Daily stressors are inevitable in dentistry. But you have it within your control to mitigate or even eliminate them.

DO YOU KNOW what really creates stress for me? I can handle the occasional difficult patient. I can cope with a periodically prickly team member. Put the two together, though, and my pulse increases and my teeth clench. Want to triple the fun? Add a difficult procedure—restoring distal decay at the cervical of a #2, say. One problem is manageable. Two are troublesome. Three are unnerving. Add a fourth, such as time constraint, and the seemingly tolerable has now become a source of great stress.

Fortunately, as a seasoned veteran, I avoid potential dental debacles more than ever these days. Four pointers that might help you as well:

1. Difficult patients will always find a way into our schedule. They’re not (necessarily) mean-spirited or overly demanding, but perhaps they have special needs: too much saliva, frequent swallow breaks. These needs are real, so I add at least 10 minutes for such patients. When you discover these needs during a first-time procedure, permit yourself to shorten the planned treatment if possible: Complete two restorations instead of three. Yes, this will decrease your production, but your health is more important than your daily production goal.

2. Not all team members are trying to be difficult, either. Novice employees and experienced staffers alike can create problems. Try, then, to train one new person in a given practice area at a time. In other words, avoid training two dental assistants or front-office staffers at once. Share training responsibility, too—training is challenging, and not everyone picks up on things as quickly as others. Break up training periods, and try to instill a culture in which advance notification of absences is expected so you’ll have time to prepare for a team shortage. Maybe even hire a part-time “floater” to ease the strain when someone’s home sick. Make sure your team is cross-trained to pick up the extra duties of the absent. It’ll help your team feel less stressed—and ensure more consistent patient care.

3. If a team member is not working out despite your best efforts, don’t suffer. Continue your search for someone else and let the ill-fitting employee know, preferably prior to the end of the 90-day probation period, that the relationship isn’t working. Let them go. Move on.

4. Really learn how long it takes to complete a procedure. Do a study to time the duration of a crown completion, a crown and core, two or three restorations, and more. This can be eye-opening; I tend to think I’m faster than I actually am. This used to get me in trouble. If you’ve booked too little time for a procedure and a difficult patient creeps in, you’re in double trouble. Be realistic about your abilities. Achieving optimal scheduling isn’t easy, but with consistent communication and realistic expectations, you can avoid the frenzy of being overbooked.

It took me a while to become more production-efficient. Once I recognized the four stressors above, I changed my systems to alleviate the problems. You’ll experience stress amid the rigors of clinical dentistry. But you can manage it, whether through external means—meditation, yoga, tai chi—or internal systems that can help mitigate those cortisol releases. Ideally, we work on both and achieve more peace—both before we enter the office in the morning and while we’re practicing dentistry.

DR. LISA KNOWLES is a dentist in East Lansing, Michigan. She also speaks nationally on mindfulness-based stress reduction for health-care professionals, eco-friendly dentistry, restoring teeth and the team, and oral/systemic issues beyond 32 teeth. Her website is Beyond32Teeth.com.