First Patient!

Friday was big. Not really procedure wise, but career wise, I actually treated my first patient! :). The patients presented for a periodontal recall appointment. They got the whole deal - complete with vitals, extra and intraoral exams, cranial nerve exam, periodontal charting, including pocket depths, mobility, plaque indices, oral health instructions, and a thorough examination of the gingiva levels, and junctional levels. After all that, we were onto scaling, root planing and polishing. Being the awesome novice dental student I am, the appointment took a little less than the entire 3 hours we were given (SKILLS...but not really). I'm sure in practice taking that long would be a quick way to go under fast, but for now, it's great. I'm really happy I got to do this so early on, cause it's like an extra boost of motivation as to why we're learning everything we are, and puts everything in perspective.

The major take-away I got was that being knowledgeable and competent are vital, but equally important is a sincere interest in people and communication. I honestly feel like I could have simply just talked to my patient for so much longer, but I was definitely concerned with completing all the tasks.  I need to ensure that explaining procedures before doing them becomes routine. It felt very natural anyway, since dentistry really is a personal encounter. The setting of the dental office does imply some consent and openness to work in someone's oral cavity, but I think people appreciate the added consideration of letting them know what you'll be doing, before touching areas of their head and neck. Probing really isn't my favorite, but after doing it so many times it's becoming pretty routine. I was particularly happy my patient thought I was the gentlest he's had (:D!!). I remember the one thing in the back of my head was something my friend's grandfather told me when I told him I was going to dental school - "You better have golden hands". Thus far I'm probably a bronze, but practice will most definitely make perfect!

Aside from awesome clinical experiences with real people, the semester's moving along nicely with a whole ton of lab work. For removable, we've placed wax rims on the record bases we did to approximate the position of the teeth we'll be mounting next week.  We then took a bite record of the wax rims in occlusion to aid with mounting. Placing the rim wasn't bad, but I'm ever grateful for the help of classmates in using the facebow to mount the record bases on our articulators. To do that we had to fix them to the manikins, secure the relationship of the maxillary, then transfer it to the articulator, then mount the maxillary, then the mandibular using the bite record.  Its crazy how long a way we've come with the facebows and articulators. From struggling through using it last semester on each other, to now. I really can't wait to actually use them for a real patient.

For indirect we had a great exercise in the second floor simulation clinic where we had to prep #30 for a crown using water, then take an impression. Drilling and not having the tooth turn black and brown was awesome, but the water really does make things tricky visually. Mirrors are flooded, and when you think you're cutting a beautiful chamfer margin, you realize it's actually just water being splashed away by the bur. All in all, really fun working in an operatory setting. Hopefully this becomes a more frequent occasion.

After a nice three day weekend we're diving back in tomorrow starting with amalgams in direct. Pathology Exam 1 on Friday, Oral Sciences Exam Monday. If anyone's ever bored with Pathology, or any studying in general I'd reccommend creating an account on DrBicuspid. They've got great news and case studies that are really interesting. Being bored after hours of Path just now, I came across one that was completely applicable to the neoplasm chapter we had in Path. Being able to actually evaluate histological sections and answer questions makes me feel like an almost doctor :).

And, back to the books!
Cheers.

B28: A Second Home

So to all the first years out there feeling like they're basically medical students, except for a class in dental anatomy, set your gaze upon second year, where you'll truly feel like a dental student. A couple weeks in, I definitely love it. We've been busy going through the motions of making dentures in removable prosthodontics, doing more difficult restorations in direct, and taking a step-by-step approach to making a crown for #30. Really need to get back into the lab and practice that crown prep again cause I get the feeling those are going to be really important later on. After watching Dr. Levy do a ton I'd be ashamed of myself if I wasn't preparing proper crown preps.

I heard before that removable would be the killer class and I guess there's some truth to it, but if you really love what you do, it's a great time. The hardest part I'd say was getting the feel for the materials since you work with so many different ones, with different handling characteristics, and there's a bit of a learning curve to everything. Ivolen is definitely my LEAST favorite thing ever. It's a putty like substance we work under a hood with to fabricate a custom tray. The working time is fairly limited, so you need to be quick with the mixing of the powder and liquid, and precise with the trimming so it fits the patient (or cast in our case) properly. Thankfully I got those signed off, so now it's onto the impression, then beading and boxing before pouring up the cast :). 

This week we've got a ton of things due, and a practical exam - preparation/restoration of #12, #5 DO. Originally an MOD but switched to DO because Sabatini fully understands our pain. The month off from working with handpieces really took a toll but after a weekend in the lab it shouldn't be so bad tomorrow. Record bases for our dentures are due and Triad custom trays with wax rims both being submitted for grades. Wax rims...not fun until maybe the 5th one you make, when you become one with the wax. I'm sure the faculty's intentions are good in assigning us exact measurements for every dimension of these wax rims, but they have been quite troublesome. I had a little better luck with the record bases after going through many packs of pink Triad material, and shellac (gutta percha). Triad I really didn't mind, but shellac definitely took some time. At this point I can say I almost enjoy working with the shellac because once you get a sense of how much heat the material can take before burning, it's really adaptable and somewhat fun (unless you get burned...which is kind of inevitable in the early stages). 

For our crown preps we took an impression and poured up some jade stone casts which are totally cool.    The impression looked deceptively simple, but took me 4 hours to get it right. However, I wouldn't trade the fulfillment of finally getting it right for anything else. To take the impression your assistant fills the custom tray with purple heavy body impression material while you carefully cover the prep, adjacent teeth and occlusal surfaces of the arch with blue light body to capture the detail. Then, the custom tray needs to be carefully placed on the arch, pushed down to capture the vestibule, but in a way that you don't get bubbles. Far, far easier said than done. 

So dental school really feels like dental school now and it's fantastic. I'm going to try to get some pictures up here cause I'm really loving the way some of my trays came out! Quiz and a practical tomorrow so its about time for some sleep!