Thursday Troubleshooter: Dental assistant struggling to support dentist’s subpar work

July 18, 2019
This dental assistant doesn't know whether or not to look for a new position, but the doctor's poor dentistry is making her very uncomfortable. What should she do?

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QUESTION: I’m a dental assistant and I love working at this office; however, I'm having a hard time promoting the subpar work of the doctor. Please set me straight if I’m wrong. There are some, including this doctor, who think it’s OK to leave a little decay as long as it’s sealed. I’ve never worked for someone who does this. The contact is sloppy because she took out part of the adjacent tooth. (See the photo.) Also, most of her root canals are overfilled and many fills are not continuous throughout the long axis. Don't get me wrong. I'm grateful to be working, but I don't think this is acceptable dentistry. I would appreciate any thoughts and advice.  

Dentistry is an art, and as with art, some artists have more talent than others. I have been faced with this situation in the past where I have felt the dentist’s work was subpar. I morally have a hard time standing behind the work of someone who I would not feel comfortable treating my family. Questions that come to mind about this dentist: Is it truly careless work or is the dentist just not as talented in her craft as others? Is the dentist a new dentist and still perfecting the craft and in time the work will improve? 

I have worked for two doctors in cases where the dentistry was not up to the standards I expected. In the case of the dentist who had practiced for many years, the work was more about the rush to get things done than about quality. I continued to perform my job while quietly looking for a new position in an office where the doctor’s work was known to be outstanding. In the year I was there I would not allow him to treat my children or me for anything restorative since I knew the lack of quality. 

In the second office I worked with a newly-minted dentist who was still finding his pace, and with practice he perfected the craft over a short time. He strived to be better, and it was that wonderful office where the doctor and staff all meshed well. I chose to stick it out and as he improved, he became one the best dentists I’ve worked with over the 10 years I spent there. 

Weigh your options carefully if you love this office and the staff is great to work with. You could be leaving to join an office filled with drama and no guarantee of improved dental care. Trust your gut, and if this is causing you daily grief, it may be time to move on.

ANSWER FROM DIANNE WATTERSON, MBA, RDH, Watterson Speaking and Consulting LLC:
From the radiograph you shared, it is very easy to see quality issues. You are an astute dental assistant, and you have obviously seen what high-quality dentistry looks like. 

The reality is that dentists do not all develop the same level of skills. Some dentists are like master artists who turn out excellent dental masterpieces, patient after patient. On the other end of the spectrum are dentists who routinely create dental disasters. It’s like the television commercial where the worker, when asked if the carnival ride is safe, answers, “Well, it’s OK.” Some dentistry is just OK, and some is actually not OK and eventually fails. 

If the doctor’s skill level is so low that it makes you uncomfortable, the best thing you can do is find another job. As a dental auxiliary, you are really not in a position to question the doctor’s work. If you decide to stay, you have to accept that this doctor is simply not as skilled as some other dentists. Eventually, your boss may find herself standing before the state board of dental examiners after a patient files a complaint related to the quality of her dentistry. Good luck! 


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