A Dental Perfectionist’s Confession

In My Story, Print Issues by Kandice Swarthout

Hi, my name is Kandice and I am a recovering perfectionist.

Five years ago I lived in fear that you would hear my voice quiver during a lecture, ask me a question I could not answer, notice my messy car, and heaven forbid detect that I was in dire need of a pedicure.  What if everyone thought I was not smart enough to be a professor, pretty enough to step out in THAT dress on a Saturday night, fit enough to teach the kettlebell class, or a good enough speaker to carry a course on my own?

I would have rather died than be seen as an imposter, pretending my way through life. Fake it until you make it? Who came up with that line of nonsense anyway?  Oh no, not this girl. I would read it, study it, know it and then become it. It was only acceptable to take a chance once all the T’s were crossed and the I’s were dotted. I began to slowly lose myself, referring to these times as the “zipping up.”   

These insecurities began rising in my 20’s after I left a relationship that was drenched in infidelity and lies.  I packed my belongings and set out to pretend my life was perfect. It seemed great at first, this whole “being perfect” thing.  It was shiny and clean. Just fake it for a while and no one will notice. The problem with faking it and getting away with it is that it becomes a way of being if one does not believe they can become their imposter self. There is a big difference between believing in the person you want to become and refusing to deal with core issues that plague the darkness of your mind.  

Fake it til you make it

On one hand, I do believe in the old adage “fake it til you make it.”  I preach this to all of my students in the clinical setting. Act like you know what you are doing in front of your patients and soon you will. Act like you are confident. This reframing of thoughts will rewire firing neurons and you will soon feel as confident as you once pretended to be. I am a big believer in positive psychology and that redirecting our thoughts will, indeed, create new paths in the brain.

In the psychology world, this is why we know Cognitive Behavioral Therapy is effective. New thoughts and behaviors equal new ways for the brain to respond which eventually results in new habits in thinking. The faking it I am talking about lives in self-doubt and unworthiness that stems from fear of being judged.  Sometimes we are smiling on the outside and dying on the inside. If this is happening more often than not, I believe a mind-shift is in order. This is not the kind of faking it that supports mental health and career longevity. 

Jazz Hands

I began to come to terms with perfectionism and imposter syndrome in graduate school while training to be a mental health counselor. One of the most anxiety-ridden experiences was watching videos of myself with clients in a real session for the entire class to openly critique.  Watching my quirky mannerisms (which earned me the nickname “Jazz Hands”), hearing my voice over the speaker, and observing my awkwardness as a brand new counselor on the big screen was more than I could stand. I wanted to crawl into a hole and die.

When classmates and the professor made positive comments, I thought that they were lying in order to be nice. When they made criticisms, I thought I was the worst counselor that ever existed and that I should immediately quit the program. It was a lose/lose situation for all involved.  The preface to this was one night in the pre-clinical lab, I volunteered to be the first person in the class to take a fellow student through a five-minute counseling session in front of the class. Two minutes into it, the professor kicked my chair and said: “don’t use 50 cent grad school words in my class.”

Oh, the humiliation!

No surprise that my anxiety skyrocketed in preparation for future showcase shaming. This experience is a perfectionist’s nightmare. The anxiety around being perfect became even worse a few years later when I took a full-time faculty position in a dental hygiene program. As faculty, there is an unwritten expectation that you are all-knowing of all things dental hygiene. I wish that that was true, but like all of us, years of clinical practice recesses some of the massive amounts of didactic information learned in school to the depths of the memory. In fact, much of it is deleted after years of not using it. This expectation put me into an anxiety-ridden tailspin of perfectionism. 

Now, you might be thinking that perfectionism is a positive term because it instills accuracy, hard work, and a stellar final product. Do not confuse perfectionism with excellence. You may occasionally hear someone self proclaim perfectionism with pride like it is a fresh tattoo to show off.  During candidate interviews for the dental hygiene program, potential students often boast perfectionism as their strongest quality. They believe it will be the secret ingredient to rise above and shine in a demanding and stressful environment.

I know all too well, that this is not the case. Dental hygiene school is a great place for the perfectionist to come undone and suffer great anxiety to the point of being frozen in procrastination and/or panic. I’ve been there myself. Trust me, counseling school was almost the death of me on several occasions.  Let me take a moment to explain perfectionism from a clinical standpoint. 

Perfectionism is a myth and social media is the storyteller

Perfectionism can be defined as having unachievable expectations of flawlessness on oneself, unforgiving self-criticism, constant uncertainty of one’s abilities, and an overwhelming sense of critical demands from others. These excessively high personal standards are multifaceted and can present as a polished professional on the outside, but some researchers consider it “deadly.” It is linked to depression, anxiety, stress, eating disorders, and suicide.1

Simon Sherry and Martin Smith, a clinical psychologist, and research lecturer, conducted an extensive longitudinal study on perfectionism that raised serious red flags around the mental health of people that struggle with these self-induced expectations.  As perfectionists age, they have a tendency to unravel with higher levels of neuroticism, shame, and envy.

This tends to lead to burn out and an unstable life.

