Going Dental

More Requirements

2008-02-29T03:37:04Z

I've managed to knock a couple of requirements off the list. Including all of my OMFS rotations, an endo, and a complete denture. It has been difficult being trapped in OMFS, though, because I haven't been able to see many patients this week. I managed to have the guts to schedule one during my lunch [she never showed], and I saw one of my patients as an emergency. Needless to say, I am looking forward to being done with this rotation and getting back to hammering out more of these requirements.

ps - I'm trying out this trackback thing.

The Luck of the Draw.

2008-02-13T06:00:00Z

Part of the challenge of dental school is completing your requirements in a timely fashion. What makes the challenge great, is the variety of patients being admitted to the school. In addtion, there is a mysterious force that seems to bring the same type of patient to the same doctors over and over.

It may be better stated that the force seems to keep certain procedures from some doctors. I have completed many crowns, and much opperative dentistry. I have scheduled my removable prosth requirements. Why is it that I have yet to treatment plan any Class III restorations or anterior endodontic procedures? The patients to which I have the privledge of caring for simply do not need it. This goes for some of my collegues as well, who may have yet to complete a single unit of fixed prosth.

Is there a solution to fight this mysterious force? Yes, there is, and it is called the "admitting overflow signup sheet". After realizing that I was behind in units, I have made it my mission to sign my name at least three times a week on the overflow sheet. That has netted me about one new patient every two weeks, and allowed me to begin to finish my removable prosth requirements. Hopefully, I will soon be able to say that I am working on my senior requirements.

You might be a board patient if...

2008-02-10T14:47:26Z

...your student doctor asked you to floss with pixi-stix.

...you think that every cavity is worth $100.

...you've been offered a free trip to Mid-Michigan.

...in your last three appointments, you've only had more x-rays so your student doctor can "double check".

...you've been seen by more doctors in your last two visits then you have in the last ten years.

It's So Hard To Say, "I hurt you"

2008-02-05T00:16:08Z

But when you're patient is anesthetized, they have no idea what you've done in their mouth. When [as dental students working without assistants] you are working by yourself it is important to isolate the area where you are working. I have tried everything, including the sphedopter [sp?] that was in our kits. What I have learned is that the cotton roll is my friend, and if I'm doing any sort of opperative the rubber dam is the best thing going.

There is nothing worse than hurting the very person we are trying to help. Except, having to let them know that they will be sore when the anesthetic wears off.

The question of the almighty dollar.

2007-10-17T14:55:46Z

It may seem straight forward, but it has taken some time for me to master the art of answering the question, "how much will it cost?"

Yes, we have a fee schedule. And, yes, I can look up the cost of any procedure completed in the clinic. In most cases [75-95%], I will be right-on. The other 5%, however, I'm not comfortable trying to anticipate the exact dollar amount. So, I've learned to respond, "I don't know right now."

I take my time when treatment planning, and in many cases arrive at a different treatment option than I first thought as optimal. Many times, my preceptors introduce concepts and considerations I haven't had experience with. Therefore, I schedule another appointment to discuss treatment options and cost. This way I give myself time to think through all of the options, and also save myself from giving the impression of being indecisive and unreliable [among other things, I'm sure].

The importance of implants Part 1

2007-10-09T20:39:49Z

Here's the hypothetical situation: You have had much dental work completed over the last 20 years of your life; several [7] crowns, a 3-unit bridge, root canal therapy, fillings, etc. Excluding your wisdom teeth, you have had only 4 other extractions. Two were not restored because they were in the very back on the same side [top and bottom], one was restored with the above stated bridge, and the other missing tooth is the reason you went to the dentist today. After a complete exam and the necessary radiographs, you hear that several of your crowns [placed 10+ years ago] need to be remade. In addition, one tooth is now unrestorable which will leave the left side with no molars and only one pre-molar on the top. Your dentist says that 2 implant crowns would be the optimal treatment. Is he right?

What other treatment would you offer your patient?

Dentistry.co.uk - News - Website awards shortlist announced

2007-10-03T21:02:16Z

Click Here

The websites listed here are pretty impressive. Look around at the dentists in your area, and check out there websites. Would you go there? Does their site welcome you into the office? Does it make you want to go see how it looks in person?

Obviously, there are certain things that a practice's website must include. Those are pretty tangible: address, biography, etc. What about the things that aren't tangible like the feeling that the site gives? The quality of the images, are they stock photos? Also, and item that is often overlooked in favor of splashy image heavy extras, useability. If it takes more than 10 seconds to load, most people are off checking their email and not your site.

Look at these shiny parts!

