Tuesday, October 26, 2010

Pain

Today I felt was a really great day.  I started out with a patient who was a mix of class II & III - YAY!  She allowed me to finish up my class III exam requirements.  She also had a lot of staining on her teeth that I was able to remove with the ultrasonic! That was really cool.  I really felt like I was able to help her and she was soo grateful to be in our clinic and wanted to tell everyone about it - YAY again! :-) 

Afternoon patient was a returning class III patient and all I can say is TENACIOUS CALCULUS and my back is KILLING me!!!  I have never wanted a patient to tell me to please not continue on to another quad.  After her UR I was sooo done.  My hand was hurting and my back was writhing in pain.  Of course she wanted me to keep cleaning her teeth though...so I did.  She had pretty deep pockets on the maxillary anterior teeth and that was a challenge.  I've never had to clean deep pockets there so I pretty much sucked at it on the UR.  By the UL though, I was kind of getting it down....after I got out my files, mini graceys, regular graceys, and every ultrasonic tip I own!  I worked and WORKED on getting that calculus out and it did pay off...but again, I'm HURTING SO BAD!!  I was even trying to watch my posture...but I think I must have been having chicken wing arms or something, which is why I'm suffering.  I was really proud of myself for using a TON of indirect vision today.  Overall...I finally feel as if I'm learning something.  Prof. Alexander is awesome.  She is sooo good at teaching you and showing you new techniques and really watching and correcting you.  OH and I got to do 7 more injections today!  :-)  WOOHOO.  It gets less scary the more you do it.  That makes for a total of 15 so far...I think.  Anyway, by the end of clinic today I was feeling pretty good about scaling & root planning (and yes I passed off that PE).  YAY FOR A GOOD CLINIC DAY!

Tuesday, October 19, 2010

Dont worry...I've done this before

Today was great.  FIRST: both of my patients showed up!!! HALLELUJAH!  SECOND: Both class III"s!!  THIRD: I did 8 injections between the 2 of them! (lucky them)  So this was my first time doing injections on someone other than Jenny so I was a little nervous.  I find the left side IA much easier to do, but the left PA super hard!  I find it harder to do the right side IA.  In fact...I kept having "osseous" contact with my last patient and had to poke her 3 times to get her IA right. I felt really bad, especially since she didnt speak a lick of English and I couldn't ask her questions or explain what was happening...though that might have been a good thing since I kept having to tell Prof. Alexander, "I'm hitting her bone" over and over.  No one wants to hear that!  But overall I was able to complete 3 quads of a class III (I think I only need 1 quad left to have my class III exams finished). 

My last patient was REALLY hard.  Her calculus was really tenacious and I felt like even the ultrasonic was struggling!  I passed off 1 PE (ultrasonic) and I wanted to do the file PE but Alexander wants me to have used it more than "once" before she passes it off...but I used them none the less so why not let it count?  They aren't that hard.  I did learn a lot about accessory fulcrums.  Fulcruming on your finger is awesome. (not being sarcastic either...it seriously worked, especially since the pt had class III mobility on her lower anteriors and there was no where else to fulcrum)  Anyway - GOOD DAY! YAY!

Tuesday, October 12, 2010

Mock board #1: Failure

Well needless to say my patient DID NOT show up for mock boards today...is this a surprise to anyone?  Certainly not me.  Although I must say the lady was quite convincing that she was going to come in; especially since she went out of her way to come in for x-rays on a Friday so that I would have everything ready to go for her.  Confirmed her yesterday, she said "Yes I will be there by 8:00" and what happens?  8:10...8:20...8:30 rolls by.  OOPS! SHE MUST HAVE FORGOTTEN! AND she refused to pick up her phone when called. @#$(*@ Anyway...at about 8:15 I realized she wasn't coming and decided I better start scrambling for another patient.  I just wanted SOMEONE in my chair.  Luckily there was a man in the waiting room with his wife, that was willing to be my patient.  I had NO clue what the condition of his mouth was but I was just desperate to get ANYONE, especially since "check in time" was 8:30.  I hurry and take xrays on him (wasn't able to complete all of the ones that were necessary though because I had NO clue which quad I would be cleaning! so there went 4 points right off the bat) So I took 4 BWX and chose the one with the most radiographic calculus (UR) and then submitted 4 extra teeth in 2 of his other quads, and PRAYED it would be accepted. 

After I sent my patient to the examiners (30 minutes past check in), I then went straight to the back room and sobbed for 3 minutes and then pulled it together and went out and cleaned some teeth because HE QUALIFIED!  (truly an answered prayer)  I then proceeded to do the most thorough cleaning of my entire life (I'm pretty sure I explored his mouth 8-10 times before he left my chair).  However...I still missed 5 places!!  They were the TINIEST most MINUTE specks of calculus known to man...I'm not even sure how they were found.  SO there went -30 points.  And then, come to find out I had a -1 deduction because I clearly dont know how to classify a cross-bite!  So yes...add up all the points and I'm left with the grand score of 65%.  10 points below passing for a REAL board exam. 

It then dawned on me that on the "REAL" boards I can only miss 4 spots of calculus and EVERYTHING else MUST be perfect!  It makes me sick to even think about it.  A $975 test could all be blown over a couple of tiny specks of missed calculus.  However...I want to say that this was an extremely good learning experience for me and that I'm looking forward to the next one as LONG as my patient shows up.  That no show threw me into an emotional roller coaster.  I'm pretty sure I have set a record in the program for the most confirmed "no shows". 

Sunday, October 3, 2010

Class III's have arrived!

So after my long, LONG, wait for class III patients...I have finally had the opportunity to clean 3 of them!!  Hallelujah.  It all started with my angel friend, Marilyn, who gave me her patient after my patient canceled. (Whats new? my patients ALWAYS cancel!!)  I was able to see a class III (who I think should probably be a class IV...but beggers cant be choosers) and she had severe mobility on her lower anterior teeth.  They were also completely coated with calculus.  The calculus was hanging over the facials even.  So I did a debridement in 30 minutes (this was all the time I had due to cancellations and meeting with the dentist about my pt...etc etc) and as I was debriding, I was FREAKING out because I was pretty sure her teeth were about to come out!  I had to hold them in place as I used the ultrasonic around them.  The calculus that came off was incredible.  I'm talking HUGE pieces...had to get out the HVAC.  Anyway, that day was awesome.  Got to declare her as 2 quads of a class III exam.  The next day at the VA, I saw two class II patients.  Let me tell you about them.  The first man had all crowns and bridges.  He did not know how to care for his bridges so I had to scale food out from under them for a good 5 minutes *gag...I know its unprofessional to say that but FOOD is the only thing that churns my stomach as I clean someones mouth...I just cant handle it* but I kept it together and cleaned him up.  The second guy was a 23 year old and I thought for sure he would be a 1B.  However, he had not been to the dentist in so long that his tissues were very infected and he had so much calculus.  Cleaning him was very fun!! (not being sarcastic, being serious!)  I was able to declare 2 quads for an exam so I have officially completed 1 class III exam and scaled 7 quads (8 are required for this semester).  I'm feeling SO much better!!  I hope they keep comin in! :-)