What type of test would you use to assess finger dexterity of dentist applicants?

How to Practice Hand Skills Before Dental School

Posted on September 06, 2019

Have you ever thought about why hand skills are so important in dentistry?

In order to perform dental procedures, a dentist must be able to work with precision on an extremely small scale. This requires exceptional hand-eye coordination to ensure the safety of patients and proficiency in the use of many different instruments.

These skills are even tested before students enter dental school. The Dental Admission Test (DAT) contains a section that specifically tests hand skills, called the Perceptual Ability Test, or PAT. The PAT tests your spatial visualization skills, including your ability to interpret two-dimensional (2D) representations of three-dimensional (3D) objects. These perceptual skills are essential for dental practice because you will need to construct mental images of teeth from X-rays, create and manipulate casts and fillings, and evaluate complicated 2D and 3D objects.   Most dental school admissions staff will ask you to discuss how you have developed and practiced your hand skills in everyday life.

Fine Motor Skills

Collectively, these skills are referred to as fine motor skills, which combine hand and perceptual skills. Fine motor skills involve small hand actions that require precise, coordinated movements of small muscle groups. Precise movements are guided by accurate spatial perception through direct and indirect visualization (such as through mirrors). It’s about correctly perceiving what you're looking at, and then making quick decisions to use your hands in a very precise manor.

Fine motor skills are a large part of the expertise that dentists must develop to be successful,” says Dr. Priscilla Chang, Clinical Associate Professor, and a Co-Director of DMD Pre-Patient Training.   A great way to build these skills is to explore hobbies that require them such as playing a musical instrument, painting, sewing or jewelry making. “We've had students that have done everything from playing the flute, to restoring furniture to playing video games.”

As a dentist, you work in the mouth, which is a very small environment. It's dark, it's wet, and it moves and breathes. So the better your hand skills are, the more adept you are to working in this very challenging environment.

“In dental school, you are learning the science and the procedures for treating patients, first using simulations in a safe, comfortable environment, before working with patients. A big part of this learning is how to use our hands efficiently, cleanly and consistently,” says Dr. Chang.

How do I practice my hand skills before dental school?

There are actually a lot of things you can do to improve your fine motor skills and hand-eye coordination.  Here are a few:

• Drawing and painting
• Playing a musical instrument such as flute, guitar, piano, violin
• Carving and sculpting, woodcarving, soap carving
• Woodworking and furniture making
• Pottery and ceramics
• Sewing/needlepoint, cross-stitching, crocheting and knitting
• Boating and fishing - earning to tie boat knots and fishing knots
• Even playing video games!

“Practice with anything that requires precision,” suggests Dr. Adriana Semprum-Clavier, Clinical Associate Professor and Director of DMD Advanced Standing Pre-Patient Training. 

 “One example is origami, which I find helpful.”

Playing musical instruments

Try making some beautiful music to build hand skills! Several musical instruments require precise hand-eye coordination and dexterity. Playing musical instruments such as flute, guitar, piano, and violin require precise finger placement and coordination of several movements in unison.

 “I played the flute and piano during my middle and high schools, and both were very helpful in developing my hand skills.”

-- Renata Berry, DMD Candidate, Class of 2022

Arts and crafts

Feeling artistic? Arts and crafts activities can be a fun, creative way to practice fine motor skills. There are so many options here that just about anyone can find something they like. Do you enjoy drawing or painting? What about pottery? Or, maybe you can improve hand skills while sewing a fix in a shirt, or knitting yourself a scarf.

Many of these activities don’t require a lot of space, and also produce something nice to keep or give as a gift.

• Painting and drawing
• Jewelry making
• Carving and sculpting, woodcarving
• Pottery and ceramics
• Sewing/needlepoint, cross-stitching, crocheting and knitting

“I’m really into an art form called printmaking which involves carving and many different shapes, so it was great practice for wax ups and casts.”

Kate Girard, DMD Candidate, Class of 2022

Cooking

Try cooking at home. Finely cutting and slicing ingredients requires very precise hand eye coordination. The same goes for measuring out and pouring liquid ingredients.

