Day 1. New shoes, fresh shirt, loupes in hand, ready to roll. You’ve got the job, the degree and now patients are waiting. On top of the world, what could go wrong?

We’ve been there and it is a great feeling. Yet the months and years to follow truly will shape your career. Dentistry is tough and the real learning has just begun. Dental school provides us with a solid, broad foundation and produces well rounded safe graduates. However graduation is just the entry ticket, now the game begins.

The stresses of Dental School are about to fade into a distant memory while the stresses of private practice are rising over the horizon. Much of this stress is due to inexperience and the unknown. Anxiety about the day ahead, a feeling of insecurity about our abilities and the fear of being incorrect in our diagnosis, we all experience these cortisol spiking emotions.

It takes years to become comfortable, proficient and relaxed as a dentist. One of the quickest ways to alleviate the pains is be prepared, find a mentor and work at it.

Transitioning into Private Practice

Dental schools have a big responsibility. They need to turn a bunch of naive kids into dental professionals who are safe to let loose on the public. This does not leave much time for the nuances of private practice or the complexity of larger cases.

Here are the 5 key concepts that will help shape your thinking and give you a head start in private practice.

1. Paying patients

Early on in our career the cost of private dentistry can shock us as much as it may shock the patient. You got into dentistry as you are a compassionate person and this can be a double edged sword.

Caring about your patients and outcomes is essential however this not uncommonly leads to guilt over the costs. You find yourself discounting or worse still, under treatment planning – doing fillings where crowns are indicated to save the patient money and making that decision for them.

Arguably under treatment planning is as bad as over treatment planning. What if the tooth has a catastrophic failure in a few years and now they’re staring at an implant or plate!

Graduates also tend to discount their work feeling that it’s not worth the price, “someone else could do it better”. Short changing themselves, the business they work in and setting themselves up for a career of insecurity and financial troubles.

2. Efficiency

Good dentistry takes time and you should strive to take the time to do good dentistry yet no matter which way we slice it, we’re still working within the context of a business. Thus being efficient where you can will allow you the time that you need to optimise the little details, your communication and ultimately improve outcomes.

Grouping treatment together, often termed quadrant dentistry, is a win-win situation. Patients don’t want 3 appointments for 3 fillings and you don’t want 3 room changeovers, 3 welcome discussions, 3 rubber dam applications. Group it, your patient and your production will thank you.

3. 4 handed dentistry.

University teaches us to be the MacGyver of dentistry. One hand for the mirror, suction and retraction it’s a wonder we got anything done at all. We’ve now moved on from the playground and into the private practice arena where you need to learn to work optimally with support staff fast. Understanding the basics of four handed practice is invaluable. If you’re fortunate enough to have excellent nurses, this can add hundreds of thousands of dollars to your yearly production

4. Communication.

“I’ve seen the same dentist for 30 years and he was fantastic” says the new patient with overhanging restorations and unmanaged periodontitis. Your dentistry will be perceived based on your communication skills so to succeed in private practice communication is the key.

Communication is an area that for some will be a struggle and others will come naturally. Regardless, I think all new graduates should spend the time, preferably in person, doing communication courses. We all form our own style however the basics are the same. Build rapport, communicate clearly and efficiently and your patients will thank you; often with referrals.

5. Continuing Professional Education.

University is the entry ticket. Now for the big leagues. Continuing education is by far the most critical step in going from good enough to great. And the time to start is now. The more you’re able to learn and develop in the earliest years of your career the more time you have to perfect and benefit from it. I suggest choosing 2-3 focus areas for the year and honing those skills before moving on. First up for me – communication and restorative dentistry. Bread and butter.

The transition to private practice is a steep learning curve. Enjoy the ride, you’ll be fine if you continue to learn and focus on some of the key areas. 

If you’ve been through it let us know what you found tough and what advice you would give yourself in final year! If you’re about to graduate, get in touch if you have questions or a topic you want us to cover! 

David is a recent graduate dentist working in private practice in regional NSW, Australia. Read more at

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