“I was holding the mirror with one hand, and my breath with the other.”

It wasn’t the first time I performed that procedure. But that day, everything felt off.

The patient was anxious. The assistant wasn’t in sync. The impression failed, and so did the rhythm I usually trust.

My hand didn’t tremble, but inside, I did.

That quiet moment of doubt is one we rarely discuss in dentistry. But we should.

Because this profession isn’t just about precision, it’s about presence under pressure. And when the hand shakes, leadership begins.

The myth of unshakable hands

Dentistry celebrates calm hands and flawless execution. We measure in microns. We train for certainty. We’re taught that steadiness equals mastery.

But certainty is a myth, and perfection, as I’ve written before, is its most dangerous illusion.

What no textbook prepares you for are moments like these:

• When anesthesia fails and a patient’s eyes fill with fear.
• When your assistant freezes mid-procedure and you have seconds to restore flow.
• When a parent confronts you over a plan they never fully understood.
• When a team member breaks down and your clinic becomes a space for humanity, not production.

These aren’t “technical errors.” They’re ethical intersections. And they demand something deeper than clinical mastery: judgment, humility and leadership.

Precision is a skill. Composure is a discipline.

Across my journey — from private practice to federally qualified health center leadership, from human resources boards in Baghdad to community clinics in California — I’ve learned this truth:

Your hands may slip. Your schedule may collapse. But your presence, your ability to stay composed, intentional and ethical, must not.

Composure isn’t silence; it’s strategic calm. It’s pausing instead of panicking. It’s saying, “Let’s step back and do this right,” instead of pushing through chaos. It’s remembering the compass that has guided me in war zones, boardrooms and operatories alike: When systems fail, values lead.

What happens when…

1. The procedure breaks down
The crown won’t seat. The file fractures. The clock runs out.
What to do: Pause. Reframe. Speak it out loud: “Let’s reassess and do this right.” Patients don’t expect perfection. They expect honesty and safety.

2. A team member loses confidence
The assistant avoids eye contact. The hygienist hesitates. The room shifts.
What to do: Redirect with grace. Ask: “What do you need from me right now?” Leadership isn’t about control; it’s about presence.

3. Burnout creeps in
You’re depleted. Then one difficult patient tips you over.
What to do: Recognize the signs early. Protect your integrity before exhaustion erodes it. Rest isn’t weakness; it preserves your leadership.

The mistakes we don’t document

We all record clinical errors, complications, revisions, delays. But what about the ones we don’t: the rushed procedure because the schedule was tight, the softened truth to avoid discomfort, the choice of “what’s easy” over “what’s right”?

No one will sue you for those. But the mirror knows.

I don’t lose sleep over technical missteps. I lose sleep over the moments I knew I could do better, but didn’t. Because peace of mind doesn’t come from avoiding hard truths; it comes from facing them with integrity.

5 rules for leading when the hand shakes

1. Calm the room: Your tone sets the rhythm. Breathe. Then speak.

2. Communicate the plan: Uncertainty breeds fear. Even saying, “We’re going to pause and reassess,” builds trust.

3. Anchor in values: When the patient’s best interest conflicts with the day’s schedule, choose the patient.

4. Document with clarity: In uncertain moments, your notes become your voice. Write them with integrity.

5. Reflect, don’t ruminate: Learn. Adjust. Then let it go. Growth requires grace, not guilt.

Leadership isn’t the absence of mistakes, it’s how you rise after

There is no universal protocol for pressure. But there is preparation for presence.

And that preparation isn’t taught in lectures. It’s forged in long nights, difficult conversations, failed moments and choices that cost you something.

Leadership is not formed in titles or honors. It’s shaped in tension and proven in humility.

When the hand shakes, let the heart hold steady

The future of dentistry doesn’t just belong to those with the steadiest hands. It belongs to those with the strongest character.

If you’re a young dentist reading this, remember: It’s not your mistakes that define you. It’s how you hold the mirror when they happen.

