April

This month we focus on posterior composites. Now we like to have fun as we teach at Aspire. That means a positive environment along with trust between us all and and also some room for open, non-judgmental talking. We like to call out the elephant in the room.

This particular multicoloured elephant, in a posterior composite, is the value in carving tertiary anatomy and using stains to emulate a natural tooth to near perfection.

Dentist: ‘My lovely nurse, we are nearly done with this beautiful invisible restoration, please pass me the brown and yellow stains”

Patient: ?

When we talk in our groups, it’s made clear that the key components to patient care are delivering the right treatment for the patient and doing it as well as you can….for them. Health and happiness under pin everything. Our goals are not for social media and not to act primarily as a lure for more private income. If health and happiness are your goals the income just comes.

This means a posterior composite that doesn’t need time to ‘bed in and not hurt whenever the patient drinks cold water for the next six months. It means one designed with the innate and seemingly immutable characteristics of a material that shrinks as it reaches adulthood. And one that lasts, perhaps comparably with its mercury cursed predecessor.

Does it mean one with carefully carved yet clinically irrelevant secondary fissures? And one which has stain simulating a fissure that the brush bristles never quite tickled?

I can hear people screeching at me from here. ‘Secondary fissures are essential for cognitive processing, core strength and skin hydration….I saw it on TikTok’.

Ok mate.

They’re not. At least there is no evidence to suggest stain on posterior composites is an underlying foundation of civilisation growth and ranks alongside other achievements like – the rule of law, representative government, social cooperation and scientific process. We are not that important I’m afraid.

But, does that mean they are of no value. No not at all.

I think they’re vital, perhaps not to the patient but possibly to you and to me and for two reasons which I believe I lack the words to describe adequately.

Those reasons are freedom and purpose. I know it seems a trivial example of them both but little things matter and can illustrate far deeper meaning for us all. Freedom and purpose.

Freedom. This isn’t something you measure. You may have freedom to learn, to travel, to live well, to vote and much more. We should feel free to live fully and on that vital and easily missed point we should remind ourselves that if real freedom cannot be measured, that is because it is only how we feel that counts.

You only have freedom if you feel free.

Some people never do. They feel controlled and obliged. They may feel compelled to react when they get a glimpse of freedom as they now know what they’re missing.

I see people at work limited on time to do difficult clinical procedures. Always under duress. Always under pressure. Always being told they run late, to work faster and earn more. Are you really going to work that way for 40 years? Caged to someone else’s clock?

Freedom means acting out of choice not obligation. It means choosing your path rather than appease another who chooses it for you. That means if you want to stain a composite and it adds three incy-wincy little minutes to the process, you should be free to.

I believe when we feel free, we can then choose our obligations and limits. We choose what freedoms we sacrifice, but it is then our choice so we still feel free. We have to. I am writing this on a Sunday morning when most of the rest of the UK is fast asleep. But I choose to. It’s 5.36 but I enjoy it.

‘You work too much’. Maybe but I choose to. I feel free.

I want you to too and if that means you spend 15 minutes creating beautiful little mid-lobes on the mesio-buccal cusp on an upper 6 composite then we just love you for that. For choosing to oblige and devote yourself to composite mastery and feeling free enough to make them stunning.

Next is Purpose.

I could write forever on purpose. We all need it and for many, I’d argue mosttt, life is worthless without it. I am one of those for sure. Purpose alone won’t make you happy but for a lot of people, a lack of purpose is a path to misery.

So, what is my purpose?

Sadly the term purpose is pretty useless, as it implies the idea that there is some cosmic thing that we must spend our lives searching for, that will give meaning to all our actions. Your individual purpose is written in the stars and if you meditate naked under a full moon, eat enough Kale, do a yoga and align your chi-chakra with your pet guinea pig then your purpose will become clear and your path to nirvana is obvious…..total gibber.

Purpose is simply something we make up in our head. It’s deciding that something is important, and then doing it because we feel it’s important. It’s choosing something to sacrifice other freedoms for because you want to as it feels worth it.

In that sense, we can find purpose almost anywhere. I can find purpose in chopping wood, lifting weights, listening to music, whatever I we or you choose to make meaningful. We can certainly find purpose in other people and our relationships with them. More purpose = deeper connection.

