Finding Fulfillment in Modern Dentistry: A Discussion with Dr. Sheila Samaddar

We're perfectionists. We get upset if what we do is not exactly what we want. And that's a hard stress to put on ourselves. I really feel, and for especially the people that have spouses or partners that are not dentists, they have no idea what is going on in our daily life. Welcome to Austin, Texas, and welcome to the Phil Klein Dental Podcast. Dentistry has never been easy. But today, it feels like the challenges are coming from every direction. Between rising stress, physical demands, changing career paths, and a profession that looks very different than it did even a decade ago, it's fair to ask a big question. Is dentistry still a great profession to pursue? Our guest thinks it is. She tells us that although some days can be quite challenging, the upside of being a dentist transcends all the pain points. She also believes that using the right tools, specifically her handpiece, makes all the difference in the world. We'll be talking with Dr. Sheila Sammadar, a general dentist practicing in the Washington, D.C. area. She serves numerous volunteer roles locally, regionally, and nationally with the Academy of General Dentistry, including as a national spokesperson. Before we bring in our guest, I do want to say that if you're enjoying these episodes and want to support the show, please follow us on Apple Podcasts or Spotify. You'll be the first to know about our new releases and our entire production team will really appreciate it. Dr. Sammadar, it's a pleasure to have you on the show. Thank you so much. I appreciate you having me. Yeah, we're real happy to have you. And before we begin, I do want to mention to our audience that you're a third generation doctor on both sides of your family, which is quite remarkable. And I remember you mentioned on a previous episode that we did together that your interest in dentistry began at a very early age when you worked in your mother's dental office. I was just curious, how old were you at that time and in what capacity were you helping your mother in the dental office as a child? I think I was helping her when I was seven or eight and it was breaking down the room. Sometimes I was answering the phone, collecting money. I was probably doing things that I definitely was not. Collecting money at seven years old. It was checks back then. Well, listen, your interest obviously started at a very young age and the good news is you're still loving it. You're still enjoying what you're doing. So fast forward to the present with all the pressures you know that we have, clinical, financial, regulatory, which could be really a pain, emotional challenges that we have, managing our HR, our staff. With all of this, do you still believe dentistry is a great profession to pursue? I absolutely love dentistry. Even on my bad days, I still am grateful for what I do, what I'm able to do for my patients. Even the simple things, getting people out of pain or giving them a beautiful smile or whatever it is. Yes, I still do. I think since we went to dental school versus how things are now and how they look to be going in the future, I think these younger potential dentists or young dentists have a lot more things that they have to deal with or just very different things that they have to deal with. And the tuition is one of them, right? The tuition for dental school has skyrocketed. Healthcare graduate school program. Exactly. To get into now. It was high when I went. I mean, when I was in graduate endo, I remember very clearly it was $8,000 per semester, $16,000 a year. And that was in the mid 80s. Okay. So we're talking, I mean, I don't even know what it costs now. So we're seeing major shifts in dentistry right now. A large swath of dentists are retiring. We have... Corporate influence with the DSOs, those large corporate entities that own a thousand practices. New grads are entering the practice with digital dentistry like they've never seen before. Lots of expanded CE opportunities, way more than we used to have. So there's a lot going on. From your perspective, what changes do you think will most shape the profession over the next five to 10 years? conversation that I seem to be always falling into is about the DSO and how a lot of the new grads are going to DSOs. And a lot of people vilify them. But the reality is, with the loans that they are right now, with the height of the numbers that these kids are accruing, a lot of them can't also go right into either buying or starting a private practice. And as you and I know, most people or there are not everybody is cut out to be a business owner either. So while some people may not like DSOs, you know, I'm not going to weigh on that. But sometimes that path might be good for these new dentists to get into, whether it's to get experience in lieu of a residency or to cut their teeth and just say, you know what, I like being an employee or. I like having more freedom without having to do all the hours as a business owner. So that's one really big shift that I see. One time they were saying that dentistry was transforming into corporate opportunities so quickly that they thought within a very short time, 60% of the dentists will be practicing in a DSO. But I don't really think that's happened quite at the speed that they thought it would. And the more dentists I talk to that are in their 30s, fairly new out of dental school, are trying not to go that route if they can. They want to start as an associate, let's say. Now, I do think the opportunity is, for some people, the DSO. There's no question about it. But depending on the DSO that you work in, some of these DSOs are very focused on production. Some are more focused on... health-centered, a wellness center approach. Some are more conservative than others. So you really, when you are