We Can Work It Out!

I remember my very first day as a dental assistant. It was Thursday  August 28th 1997. (Cue the dream sequence music.)
The night before, the doctor called me at home and asked me to be at the office at 8:00a.m. for training. I was pretty excited, but really nervous! I didn’t know the first thing about dentistry. I had graduated from high school 2 months before and was about to start some classes for a degree in education. I applied for this dental assisting job because I needed to be able to support myself and put myself through college. I figured that this job would be able to financially do that for me. I remember thinking, “How hard could it be to be a dental assistant?” (Famous last words!)

When I arrived the next morning, the doctor brought me in, showed me around, and introduced me to the other doctor and assistant. That took about 20 minutes. The first patient was due to arrive in 40 minutes. He brought me back into the operatory and told me where I could find instruments and other supplies. That took about 10 minutes. He brought me to the front desk and showed me the computer and where all the charts were located.  5 more minutes ticked by. He grabbed one of those charts and explained tooth surface and how to chart restorative and periodontal findings. I remember looking down at that chart when a bell chimed at the door.
The first patient had arrived. The doctor didn’t have any other assistant. I was it.  My training was over.
He looked at me and said, “Ready?”
“Sure!” I lied.

Looking back on it all, I’m not really sure how I made it through that first patient, let alone the whole day. I was so completely unprepared. I don’t know how the doctor didn’t murder me either. He never did any other private training with me. Everything else I learned was literally on the job training. I remember feeling so inept, so lost, and so frustrated for a very long time. I used to go in the bathroom between patients and cry because I didn’t know what I was doing. Even though the thought of going to work depressed the heck out of me, I didn’t quit. I had rent to pay and tuition to make, and besides I wasn’t a quitter!

It took about a year for me to start feeling comfortable assisting. That was one painful year. As more time went by, I realized that I was starting to actually enjoy coming to work. I became fascinated with dental disease, with patient behavior, and with the business aspect of dentistry. I was falling in love….

Over the next 6 years, the practice grew and more employees were added. We were quickly outgrowing our space, and so the doctor decided to end his partnership and branch out on his own in a larger practice. Even though I had already graduated from college at that point and was doing some teaching, I was still keeping some hours at the dental office. I liked it there too much to leave completely. One day, in 2004, the doctor asked to speak with me privately. He sat me down and offered me a promotion. He wanted me to be the office manager. I was pleased, but also curious because we had never had an actual office manager before.
“What would my responsibilities be?” I asked him.
“Well, I just want to fix teeth. I want you to do everything else.”
“Everything?” I repeated.
“Yes, and I want you to streamline this office and create systems for things we don’t have systems for. I want it to run like a well oiled machine. You’re smart enough, you can figure it out.”

This sort of opportunity was something I had secretly dreamed about for a long time. I had a ton of ideas and I couldn’t wait to get started.
“I’ll do it!”

Since then, I’ve created new systems and cleaned up old ones. There was one system that I knew for sure we HAD to work on. I knew we HAD to do better for our new employees. Although we had gotten better at training new employees, we still had a long way to go. The whole training process was something I dreaded because it took so much out of me. There’s so much to teach, where does one start? Spending days hand holding a new front desk employee or an assistant took time away from MY work. I’d come in early and stay late and still fall behind on my own projects. I always felt like a broken record around new employees; I’d answer the same questions over and over and point out the same mistakes multiple times in a day. This frustrating period would last a few months until the new employee learned enough to muddle through the day independently. By the time we got to that point, I’d need a vacation.

A few years back, we needed to hire a new assistant because one of ours was leaving to start hygiene school. As soon as I received her two week notice, the acid in my stomach started to rise. I knew what I was in for. It was summer time too, and I started to think of all the beautiful weather I’d miss because of the extra hours I’d have to put in. Dang it!

