this stinks!

this morning my pt was a six year old boy. He was a bit grumpy and wouldn't really talk to me. I went to get a professor's signature and when i came back my operatory stunk! I didn't know who let one but it was bad. I took this little pt to get some xrays done and when i came back from processing the radiology room REALLY STUNK!!! This little guy was letting them loose!! Unfortunately we needed to do retakes and so i was stuck in there with him.. I invited Jessica to come in and smell and it made her gag!! haha.. My afternoon wasn't so stinky. My pt was early and ready for tx. She was willing to have Blood Glucose taken on her. And the LA went smoothly. I was grateful for such a trooper of a pt. She wasn't a jumpy person at all and that got her out early. Love it!!

mock board miracle

Last week was mock boards. At 3pm the day before, I was crying to my husband because i still didn't bave a pt. By about 5pm, a fellow classmate called to say that someone was coming in at 8am to be my pt. I was relaxed and happy. I got to clinic the next morning a tad late and felt super unorganized. By 8:15am, that pt still hadn't shown up. I was panicking inside. Prof Alexander said to start calling people to be my pt in the afternoon. As i went to the locker room, i could feel tears starting. Luckily, Camille came up and told me to find a pt in the foyer of Midtown. I was doubtful but I went out and told the three men there my story. The 26yr old said that he could stay as long as i took a pano on him. I gladly agreed and we got started... I sat him in the chair and realized with only being in the mouth for about 20sec that this kid was going to have plenty of calculus for me to remove and might even qualify for Boards!!!! I rushed him to be checked and he QUALIFIED!! everyone was amazed.. The calculus seemed to come off with such ease-we were chatting and laughing together and pretty soon i was finished and had 30 more min to go. I probed and then sent him on to be checked again.. oops.. i didn't do any of the paper work!! I only missed 3places of cal. and with having no xrays and no probe depths i felt good about that. I got my score back.. 72/100 wow.. that was exciting to know even when i didn't do the paper work. that was a great experience and i felt that this pt was a miracle.. ps.. the pano turned out great too.

Extra VA day

Prof Hanson was feeling sorry for me and, with some luck, got me in for an additional day at the VA. I was sosososo grateful to have someone else on my side. I was able to get so much accomplished too!! The morning consisted of 2quads of a 2 and 2quads of a 3.. and I got to do Local Anesthetic on both the UR and UL.. then the afternoon was pleasant Mr. Hogge with 3 quads of 3 with 11 injections!!! what a day.. I was so happy and grateful for prof hanson and besides that, she was an absolute delight to talk to at lunch. She made the whole experience positive, open for learning and organized.

my professor is worried

I just had my semi semester interview with my professor and she is worried about me. I haven't seen very many pts with perio and we are running out of time. I am super excited about my two pts today. both of them have perio to some extent and i am grateful. My after noon pt was 2/3 and I got to use local anesthetic on her ur quad. It made me super nervous but with my prof's help i got through. I think i was a little shaky. She was super numb though.. so that felt good..

just as planned

OH.. I am so grateful for good days like today. My sweet pt came a little late-but she came!! She was very patient and kind and we had a good time communicating in broken spanglish. She didn't have #30,29,28 nor 19, 20, 21. So instead of BWX we took 4 PAs. The first set were going to be perfect but the film that was set out for us to use was duplicating film and so didn't create an image. SO the second set had to be taken. They were pretty good considering the missing teeth-but not perfect. Because of time, I was only able to get 1quad done.. but because she is so relyable, i was ok with it.
My afternoon pt was right on time, and when i went out to get her she was gone!! The clinic manager had sent her to get a parking pass and she got confused and didn't come back for 30 min. Finally we got started and since she was a recall pt, I got right in the mouth and cleaned her up. It went pretty smooth. I was amazed at how much better I am adapting the ultrasonic and using the gracies... i saw several large pieces of cal removed by hand scaling. she was out the door in just a little over an hour.