going to a DSO, if that's where you want to go, I think it's important for the dentist to be particular and discerning about which organization to start their relationship. Do you agree with that? Absolutely. Because the thing is, you really want to make sure that the doctor is... providing or guiding on the healthcare decisions and not a finance person. And there are some DSOs that are doctor owned and some smaller DSOs that are maybe local into specific communities. And I think there are opportunities there. And like you said, not everybody's cut out to be an owner. So I think as if they're going into things with their eyes wide open. I think then it could be a really good learning experience for them. What typically, as far as the timeframe, do you see dentists staying in DSOs, those that choose to go that route? Are they out in two years looking for something on their own or as an associate with the option to buy a practice from an older doctor? What do you see that timeframe usually as? It seems like two years, three max, if they're not going to stay in the DSO. They really want to make sure that they're doing the right thing and looking around and meeting other doctors and making sure that if and when they do leave the DSO, they're going to find a good match for themselves. Yeah. Do you agree that DSOs didn't materialize at the rate and number of dentists that they originally anticipated? I think so, yes. I don't think anybody really had any idea. It was just this sort of wild projection that, okay, by X time, this is going to happen. I don't know. Is that good? Is it bad? It just is. But it's going to be interesting to follow along and see how things progress in the next five, seven, 10 years for sure. Yeah. And it's interesting to hear a lot of the key opinion leaders out there teaching. dentists that are young to try to start their career by extricating themselves from dental insurance. Because dental insurance just is so restrictive when it comes to what you are getting paid that in many cases you can't make any money. You cover your lab costs and you're working for nothing. So one of the things that a dentist has to consider is making that difficult decision and getting their practice to be in a situation where they aren't. controlled by the insurance company, because that's something we don't want to do to ourselves after all the work we put in to get our dental degree. So let me ask you this. With dentistry evolving so rapidly, we know that dental school can't cover it all. It didn't cover it all back when I was in dental school. And with everything that's out there digitally and everything that's changing, how could it possibly do it now? You got to get the fundamentals in dental school and figure it out later. So do you think continuing education is now essential and non-negotiable for every dentist in order to build a successful practice? And that includes expanding services in areas like implants, airway, high-end aesthetics, and so forth. You know, in the past, it was like, yeah, I take some CE for my relicensing mandate. I got to get X number of CE credits in my state. I'll do some webinars, which is great. But do you think it's changed now where it's almost a necessity they have to do this? Well, I think it's always been a necessity. And I personally would be a little leery of going to a doctor that only gets the bare minimum because there are always changes. There are better ways to do things, more efficient ways, things that are less uncomfortable, you know, all these kinds of things. I actually had a colleague of mine say, I need to get credits really quickly. I need to get my 30 credits to renew my license. And I was like, I take like 30 a month. And like maybe, you know. 30 a month, that's a very. You throw a weekend in there and then like a meeting or two at night, you know, a week. And we have a pretty robust study club. arena in in the dc area so now you teach you teach in some of those i do i do yes so you're a hybrid type of person right you're a teacher and a student i'm not quite a hybrid yet but i would love to do more teaching and um it's fun to really engage with the younger docs especially if they're just you know trying to soak up that knowledge and and learn more um I always joke about how it's just so dorky, how I love dentistry so much and I love what I do and I love to share it. And I think it's a little bit, it's probably a little odd, a little off, but I'm going to embrace it. Right. And you also, you must have taken a lot of CE with clear aligner therapy, right? Because you've done a lot with Invisalign and you were, I believe, awarded some accolades related to your cases. with clear aligner therapy. How did you get into clear aligner therapy so avidly? You know, it's one of those things. First of all, let me back up just a tiny bit because I think that you have to pick maybe two, three, four things that you really like in dentistry and focus on those. Those folks that say that I'm good at implants and I'm good at root canals and I can do a full mouth reconstruction and do your braces, you know, all the same day. I think that's a little ridiculous because Maybe there's a few people who are really good at everything, but I would definitely say not 90 percent, 98 percent of our population. And so what happened with Invisalign when I got out of school, anytime there was a class that sounded interesting and it was never removable and it was never, you know, there are these things that I just haven't done since I graduated. So don't come to me for a denture. I saw the Invisalign course being advertised and it was the very first course that was offered for GPs. And that was, I want to say 2001. So I've been certified for a really long time that initially I was working for other doctors and they weren't really keen on bringing that into their