At home that night, I decided that it was time to revamp our employee training. I thought back to my days in college when I was studying to be a teacher. That’s when the answer came to me!
If I wanted my employees to be successful AND I wanted to make the training period less stressful for myself, I’d have to DO MORE for my new employees. I know that sounds contradictory, but here’s what I mean.
In order for them to WORK independently, I had to GIVE them the tools to work independently. I realized that I was the problem. I’d been handling it wrong this whole time. I was basically offering the same type of training I’d received. By not giving them proper training materials, I was teaching them to rely way too much on me, and that was wrong!  They needed more. I needed to give them more to be successful. Back in my teaching days, I wouldn’t have expected my students to ace a test if I didn’t prepare them properly for it, right? There was only one problem. We didn’t really have any training materials. All we had was an office manual that explained office policies. New employees needed more. Sure, there are some assisting books that exist, but we didn’t have any materials that were specific to our office that I could use. I took myself back to August 28th 1997 and my 40 minute training session. I thought about what could have helped me through that time. I realized that what I needed then, did not exist. I’d just have to create a Training Manual myself.

Here’s what I did. For every dental procedure, I created the following template: description of procedure, materials and instruments needed, step by step description of the procedure according to the doctor’s specifications, and a photo of the set up. I didn’t stop there. I also created training manual pages for all of our systems (like taking inventory and answering the phone) and other procedural logistics (like setting up a rubber dam and assembling a tofflemire/matrix band).  By putting all of this together for a new employee, I was now taking the accountability OFF of me and BACK on them. I wouldn’t have to repeat myself multiple times a day because everything was already written out. All I’d have to say is, “Please check your training manual!”

All new employees now receive an office manual AND a training manual. They all tell me that they’ve never been given anything like it at other offices and are very appreciative. All I’ve ever wanted was for our employees to not feel the way I did on August 28th 1997.  We’ve had a few temps in too, and it’s SO nice to give them procedural sheets from the manual for set ups and procedures so that I don’t have to take away from my own work. The Training Manual accomplishes everything I ever dreamed of. (Where’s that dream sequence music again?!)

Want to see some of the pages? There’s one below.  You can also go here and scroll down a bit for a few more.  Do you offer anything like my training manual for your office? How do you handle training new employees?

Training Manual Denture Wax Try In


About Missy


  1. Great blog Missy! We offer Comprehensive Dental Systems – these types of set up manuals for our clients and they just open a whole other world for them of systemized and organized work days – less stress, more production and happier employees! The Perpetual State of Preparedness is a great place to be!

  2. That’s really cool, Mary Beth. What sort of systems do you find the most lacking in practices? Tell me more!!

  3. Love your story Missy. I can remember my early days struggling with hiring and training.

    I’ll bet little has changed for most dental offices – dental assistants thrown into the fire with no preparation.

    Your Training Manual looks exceptionally organized. Well done.

  4. Your story is great Missy! -painful to hear, but a really good one. I remember when I started out, I didn’t feel like I could afford an assistant with a lot of experience, so I hired someone straight out of high school. Her first day, she fainted in the sterilization room at the sight of a dirty needle, then spent a little while laying on the floor in the supply room, recovering.

    I spent a lot more time with her in training than you first received. I made some templates similar to these, with pictures of tray setups, bur arrangements, etc. (though honestly, I like yours better), that were part of our training process. Now, on-the-job training like that is no longer possible in our state, unfortunately.

    Like you, she advanced quickly and has now been an office manager in a major, multi-doctor practice for several years quite successfully. I am really proud of her, and though she’s had to move away, we’ve remained in touch. There’s a lot to be said about starting out with someone with the right personality traits and the overall quality of the new-hire.

  5. She fainted on the first day?! Poor thing! It’s great that she stayed with it all and turned dentistry into a career for herself. That says a lot about her personality and intrinsic motivation. A lot of people would have given up!

    Although we have a couple of dental assisting schools in the area, we’ve found that the students still need a LOT of in office training. Our Training Manual is really great for those new employees, for temps, and for my sanity! 😉

  6. Missy, Reading your story was like reading my very own. I, too, received a brief introduction and began assisting right after high school. I was an assistant for 6 years and just learned as I worked, figuring a lot out by watching and asking questions. I now own my General Practice and have been trying to put together something like this for the last 10 years! There is just too many other things on my plate as a practice owner and I don’t have any time to devote to this. I loved assisting, especially the organizational aspect and creativity it offered and I look forward to making time to develop my training manual…you have inspired me to finally put it together! Thanks so much.

  7. Thanks! Why not delegate this to a reliable staff member? Get them involved! Create a template and have them fill in the blanks. Have fun with it!
    If it makes you feel any better….I’m ALWAYS adding to our manual, updating it, etc. I just consider it a ‘work of art’. How do you know when it’s REALLY done? 😉