Treatment Planning

How we CRASH #2- MENTAL Capacity.

Written by Dr. Lincoln Harris | Mar 13, 2019 2:08:50 AM

Women can multi task.

Men can't.

Actually, that is a myth. No one can multi-task. Not even fighter pilots.

Each of us can only do one thing at a time. If we want to do a second thing, we must stop doing what we are doing and switch to a second task.

This takes a bit of energy. The energy it takes to change from one task to another is called your switching cost. People who do what we call multi-task are usually just people with a low switching cost. They do not get exhausted by changes of task.

Constantly switching our attention uses up some of our brain power, or mental capacity.

And mental capacity is one of the main reasons we make mistakes or errors in judgement.

Imagine this. You are prepping a crown. It's going quite easily. You are using less than ten percent of your current mental capacity to prep the tooth. Life is relaxing.

Suddenly, the patient jumps unexpectedly, sending your heart racing. It hurts he says. You redo the block, and do a lingual infiltration, and a buccal infiltration and a PDL injection. 20%

It still hurts. You try using an intraosseous bur and have trouble getting the needle tip into the osteotomy. Finally patient is numb, but you are now twenty minutes late. 30%.

As you prep, the entire lingual wall falls off the tooth 2mm subgingival. The gum is bleeding everywhere. 40%.

You ask for viscostat clear and some cotton but the dental assistant tells you that you've run out and disappears out of the room to get some more. It seems like she is gone ten minutes. 50%.

And so it goes. Each distraction. Each loss of flow. Each decision. Each problem using up some more of your brains capacity.

And like a computer, if you reach 100% capacity, you crash. You lose all ability to do anything useful or make any reasonable decisions. I see this when we are training people with live patient courses. They become too stressed and sit there doing things ineffectively or making poor decisions.

So how do we manage to not get overloaded

  1. Avoid distractions. Where-ever possible, train your staff to make their own decisions. It would be better that they made a wrong decision on their own occasionally than to constantly distract you.
  2. Do methodical steps. Break a procedure into a lot of tiny steps. Do NOT think about anything but the step you are currently on. When you are doing local anaesthetic, do NOT think about pre-op impression or the prep. Just focus on your current step.
  3. Control patient anxiety and pain. I cannot emphasise enough how important pain control and anxiety control are to doing great work. A patient experiencing pain or anxiety will use up more than half your mental capacity.
  4. Avoid doing too many types of procedures at once. Doing three different procedures is much more difficult than one procedure three times. It's hard to get methodical, routine based flow going when you are doing endo, composite and perio all at the same appointment.
  5. Take training. Many times, training makes complex procedures seem simpler so that they take less brain power to carry out.
  6. Rubber dam isolation so you can concentrate on the area you are working on.

These are just a few options for reducing the amount of mental capacity that a procedure takes up.

What ways do you reduce stress or distraction when you are working?