practice. So as soon as I was able, I jumped right in. And, you know, so it's kind of like the CERAC, right? You start at this level and then you... You get a new machine and you get new products and you get new methods and all these different things. And so I've just really grown with the program. And I have submitted numerous years in a row cases to Invisalign that have been published. And so I've earned top 10 recognition on several years in a row. And then the American Academy of Clear Alignors also had their own sort of best cases situation. And I got a top 10 recently. Congratulations. That's very, very impressive. You know, they're actually developing now virtual collaboration platforms with orthodontists that are really guiding the general dentist in their cases, especially if you're new to clear aligner therapy. So you can look into that. And I'm talking to the audience now about checking into various. virtual orthodontist platforms, like I mentioned, where you can actually upload your case and do a lot of stuff with them before you even get charged. And they actually say, yeah, this case is definitely doable by you. They get to know your profile. You probably didn't have any of that, Dr. Sammadar, but that's what's evolving right now because dentists that are on the fence that may not feel they have the confidence in doing ortho, you know, would really benefit from getting direct. contact with an orthodontist. You're actually assigned an orthodontist. It's really cool stuff. And I recommend everybody, we are going to have a podcast on that coming out soon. I interviewed somebody who actually has his own orthodontic collaborative platform that he's developing with Solventum. So let's pivot a bit here. And let's talk about one of the under discussed challenges in dentistry, which is burnout. What advice do you give dentists on maintaining their sanity, keeping things in balance? essentially protecting their mental health, and also talk about the importance of cultivating interests and hobbies outside of dentistry. So I think one of the huge, huge, huge things is that you really have to have a good network. And I don't mean your professional colleagues in the sense that, oh, let's discuss this case. But even a little deeper, let's discuss what went wrong, how am I feeling about it? It's okay because we want to do the best for our patients. Obviously, we don't ever want to have issues, but you just have to sort of take a deep breath and know that you can talk with somebody and really hash out what happened or if you just want to complain about a patient, not even the specific case, but just know that you've got ears that you can sort of bend. Now, is that person in dentistry or do they know about dentistry or you're talking about just a friend that you could just really kind of commiserate with at times? You know, that's a tough question because it's great to have people on both ends. But I really feel and for especially the people that have spouses or partners that are not dentists, they have no idea what is going on in our daily life. And I have a friend who was a police officer. And I said, you know, when you have an emergency and everybody's running around and it's totally loco and, you know, whatever, all this is going on. I said. That's every day in dentistry. And he just couldn't, you know, he couldn't understand. Because especially if you're a business owner, you know, you're doing your case, you stand up, this doctor's on the phone, somebody's calling you, the hygienist wants to check, you know, getting a text message on your phone, the regular phone's ringing, and then you're getting all these emails. So it's like, you're just bombarded. And then if you're doing your own marketing, which I do, if you're doing your hiring, you're firing, you know, like there's just all these things. And it is so much pressure. I think that you have to have some dental friends. not just one, because you don't want to burn that one person out from listening to your problems. I mean, I know it depends if you're married. I know it depends on your marriage. It depends on your spouse. What's your thought about sharing your day with your better half, your partner at home? Is that something you think should be minimized or avoided? Again, each relationship is very unique in its own way. It sure does depend on the relationship. Sometimes when you've gone through the day, you just want to get home and you just want to be done. You know, sometimes we can have these conversations via text with some friends or, you know, on the car ride home so that you just hash it out, get it out of your system and you get home and you can focus on pets, kids, dogs, whatever, husbands. But you said you still love dentistry, though. I love it. I love it. Even with all the headaches and all the stress. I mean, you told your friend who was an ex-policeman that every day in your practice is like one of his stressful days. So why do you still love it so much? Because I think the good days outweigh the bad by far. And I don't know. There's just something about solving a problem. You know, I think one of the things that's a really big deal to consider is that not everybody could be a health care provider, right? We're a special kind of person. And think about folks that you know that have left the profession early or left while they were in dental school or med school because they're like, you know what? This is not for me. We lost 20 people in our class. Oh, yeah. I mean, attrition is a thing. Yeah, I couldn't believe it. It was like after a year and a half at dental school, I said, oh my gosh, they're leaving dental school. They just finished the toughest part. I know. But it's very specific, right? Right. There's no reason why they should spend 40 years in a career because they, they barrel through a year and a half of dental