance is not something you can do really every day …it’s the peak of performance, not the average result.

I realized that even in dentistry is the same ..we claim to perform at our best everyday but it’s not realistic…

So I started questioning what was a good and acceptable and realistic daily routine ?

Something that made possible going back home with a smile my face, proud of the working day, satisfied .

Satisfied like a professional athlete going back home after his training day knowing that despite being below their maximum performance, the training day was a productive and proficient one.

So I started a slow process of rethinking all my goals…

so it was not about placing a rubber dam in a perfect way but it was perfectly ok as long as I was able to work in a dry environment.

It was not about using super colors and doing fancy anatomy but doing a good contact point .

I started changing my goals and priorities and, almost without any will, in the same time I started redesigning my idea of dentistry.

An idea of what really dentistry is …of what is really achievable on a daily basis .

AN idea of dentistry that allowed me to become satisfied with most of my working days.

An idea of dentistry that, I discovered along the path, is also much easier to match with patient requests.

So i found that my dentistry was not only real dentist-centered but also more patient centered.

I realized that many times we indulge in a sort of self -congratulation cause we have been able to follow the “protocol”, the “gold standard “ : We feel ourselves satisfied and “protected” in our ability to work according to “academic rules “.

Yet I realized that the sentence “ Surgery was perfect yet the patient died “ is something we can say also to our treatments …perfect shoulders with crown breaking after 5-7 years, endodontic treatment straight to the apex with the precision of a sniper collapsing after some years for other complications.

I realized that we have different definitions of success ..and each definition is related to the desired outcome.Outcome may be related to the adherence to the protocol like a endodontic treatment erfectly at the apex, or outcome may be related to patient’s perception and needs.

What I found along my journey is that the road of focusing on a patient centered outcome was also the road to a better practice and much more satisfying.

All my dentistry is designed around this concept .

Vertical prep, bioclear restorations are just the technical expressions of my thought. They may change in the time. But now they represent the best technique allowing me to follow my goal. 

A patient centered practice. 

No frustration.
Pure satisfaction.

If you wanna learn more about my techniques follow my website educational.studiomaiolino.net and subscribe to my mailing list. 

Last vertical course for 2022 is planned for 25-26 November

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