27 April 2026

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Grounded and Guarded: Armor You Need in the Chairside Journey

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Written by: Dr. Maggie Augustyn, FAGD, FICOI, FIADFE, FAAIP

Key details

This story is not just about a single patient or a single encounter. It’s about the broader lesson of finding stability in the storm, of building systems and communities that support us, and of learning to let go of the weight of others’ judgments. It’s about the courage to face the darkness, to feel the hurt, and to rise again—stronger and more steadfast than before.

Have you ever felt the immense weight of your professional responsibilities, questioning whether the emotional toll is simply part of the job or something we can learn to navigate more effectively? It’s a sad world when what you dreaded most in your career is more commonplace than you’d imagined. Chairside, I find myself using language like: “I’m saying this for completion’s sake,” “I am required by law,” “This protects you as well as me.” We’ve grown, as practitioners, used to attending seminars and webinars about documenting the right things to avoid lawsuits or board inquisitions. I’ll give you another quick example. If a patient comes in to “patch” a tooth, we might refuse to do it—not necessarily because it’s the wrong thing to do. I believe, as humans, we all have the ability to make decisions about our own bodies, as long as we understand the consequences. We refuse to patch a tooth because when it breaks—and it will—we are held responsible. We refuse to patch the tooth because when the treatment fails, patients become disrespectful, hostile, and sometimes even cruel.

I remember how, in the early days of my practice, what patients said would hurt me. I’d walk around lifeless for weeks, second-guessing my choice to enter dentistry or the treatment plan I’d proposed. And it’s not that I no longer take it seriously—I absolutely do. I just look at it differently than I used to. Ultimately (though not in every case), the way patients treat us, the way they talk about us, is a reflection of them and not necessarily the care we dispense.

Why it matters

I once had a patient who became angry—really angry—and texted me several times on my cell phone after the encounter. Her grievance? Due to a lack of enamel on the lingual of her upper anterior teeth, I asked if she’d ever found herself in a situation where she had vomited. She looked at me, puzzled. I clarified the question by asking: Have you ever suffered from an eating disorder such as bulimia? Have you vomited frequently during your pregnancies?

I performed a thorough, comprehensive exam of every angle of her teeth at both her request and for her absolute benefit. Yet, in some way, it threatened her. The question created so much fury for her that she and her family never returned to the practice. And I have no doubt this very issue was probably brought up within her community. But here is the rub: It was her outlook and insecurity that turned my exam and requirement to rule out etiology into an attack.

It has taken me my entire career to look at such encounters from a different perspective. I now refuse to carry the burden of being unliked or left for another provider. For much of my life in dentistry, the reaction of that woman would have made me feel unkind, compassionless, broken, defective, and wrong.

We can only see ourselves in a true light for the care we dispense if we, ourselves, stand on steady ground. We can only see that if we, emotionally, aren’t hijacked into a situation. This can be both taught and learned with experience. Learning to stand on steady ground can be confirmed within the right dental communities. But until we get to that place of very stable standing, I present here objective workarounds on how to keep sane and away from self and other judgment.

Industry context

The point of this article is not to drag you down to a darker place, one in which you might currently sit. Things have been difficult for many of us since 2020—not all the time, but enough. It’s not to de-romanticize the profession so many of us love. It is, rather, to present a challenging situation, one that none of us will avoid. And it is to show how it can be overcome—not necessarily with ease, but rather with a self-protecting, levelheaded approach.

As I continue on my implant and surgery journey, I always welcome patients in pursuit of such treatment. A woman in her 60s presented for a consultation appointment due to throbbing pain around her implant. She had visited the office here and there, often with emergencies. This visit was also emergent. She began the encounter by refusing radiographs, stating I should refer to the ones taken at her last visit. She also refused a blood pressure reading, which I consider very important during new patient exams, surgery appointments, and some others in between. She admitted that, to treat the pain, she had been taking antibiotics she found in her medicine cabinet, insisting that antibiotics never truly expire.

Despite her angst and poor attitude, I approached her with compassion and understanding. I explained my own liability and ethical obligation, as well as the clinical and medicinal nature of my profession. With that, I persuaded her to agree to a couple of radiographs and a blood pressure reading.