Sherry and Smith were particularly concerned for younger generations that are more influenced by social media and critical parenting practices.  Images on social media portray perfect faces, bodies, and lives that are unattainable. The researchers stated that “perfectionism is a myth and social media is the storyteller.”

People of all ages are more often comparing themselves to unrealistic standards. They also noted that the increase in parenting styles around control and criticism do not allow children to learn lessons in failure and learn how to emotionally self-regulate. Parents that offer acts of love that do not revolve around performance, rank, or appearance reduce the chances of raising a child that struggles with perfectionism.1

Imposter syndrome

I want to add a side note about the perfectionist’s sister, imposter syndrome. Imposter syndrome is not a true disorder, but a term coined to describe when someone does not take credit for their own accomplishments. When someone is feeling the pulls of imposter syndrome, they can give an amazing performance and later derail with doubts. They believe that their success is by luck or chance.  Imposter syndrome and perfectionism work hand in hand. Most people with imposter syndrome and perfectionist tendencies can relate to thoughts of “not good enough” even when they are the best in the room.

A combination of these two confidence enemies can lead to increased anxiety, stress, depression, and shame.2  Not reframing and getting imposter thoughts under control can wreck the intentions of a professional that desires a career change or advancement. They live in a world of an “I do not belong here” mindset and may never take a risk to go after what they want. This leaves many people paralyzed in the humdrum of the status quo with just dreams of doing greater things.  

Am I walking the walk or just talking the talk?

It seems this wonderful profession of dental hygiene attracts the perfectionist.  Go to any dental hygiene conference and mingle with hundreds of well-dressed, well-spoken, men and women that can all relate to the above definitions. As a dental hygiene educator, every year I observe an increase in students struggling with anxiety due to perfectionism.  They fall apart when they do not live up to their own expectations. The entire faculty expounds that it is okay to make mistakes. We let them know that they are there to learn and mistakes are to be expected.

And yet I have to wonder if, as a faculty member that wants to raise healthy professionals, am I walking the walk or just talking the talk? Is my own perfectionism rearing its ugly head in the classroom and the clinic and sending messages that it is, indeed, not okay to make a mistake? 

Being a dental hygienist is my superpower!

I can assume that most people reading this are not educators but in clinical practice. I believe that perfectionism and imposter syndrome are two very important factors that lead to clinical burnout.  If you know me, then you have heard my rant on how, as hygienists, we have to wear a cape every day. What other profession does as many assessments and treatments in less than an hour, 8-10 times a day, with a full bladder, all while building incredible relationships and smiling through the process?  There is not one that I can think of.

Perfectionism ghost

Day after day we walk this path and when perfectionism is the ghost that haunts us, burnout is just around the corner. How could it not be around the corner when everyone thinks you are fabulous except for you? How could it not be around the corner when your hard work in a demanding environment never adds up to your own expectations? 

Can we overcome perfectionism and finally lead a life with true confidence and pride in our work? Personally, I had to start by taking risks.  I had to take the scary risks that really put myself out there. I started with small things like sharing personal struggles with a few people I would normally keep at arm’s length. Then I started taking bigger risks like public speaking. The fear of getting a bad evaluation after a CE course used to send me in a spiral, but the more I do it, the less I care. I care way less about the one person out of 150 that did not like my presentation. 

That one person used to make me want to quit. I did not quit, I kept pushing through and accepting that one person’s opinion does not define me. I started believing the positive evaluations and using those to catapult me into the next goal. After all, I am not all-knowing. I am just a girl that likes to share what I learned with other hygienists. 

Shame loves perfectionists

Brene Brown says, “shame loves perfectionists. It is so easy to keep us quiet.”  She talks about perfectionism being an armor that we wear to cover up shame. If you follow Brene, you have heard her speak on dragging shame into the light because dark is the only place it can survive.  I started putting this into practice, little by little, by openly admitting to students when I am wrong or do not know the answer.

I make mistakes! Yes, it is true! It happens and sometimes more often than I want to admit.  The demands of full-time faculty are arduous and mistakes happen. At first, I would go to my office and stew in embarrassment for being wrong. I would convince myself that someone else was more cut out for the job. After several practices in this newfound admitting to being wrong thing, I realized that it was okay and sometimes even gained respect for being real.  

Real is better than perfect

If you are reading this and see yourself over and over in my words, I highly encourage you to seek out a licensed therapist that can assist in your journey to recovery.  It is a process that requires work and is often painful. A therapist can help you reframe your negative thoughts and regulate emotions that may surface. As I said before, I am a recovering perfectionist. I am not recovered. I deal daily with anxiety about being less-than, I just have better skills to manage this anxiety than I used to.  My guess is that this will be a lifelong recovery process as the layers are peeled back and the healing progresses. The thing I have learned most from this journey is the truth in a quote from one of my favorite teachers, Dorothy Sateen, “Real is better than perfect.” 


  1. Simon, S., Smith, M., 2019.  Young people drowning in a rising tide of perfectionism. The Epoch Times. B8, Feb. 14-20, 2019. 
  2. Dalla-Camina, M., 2018.  The reality of imposter syndrome:  Feeling like an imposter? Know what it is and what to do about it.  Psychology Today. Sept 03, 2918.