Hold it with humility. Hold it with presence. Hold it with truth.

Because your patients don’t just trust your hands, they trust your humanity.

Dentistry is more than beautiful restorations. It’s about shaping trust, sometimes rebuilding it. We don’t just shape smiles. We shape character, clarity and courage.

This post completes my leadership trilogy, which also includes “Mastering difficult conversations: A guide to leadership with resilience and heart” and “Speak to lead: How dentists can communicate like leaders, not just clinicians.” Each piece builds one truth: Dentistry’s future won’t be written by perfect hands, but by present hearts.

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Forming my own opinions about how to practice dentistry has been challenging for me after dental school. How do I build my own views when more experienced dentists disagree? I’m sure you have seen this in your own work so far, no matter how new you may be. The decisions are everywhere: amalgam vs. composite, when to crown, what “nonrestorable” really means, and the list goes on. So, what do you do? Well, I’m still figuring it out too, but I can share how I sometimes navigate these waters.

1. Say what you know. This can be from experience, school or your own review of the literature. Take composite vs. amalgam, for example. I know that both types of restorations often last seven to 10-plus years. I prefer to use composite for Class II restorations, mostly because I hate breaking the contact of an amalgam when removing my matrix band. The public has questioned the safety of amalgam in recent years, but trusted sources like the American Dental Association and Academy of General Dentistry have responded with strong statements and studies in support of its safety and efficacy.

2. State what others say. Several older docs I know still love amalgam. They praise its longevity, compressive strength and ability to set up even in moisture. They’re amazing with it and plan to keep using it. I also know skilled dentists in offices that are entirely amalgam free. Check what the ADA, AGD and American Association of Endodontists say on the topic. It is usually easy to find succinct practice guidelines or topic essays on their websites.

3. Learn what evidence says. A quick search of PubMed (or your preferred database) will show hundreds of results. Your ADA membership also provides you with access to a well-stocked health sciences library, including thousands of journals, evidence-based summaries of clinically relevant topics, and the research services and scientific expertise of staff to support you in your efforts to find what you need.

My advice: Focus on the most recent systematic reviews, ideally those with meta-analysis. Even then, you might still find a dozen relevant reports. Skim the summaries of key articles. Check what was measured and how, who wrote the article, and what the actual outcomes were. Assess the outcomes’ validity and applicability to patient care. Do this before you jump to the conclusions section. Beware of biases, yours and others’. If you’re curious, open one and give it a skim.

4. Decide. OK, now that you have gathered your information, decide! Do you need perfect knowledge right now? Absolutely not, but you do have what you need to make a solid choice and support it with reasoning and evidence. Move on and apply this knowledge in clinical settings to improve your patients’ outcomes. And remember, your opinion can, and should, change with new experience or evidence. Stay open minded.

You can make these kinds of decisions. You are not a parrot of your boss, your professors or any single organization. You can review the evidence and reach your own conclusions. Don’t be afraid to look things up or dig into a topic, and once you do, don’t be hesitant to trust yourself. We all feel imposter syndrome sometimes. That’s OK. You got this!

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A metaphor I have heard all too often when discussing the stressors of the dental field is the reiteration of the pre-flight announcement, “You have to put your oxygen mask on first before helping others.” While that metaphor has validity, the reality is that it is difficult to put ourselves first.

We, as dental professionals, provide constant care for our patients but tend to neglect the constant care we need for ourselves. Being new to the dental profession, I have quickly realized that navigating personal life and patient care requires an emotional intensity that can result in being completely depleted at the end of the day.

I have come to the conclusion that there is not one simple answer for how we can figuratively “put our oxygen masks on first,” but there are many resources that can help us prioritize our needs. Self-care is complex and dynamic, thus requiring us to constantly add more resources to our toolbox.