Having analyzed the digital information, photos, and performed a visual and intraoral exam, I informed the patient that there was an infection around the implant. I recommended a sound treatment plan.

The patient was rude, condescending, insulting, and combative. Despite this, I spent time going through the photos one by one, outlining the inflamed gum tissue and the bone loss visible on the radiograph, along with many clinical details. I also emphasized the risks of delaying treatment.

I must have spent at least 45 minutes with her. My response, though varied in tone, was rooted in evidence-based science. I met her with more kindness and attention than some might argue she deserved, if fairness and equality were to be considered. In the end, based on her calmer demeanor and body language, I truly believed I had convinced the patient to follow through with care for her diseased implant.

I underestimated the pause she might take as she returned home. Two weeks later, she called the office to say that if I did not refund the cost of the exam and X-rays, she would contact the dental board and file a claim against me with both her insurance company and the Department of Professional Regulation. We have a program that can document our calls, incoming and outgoing. More on that later.

“Take these charges off. If you don’t want to do that, I’m going to call my insurance company, OK? And I’m also going to write to the Illinois Department of Financial and Professional Regulation.”

She continued a few hours later: “It would be very easy. It would be easy to take these charges off, and then we don’t have a problem.”

Let’s pause here. I had a choice. I could have waived the fees that her insurance paid or retracted the codes altogether. But I didn’t. I was paid $63 for an exam/consultation that took me close to an hour; the insurance covered the visit at 100%. The patient paid nothing.

I had done that to the best of my ability, going above and beyond in extending myself and my expertise to this patient. I had approached her with care and kindness despite her unreasonable demands and attitude.

In the call transcript, you get a glimpse of the woman I was treating. She continues to refer to me as Maggie, which, in her eyes, is meant to strip me of my authority or expertise. To her, I am not Dr. Maggie, not Dr. Augustyn. This occurred on multiple occasions.

“OK, but Maggie didn’t want the PA or whatever you call it…”

“So finally I said to Maggie: There’s no infection, no infection whatsoever. Maggie said it’s infected. So I asked Maggie, where is the infection?”

My office administrator states: “OK, I personally can’t take it off. I will have to confirm with her first,” to which the reply was: “Yeah, confirm with her, and I don’t even want to hear her voice, OK?” Really? “I don’t even want to hear her voice???”

IF YOUR GUM HURTS, PLEASE DO NOT HURT YOUR DOCTOR

Reading transcripts is one thing; listening to someone say those things about you is another. You hear their emotion, their anger, their manipulation directed straight at you. You hear it in full color—the words are all-encompassing, and you create a memory of the call. The call becomes your soundtrack and background noise. You hear “Maggie.” You hear “her voice, OK?” These are things that are hard to listen to, even for a seasoned clinician. These are things that are difficult to hear from someone you chose to care for and invited into your practice.

It’s difficult, in the days that follow, to return to the office and serve again, not knowing how much respect you’ll receive. A part of you wants to scream, a part wants to cry, and a part wants to walk away and never come back. But come back we must.

With this encounter—though not with every one in my rearview—I chose to stand my ground. I chose the fight, if one was coming. I chose to charge what was owed to me.

Three months later, I did indeed receive a letter via email from the Illinois Department of Professional Regulation. Her formal complaint alleged improper diagnosis, insurance fraud, and overcharging for treatment that was not needed. It was requested that I send a copy of her medical record: all notes, ledgers, X-rays, documentation, and the treatment plan related to this patient.

Additionally, I was asked to provide a letter of explanation—a detailed written description regarding the treatment.

No matter how many years you’ve been in practice, an elevated heart rate will always accompany the opening of such correspondence. Sadness, anger, and disbelief settle in. Reviewing records, both digitally and mentally, begins to consume the many evenings that follow.

I hired an attorney through my malpractice benefits, and together we put together a 1,200-word letter of explanation. Writing this in a monotone and clinically thorough manner is also difficult. There is a part of you that wants to add passive-aggressive phrases within the text. There is a part of you that wants to react in this letter. And yet, you can’t.

All I could do was allow the body of support I had to speak for me. And this is where it gets good—I had more than enough to speak for me.