VA day

I finally had a really great day at the VA. Not to say that all the other times that i have been there have been bad.. just that i finally saw some perio! it was a relief to see some pockets deeper than a 4mm and I got a really awesome view of calculus coming off in chunks. I was really grateful for the lesson we had on ultrasonic instrumentation. I was able to better adapt the insert to the tooth and the calculus removal went much smoother. Both of my pts there were considered class 4 perio pts.. because of the gravity of their situations, i was only able to complete 2 quads on the first and 1 quad on the second. I also had a good learning experience; i broke an instrument tip in the sulcus of 2D. I was totally blank as to what i should do. all i could remember is what i shouldn't do.. don't get the suction, don't stress out.. I had him keep his mouth open while i went to get an instructor. she tried many instruments, including the proxy brush and finally it came loose.. wow.. we were just about to take a PA too. I was glad for the learning opportunity..

interesting afternoon

Last week's morning appt was a stress. The pt couldn't find the parking pass ticket box and ended up being more than 45 min late. we rushed to get her started and in the chair. her 4bwx went smoothly-we took a supplimental to get the very back of a 2nd molar. then she was dx as a class 2. Because i know this pt is reliable, i made it my exam pt. it went pretty well.. i did miss some spots which is hard to take sometimes. My afternoon pt was a 16yr old and her mother was my pt in 3 weeks. after several conversations about fees and bleaching, i went to set up the xrays and came back to see that the office manager had given the mother to another student without any consent of mine.. I was furious and it showed in my scaling of the daughter. the mother ended up being a class 2 which is what i needed. During all this, I also had a first year student observing the clinic session.. she learned a lot!

busy morning

I am trying to focus on the possitve, since, so far, i feel pretty unproductive. I am grateful for the little 7year old boy was such a joy. Our goal was to get 2bwx and clean his teeth. He only has 2 permanent anterior teeth and 2 of his 6year molars. We also had his molars 19 and 30 evaluated for sealants and he needed them. So after the cleaning we were able to get that done. I had my second pt out in the foyer waiting-so i was a bit hurried-but they turned out great. My second pt came at 9:30am and I didn't get to him til 10am.. i was worried about time. Good thing he didn't need xrays. He is really cool for a 15yr old and we laughed some.. that was good. He had obviously more plaque and calculus on the right side and i found out that he is right handed.. he has flossed a few times since our last apt. He's learning. My afternoon pt didn't show up and she didn't answer her phone the 3-4 times that i called her.. I even tried calling her husband. i am surprised because they were so wonderful last year and so reliable. I hope all is ok.. especially because her husband is my pt next tuesday!!! so I got a walk-in pt who all she wanted was xrays.. for many reasons, it took me quite a bit longer than normal. oh well, they turned out great and i even challenged myself and did conventional films.. i'm happy about that.

first pt as a 2nd year

I am so grateful that I brought in my little brother (a 1b) to be my first pt. I feel SO SLOW!! I am super frustrated, because my pt in the afternoon just canceled AGAIN!! I don't know what i am going to do.. i guess i better start calling people.. ARG!! that is the worst part of this-you never know if your pt is really going to show.. well.. I hope it all works out.

first week back

I am writting this a week late, but I still feel that i am adjusting to being back in school. I a surprised at how much i have forgotten. I am also surprised at how much i have remembered. I really am not thrilled about being back so soon. I want more time to play, but such is life. It is really good to see everybody though.

exam, sealant and pe

IT really felt good to get so much done. I am glad that my cute little pt ended up needing sealants. I grabbed the dr right away and he was able to come and check as soon as we sat down. Her parents are in Hawaii right now so we were only able to get one sealant cleared but she was my class 1a exam pt-no mistakes-and i did my intra oral camera pe. that was hard! I couldn't steer it very well. i'll need more practice. I also got my retainer cleaned by a fellow student..nice..