It may mean finding an important use of your time. Something that feels important to you, that you choose, that you love or are proud of. No-one can choose and enforce that on you.

No-one can choose and enforce who or what should be your purpose. Only your heart choses. In this instance your head offers advice perhaps, but your heart is what counts. That will never change.

Finding our purpose won’t solve all our problems, but it will solve a lot of them.
A lot of the low-level tactical problems we have in life—lack of motivation, incomplete goals, arduous careers and even bland or exhausting relationships can be are actually looked at through the lens of “purpose”.

For example, there are many tips and courses on how to get motivated, along with tactics and strategies we can implement to be more productive at work. But if we hate doing dentistry or dealing with patients and we think it’s completely pointless, absolutely none of these tactics or strategies will work. We need a why. And the answer needs to be honest, and good….and chosen by you!

If we can find meaning in our job and the care we provide you see as extremely important, then you not going to need any tactics or strategies.
You may look forward to your work day and enjoy the process. That I feel has been increasingly eroded for many in dentistry these recent years.

We teach ‘How you do one thing may be how you do everything’. By that we mean if you diligently aim to produce an excellent result in one aspect of work it spills over into all of them. Your nurse and admin team see your endeavour and what it means to you. They react to grow too nearly every-time. If you pursue that at work, you probably do in other aspects of life. It’s truly hard to aim high somewhere in life and accept mediocrity everywhere else.

Similarly, people look for tactics and strategies to optimise their work and personal relationships, to have better friendships, to network better, to bring more intimacy into the relationship that they have with other people.
Superficial tactics might amount to little things we can do that benefit us at the margin. But ultimately, the thing that matters in a relationship is having a shared sense of purpose, having shared values, goals, and dreams.

Dreaming together is really quite a thing too with someone. That’s what binds people together. In a micro- version of dreaming is your aesthetic treatment plan.

Purpose is seen as this mystical cosmic meaning, this predetermined universal destiny that each one of us has, and if we just find that one sense of purpose, everything will fall into place. That’s simply not true. In fact it’s anti-truth intuit it actually stops you knowing that you need to act and to create purpose.

You can do an audit of your sense of purpose in life today.
Do you feel a some sense of purpose in life? If so, from what aspects of your life do you feel this: work, relationships, goals, etc.? Do you feel like you’re making meaningful sacrifices? If so, what makes that sacrifice meaningful?

Has your purpose creation been allowed to be freely chosen. This is where freedom and purpose merge.

Purpose is an activity, or an idea, or a person, or a relationship that we’re willing to sacrifice for, that we’re pleased to give other things up for. It brings us joy almost to make that sacrifice. Perhaps you find that in a person rather than work at some stage in your life.

This is why people who lack a sense of purpose may suffer from low-level tactical problems. If dentistry lacks purpose for you, then it needs to be actively created.

That may be in the artistic side, the creative side, the relationship side, the psychology, the academic or even the financial side of our profession. It doesn’t matter but the meaning and purpose does, especially if you are committed to this career for a long time!.

Can you be curious about your patients feelings and experience?

Does improving their lives register to you in terms of the meaning it offers?

Do you love to learn new things and expand you beautiful brain at least a little more everyday.

I am doing a lot of work on Neuroaesthetics and how art, surgery and dentistry relate to the emotional experience of being a patient.

When you go to a gallery and the art moves you, really emotionally moves you ….do we re-create something similar in our work. Can we capture some of that transcendent meaning and depth….

….only if you use stain Rich…..

And there you go. There is the lesson I learnt…, stain isn’t about stain, its about the dentist creating purpose just to feel it. There is purpose in secondary fissures and stain. There is meaning in the small things. There is a reason to be excellent just for the sake of being as excellent as you can.

So consider doing a private audit on the meaning you have. Outside the surgery too. For me it’s the connection I have with a very few people in this world, building something with them, being the best teacher I can and somewhat indulgently, intellectual endeavours; particularly how they relate to healthcare.

Take some time to think about it, and remember that it’s totally OK to answer “no” to all of these questions. It’s OK to realise you don’t feel deep purpose in many areas right now, and that none of your sacrifices feel particularly meaningful. Because that’s why we’re here, to find it and if you need help with that we will.