I had more than enough to speak for me because I had made a decision a couple of years ago to invest in a form of self-protection. Growing into practice ownership earlier than I might have been prepared for, I pinched as many pennies as I could. Sure, there wasn’t enough money available to pay for many things on my wish list. But I also failed to see the importance of certain things.

For years, I failed to see the value in investing in software that analyzes numbers for you, records and creates summaries of calls, and sends text messages to patients pre- and post-procedure. I didn’t understand the importance of tracking things like hourly production, hygiene reappointment rates, or other basic KPIs. As I watched myself grow into being as much a business owner as I was a practicing dentist, the importance of these metrics—and the shortcuts to gain them—became more evident.

I went through several companies to find the most ideal match for our practice. The current company we use integrates effortlessly across the types of data we collect. It streamlines calls, messages, forms, online scheduling, confirmations, campaigns, billing, KPIs, and many other functions—all on one screen. It even translates text messages into different languages and offers proposed responses using AI. There’s no need to switch between different windows or websites. This company is called Practice by Numbers, and it is the best solution I have found to make life easier for me, my team, and my patients. It has also helped me remain protected from litigation, as mentioned in this article.

Practice by Numbers also records our calls, though we’ve had our calls recorded for more than a decade with various companies. This is a service I don’t think I could ever go without. You’ll see how instrumental it has been in this case. It has also been incredibly valuable for team training and information analysis.

It was the phone recording of a conversation the patient had with my administrative team that saved me. It was the patient’s own words on the recorded line that revealed who she truly was, in the most accurate light. Her words, demeanor, choice of verbiage, intonation, and even pauses were used to create a clear image of the patient I was working with—unrelenting and difficult.

It was the transcript and the provided recording that likely spared me from further investigation. I believe it was that recording that made it easy for the board to decide whom to side with. Even within the AI analysis of the call, you can communicate quite a story.

In the following screen, you have more information that, if chosen, can be used in team training and further analysis.

Dentistry, like many professions, is not immune to the emotional toll of human interaction, especially when those interactions are fraught with misunderstanding, anger, or misplaced blame. But it is in these moments of challenge that we discover the depth of our resilience and the strength of our character—even when we are too tired to do so.

The journey of self-protection and remaining grounded is not one of detachment or indifference, but rather one of clarity and self-respect. It’s about recognizing that, while we cannot control the reactions or perceptions of others, we can control how we respond, how we prepare, and how we protect ourselves. It’s about standing firm in the knowledge that we have done our best—with integrity and compassion—even when the world around us feels hostile or unfair.

Thankfully, we are not alone in this journey. We have tools at our disposal that help us navigate these difficult interactions with confidence and clarity. Tools like phone recording systems, comprehensive patient management software, and AI-driven analytics provide us with the ability to document, analyze, and present the truth of our encounters. We have companies—and sometimes even dentists—who build these tools. These tools not only protect us from potential litigation but also offer invaluable insights for team training and self-improvement. They allow us to step back from the emotional weight of a situation and rely on objective data to tell the story—our story—with accuracy and fairness.

This story is not just about a single patient or a single encounter. It’s about the broader lesson of finding stability in the storm, of building systems and communities that support us, and of learning to let go of the weight of others’ judgments. It’s about the courage to face the darkness, to feel the hurt, and to rise again—stronger and more steadfast than before.

Because at the end of the day, we are not defined by the moments that break us, but by the way we choose to rebuild ourselves. And in that rebuilding—with the right tools, companies, and support—we find not just survival, but a deeper sense of purpose and peace.

Dr. Maggie Augustyn , FAGD, FICOI, FIADFE, FAAIP, is a Dawson-trained practicing general dentist, owner of Happy Tooth , author, and inspirational keynote speaker. Featured on 4 dental magazine covers and recognized by Dentistry Today as one of the top 250 leaders, she inspires others through her writing, helping them find healing and connection. Dr. Augustyn serves as the national spokesperson for the Academy of General Dentistry. She contributes monthly to her “Mindful Moments” column for Dentistry Today and AGD Impact and writes for other publications as well.

With unwavering compassion and a dedication to excellence, Dr. Augustyn addresses audiences ranging from a few dozen to thousands, guiding them toward fulfillment and meaningful impact. To contact her, email drmaggie@myhappytooth.com.

Source: https://myhappytooth.com/