“A lot of what we teach in dentistry is like cooking,” says Dr. Chang. “You’re following a recipe and it can be made by many different hands in somewhat different ways, so each dish is unique. That signature that is given by each practitioner is similar to what chefs give to make their work special.“

"I love to cook and spend a lot of time in the kitchen doing all these fancy cutting techniques that I learned from watching chefs on TV.”

-- Renata Berry, DMD Candidate, Class of 2022

Video games

The cool thing about video games is that they are fun to play, and they really help with hand-eye coordination, and even decision making. You're moving a character around on a screen, which is really similar to what we do with a handpiece and a mirror. Video games also help in learning new dental technology, for instance, CAD/CAM and 3D scans.  

Practicing mirror skills

Learning how to use a dental mirror and explorer is a basic yet crucial component of dentistry. It is essential for performing patient exams. And, gaining proficiency with an inverted mirror is extremely important when you’re using high-speed handpieces. Building mirror skills takes persistence and patience, and good methods can be a huge help. That’s why the DMD dental school curriculum at UIC places emphasis on mirror and fine motor skills.

“In their first year, we have students perform exercises to build comfort and control of using instrumentation with a mirror. So basically it's to develop, indirect vision using mirror skills. One of things we do is to have students draw and write by mirror view alone,” said Dr. Semprum.

These same exercises can be practiced just about anywhere, using a small mirror.

Dealing with shaky hands

A lot of students have problems with shaky hands. Some people just naturally have a little shake in their hand movement. Whether it has to do with having too much coffee in the morning, or maybe you need some sugar in your system. Maybe it's almost lunch time and you're hungry.

At UIC, we use a number of techniques to help dental students deal with shaky hands.

One technique is the modified pen grasp, which is the way that you hold an instrument with your dominant hand. It’s a three finger grasp, very similar to how you would hold a pen or pencil and you extend the middle finger. By extending the middle finger, you get a much more stable, stable grip.

We also teach the fulcrum method. A fulcrum is where you use your other fingers, not involved in your mat and your modified pen grasp. When your hand is just floating in space, it might shake a little, but when it's resting against something stable, it doesn't shake as much.

Another technique is to increase your control. So for instance, when you're drawing a line on a piece of paper, you can draw a line away from you, or toward you.  Oftentimes people feel much more control when they draw a line towards them. Likewise, a right handed person feels more control when drawing left to right, because it feels more comfortable.

“In my first year, I had really shaky hands, probably because I drank a lot of coffee. So, first I lowered the coffee intake, and made sure I got a really good breakfast and lunch so that my body is not so shaky.”

-- Renata Berry, DMD Candidate, Class of 2022

Shadowing a dentist

Shadowing not only helps to learn about the practical aspects of being a dentist, it is also a great way to get tips for how to practice hand skills using models. When I was getting ready for dental school, I shadowed one of my dad's friend who was a dentist.  They allow me to observe and even practice waxing on models,” said Dr. Semprum.

Most dental schools (including UIC) require that applicants have shadowed a dentist or dental professional. So, it makes sense to get the most out of the hours you’ll spend shadowing, including honing your hand skills.

If you don’t have access to models, you can do the same thing with a bar of soap. Carving soap is a very cost effective method to build the same skills used in dentistry.  

Dentistry is a mix of art and science

Dentists really need to understand the science in combination with the skills. It’s about knowing the best outcomes based on evidence, and also having the ability to do it. So that's when you have to combine your hand skills with your knowledge of science.

“You have to combine the best, relevant scientific evidence with your own expertise, and the patient's needs and preferences, The artistry is in your expertise,” says Dr. Chang.

With practice and expertise, students learn how to perform procedures not only correctly, but also efficiently, resulting in the most functional and aesthetically pleasing outcomes for the patient.

Self reflect and seek feedback

Even with practice, it’s always a good idea to stop and evaluate what you have learned once in a while, to ensure you are learning the right things in the right way. “My best advice is to take time to self-reflect and seek advice and feedback from others along the way. You can practice a lot, and still end up making the same mistakes and not know it,” said Dr. Semprum.

After evaluating, have a plan to improve and try again. In building hand skills, practice does indeed make perfect.

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