class 5

Goal: clean a class 5, and pass of my area specific PE.
Accomplished: Class 5s are a lot harder than i expected. They only count for us as a class 1b but they really put you to work. I had to be instructed and reminded about how to use the area specific instruments. 15/16 is for meisial 13/14 is distal and the 1/2 is anteriors. I caught on pretty well, but it is still a bit freightening to go so far subgingivally! my pt was great, really nice and excited about my new learning. I am grateful for my good pts.

future inlaw

Goal: get my future brother in-law in the chair and clean his 1b mouth!
Accomplished: that's what we got. Of course, during the appt he had to give me a hard time and i didn't pass up the opportunity to do the same. It was a fun appt and because i didn't need to do x-rays we were done about 45 min early. I didn't do super perfect on him, some days are better than others. but i feel that i am learning a lot.

another od on a class 3

goal: well i met this pt in the weber midtown dental clinic and saw that he has COPIOUS amounts of calculus. So my goal is to make sure that he qualifies to be my class 3pt and get some xrays to prove it.
Achieved: He had to leave within one hour so all we got done was the fmx and 4bwx and I was SO SO grateful! He has calculus deposits showing in all the xrays and they all went pretty well. I also had my instructor come and do a PRE od to check to see if he would qualify for a class three and she said yes.. that means that at the next appt we have to do the complete od and tx. i'll have to be fast and good!

1a angel!

Goal: get a hold of my pt and her mother to comfirm appt. she's 4yrs old and will be my exam pt.
accomplished: i had a backup because it was scaring me that i couldn't get a hold of my pt's mom and i was grateful for that. Jessica also said there was a 14yr old coming with her dad who would need her teeth cleaned.. so i had some options.. i just really needed a 1a though. miracle happened and they showed up right on time!! it was great.. i was just so excited that i totally forgot to declare her as my exam pt.. bummer! I have one more that i can do-but still.. besides that the appt went perfect.. this little girl was an angel..

CA

Being a CA was SO relaxing in the beginning of this semester. I was so grateful to not have to worry about getting a pt that afternoon. I was also excited to feel like an assistent again.. i kinda miss it! I felt prepared to do all the requirements/my favorite was to call the girls to let them know that their pt was here. It was also fun to talk to the pts as they came out to pay for tx. some of the pts were super funny and didn't talk much. I can relate to that, i don't say much after someone has been messing around in my mouth-i get a little irritated and quiet-so it was entertaining. the only thing i would say needed improvement was that we were told that we were done, and we hadn't done everything on our list so i had to check and double check to see if there were more things to do.. and there were.. Over all, i can say that i am excited for my next CA day in april! April 16th-tax day!

never been better..

Yesterday the pt who was my very first pt came in to have his teeth finally cleaned.. He has been out of town and just barely returned. I was so excited to see him again and think of how much my skills have improved since that first clinic day. He was surprised when i told him that he wouldn't have to come a third time because we were able to finish all 4 quads of class 2 in that appt.. I was also excited! the best part was to see that he had been doing EXACTLY what i taught him to do in our OHI. When he came in back in January he had a BLACK coated tongue-how about that for a first clinic experience! and I got him using a tongue scraper everyday and his tongue was a beautiful pink this time. He also has been brushing 2xday and flossing with glide and rinsing with listorine daily.. this cute man is 74 yrs old and didnt know much of what i taught him.. it was fun to see that old dogs can learn and do new oral hygiene care.

grateful for a backup!

The night before this appt i was totally stressing and about in tears as i frantically called all of my pts to see if anyone could come in the next morning.. My class 3 pt wasn't going to beable to show and it was totally unexpected. I was so so so grateful when at 10 o'clock at night, i was able to get a hold of a pt who would beable to come in. The best part was that he was RIGHT on time, brought his wife (who is another of my pts and who talked to me during his tx) and they were SUPER excited about learning ANYTHING and EVERYTHING about the mouth.. they loved that buccal is like buckle it is the front of the tooth... funny.. because of missing teeth he only ended up counting for 3 quads-i didn't need any of them, but i was grateful for the experience. I missed lots of spots of calculus and Prof. Costley really helped me to feel and remove them.. She is good at this and i really want to learn a lot from her. One thing is when exploring, i need to roll that tip right into the col and use ONLY the tip to feel-it's better that way..