school. Exactly. Exactly. I mean, but at the time I thought it was crazy. Yeah. Yeah. Sorry about those loans. You got to figure out how to pay back now, but yeah, I mean, it is tough. And especially for example, you know, you've got this little area that you're working in, right? So do we in a different sense, but. we're perfectionists. We get upset if what we do is not exactly what we want. And that's a hard stress to put on ourselves. I would say most other careers don't do anything like that. Yeah. Well, I mean, if you look at the parochial area where we're working, both mentally and physically, it's unbelievable. And you're looking through loops where now the loops are such that you look horizontal. There's a mirror in the loops that go down. So you maintain your posture and then you're holding a mirror and looking at something backwards, upside down. Yeah, you're doing the tango. Right, yeah. I mean, it's, yeah, I once explained that to my wife and she said, how does anybody work like that? It's exhausting, but it's also rewarding. Yeah, well, that's the part. We should start talking about the rewarding part instead of dwelling on the other side. But let's talk about, here I go again, but let's talk about the physically demanding part of it. Many clinicians don't think about injury prevention until it's too late. Now, I've done a lot of podcast episodes with some really amazing ergonomic experts. on the show. And I've gotten feedback from thousands of dentists that have said that they're so happy they heard that podcast. That's why I want to bring this question up again to you. What are the biggest physical risks dentists face over a long career? And what should they be doing early on to protect themselves? So many. Hands, neck, back, eyes, ears, you name it. And then even the things that you don't see, the mental health. If you need to go to therapy, go to therapy. There's no qualms about doing it now. It's very mainstream. And honestly, I joke about it, but I say, you know what? I need to have people to talk to that aren't my friends because I don't want to put my problems on them. I'd want to put it on somebody who does that for a living. Right. So we're not talking about physical therapy here. We're talking about... Well, for this part, yes. Yeah. But as far as physical, the physical demanding aspect of dentistry. There's equipment, there's handpieces, there's instrument design. The handpieces are a workhorse tool. They are. That in itself, if it's not the right handpiece for the right person, over time can cause damage. And we've talked about this at length before. Talk to us about handpieces, for instance. What is it that you find so important that we should be looking at when we're purchasing one and using one? Well, we all grew up with the air. right the handpiece and it seemed fine it's like it's fine until you realize that there's better stuff out there and very early on in my practice when I was setting up my startup I got NSK handpieces and I really loved them so this has been almost 20 years that I've been using them And I love them for a lot of reasons. Number one, they just seemed so much more durable and stronger and faster. It put so much less pressure on my hands and my forearms. It was the power of the instrument. It was the mechanism because it was just stronger in general and had less vibration. So they've just come out with an even newer one, which is like... magic. It's like cutting butter. You're an endodontist. So you've had to go into crowns that people have put on. And I firmly believe that zirconia was invented by a misanthrope. I swear to God. Yeah. I actually didn't have the privilege of accessing a zirconia crown in my day, which is fine. But we used round burrs, carbide, carbide round burrs. I'd go through dozens of them. sometimes in a day. But I went through a lot of round burrs and that's how I made most of my access. And the hardest thing we went through was obviously ceramic crowns. But I mean, it is the burr though that you're using too, right? I mean, it's not- It's a combination. It's a combination because sometimes I'm pushing so hard that I'm literally like, this is the crown that's going to end my career. Now, what are you going through there for to do endo? No, because- They've come in as a new patient and somebody put this crown on. It's never, you know, it's never sat right. You just want to get it off. You want to get it off. Yes. You look at the film and there's like gaps and decay and like sombrero and the whole bit, you know? So yeah, sometimes they have to be taken off to be replaced. And if it wasn't for my NSK hand pieces, I'm not even joking. I would have retired by now. And you're using, you're using air driven or electric? I'm using electric. Oh, so you're using electric. Yes, I have been using electric, like I said, for almost 20 years now. So the big advancement in electric, generally speaking, is that in the beginning when they came out, they were pretty heavy and unwieldy, right? But the newer electric handpieces, they rival the size of an air-driven handpiece. They're smaller, they're lighter, you can get back in the posterior area a lot easier. Major changes for the better. Now they've just come out with this newer product and it's so lightweight. The head goes back. You don't have to struggle doing second molars or third molars. The machinery, the internal components are just so light. It's quieter. It's faster. It's stronger. What's the model for that? The Z99L. I have a prosthodontist friend who loves that. Oh my gosh. Unbelievable. He's been using that for quite a while. So let me ask you this. So when a dentist... shops for equipment you know they they're all like if you went to a dental show you're all be all of you guys are being pulled over to a booth and say hey look at this and then the salesman trying