Going back to school for a general practice residency after four years in private practice was not what I imagined it to be. It was better. The only regret I have is not having done it right out of school, despite my mentor advising me to do so. Had I taken her advice, I would have been gifted with the perspective, mentorship and vision I have today, years earlier.

First, the elephant in the room. Why did I go back for a GPR?

Things changed by the end of year two of practice, when I began experiencing serious burnout and realized there are aspects of general dentistry that I don’t like. I also felt stuck in one insurance-driven practice after the other, where “what’s covered” is the question of the day.

Practice ownership seemed exciting; however, I felt disillusioned about starting a practice only to be doing exactly what I was doing as an unhappy associate. I believe this is a question many associates debate.

Year three was when I was able to connect the dots, thanks to the Leadership Education in Neurodevelopmental and Related Disabilities fellowship I completed at the University of Washington. The LEND fellowship reminded me of my passion to serve those with special health care needs. It taught me the gaps that exist in our current health care system. I was alarmed to understand the dismal rates at which adults with special health care needs receive dental care in the country. When I moved to California, it became obvious to me that I needed to go back for a GPR to gain the necessary skill set and training to serve this population.

4 things I learned in my GPR

1. Learning endodontics from an encouraging endodontist

We all have had the experience of learning endodontics from professionals who scare us into thinking general dentists can’t do root canal treatments well. We are made to believe we don’t have the knowledge or the experience. And that is absolutely true for most new graduates who do not have a robust endo experience in dental school.

However, while an endodontist may be able to do things more efficiently and should be referred to, when the times arise, there simply are not enough endodontists out there to do all the root canals that need to be done. Learning to do root canals in the right way has been one of the greatest benefits from this residency. Our superb teacher, Raymond Scott, D.D.S., was a gem of a person who made root canals fun and calming. I looked forward to the days he was attending because I knew I was going to have fun that day!

How many root canals were we completing on average in this residency? Between six to eight every week. Do the math. The endo experience I got out of residency at Highland Hospital was unbeatable.

2. Learning how to give a successful inferior alveolar block

There will always be a percentage of times that I miss an inferior alveolar block and need to give it again. However, prior to this residency, I am embarrassed to admit, I used to miss it probably half the time. In year three of practice, I had gotten so humiliated about missing it and disappointing patients that I would dread seeing a No. 19 or 30 crown prep on my schedule (the most common teeth that need crowns, fillings or root canal treatments). I don’t mind admitting to this now because I know I have finally conquered the beast! All credit goes to Akshay Govind, D.M.D., M.D., the head of oral and maxillofacial surgery at our residency.

3. Patients with special health care needs

Working with this patient population has probably been my most treasured experience this past year. I’ve found that many patients with special health care needs can be treated safely in a regular dental clinic setting and need not be fully sedated. They need more time, desensitization, patience from the team and additional supports, as necessary.

One thing that helps tremendously with this population is using teledentistry. We can get the full medical history prior, understand what specific wheelchair transfers they need, find out if they require transport before and after the appointment or an American Sign Language interpreter, etc. It makes the following appointment in the clinical setting very smooth.

Being on Epic and having access to a patient’s full medical history, including labs, and sometimes the ability to contact their primary care provider, is also a huge boost. I can’t imagine being able to treat patients with medical comorbidities and complex surgical and treatment histories without a system like Epic. I would often quiz patients on their medications, while simultaneously eyeing what was on their Epic, and sometimes, the differences were very big. Medical-dental integration should be the norm, not optional. We should demand more from our practice management software solutions.

Patients also have a habit of remembering only the more positive details of their lives — “selective memory.” I had a patient tell me very convincingly that his hemoglobin A1c was 6 this year when in fact it was 9 in the past month, per Epic. This made it unsuitable for us to extract his teeth that day. By not getting the complete medical history of a patient, we are opening ourselves up to liability. In the case of a poor outcome from a procedure, the first person to be critiqued would be the doctor because “you should’ve known better and done more research.” Our role as a health care provider should be taken seriously.

4. What is an emergency and what could wait until Monday

While there are many, many more things we learn in GPRs, I will end with this point. In private practice, I can remember several times patients and bosses talked me into performing certain procedures because they were “emergencies.” These procedures, such as addressing post-operative discomfort after an extraction or restoration, performing temporary crown re-cementation, etc., would be added on to an already full day. Team members would scramble to seat multiple patients and prep rooms at the same time. At the end of the day, everyone feels depleted and exhausted, only to repeat the same dance the next day.

Being through the GPR program and having seen a few true emergencies, you gain much-needed perspective. Personally, I have gained the confidence and wisdom to say the golden word: no. Being in control of your schedule and taking care of your assistant will serve you many times more favorably in the long term than you expect. Taking care of our mental health in this profession is very important, and the time to do it starts now.

