MOCKBOARD

FAILED...dangit.  It was very good to go through how the board procedures will go.  The paperwork was so confusing at first but is a lot more clear, now.  It was also good to experience what my stress levels would be like.  My professor talked to me after the ordeal to let me know how I did and what I could work on.  He complimented me on my probe and recession measurements, but told me I missed one spot and burnished a few more. :(  We talked a lot about improving my exploring skills.  He said to explore as if you are looking at someone else's patient, because when you think of them as your patient, you rationalize saying "there can't be anything left there, I spent forever in that pocket".  I think it will help me a lot.  I haven't really focused on exploring a lot because it is so time-consuming, but it is definitely worth the time if it is the difference between passing and failing.

You've gotta pay for what you want!

Had another class 3 patient.  He said he didn't have the money so I paid for him.  :(  Lame, but it's my grade so I guess it's worth it.  Quite the experience cleaning a real class 3.  

September 30th

Another day of class 3 patients!  YES!  My first patient has been a class 5 for years but hasn't been in for a while now so there were signs of infection and some calculus deposits.  I didn't feel like she was a well-maintained perio patient so I took a chance and explained her case to my instructor claiming I felt better about classifying her as a three.  Maybe a tiny portion of that was that I need this classification, but I really did feel like she was not a 5!  End of the story...got a class 3 exam done. :)  My afternoon patient was incredible.  He had never had a cleaning before and displayed the worst infection I've seen yet.  He even had occlusal calculus!  And tons of it.  He requested some x-rays so it was a good opportunity to get some periapical x-rays done.  I took a lot of pictures with the intra-oral camera as well because I thought it would be neat to see before and after pictures.  It also helped to use for educational purposes since he didn't speak a word of english.  I put him on a chlorhexadine rinse to reduce the infection and bleeding before I attempted to clean.  I'm looking forward to him coming back. It should be a great experience.

YIKES!

Started the day with a class 3 (so exciting!!!!), but unfortunately I only finished one quad...
WHY?
Well...problem number one..
I BROKE AN INSTRUMENT
Yup, that's right.  I didn't even do anything differently and wasn't putting more force than I usually do...but it was in a very deep and bloody distal pocket of #3.  Luckily on the outside I remained very calm.  I told the patient to bite on a piece of gauze and I would be right back.  In my head all I could think of was "OH CRAP, OH CRAP, OH CRAP!"  I notified the CA (thanks for your help, Kathy!!!!) to find the instruments that we use in this situation, but apparently the VA doesn't keep them on hand.  I asked Professor Bossenberger to come help and luckily after a few minutes of skilled searching she pulled it out.  WHEW!  Later she complimented me on how well I handled the situation, which surprised me because I just felt terror throughout the whole ordeal.  She also told me that it has happened to her many times in her 30 years of practice so maybe I won't make such a big deal about it next time.  It was quite the experience, but I actually think it's a good thing because I figure no matter what happens, I've already had worse (hopefully)!


problem number two....
The dentist took a long time doing the exam...which is ok because the patient needed the attention, but frustrating for me.  On the upside, I ended up only missing 2 spots.  A lot better than I expected.


Afternoon patient was a young and healthy guy...pretty easy class 2.  Gotta remember those distals of the 2nd molars...

A CLASS 4....

My morning patient....Wow...I have my work cut out for me.
I finished my day off easy (as planned!) with an 11-year old.  One 1A down...one to go.  I usually am more enthusiastic and put more effort into being fun with the kids I see, but I think I was still thinking about my morning patient.  I'm not too proud of myself for not putting my energy and attention into making the kid I treated feel comfortable and motivated to improve his oral hygiene.  Sometimes I just don't have the energy...

Another day...

I like doing the hard patients in the morning and ending my day with a nice, easy, and friendly patient.  I know that won't always be the case, but at least for now when I have control over my patients, it's better for my stress levels to schedule my patients that way!!! My morning patient was a class 3 and although I only finished the OD (extensive medical history...) I'm excited to get started on him.  I've only done one class 3 in my life (last year) and I was at a lost at how to effectively treat back then so I know this will be a learning experience for me.  One thing I need to remember is to keep an open mind during OHI and not to judge too quickly.  My patient was really picky about the toothbrush and toothpaste he liked and said he didn't want to brush more because it hurt his gums and they bled.  I tried my best to explain to him (in spanglish) that his gums were sore and bled because of the periodontal disease.  I talked to a classmate later about her chemotherapy and she mentioned the same things...sore gums, couldn't handle really minty toothpaste.  I felt horrible that I didn't understand and be more compassionate with my patient.  I'll talk to him next time he comes in about it.  My afternoon patient was SOOO sweet.  It really helps me relax and do better work when my patient is confident in my abilities and compliments me.  I really enjoyed working with her.  It made me excited for when I can work in an office and hopefully create relationships with my patients as I see them for recall appointments.

Can't think of a title...

I love the VA because I get to meet such amazing heroes of our military. That may sound cheesy, but I just really appreciate what they do for us. I saw a young soldier today who suffered from severe PTSD. I had never seen anything like it before. He was VERY nervous. He would check around his shoulders when I came into the room and couldn't even really handle me working in his mouth. I offered to give him nitrous gas which seemed to help A LOT. He was able to relax a little bit. He also chewed tobacco so I was able to see a "chewing tobacco patch". It looked like a white lesion in the vestibule, where he keeps the tobacco. The doctor and I both urged him to quit and he said he had cut back a lot already. I hope he is able to quit someday soon because not only did he have TERRIBLE breath, but it will really take a toll on his oral and systemic health. I saw another older man who was paraplegic. It was a great learning experience on working with a patient who had a severe physical handicap. He was able to put himself in and out of the dental chair. It was amazing. He also had SEVERE stain. I found out it was from a liquid iron supplement he was taking. (Take note!) It covered his teeth. It was tedious but I got it all off with the ultra-sonic scaler. He went out of there with a brand new smile. Unfortunately he wasn't the type to be too excited so he didn't share in the thrill with me, but I was happy!