ps - I'm trying out this trackback thing.

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 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.

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.

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].

What other treatment would you offer your patient?

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.

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.

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.

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.

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.

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?