One way I practice self-care is through hobbies. Since graduating from dental school, I have found that jigsaw puzzles are a mindless hobby that help me unwind after work. Completing a puzzle allows me to focus on something other than dentistry so I can rest my brain once I leave the office. Puzzles are a small addition to my self-care routine that have helped me disconnect each day when I get home.

Another way I care for myself is by accessing support when I need it through the Talkspace Go app. The app, which I can use for free as an ADA member, encourages me to be intentional with my time and take a few moments to focus on myself no matter where I am or how much time I have. Whether I am in between patients, at the grocery store or at home, I can open the app and use the self-guided lessons to assist with my emotional and mental wellness.

The app organizes resources by topic, making it easy to find what I need at any given moment. My favorites are the guided breathing exercises. When the day is not going as planned and something as simple as taking deep breaths seems like a challenge, I open the app and take less than two minutes to regulate my breathing.

Practicing self-care helps me prioritize my mental health so I can be better not only for my patients, but also for myself.

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What makes one dentist command a room while another, equally skilled, struggles to be heard? It’s not always about knowledge. And it’s certainly not about volume.

In today’s dental world, leadership is increasingly measured by our ability to communicate clearly, calmly and intentionally. Whether it’s a treatment plan, a team meeting or a high-stakes conversation with a colleague or patient, your words have the power to elevate or erode trust. And in dentistry, trust is everything.

This is the second post in my leadership series for new dentists. In my first blog, I wrote about mastering difficult conversations and how they reveal resilience under pressure. This time, we’re taking a step back to look at the everyday power of communication and how it can make or break our impact as leaders.

Communication isn’t about volume. It’s about vision.

Earlier in my career, I believed that speaking more meant leading more. I filled meetings and hallway conversations with words, trying to prove I belonged. But over time, I noticed something else. The most respected leaders in the room weren’t the ones who spoke the most. They were the ones who spoke with clarity, purpose and intention.

Their presence lingered not because they had the loudest voices but because they knew when to speak, how to listen and what to leave unsaid.

Lead by lifting others: The quiet strength of clarity

A few years ago, I was still growing into leadership, learning how to turn challenges into meaningful progress through trial and error. One experience stayed with me.

I joined a team full of talent but weighed down by silence. People were walking on eggshells. The work got done, but the trust was low, and the energy was fading. I didn’t show up with all the answers, but I knew one thing: Real leadership doesn’t begin by talking; it begins by listening.

So I stayed quiet in meetings — not to disengage, but to create space. I introduced a few simple steps: an anonymous feedback box, group reflections and a short video on how teams grow together. None of it was dramatic, but together, those small choices sent a clear message: You matter here.

I focused on tone, timing and presence. I tied every action to one goal: to build a place where people felt seen, heard and safe to speak.

Months later, something shifted. People opened up. Conversations became honest. Trust began to return. That change wasn’t about me being “in charge”; it came from consistently showing up in a way that helped others rise, too.

That’s where my CLARITY framework began to take shape: Lead with purpose. Speak with intention. Build trust by giving others room to grow.

Because in the end, leadership isn’t about having the loudest voice.

It’s about holding steady when things feel uncertain. It’s about listening well, choosing your words carefully and helping others discover their strength. I’ve seen this across clinics, teams and communities. When you believe in someone — even before they believe in themselves — you don’t just lead them.

You lift them.

My framework: CLARITY

This is the communication model I lean on when managing teams, mentoring providers or navigating tough conversations:

• C — Connect first: Acknowledge the emotional tone in the room — stress, fatigue uncertainty.
• L — Listen actively: Reflect what you hear. Build connection before delivering direction. Let others speak.
• A — Adapt your tone: Your energy, pace and body language matter as much as your message.
• R — Relay concisely: Speak with focus. Be clear and kind, not rushed or vague.
• I — inspire action: Don’t just instruct — motivate. End with vision, not just a task.
• T — Track impact: Reflect on what landed and what didn’t. Communication is iterative.
• Y — Yield space: Sometimes leadership means saying less. Let others rise.