2007-10-03T13:39:59Z

Shiny Parts

Found this site while looking for new design inspiration / styles for MT4 blogs. Best of all there is some how-to along with the editorial! Can't wait to get into my templates. Thanks, Shiny Parts.

Quick Post Problems...

I had to alter the entry to get the Link to come up as a link and not simply http:// etc. Anoying.

Models

2007-10-03T12:00:00Z

No, not the ones in magazines or on TV, the ones you just sent to the lab. Did they look as good as they could have?

It has been said that you can tell the quality of a dentists work [operative or otherwise] by the quality of his models. I know that lab work isn't the shining star in your life, because if it were you would be runing a lab instead of a dental office. Are you doing everything you can to make it easier on your self? Here is how I [try to] keep my lab work looking its best.

]]> Continue reading "Models" »

A New Direction

2007-10-03T02:11:00Z

I am happy to announce that I will not be the only one publishing to this site. I have invited, and will continue to invite colleagues to join me in discussing topics related to all aspects of dentistry. My good friends, Meena Barsoum and Crystal Perry, will be the first to join me here, and I look forward to a collaboration that will last many years.

Application of the Hydro-dynamic theory.

2007-09-30T22:00:56Z

We are well aware of the hydro-dynamic theory of tooth sensitivity. The dentin tubules that lie between the enamel [or cementum] and the pulp chamber are filled with fluid. When they are opened [due to a cavity or a dentist] a greater amount of movement of the fluid is created. This movement is created even after the tooth has been filled, because of several reasons, but most often because it wasn't sealed. When this change in pressure is too great, it causes an action potential in the nerve to fire, illiciting a pain response.

Thanks to the advent of etching and bonding, we are able to seal these tubules very predictably. If most dentists are aware of this, why don't we take advantage of it more often? Of course, we have to use bonding agents for successfull composite restorations. What about other operative restorations like inlays, onlays, and amalgam? Should we be taking advantage of it during our crown preparations as well?

Are there contra-indications to using bonding agents with diferent cements? Or, could we bond our crowns in place of using luting agents?

A search of the literature is in order, I believe.

The use of Loupes as a dental student.

2007-09-21T13:47:58Z

My fellow blogger at http://www.dmdstudent.com/ mentioned briefly that he had ordered some loupes. Now, there are several companies that supply loupes with different designs and quallity of lens, but that's really not important. What is important is that you use them. "Why," you ask? Because you can, because most dentists do [making it a standard of care], and because you want to be better at what you do [we hope].

There are many benefits to using loupes, especially as a dental student. At Case, they were included in our first year instrument kit. They took some time to get used to, but nothing ridiculous. Though, I will say that I wouldn't want anyone working on me the first time they put a pair of loupes on. Using them for waxing, and the sim-lab, even on our sealant rotation helped to visualize exactly what I was doing.

It wasn't long before I wanted to see things even bigger... I would find myself leaning in over the patient trying to get things as close as I could. There was some back pain, and after 20 minutes or so, I'd catch myself leaning in again. Then, at a vendor fair, I tried on a pair of 4.8x loupes. Wow, were things big.

Now, some will say that you should step up from 2.5 to 3.3 to 4.0 to 4.5+... That is too much time spent adjusting, and too much money spent in upgrades. Do it once, and do it big. After spending a year with my new loupes, I am completely satisfied, my posture is better [thanks to a narrow working length], and my work is limited by my hands not my eyes.

Continued Trials...

2007-09-20T22:13:43Z

Spending a week in Oral Surgery... made me want to pull my teeth out. Maybe it was just the slow week. Maybe it was that I'm not that interested in pulling teeth [I prefer to save them]. Who knows?

There was a few positives, though: Learning how to suture, and practicing anesthesia technique.

Speaking of anesthesia... I now know that the effects of topical anesthetic prior to injection are simply mental. I intentionaly placed the topical two teeth infront of my injection site [only after I tried to proceed without]. After giving the injection I recieved great compliments on my technique "didn't feel a thing, doc". I wanted to tell the patient that it had nothing to do with the placement of the topical, but I felt like that would be similar to telling a 6 year old that Santa doesn't exist.

For Real.

2007-09-03T20:24:42Z

While I'm working on setting up the design of the site, I decided that I shouldn't wait any longer to start back to my old posting habits.

A patient presented last week into the pediatric clinic expecting a cleaning and sealants. He was an african-american male, age 14. I scaled the minor calculus off of the lingual surfaces of 22-27, finished the prophy, and took four bitewings. Looking at the radiographs, I was suprised to see a sharp bony defect between 19 and 20. Can you guess the diagnosis?