Teething problems – hurdles faced by early career dental professionals

14 October, 2026 by Shamir B. Mehta

We want to regulate in a way which promotes learning over fear, supporting dental professionals to continuously demonstrate professionalism, rather than driving behaviours through the threat of fitness to practise. Our role is to give clear, easy to use guidance that supports dental professionals to show good judgement and professional behaviour in providing good oral healthcare for patients and the public.

This blog, Teething problems – hurdles faced by early career dental professionals, is part of a series to support your learning and encourage good practice and continuous improvement to achieve positive patient outcomes.

For many dental professionals, the transition from dental school to independent clinical practice can be exciting, yet daunting. Clinical and professional responsibilities ramp-up, while the familiar support and supervision available during training are often highly reduced, or lost.

Early career dental professionals must balance managing patient expectations, learning to make important and sometimes complex clinical decisions, keeping up with evolving technologies and new techniques, and navigate professional risks, while also continuing to develop clinical judgement, experience, and professional identity.

When these demands are coupled with workplace pressures, relocation to a new region or country, unfamiliar healthcare systems and rules, personal expectations, financial commitments, and increasing patient scrutiny, it is little surprise that the first few years of practice can feel particularly challenging. My own journey into practice was far from straightforward and included its fair share of obstacles and steep learning experiences.

Unfortunately, today’s newer dental professionals face an added challenge - social media. The breathing space some of us enjoyed, is perhaps no more. Every day, clinicians are exposed to carefully crafted accounts displaying complex rehabilitations, dazzling smile makeovers, and professional success. However, for those still finding their feet, this can create the impression that everyone else is progressing faster, treating more advanced cases, and achieving better outcomes.

The reality of course is that social media often represents the highlights section of a long innings rather than the full story. Nevertheless, for some, constant exposure to these comparisons can be overwhelming, particularly for those working in relative isolation. This may negatively affect confidence, wellbeing, and professional satisfaction.

Drawing on recurring themes identified in Fitness to Practise (FtP) cases involving early career dental professionals, this blog looks at some of the factors that may place newly qualified dental professionals at greater risk.

Time pressure, the pressure to say "yes" and the importance of pausing

Time pressure can have a major impact on clinical decision-making. Inexperience, overbooked appointment books (those all too familiar ‘triple bookings’), and a desire to meet patient and management expectations can create a powerful force to move quickly. Unfortunately, shortcuts in examination and history taking, diagnosis, consent, or treatment planning can have significant consequences.

One case I encountered involved a recently qualified dentist who was approached online by a patient seeking a crown restoration at a root-treated molar tooth. The patient had viewed the dentist’s profile on the practice website, had previously received specialist root canal treatment, and lived over 100 miles away. The dentist felt flattered and was eager to accommodate the patient, mindful of the effort they would need to make to travel to the practice.

The patient arrived 25 minutes late for the appointment and crown preparation was hastily commenced before a comprehensive assessment of the tooth's history, prognosis and previous treatment had been undertaken. At the end of the appointment, the patient took the highly unusual step of critically assessing the technical standard of the tooth preparation and asked to inspect the impressions. They expressed dissatisfaction. Naturally, this proved disconcerting for the dentist, especially having only done a handful of crown preparations before.

During the crown fitting appointment, the patient reported symptoms, and further investigation revealed that the root canal treatment had failed. The dentist later learned that the specialist had recommended extraction.

The failed root canal treatment was not the main concern. The dentist had not gathered the information necessary to properly assess the case before embarking on their treatment plan. The patient then sought substantial compensation for a dental implant, threatened legal action and raised concerns with the GDC about their standard of care.

The dentist was now able to ‘see the bigger picture’. They reflected on why they may have been specifically selected, their own shortfalls, and the patient's likely intentions. Whilst the experience had left them shaken, it stirred the need to be more vigilant and diligent.

Cases like this are often less about technical ability and more about decision- making. Early career dentists can find it particularly difficult to decline treatment, particularly when patients appear highly motivated and when they have travelled long distances or express confidence in the clinician's abilities. There can be a natural quest to prove competence and avoid disappointing patients and managers.

One of the most valuable skills a dental professional can develop is recognising when not to proceed. Good case selection takes time to acquire. Professional confidence is not just the ability to provide treatment. It is also about knowing when to stop, step back, and attain more information, seek advice, and when necessary, postpone the decision until the picture is clearer.

GDC clinical advisers will consider factors such as the dental professional’s level of experience (if known) in deciding what would be reasonably expected. In the above case, it may have been quite impactful on the investigation outcome.

Communication, consent and record keeping

Poor communication and inadequate records feature repeatedly in FtP investigations. For early career dental professionals, these challenges can be amplified by productivity pressures, financial targets, and a lack of confidence when discussing risks, costs, and relevant alternative treatment options.

One case involved a relatively inexperienced dental therapist who recommended two private tooth-coloured restorations to an NHS patient. Although their records indicated that silver amalgam restorations had been discussed as an alternative option, the patient later alleged that they had been told the “mercury filling option” was "toxic", soon to be banned in the UK and therefore should be avoided.

The patient felt they had been steered towards private treatment and raised concerns about possible financial motivation and unscrupulous behaviour. Interestingly, the patient chose amalgam restorations.

When the case was reviewed, the central difficulty was proving exactly what had been discussed during the consultation. The records lacked sufficient detail and there was little contemporaneous evidence to support either account. A statement of account was sought from the dental nurse assistant by the GDC at an early stage of the investigation, but this was not made available. As a result, determining the facts became considerably more difficult, risking case progression.