class 2 exam pt

goal: that my pt shows up and i can finish his tx in a good time and with minimal mistakes
acheivement: exactly that!!
today went really smoothly and i am really grateful. My sweet pt came in this morning because he knew that he needed to premed and he didn't have his Rx filled. He came and got 2gm Amox and was all premed by the time the appt started. We got him right in the chair, did a quick visual extra and intra and then got right started with tx. I hand scaled all his anteriors and then got my instructor to pass off my ultrasonic PE. That went really well. She even told me that if interproximally i would turn the ultrasonic just so then i could reach in a bit deeper and it worked.. poor pt though had lots of water going everywhere.. I then hand scaled all quads and my scale check was with only 2 mistakes. Phew! I want to work on my speed cuz it took me 50min to do it all.. but i also don't want to miss deposits..

class 3

Goal: have my roommate be my class 1b patient today, 4bwx and fm hs, pol, ect.
accomplished: my roommate failed her appt and i was going to just do the intra oral camara PE and the peer reviewed PE.. i was going to help chart with one of the girls and then my prof came over to tell me that she had a pt for me.. GREAT! He was the husband of a pt being treated right then and he was going to be just waiting.. I hurried and got his info and HHX and we started.. I could see from his tissues, and xrays that he was going to be a class 3.. it startled me to see my probe going in 7-8mm!! OD was definately class 3 perio.. I was grateful, suddenly, that my roommate wasn't able to show and i decided right then that perhaps i shouldn't react to such things so negatively.. i need to know that everything is going to be alright-i'll keep doing my best.. I really stressed to him the importance of cleaning his teeth and flossing.. he speaks mainly spanish so it was Super fun to try out my portugues/spanish mix.. it worked most of the time..

easier than before

Goal: class 1b pt 4bwx
accomplished: exactly that. I was so grateful for my pt today. My first pt canceled and I frantically called all my upcoming pts to see if anyone could come in. I was so happy when he called and said he could make it.. He was even early!! For me, digital xrays are SO much easier. He had large mand. tori and the xrays still came out perfectly. His cleaning went so smooth and i only missed one little spot that my professor didn't even count. I was so happy..

super patient

Goal: at seeing the pt chart, take fmx, 4bwx and od
accomplished.. Just that! we decided to do the xrays in digital and it went so smoothly, i loved it. my pt was awesome and had been to this office for many years and really enjoys the work he gets done here. my probe depths were basically right on. seems i got a little deeper than my instructor on a few. we classified him as a class 5 perio maintained because he didn't seem to have lots of bleeding.

lab day

it was a refreshing experience to be the student again today in clinic. It was good not to be totally paranoid about having my patient show up. I am grateful that i haven't had too much difficulty with that yet. I am also excited about what we learned today. I didn't know that we would ever use the diagnodent. I saw my dentist use it several times but never my hygienist. that was my favorite lesson of the day. I also was exctied (again) to see how well the ultrasonic works.. I like using it, but i can see that at times it would just be so much faster to hand scale and get it off. .. I have never found any satisfaction in insurance anything and today was no different. It is so frustrating to think that stupid money bla bla makes the call on what you are doing in the patient's mouth.. i'll have to deal it seems.

unpleasant pano

goal: assess my new pt., take necessary radiographs, finish od,
Ok so today started great. My pt showed up RIGHT on time and i am so grateful and we started looking into his HHx. He had a few things to be careful of-like a latex allergy! and then I talked to him about taking a panorex x-ray. First of all he has never had one, second-he has some broken teeth and we were looking for abcesses and such.. we also took one pa and some bwx. I felt really awesome about the 4bwx until processing. I turned the light on after loading them in and realized (in horror) that i had left 2 out!! they were ruined. I then took the pano and guess what? I messed that up too. I totally checked to make sure that the film was on the L1 part.. but when it went around the head somehow something got shifted and it wasn't on the L1 and the xrays went all over except on the film.. bad.. so we retook the bwx and left it.. so much for my efforts in helping my pt be updated on his xrays.
Probing is getting faster and faster for me (which is rewarding) and we were able to find that he is a class 2 pt. I am soo grateful!! He will be a great pt because he is kind and understanding and he will be a great exam pt too. I just have to calm down and take each thing as it comes.

