Every dentist has had this moment. You’ve shown your trainee dental assistant how to set up for a procedure more times than you can count, and yet they still hand you the wrong instrument, or forget a step, or need prompting again. It’s easy to read that as a bad attitude, or as someone just not being mindful. But in our experience, it’s very rarely either of those things. Far more often, it comes down to something much simpler than that. You don’t remember what you don’t understand.
Being told the steps of a procedure over and over doesn’t automatically build a mental picture of why those steps exist. If your assistant is setting up instruments in a certain order because that’s what they’ve been shown, rather than because they actually understand what each instrument does and what it’s achieving at that point in the procedure, they’re memorising a sequence rather than understanding a process. And sequences memorised without understanding are exactly the ones that fall apart under pressure, or get forgotten a week later. The fix isn’t more repetition. It’s narration.
Next time you’re doing a procedure with your assistant, try talking through it as if you were explaining it to the patient, but pitched at your assistant instead. Not just what instrument comes next, but what it does, what it’s achieving, and why that particular step matters at that point. Take a crown preparation as an example. Rather than simply asking for each instrument as you go, talk through it out loud. Explain why you’re reducing the tooth in that particular sequence, what the retraction cord is actually achieving before you take the impression, why a particular medicament is being used and what it’s doing. When your assistant understands that the retraction cord is there to expose the margin cleanly for an accurate impression, they’re far more likely to anticipate that step themselves next time, rather than waiting to be told.
This works because we remember things far better when they’re attached to meaning. If your assistant understands the purpose behind each stage, they can follow the logic of the procedure and start predicting what’s coming next, rather than relying purely on recall of a list. That’s a much stronger foundation, and it holds up under the pressure of a busy day in a way that memorisation simply doesn’t.
This isn’t just useful for crown preparations either. The same approach works for root canal therapy, restorations, and really any procedure with multiple stages. Talk through why you’re using a particular irrigant and what it’s doing, why the rubber dam goes on when it does, what each medicament is achieving and why the timing matters. Do this consistently across your procedures, and you’ll find your assistants start to genuinely understand the clinical logic of what they’re doing, not just the choreography of it. Over time, that builds assistants who anticipate rather than just follow, and that’s the real difference between someone who needs to be told every step and someone who’s already reaching for the next instrument because they understand what’s coming and why.
The good news is this doesn’t actually take any extra chair time. It’s really just about choosing the right patient for it. Steer clear of anyone who’s anxious, and go for someone you’ve already built a relationship with, someone relaxed enough to enjoy hearing what’s going on. Let them know briefly what you’re doing and why, most patients are genuinely interested in the reasoning behind what’s happening in their own mouth, and it tends to leave them with even greater respect for the skill involved in what you do.
It’s a simple shift, but it’s a genuinely valuable training tool. The next time you catch yourself thinking an assistant “should know this by now,” it might be worth asking instead whether they’ve ever actually been shown why, not just what.