Qualifying as a dentist with a disability

After receiving a diagnosis of a connective tissue disorder, Shona Sawhney explains how she pushed on despite her disability to qualify as a dentist.

As a dental student, we have the privilege of seeing patients from all walks of life. We see people not only as a set of teeth but holistically.

By discussing medical, social, and familial histories, we gain an overall understanding of the patient and aim to treat them to the best of our abilities.

Through our course, we witness first-hand the links between chronic conditions and their oral manifestations. But how do you manage when you see patients struggling with conditions that you are personally experiencing yourself?

This became an important issue for me after I received the diagnosis of connective tissue disorder during dental school.

Changing function

In my third year of dental school when my clinical experience was just beginning, I began to notice changes in my day-to-day functioning.

Over a period of three months, extreme fatigue and stiffness slowly progressed to severe joint pain. This continued to the extent that my hands were always in splints whenever off clinic.

I would constantly reassure myself that I was just a bit under the weather. Or that it was just bad cramp. Speaking to tutors would also help put my mind at ease. They would say it was probably carpal tunnel syndrome or a similar variant. This was feasible as these conditions are quite prevalent in the dental field due to risk factors including forceful exertion, strained posture and stress.

However, as time went on and my symptoms progressed to swelling and then seizures, I realised my self-reassurance was no longer enough to keep me going.

The potential impact of my symptoms became apparent when a neurology specialist says: ‘You really need to think about another career. You will struggle.’

I was devastated, but this reaction from others would come to be the norm.

Dentistry slipping away

I found myself in a repetitive, never-ending cycle of explaining to multiple clinicians about my disability. They were always very surprised about the profession I had chosen to pursue.

I had worked exceptionally hard to gain my place at dental school. But through a chronic illness over which I had no control, I felt my future plans slowly slip away.

Unable to accept what was happening, I attempted to engage in a constant state of positivity. To the extent it almost became toxic.

Anything negative that came my way, whether from doctor appointments or unsolicited advice, I maintained a façade of blocking any negative emotions, hiding behind a smile when in reality I was suffering inside.

As dental students, it is important to have some kind of outlet for stress. For me, it was always the gym and playing the piano. Both of these were commonplace activities in my life, allowing me to calm my mind when under pressure.

However, as I saw my health deteriorate, so did my ability to partake in activities that once gave me such joy. It felt like I had lost a sense of control over my body and my thoughts. I became increasingly scared to lose my career and future.

Seeking help

When starting fourth year, I had been beaten by the suggestions of a ‘career change’ and that ‘dentistry isn’t for you anymore’.

I accepted that I would be unable to do what my peers were doing. The thought of completing my crowns gateway test that I was yet to sit was almost laughable. I can honestly say that I have never felt more alone.

Every time I entered the clinic, I would inform the tutors of my joint problems, as well as having a history of seizures. This was particularly hard. This is not what I wanted tutors to know me for or for it to define me. I feared yet again they would tell me this profession is not for me.

Going into clinics to see a patient straight after a doctor’s appointment, words cannot explain how challenging this was.

To have to push down the plethora of emotions and worries in my head and concentrate my attention on the treatment on hand was so demanding.

It was genuinely shocking when a tutor in clinics one day asked: ‘What can we do to help you?’ I almost cried.

After seeking advice from a number of tutors and staff, I saw how the simplest of changes makes a drastic impact. Not only on how I felt physically after clinics, but also mentally too.

For example, seeing oral surgery patients exclusively in the afternoon rather than the morning. This means my body and mind are prepared if I was required to perform an extraction.

To quote the incredible Mohamed Jemni, I noticed that: ‘The disability is not the problem. The accessibility is the problem’.

‘To have a disability does not mean you miss ability’

In hindsight, I now see just how hard I was on myself.

Initially, when my health condition deteriorated, I would force myself to do things. Even if I knew that my body was not physically up to performing the actions.

If I could not carry out the task, I got mad and angry at myself. It was a perpetual self-destructive cycle.

I have come a long way since then. Over time – and with perseverance – I have learnt how to be kinder to myself by focusing on the things I can do rather than the things I find harder.

Celebrating the small victories sounds cliché. But it has really helped me transform my way of thinking. I may not be able to squat as heavy weights as I once could, nevertheless I am proud to still be able to work towards my gym goals.

There is a place for those with chronic illnesses to be key members of the dental community. To have a disability does not mean you miss ability; with the right support and adjustments, anything is attainable.