Endodontist

Wearing braces as a teenager led to familiarity with dentists. Eventually he decided to switch from knowing how to do many procedures well, to focus on performing one type of procedure very well. 

FAMILY BACKGROUND

LD’s father was very skilled working with his hands and mechanically inclined but felt a responsibility to get involved in his father’s restaurant / food service business, which required many long night and weekend efforts. 

LD’s mother was a homemaker. 

Because LD’s father’s work duties often conflicted with family time, LD was indirectly influenced to eventually choose a career with a better work-life balance – so he could have dinner with his family, play time afterwards and participate (e.g., coaching a child’s team) or at least attend his children’s events. 

One further, indirect parental influence on LD’s eventual career path decision was his father’s lament: “If I had studied more to achieve better grades, I would have liked to become a dentist.” (Editor’s note – Contrast LD’s father’s indirect influence with a potential for attempted direct parental influence: “You should become a dentist!” which often backfires as the child opts to display her or his independence by purposefully avoiding any direct suggestion or attempted mandate.)

CHILDHOOD THOUGHTS OF AN ADULT CAREER

LD recalls no specific career thoughts during his journey through elementary and middle school years. But during many of those years, into high school, LD wore braces to slowly adjust his teeth, which led to many visits to dentists for installation and maintenance of his braces. 

Early on, LD noticed that his dentists seemed to be happy while they worked. So, he arranged to ‘shadow’ (observe) several dentists while they – with permission of the patients they were treating at the time – performed all the tasks of general dentistry, ranging from supervising the dental assistants who had cleaned the teeth and taken x-rays, to interpreting x-rays, checking for cavities, drilling, extracting, capping, and root canal procedures, all while interacting with the dental staff and assuring the patients and their families. 

EXTERNSHIP 

Editor’s note: Unlike an ‘Internship” which implies personal involvement, an ‘Externship’ is an opportunity to go off campus to merely observe others at work, without getting involved in that work. 

LD was fortunate to attend a high school which offered ‘Externship’ programs, wherein a student could choose to observe various types of professionals at work during three weeks of half days: at school in the morning, then at an off-campus workplace in the afternoon.  

Based on his earlier, personal experiences as a dental patient, LD found an opportunity to observe a pediatric (children’s) dentist in action – of course with the consent of any patient and their parent present at the time. By good chance, the dentist LD observed was both highly skilled, a patient teacher and super organized in running his dental business. 

As a result of this experience, LD was firmly committed – at that time – to becoming a dentist, although not for children, who as patients in general, presented special challenges while adults would have their own, but lesser, emotional and behavior challenges. 

COLLEGE

Following high school graduation, LD realized that adulthood, involving choosing a career, was now in sight. So, he chose some college science courses to prepare for admission to dental school following college graduation. But LD was not yet firmly committed to becoming a dentist, so he had a ‘Plan B’ based on his fascination with how the brain works, which is the study of neuroscience. 

At the time LD was pondering his future career path, A.I. (artificial intelligence) was emerging as a science hot topic, along with computer programing design. In addition to those interesting issues, LD took advantage of attending a liberal arts university by enrolling in a philosophy course, which included the study of ‘What is a thought?’ 

INTERNSHIP

During his college summer vacations, LD volunteered to work – for minimal pay – within various dental offices as an intern, assisting with and thereby learning every aspect of dental practice, ranging from the business side to the professional dental side: observing patient procedures, updating records, dealing with off-site dental labs and the office staff.

DENTAL SCHOOL (‘GRADUATE SCHOOL FOR DENTISTRY’)

By LD’s third year in college, he had firmly decided to become a dentist, based mostly on his familiarity with that type of work since his childhood observations plus the likelihood of being able to achieve a reasonable work / life balance. 

LD realized that an above average GPA (grade point average) would be required for admission to and graduation from an accredited dental school so he balanced taking difficult science courses (for the knowledge to be gained) with a few courses which had attracted some football players (for the easier, higher grades to be obtained, based on his theory that those athletes knew where to find professors more inclined to distribute higher grades with less student dedication). 

Editor’s note – It’s neither illegal nor immoral to enroll in a few courses to hopefully pump up your GPA; just be careful to avoid the temptation to over-emphasize such courses if you may be headed toward a career involving graduate level education, where your transcript will be closely examined to determine how much you challenged yourself with difficult courses related to your career path. 

LD found the first two years of dental school to require voluminous memorization of dental science related subject materials. Two, two-hour exams had to be satisfactorily completed twice each week. The third year, devoted to clinical work, was less information intensive, more focused on the practical aspects of working inside mouths, on actual teeth. 

REQUIREMENTS TO BE A LICENSED DENTIST

1. Informal recommendation – Before briefly summarizing the formal requirements to become a dentist, LD suggests the most important, informal requirement: You must like to help people! 
2.  Formal, legal requirements – Licensing requirements vary from state to state but generally, to earn a license to practice dental medicine, the applicant must have graduated from an accredited dental school, pass a two-part test (written and clinical – i.e., ‘hands-on’) and pay the state licensing fee. 

Upon achieving the license, the aspiring dentist is well advised to associate with one or more experienced dentists as an employee still needing to gain experience from seasoned dentists, who have been involved with many situations likely never covered in dental school. 

Special certifications in endodontics may be achieved but are not required.