This highlights an important principle: good communication is only as strong as the evidence that it took place.

Patients are entitled to clear, balanced, and accurate information. They expect to be able to trust their dental professionals and misleading them can have more profound consequences. However, effective communication involves more than simply providing technically correct facts. The way information is conveyed can significantly influence decision-making.

For example, in the personal preference for a dental extraction, telling a patient with a raging toothache that a procedure aimed at avoiding an extraction has a 60% chance of success may produce a very different impression from explaining that there is a 4 in 10 chance of failure – ‘just under half’, and that symptoms may persist despite treatment, whilst a dental extraction may offer a quicker, cheaper and more predictable solution. Both statements may be factually correct, but each emphasises a different aspect of risk.

Working beyond competence and the influence of social media

While social media can be a valuable educational tool, it can also create pressure to accelerate. Self-inflicted pressure to replicate the efforts of peers and publish on social media what others appear to be achieving, may push some clinicians to undertake treatment that they are not yet competent to provide independently, or should not be offered at all.

In my experience as a postgraduate tutor, the most successful early career dentists are rarely those who progress the fastest. More often, they are the individuals who understand their limitations, seek advice when needed and develop their skills incrementally.

One GDC FtP case involved a newly registered dentist under supervision who had attended a short postgraduate course in bridgework. They were overly eager to apply and display their newly acquired skills. Despite strong reservations from a workplace supervisor, they provided a long-span, 5-unit bridge for a patient with active gum disease and significant bone loss to replace three missing rear teeth, without first addressing the underlying gum condition and without properly discussing risks or reasonable alternatives.

Complications soon followed. The bridge became mobile, the patient developed pain and swelling, and one of the infected anchor teeth was extracted. Further concerns arose when it emerged that photographs of the treatment had been posted on social media without the patient's consent. The patient later recognised the images and raised concerns about confidentiality and privacy. The case also received a lot of questions from colleagues about the lack of proper planning and execution.

By the time a written complaint was received, the dentist had been dismissed from the practice due to concerns about patient safety and ineffective engagement with their supervisor. However, when they were contacted by the practice, they refused to co-operate with the local complaint’s investigation. This triggered the GDC investigation.

Looking back, there were multiple opportunities to alter the trajectory of the case. Greater attention to treatment planning, willingness to act on their supervisor's advice, and proper consideration of consent and confidentiality, as well as effective engagement with local resolution, may all have led to a different outcome.

All too often, early career dental professionals are desperate to carve out their post-graduate careers; often with a list of ‘must do courses’, and chasing that ‘Instagram case’. Learning to walk before trying to sprint is rarely a sign of weakness. More often, it is a sign of professional maturity.

When online spats become professional problems

Following a negative online review, a newly qualified dental nurse felt compelled to defend their dental hygienist colleague. Frustrated by what they believed was an unfair account, they responded to the patient's allegations on a public review platform.

To correct the record, they inadvertently disclosed information relating to the patient's treatment history and the response raised concerns about patient confidentiality. The situation rapidly escalated, attracting further criticism and public attention.

Complaints and negative reviews can feel deeply personal and the temptation to respond publicly can be strong. However, engaging in online disputes with patients can end up being counterproductive. Sometimes the most professional response is no public response at all.

Concluding thoughts

It can feel very isolated being in the dental profession, especially in certain settings.

Early career dental professionals should feel confident and comfortable seeking support from peers and colleagues when faced with uncertainty, particularly where treatment complexity exceeds their current experience, or for pastoral need.

Easy access and availability of proper mentors and support could be invaluable.

Most early career dental professionals will encounter occasional setbacks. Sadly, these are a normal part of professional development but should not define someone. The challenge is not to avoid mistakes entirely, but to learn, grow, and develop habits that help reduce risk, at the same time taking care to avoid entering an overly defensive mindset. This is, however, a very tough balancing act!

This blog is part of a series by Shamir Mehta, please read his other blogs:

Dental record keeping: what is professional, reasonable and in the interest of patients?

Clear aligner treatment: What can we learn from complaints and concerns?

How patient consent can help build trust and confidence

Drills, spills, and protocol: when dentistry doesn’t quite go to plan

‘Bonding boom’ - composite bonding insights for dental professionals

Fear of the GDC: A personal perspective on perception, reality and responsibility

A stitch in time saves nine: insights and reflections into complaint handling

Heavy is the Head: Complaints about dental crowns – sharing insights and learning

Shamir B. Mehta

Shamir is the Lead Clinical Adviser, Fitness to Practise. He joined the GDC in 2017. Shamir manages the in-house Clinical Dental Advisory team and provides support and quality assurance for our panel of external clinical advisers. He qualified from King’s College London (KCL) in 1996 and subsequently attained a Master’s in Clinical Dentistry (Prosthodontics) and a Doctorate Degree in Medical Science (Tooth Wear).

Shamir is a dental practice owner, a Senior Lecturer in Dental Education, Programme Director of the MSc in Aesthetic Dentistry at KCL and Academic Lead for Digital Education and CPD. He is also a Visiting Professor at Radboud University Medical Centre (The Netherlands). 

Clinical guidance

The GDC does not set or provide clinical standards or guidance. The essential clinical expertise that Shamir brings to his role has been used to provide insight into clinical matters arising from complaints and concerns casework.