Max Butler, D.D.S., is a dentist in the U.S. Navy, currently stationed with his family in Okinawa, Japan. He grew up in western Montana and graduated from the Creighton University School of Dentistry in 2024. He enjoys motorcycles, airplanes, 3D printing, Dairy Queen blizzards and raising his three feral children with his wife.
Forming my own opinions about how to practice dentistry has been challenging for me after dental school. How do I build my own views when more experienced dentists disagree? I’m sure you have seen this in your own work so far, no matter how new you may be. The decisions are everywhere: amalgam vs. composite, when to crown, what “nonrestorable” really means, and the list goes on. So, what do you do? Well, I’m still figuring it out too, but I can share how I sometimes navigate these waters.
1. Say what you know. This can be from experience, school or your own review of the literature. Take composite vs. amalgam, for example. I know that both types of restorations often last seven to 10-plus years. I prefer to use composite for Class II restorations, mostly because I hate breaking the contact of an amalgam when removing my matrix band. The public has questioned the safety of amalgam in recent years, but trusted sources like the American Dental Association and Academy of General Dentistry have responded with strong statements and studies in support of its safety and efficacy.
2. State what others say. Several older docs I know still love amalgam. They praise its longevity, compressive strength and ability to set up even in moisture. They’re amazing with it and plan to keep using it. I also know skilled dentists in offices that are entirely amalgam free. Check what the ADA, AGD and American Association of Endodontists say on the topic. It is usually easy to find succinct practice guidelines or topic essays on their websites.
3. Learn what evidence says. A quick search of PubMed (or your preferred database) will show hundreds of results. Your ADA membership also provides you with access to a well-stocked health sciences library, including thousands of journals, evidence-based summaries of clinically relevant topics, and the research services and scientific expertise of staff to support you in your efforts to find what you need.
My advice: Focus on the most recent systematic reviews, ideally those with meta-analysis. Even then, you might still find a dozen relevant reports. Skim the summaries of key articles. Check what was measured and how, who wrote the article, and what the actual outcomes were. Assess the outcomes’ validity and applicability to patient care. Do this before you jump to the conclusions section. Beware of biases, yours and others’. If you’re curious, open one and give it a skim.
4. Decide. OK, now that you have gathered your information, decide! Do you need perfect knowledge right now? Absolutely not, but you do have what you need to make a solid choice and support it with reasoning and evidence. Move on and apply this knowledge in clinical settings to improve your patients’ outcomes. And remember, your opinion can, and should, change with new experience or evidence. Stay open minded.
You can make these kinds of decisions. You are not a parrot of your boss, your professors or any single organization. You can review the evidence and reach your own conclusions. Don’t be afraid to look things up or dig into a topic, and once you do, don’t be hesitant to trust yourself. We all feel imposter syndrome sometimes. That’s OK. You got this!
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