This isn’t a theory. It’s a habit that takes time to develop but pays off in trust, alignment and long-term credibility.

Three common communication traps in dentistry

Even the most technically gifted dentist can lose influence by falling into these patterns:

• Overload: Using excessive technical language that overwhelms the patient or team.
How to fix: Speak human, not textbook.

• Deaf spots: Listening only to respond — not to understand.
How to fix: Pause, summarize what you heard and ask thoughtful follow-ups.

• Force: Pushing your viewpoint without building connection.
How to fix: Ask more. Push less. Leadership grows through curiosity, not control.

Strategic communication is leadership

The best dentists today are more than excellent clinicians. They are educators, mentors and culture-shapers. Every word you choose reflects your mindset and your leadership style.

Whether you’re a new graduate or a few years into practice, your ability to communicate effectively will determine your long-term influence. Don’t wait for a title or a crisis to find your leadership voice.

Start now by speaking with purpose, listening with intention and leading with clarity.

Your voice is a tool. Use it not just to explain, but to elevate.

A lesson in influence

A few years ago, I had to step in during a staffing crisis. The clinic was shorthanded, emotions were high and delays were compounding. It would have been easy to respond with pressure — demand more, tighten control, push harder. But leadership isn’t about reacting louder. It’s about seeing what’s not being said.

So instead of pushing, I paused.

I met with each team member — not to assign tasks, but to ask: “What’s not working for you right now?” I listened without judgment. I adjusted the schedule. I simplified the flow. And I made sure they knew they were being heard.

We didn’t just survive that month — we came out stronger.

That moment reminded me that clear leadership doesn’t always mean stepping in. Sometimes, it means stepping back to understand. True influence doesn’t come from control — it comes from consistency, care and the ability to make people feel safe, even in the middle of chaos.

From culture clashes to system solutions

After working across multiple fields — including dentistry, human resources, social services, operations and international development — I’ve seen that many workplace tensions aren’t personal. They’re structural.

Lack of clear policies, lack of consistent feedback, lack of transparent expectations — that’s where most breakdowns begin.

We don’t rise to the level of our intentions; we fall to the level of our systems.

Whether you’re managing a clinic or contributing to one, design your culture. Don’t just hope for it. Create clarity before conflict. Set expectations before judgment. Train before you change.

Speak like a leader. Lead like a builder.

Dentistry is evolving, and with it, the definition of leadership.

You don’t need to speak loudly to be heard. You don’t need a title to lead. You just need clarity and the courage to use it wisely.

I’m still learning, still building. And I’ve come to believe that clarity isn’t just a leadership tool, it’s a mindset — one that helps us grow, guide and lift others with purpose.

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Members of the graduating class of 2025 recently put a bow on their academic careers with the culmination of their dental degrees. While this time may have been chaotic as requirements were fulfilled and exams were completed, it was important to remain organized, a necessity that continues with graduates’ next step: hunting for a job.

I remember when I was graduating, everyone I spoke to said the first job you get is the one you dislike the most. Whether it’s inexperience in evaluating a job position, not asking the right questions or not negotiating enough, too many people told me I would hate my first job. I don’t consider myself the exception to this “rule,” but I really didn’t want to lock myself into a contract where I would be dissatisfied (note: it is always a good idea to have an attorney review any proposed employment contract). I had a conversation with my co-resident about these complaints, and he shared with me a very objective questionnaire, which I then used to filter through job prospects.

Once you finalize a location area where you are willing to work, the beautiful thing about the questionnaire is it helps take the emotion out of a job prospect. Sometimes you see the pictures or the recruiter hypes up a location to make you rush your decision, but there are so many subtleties to this commitment that it needs to be a win-win for both you and your future employer. Your first interview will not be pretty, but as you go through subsequent ones, you will begin to sound out what is a good job prospect versus a bad one. Developing this skill will help make you an exception to this idea that your first job is your worst job.

I hope this questionnaire can help you in your journey as it has helped me.