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Golf is a sport cherished for its precision, strategy, and the scenic beauty of its courses. Across the globe, renowned golf courses are not only prestigious in the world of golf but also boast stunning landscapes and architectural brilliance. Let’s embark on a journey to explore some of the most famous and breathtaking golf courses around the world:

1. Augusta National Golf Club – Augusta, Georgia, USA:

Home to the iconic Masters Tournament, Augusta National Golf Club is one of the most revered and exclusive golf courses worldwide. Its immaculate fairways, undulating greens, and signature holes like “Amen Corner” are etched into golfing history, captivating players and spectators alike.

2. St. Andrews Links – Fife, Scotland:

Often referred to as the “Home of Golf,” St. Andrews is steeped in tradition and prestige. The Old Course, the oldest and most famous among the seven courses at St. Andrews Links, has a timeless layout and features landmarks like the Swilcan Bridge and Hell Bunker, attracting golfers from every corner of the globe.

3. Pebble Beach Golf Links – California, USA:

Set along the rugged coastline of the Monterey Peninsula, Pebble Beach Golf Links offers breathtaking views of the Pacific Ocean. This course hosts the annual AT&T Pebble Beach Pro-Am and showcases scenic holes like the iconic seventh hole, perched atop cliffs overlooking the ocean.

4. Royal Melbourne Golf Club – Melbourne, Australia:

Renowned for its strategic design and natural terrain, Royal Melbourne is a masterpiece by legendary golf architect Alister MacKenzie. The East and West courses at Royal Melbourne are consistently ranked among the finest in the world, offering a challenging yet rewarding golfing experience.

5. Old Head Golf Links – County Cork, Ireland:

Sitting atop a promontory overlooking the Atlantic Ocean, Old Head Golf Links provides golfers with a mesmerizing seascape backdrop. The dramatic cliffs and stunning vistas make every hole an unforgettable experience.

6. Royal County Down Golf Club – County Down, Northern Ireland:

Nestled between the Mountains of Mourne and the Irish Sea, Royal County Down is revered for its natural beauty and challenging layout. Its stunning views and iconic holes, such as the ninth “Punchbowl,” make it a must-visit destination for golf enthusiasts.

These famous golf courses stand as a testament to the rich history, artistry, and natural beauty that define the sport of golf. Each class offers a unique blend of challenges and awe-inspiring landscapes, making them cherished destinations for golfers seeking unforgettable experiences on the green.

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Orthodontic treatments have come a long way in recent years, offering innovative solutions to correct misalignments, improve oral health, and enhance smiles. However, amidst the advancements in orthodontics, several myths and misconceptions continue circulating, causing confusion and hesitation for those considering orthodontic care. Let’s debunk some of these common myths to shed light on the reality of orthodontic treatments.

Myth #1: Braces Are Only for Aesthetics: One prevalent misconception is that braces or orthodontic treatments are solely for improving the appearance of one’s smile. While enhancing aesthetics is a significant benefit, orthodontic treatments also address functional issues. They can correct misaligned bites, resolve overcrowding, and alleviate jaw problems, ultimately improving oral health.

Myth #2: Orthodontic Treatments Are Only for Children and Teens: Contrary to popular belief, orthodontic treatments are not exclusive to younger age groups. More adults opt for orthodontic solutions to rectify dental misalignments or discrepancies they may have neglected in their youth. Advancements in technology have introduced less conspicuous options like clear aligners, appealing to individuals of all ages seeking orthodontic correction.

Myth #3: Orthodontic Treatments Are Painful: Another misconception is that orthodontic procedures are excruciating. Even if some discomfort might be experienced initially, particularly when braces are adjusted, or after a new set of aligners is worn, it is typically manageable and temporary. Advancements in orthodontic techniques have minimized discomfort levels significantly, offering more comfort throughout the treatment process.

Myth #4: Braces Will Be Required Indefinitely: The duration of orthodontic treatment varies based on individual cases, but it’s a misconception that braces will be worn indefinitely. Treatment duration is influenced by the severity of the misalignment or issue being corrected. Orthodontists create personalized treatment plans and estimate the length of treatment, which can range from several months to a few years.

Myth #5: DIY Orthodontics Are Safe and Effective: The rise of online tutorials and DIY orthodontic kits has led to a misconception that individuals can straighten their teeth at home. However, attempting orthodontic treatments without professional supervision can lead to severe dental problems, including permanent damage. Orthodontic therapies should always be conducted under the guidance of qualified orthodontic professionals.

In conclusion, debunking these myths surrounding orthodontic treatments highlights the importance of seeking professional advice and understanding the realities of orthodontic care. Consulting with an experienced orthodontist is crucial to assess individual needs, explore suitable treatment options, and ensure a safe and effective journey towards a healthier, more aligned smile. Don’t let misconceptions deter you from achieving the smile you’ve always wanted; orthodontic care can significantly enhance oral health and confidence.

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