returning pt

Goal: to blog correctly
Goal #2: one quad class 2 and two quads class 1. Use ultra sonic FM and hand scale in good time.
Oh wow!! I am so happy about how smooth today went. It was amazing to see the calculus come off the lower anteriors. I loved it. I even saw a dark calculus come out of the gingiva at 15mb. My instructor showed me a couple tricks with the lower anteriors.. to use the montana jack at the very vertex and then flip it (on the "incorrect" side) and come up through the contact area.. the instrument adapts much better to the tooth.

my first 1a

Today my Pt was a cute little 9 year old who was super intelligent. I was excited to have a little guy because kids tend to be so much more forgiving. In taking xrays, I noticed that I cone cut both and I needed to move more mesially. It was hard to remember that kids don't have as big of mouths as adults. It really worked to tell the kid a joke-go out and push the button-and then come back in with the punch line- the time went by faster.. I need to learn more jokes. The scaling went pretty smooth, I am still pretty slow and too thorough. I did have enough time to have the DDS come and do a sealent check.. that will help me later.

I didn't know..

so i had a class 1b patient today. We have been told and instructed that we would only be able to accomplish to the od on the first appt and then do the quads on the next appt. I was going along and noticed that because everything was going so smoothly that I had a lot more time left. My prof told me that i would be able to finish and i didn't believe her. she came around 2x to hurry me along and when we had the scale check she was curious as to why i was taking so long. I didn't understand that I really was being too picky about what i was scaling. after i finished and the pt had left, she sat me down and explained that there is no reason to be scaling where there isn't calculus. we should just explore and when we find some we then remove it.. I really had no idea that this soon in the semester we would be able to sit a new patient and finish in the same day. I will be better prepared for my next patient and that is exciting!!

First 4 quads!!

I got to finally get my scaler and gracey out today. I have been doing OD's this whole semester and it really felt good to get that calculus off. My patient was awesome. He was really patient with me and seemed to tolerate the treatment well. I am grateful for good people like that. I learned that after every HHx we need to note the date of the last xrays. I think that will help to see whether or not we need to do them at the current appt. I used the ultrasonic scaler because the pt had sheet calculus and it really helped. I was hand scaling at first and it really took a lot to get every bit off. My prof. checked on me and suggested that I get more practice on hand scaling so afterward the ultra sonic, i went around each quad to get adaptation, angulation and activation right.

ok to go!

oh, boy.. I had no idea how tough today was going to be. I had a 14yr old boy and I didn't forsee any problem. I got him seated and then gathered some paperwork to have his mom sign it and by the time I got out to the foyer she had left!! We had him call her and she had gone to run errands. I couldn't do anything until she came back.. what a mess. She finally came and I got it all signed and we got started one hour later than planned.. oh well.. i learned a lot. We did 4bwx and I really just don't know what I could have done to speed that up. I took one retake and then worked on probing and documenting.. it only took me about half an hour because I had an assistant.. lucky! I know that when I am out in the practicing world, i will have an assistant.. life is just that much better!!

almost snowed out!

Today I was really grateful when my patient showed up inspite of all the snow. I was nervous and felt a bit of a rush as I took his vitals and began to fill the HHx. I felt pretty good about the extra/intra oral exam but I know that I need to do it more thorough and yet faster. I also noticed that as in the OD check my probe depth were off more than usual. I need to slow down and make sure I have the right angle in there.. there is a lot to remember to check for and I think I need to make a mental check list so that I don't have to get in the mouth so many times and I can move to the next part quicker. My main goal now is to get an order/check list to follow mentally and be complete in my evaluations..