A Deeper Understanding

In order to succeed, we’re told, it is crucial to ‘stand out’, and yet we all more or less adhere to a well-defined checklist of requirements - work experience, volunteering, extra-curricular achievements if we have them. So how does one stand out, in sight of this seeming contradiction? The reality is, most applicants are going to run through very similar points in their personal statement, so trying to stand out by getting experience in a particularly well known clinic, or racking up an impressive list of extracurriculars will not, in itself, be enough. Rather, it is your reflection on why these things might be important for a career as a dentist that will make all the difference.

Dental admissions staff recognise this - they are not looking for the most work experience, they are looking for students who have best demonstrated an appreciation for what dentistry is, the skills required to make a good dentist and why they are fit for this position. Demonstrating an understanding of the dentists’s level of dexterity as a working professional, should form part of your reflections. This article is aimed at those who want to gain insight into this essential skill of the dental profession.

So, what is manual dexterity?

It is generally defined as the ability to use your hands in a skilful and coordinated fashion. Between the ages of 2 and 4, we develop the motor control needed to perform more precise movements such as turning a book page or picking up a pencil. This only continues to develop further through life and becomes essential for anyone working with their hands, such as a dentist. Dentistry is a beautiful amalgamation of theory and application. Manual dexterity is the driving force of the latter and is a crucial component of every dentist’s technical skillset. The principal basis of correct treatment planning is obtaining correct diagnoses. Ultimately, however, the care cannot be delivered effectively or safely without the necessary hand skills. Just like an artist with their paintbrush, a dentist must be able to use the tools they have with a very great degree of precision.

Why is this important?

Put simply, because we are dealing with human beings! Our patients are trusting us with their mouths, which is a great privilege for us as dentists, and we owe a duty of care to fulfil this responsibility accordingly. Mistakes are inevitable, but it is important to be fully prepared and equipped, so that we do not cause preventable and irreversible damage. This is increasingly important from a medico-legal perspective as well. A great thought experiment is to envision oneself in the patient’s shoes, and ask yourself what standard of technical skills you would choose for yourself? There is not a single chair-side procedure that doesn’t require manual dexterity, and as such, the examples are limitless, but to name a few: preparing a tooth for a crown that can be as thin as 0.5mm, drilling conservative cavities to minimise loss of healthy tooth tissue; placing fillings with millimetre precision; working backwards in a mirror; relying almost purely on tactile feedback when filing complex root canal systems; taking accurate impressions of the mouth; extracting teeth - in all of these examples manual dexterity is what drives the application of knowledge. It is for this reason that all BDS courses will run a phantom head course. Even then, it will still not fully prepare you for the real deal. Phantom heads do not have moving tongues to impede your view, saliva contaminating the working area - phantom heads do not react. Despite these limitations, this is a necessary stepping stone which will certainly ease the transition from the artificially recreated patient to the living one. This highlights just how important practice and repetition is to develop fine motor skills; just understanding the theory behind a procedure will, in itself, never be enough.

What is expected of you as an applicant?

Rest assured, it is not necessary to possess these skills prior to entering the course. Developing them will be part of the degree. Do not try to imply that you possess the necessary skills or that playing the guitar will give you a great advantage when learning how to drill a tooth - instead, show your appreciation for the learning process and your readiness to learn new skills. It is a good idea to allocate a few lines or a short paragraph of your personal statement concisely reflecting on the importance of manual dexterity in dentistry, and perhaps to demonstrate what you have done in the past to begin to enhance yours.

How can you improve your manual dexterity?

The best way is to pick up a fun hobby which involves using your hands. Many exist, such as: drawing, playing instruments, sculpting, knitting, carving, cross-stitching, baking or any arts and crafts. Perhaps you already take part in such activities which is even better. This provides an excellent opportunity to reflect on and link your extra-curricular interests to your profession of choice. If you don’t have one, don’t worry! It is not a cut-off requirement; as mentioned earlier it is more important to have an appreciation of the skills than the skills themselves.

Will you be tested on it in your interview process?

This is entirely dependent upon the dental school’s preference and the style of interview. It may be a panel interview or composed of multiple mini stations (MMI). You may be asked to discuss skills you deem necessary to make a good dentist or there may be a station requiring you to perform a small task to test your manual dexterity at a very basic level. But it will not test you on procedural knowledge. It is more to see if you can work well under pressure, and like any exam, stress management is key. If you are the type with particularly shaky hands in stressful situations, this does not mean you will fail the whole interview, or are unable to be a dentist, so do not worry. There are many in your shoes, and everyone is as nervous as each other. Make sure to take deep breaths in through your nose and out of your mouth, and focus your mind on the task, not the environment.

In conclusion, do not worry about just how dexterous your hands are at this point- there will be plenty of time to hone your skills. Instead, spend your time developing an understanding of and appreciation for the skills a dentist will require throughout their career. I hope this short article has helped you do this, and will open the door to more research on this topic.

Article Written By Milad Divsalar 4th BDS Student Glasgow