Friday Afternoon Endo

When I see the "C" for Clincal Rotation on our Integrated Dental Practice schedule I'm never sure how to feel. The last clinical rotation I had was spent talking to a fourth year friend for a few hours about impressions, casts, dentures, patients and dental school in general. All very, very useful stuff, but while in clinic it'd be great to do something clinical which is exactly what I got this time around

I had the privilege of working with an awesome third year, named Joy whose name perfectly fits her personality. Our patient was an elderly woman in need of RCT on tooth #11. She had many other dental problems, however the canal in this tooth had been previously treated and needed to be completed. Joy began with a few anesthetic injections before removing the IRM (temporary filling -Immediate Restorative Material), while I manned the suction. Once cleared she then cleaned the canal with the slow-speed and filed and shaped it with different files. Despite some trouble we ran into with excess saliva, and placing the rubber dam, the patient was amazingly patient and understanding. Looking back, I think that situation was exactly what Dr. Goldberg in Orofacial Neurobiology was talking about. Our patients will react to our demeanor and attitude. While competence is vital, compassion and empathy for our patients is also critical.

Once we had a clear canal, the next step involved cleaning the canal with a bleach solution, measuring the correct gutta percha length and filling. While the bleach rinse was fairly painless, measuring the correct length of gutta percha can be tedious. Once measured the apex could then be filled and checked via radiograph to ensure that the apex really was filled. I familiarized myself with the digital radiography program and developer the clinic uses and some protocols for the x-ray room which was nice. Once the apex was filled we could then fill the remainder of the canal then finish it off with more IRM since this patient would need another appointment to crown off the  tooth since so much of it was lost to decay. 

This was the first appointment I got to assist in entirety at UB's clinic and I can say I completely understand  how 3 hour appointments can fly by, how amazingly helpful the professors and assistants are and how great our patients can be. Next week we've got an Orofacial Neurobiology Midterm on Tuesday and Microbiology on Thursday. Group presentations for Community Dentistry are also coming up fast. On a more fun note, I've been keeping up with the weekly Capoeria classes and it feels like I'm getting the hang of it. There's also a couple of bike rides for Diabetes and Cancer that I'm  getting excited for. Never a dull moment! 

Post Spring Break

It's been a week since we got back from Spring Break and it seems like Spring just decided to descend on Buffalo. We've had basically 4 days of consecutive 80 degree weather which is uncharacteristic of Buffalo for this time of the year. It's supposed to cool down a bit, but before it does, some classmates and I have been taking full advantage of the weather. Being super bogged down in work all the time, its hard to find time to explore the other campus at UB North, however we got to the other day which was great. It almost makes you feel like UB South is the somewhat neglected campus.

Aside from the fabulous weather, there has been work. Third Micro Test was challenging, different from the past though since the material was divided up between a bunch of professors. And questions from the longest lecture (81 slides on Staphylococcus) were left off. Thankfully I saved that lecture for last :). Physiology is the next exam coming up next Wednesday, where we'll be evaluated on our knowledge of the lungs and respiratory system. The book work continues...

Integrated dental practice though has proven to be an awesome experience. On Monday we took our first alginate impressions on one another, and poured up casts. Our overseeing faculty had sympathy on us since they realized how long this would take, and our group had one hour less than the other groups would have, since we lost an hour to lecture. Even with that sympathy, and the added stress of the Microbiology exam the next day, the process took hours. Taking impressions is probably something we'll do many, many times in our careers, and we've probably seen dentists do flawlessly, without hesitation. Learning the procedure on the other hand is another story. First you need to measure out the powder, and water. They both then need to be combined and mixed throughly in a mixing bowl with a spatula, and within that same minute that it is mixed the impression material must be placed in a tray, and into the patient's mouth properly. Spend too much time mixing and your material polymerizes and you'll have to start all over. Spend too little time mixing and the material won't set correctly and you risk gagging your patient with dripping alginate down their throat(which I may have experienced lol). Once the mandibular and maxillary impressions are taken, it is rinsed, sprayed with Cavicide, wrapped in a wet paper towel and stored in a sealed plastic bag.

The next step, which is normally done in the same day, is to make the cast out of castone. This involves mixing water, and the stone powder, then filling the impression carefully. Once full the rest of the castone is neatly placed on a paper towel which becomes your base. The impression tray is then placed on top of this and set to dry, which takes about an hour. Once dry you can then remove the stone from the tray, trim the model and be set to go.

The whole process took a couple of days since none of us really wanted to wait around for an hour when there was a 10 lecture exam the next day. This made removing the stone a little more difficult than it should have been, but removing the stone from the alginate in a pool of water made things a little easier.  All in all, a great experience to have! I'd hope to do it again sometime, before having to be evaluated, but I'm not sure if we'll get that opportunity.

D1 Spring Semester Post Midterm Update

The semester's just about halfway through and despite not having any lab work this semester, it's busy as ever. Just last week I finished up 6 tests in a matter of a week and a half. Neuroanatomy ended and Orofacial Neurobiology has taken it's place. Not much to say about this class yet but from the Pre-test it seems interesting. We're given the option of testing out of the class if you can score high enough on the pretest given on the first day of class. While taking it it seemed like the kind of thing you could study and totally test out of, but according to those who actually did study, they didn't find any detail in the readings on some of the questions. Case studies II has also began which is just a continuation of last semester.

One achievement I'm particularly proud of is being the first dental student to take courses in the medical school! At my interview for Buffalo I asked a question that I thought blew my interview right there -"Are there any opportunities to take courses outside the dental school? I'm really interested in spanish and would love to learn and become a bilingual practitioner." The professor interviewing me responded asking me if I had any idea how much work dental school was, to which I answered "Couldn't hurt to be ambitious." The class has been going great so far and it's really nice to interact with some other students, and learn something outside of the sciences for a couple hours a week.  This Wednesday I'll be heading out to a clinic to speak with spanish speaking patients and take a patient history. It should be a great time:).

Although we have no lab classes this semester, we do have one class that puts us in the Clinic a couple of times a week. This semester is the first time the school has introduced Integrated Dental Practice into the curriculum. The purpose of the class is to get us more comfortable in the clinic and introduce basic dental procedures so that we are more competent when the time comes for us to treat patients. Thus far we've done exercises in infection control, fixed prosthodontics where we poured jadestone models, removable prosthodontics and a few others. The best yet have been clinical exercises where we learned how to do comprehensive oral exams, tooth charting and placed and cured our first composites on one another. Since it's a class in the making there are plenty of issues being worked through but kudos to Buffalo for taking the initiative to provide a dynamic curriculum.

Spring break starts this Friday and I think we're all ready for a week off. That's all for now.