Why do dentists make mistakes?
Why do you make mistakes?
Why do I make mistakes?
I was recently reading an article which talked about problems with certain types of procedure. However the cases shown were not only poorly done, but exhibited very poor judgement and decision making.
The vast majority of discussion about failures focusses on what procedure or technique was chosen. However the technique, procedure, or materials are rarely the cause of failure. I will talk about several causes of failure over the next few articles.
Many times, poor judgement is related to fatigue
For instance, securing a membrane is often the most difficult part of a bone graft. It is done at the end of the procedure. When you are more tired.
Fatigue is a condition characterised by discomfort, lessened capacity for work, reduced efficiency, reduced capacity to respond to stimulation and weariness or tiredness.
Fatigue significantly impairs our ability to carry out tasks requiring manual dexterity and high order processing.
So often it is not that the dentist doesn't know that the membrane should be stabilised. It is just that they don't have the energy to keep trying until it is right because they are tired. Impressions are the same.
So how do we combat fatigue?
Obviously sleep would be good. And no caffeine is not a substitute. More than four espressos a day (400mg) will also start to affect your judgement.
Control the patient's anxiety. Nothing is more tiring than an anxious patient. Get a GA, IV sedation, or at least give the patient lorazepam.
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Have routines. The more you do something the same way every time, the more it becomes an unthinking routine that takes no brain power.
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Break appointments into two if they are long. The main reason we temporise and take final impressions another day is because we get too tired to take impressions properly and end up sending drags and bubbles to the lab.
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Book 20% more time. Time pressure is incredibly fatiguing.
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Take little breaks and get staff to do some things like hold impressions while they set or take shade photos for you.
Most failures in dentistry don't come from your hands, they come from your head.
What do you do to combat fatigue in long or difficult appointments?