To maintain the license, the dentist must attend (and may eventually teach) annual, continuing education courses. Licenses are subject to revocation for gross or repeated malpractice or criminal behavior affecting patient care. 

OBTAINING FIRST CAREER EMPLOYMENT

Following graduation from dental school, LD thought it would be helpful to his continuing need to improve his basic dental skills, to work as a general dentist. He found such an opportunity within a hospital clinic in a major city. 

After a full year of this valuable learning experience, LD decided to move back to his home area, where he continued to work for the next several years as a general dentist. Within that dental practice, LD started to perform root canal work, first under the close supervision of senior dentists and eventually – gulp! – by himself. 

During his first root canal procedures, LD proceeded very slowly – to be sure each step was performed carefully and correctly since LD was reasonably apprehensive of ‘negative outcomes.’ As LD continued to improve his root canal procedures, three important things happened: (1) he received praise and encouragement from senior dentists; (2) patients – who were not informed this was LD’s first or second or tenth root canal procedure – were pleased that their expected level of discomfort was significantly less than they had anticipated; and (3) the more that (1) and (2) occurred, the more LD enjoyed what he was doing. 

ENDODONTIST – A DENTAL SPECIALIST

After his several years’ experience as a general dentist, LD decided he would further improve his work / life balance by limiting his dental practice to focusing solely on ‘Endodontics’: dentistry focusing on tooth pain, disease, and infection. Endodontists have extra training that helps them diagnose and treat tooth pain. 

The most common endodontic procedure is a ‘root canal’ – a special procedure designed to save an infected or decayed tooth. This involves working inside the tooth, the area known as the ‘tooth pulp’ which has blood vessels, nerves and connective tissue which can get inflamed or infected due to tooth decay, traumatic injury to a tooth and even repeated dental work on a tooth. 

A dentist is legally qualified to perform such a procedure, but an endodontist has a lot more experience and usually more sophisticated equipment, to perform such procedures with a higher rate of success. 

To be certified as an endodontist, the general dentist must complete an endodontic residency within a licensed endodontic degree program. At the time LD applied for a residency, there were approximately 30 such programs available. Due to LD’s academic achievements, his record of experience and his positive interview with a highly selective residency program (only 2 of 300 applicants were accepted to this top-level program), LD was admitted. 

Following completion of his residency, LD had to proceed through a ‘matching’ program like the match process following his graduation from dental school. Some matches provided no income; LD opted for a match during which he would be paid. 

ALTERED CAREER PATH FOR DENTIST NOW AN ENDODONTIST SPECIALIST

After earning his endodontist certification, LD worked for a few years as an employee within a group of endodontists and then decided to start his own business. 

QUESTIONS BEFORE WORKING WITHIN A DENTAL GROUP

• Where do I want to live: city, suburb or rural?
• Will I be part of a supportive or overly competitive working group – i.e., will our personalities mesh or conflict?
• What is the opportunity for professional growth: have other associate dentists been offered an eventual partnership? What are the senior dentists’ plans for sharing ownership in the future?
• Work / life balance: Hours expected to be in the office? Vacations possible? Who covers for emergency patient services?
• Starting salary? Cost of living in that area? 
• If I contemplate having a family, what is the quality of local schools?  
• Or do I want to finance the start of my own business – to be my own boss? 

QUESTIONS BEFORE STARTING YOUR OWN BUSINESS

Editor – For an overview of the issues in starting your own business, see the following stories within the BUSINESS category of this collection of career stories:

• “EMPLOYEE TO ENTREPRENEUR”
• “SELF EMPLOYMENT OVERVIEW”

In brief summary: starting your own business requires:

•  Ability to support yourself financially without steady income for a while.
• Financing start-up costs such as office rent, equipment, staff salaries and required benefits (e.g., health insurance) and insurance.

COPING WITH DENTAL CAREER CHALLENGES

• Since patients are often nervous about any type of dental procedure, the dental practitioner must be able to ‘lighten the mood’ with brief, calm conversation to explain the details of what will happen and answer any patient questions; a silly joke may be useful – e.g., “What is the best time to visit a dentist? “Tooth hurty” (= 2:30…. LOL) 
• Keeping up to date with the latest procedures and technology by reading professional journals, participating in continuing education and investing in equipment which will improve your performance
• Supervising staff – balance respect for their professionalism with setting high standards of attendance and performance
• Learning to control what you can and understanding what you can’t control – for example, if too many staff are absent at the same time, for good reasons (e.g., sick, or flat tire) or bad reason (e.g., no explanation), certain dental procedures cannot be undertaken, leading to disappointed and continuing, actual pain for patients affected

Editor – Typical career challenges for all dentists – generalists and specialists – have been noted within the career story: “DENTIST” to which the reader is now referred. 

CAREER SATISFACTION

• Assuring patients that you will provide excellent care with minimal discomfort and then exceeding their expectations
• Self-assessing your own performance through objective analysis – e.g., x-ray review
• Work / life balance
• Giving back (1) Once a month, LD returns to the school where he earned his endodontic degree, to teach students about endodontics through case histories and clinical participation, where he informs and demonstrates the process of diagnosis and treatment
• Giving back (2) When anyone expresses a possible interest – for themselves or someone else, e.g., a younger family member – in becoming a dentist or an endodontist, LD offers to have that person schedule coming to his office to ‘shadow’ his real life, patient experiences (with the consent of the patient being observed, which is never a problem)