Expected pay:
• What is the salary range for associates?
• How is the amount calculated (base pay, percentage of production or collections, etc.), and how might it vary?
• When and how much will I get paid?
• Will I start with an existing patient pool or from scratch?
• Does the practice cover lab fees?

Insurance:
• What percentages of patients pay out of pocket, have PPO insurance and have Medicaid, respectively?
• What is the practice’s collection percentage?
• How quickly does the practice receive collections?
• With how many insurance networks is the practice contracted?
• Do I need to take care of my own credentialing?

Practice hours:
• What are the practice’s days and hours of operation?
• Is there an on-call schedule?
• If this is a multisite organization, will the employer have the right to assign me to practice at multiple locations in the same day?
• What is the vacation policy?

Procedures:
• Do you do specialty referrals for certain procedures?
• How many chairs will I have?
• How many patients can I expect to see?
• Will I be mentored through more complex procedures?

Staff:
• What are assistants’ responsibilities?
• Will I have an assistant for each operatory?
• Do I get collections from hygiene checks and recall exams?
• With how many hygienists will I work?

Benefits:
• Does the practice reimburse for continuing education?
• How much paid time off will I receive?
• Does the practice offer health insurance to employees?
• Do employees’ immediate family members get discounts?
• What retirement benefits does the practice offer? Is there a match program for retirement savings?

Contract:
• How long is the commitment?
• Is there a noncompete clause? If so, what are the terms?

Buy-in potential:
• Is there an option to buy in?
• Is there a time frame before buy-in is an option?
• Is buy-in for a specific percentage, or is it a full partnership?

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When I announced to family and friends that my partner, Mitch, and I had gotten engaged last October, the first question I got was: “When is the wedding?” followed by: “Are you going to change your last name?” — a question to which I still don’t feel I have a good response. I need to decide my plans for my last name when I get married — a personal choice for myself and my fiancé, but also a public choice as a general dentist practicing in the community.

I’ve been having conversations with peers who are grappling with the same decision (mostly other straight cisgender women). Is this because I’ve gotten to “that age,” or because the number of women in dentistry and the average age at marriage have increased? From talking with friends and colleagues, it seems many of us feel overwhelmed with the number of, reasons for and judgment about last name choices. Older colleagues and even patients have shared with me their reflections in hindsight about their own last name decisions.

I started my brainstorming with Mitch by talking about my individual priorities and our values as a couple. Individually, I value my professional identity that I’ve curated. I’m the third generation of dentists in my family, and the first female Dr. Merrick. My dad and my dad’s dad were both dentists. I practice dentistry in my hometown and work for the practice my father owned before he passed away. It has been incredibly meaningful to tell patients, “I’m Dr. Katie Merrick,” and hear them respond, “Oh, you’re Ben’s daughter!”

Changing my name feels like a lot of administrative work. My current name is on our office signs and business cards and my scrub jackets. Patients have gotten to know me as “Dr. Katie Merrick.” Keeping my name would be the most convenient for my professional work. Some of my colleagues anticipated a last name change to align with graduation, board exams and state licensure application. I admire such organization and planning, but this timeline would not have lined up in my personal life.

I find myself seeking a secret third option, something other than the binary choice of keeping my own name or changing my last name to Mitch’s. Hyphenating names is a possibility, one that brings up subsequent questions as well. Whose name goes first? Do both of us hyphenate or just me? Do we keep our own names but if we have kids, give them hyphenated names? Another hybrid option would be to keep my name legally and professionally but socially use Mitch’s last name.

Mitch and I decided it matters to us to share the same last name. For now, we plan to decide on a new last name for both of us. In theory, we want this to be a name that holds meaning for both of us. In practice, we’ve joked about sillier and sillier choices. While I might wish there was a perfect, one-size-fits-all last name solution for all young dentists getting married, reflecting with colleagues about what and how they decided has helped me to figure out what I think is the right choice for me.

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