to sell you this but when it comes down to it you know when you make that selection of something that you use like a handpiece which is literally I mean we're dentists the handpiece is the tool for most of for most of us as far as you know what we're doing in our operatory it actually makes a difference in our happiness right in our stress level in our productivity this is not just marketing words what you're talking about here you're talking about actually like performing it's like I'm a I'm a big tennis fan I love tennis and I watch tennis players you know it's like using a really incredibly quality tennis racket I happen to like Yonex I love the Yonex racket and I'm not getting paid to to say this but I switched from what I originally had to a Yonex racket, and my son did too, and so did my daughter. It's changed our enjoyment of the game because it's really made so well and it's so balanced that you play better and you just enjoy it more. Now, I'm not using the NSK because I'm not practicing dentistry now, but do you agree with me that when you make a decision to buy something like a handpiece, it changes everything? Absolutely. I think the hard thing is, is that when you go to these trade shows, and it's probably similar to your tennis racket, if you don't have a store that you can physically walk into or a trade show to go get it, sure, you can pick it up and you can feel it and hold your hand and pretend like you're doing dentistry. But until you actually use it, you probably don't really have an idea of how different it can be, how life-changing it can be. It can improve your ergonomics and your discomfort with your body and the stress it puts on your body. I would say if somebody's out shopping and they're considering that they should really give it a try because it is far and above better than anything else that I've used in the market. Yeah. And it's good to make a decision early on. If you do decide to buy equipment, if you're working on your own and you have your own practice or you own the practice and you're buying equipment for your employees. that are dentists or hygienists or whoever's doing the work, you want to buy them stuff that's going to last. Now, one of the important considerations is the actual company itself. So there's a philosophy to that company. There's a culture. You know, when you read reviews on Amazon all the time, you go, the product's great, but I need it apart and no one's returning my call and I'll never work with this company again. Just the culture of the company, the way they stand behind their products, the quality of the products that they put out. When I've sent an email or inquiring about anything or a text to my rep, I mean, I get immediate response. It's unbelievable. But you're not talking to Japan, though. No, no, no, locally. Okay, but they're manufactured in Japan, I believe. Correct, correct. But I get assistance so quickly. And that makes a difference because if you're having... work in a chair and your patient's waiting and you've got a question or you know you get a new product and you're like okay should this be happening or is there something I'm doing wrong you can get pretty quick feedback on what what's going on and we all know that we've got companies and and reps and whatnot that we work with and we don't hear from them for a few days a week you know sometimes I'm actually thinking about something now where I reached out to a rep and I've been wanting to order a certain product and they haven't, I've emailed three times and I haven't gotten a response back. So companies and representatives of these companies reaching out and being in contact and being accessible when you actually need them is a huge thing. And I do want to point out that NSK is very big in education, dental continuing education. There are great mentors in many areas of education, implant dentistry, restorative dentistry. They are part of all of those areas with their equipment, and they contribute to the profession with education for all of us. And I think that's a very important thing for a company to do. So as we wrap up this podcast, Dr. Sammadar, I'd like to hear in your words what you find most gratifying about dentistry. We certainly spent a lot of time... talking about the pain points. And you need to identify the pain points in order to correct them or make sure that they don't get you down and lead to burnout and other things that we've talked about. But at the end of the day, tell us what you find most gratifying about being a dentist. And we'll close on that. What we have potential to do with our patients is really change lives. And whether it's improving someone's self-esteem because they've never smiled their entire lives. or helping them so that they're going to be functional, they can floss better, they can brush better, they can maintain their teeth for life, or replacing teeth so they can chew. We have such power and such skill and such knowledge, and it's really great to impart that to our patients on a daily basis. And yes, the days are going to be hard. We just have to focus on the fact that we do something that's really great, and we are so skilled with very intricate work that we do. I'm grateful for what I do. And I think that we just need to find our little buddies and make sure that we have a good support system too. So we can rejoice or complain or just talk things through whenever we have days that aren't exactly the way that we want them to go. I think that's very well said. And I truly believe that most of us want to help other people. It's just the way. we are as good humans, at least the good people, right? We're not talking about the bad folks, the good people. The good people get pleasure out of helping other people. Dr. Sammadar, thanks for the input. Thanks for your time and have a great evening. Thank you so much, Phil.