Last Post of the Semester

Wow, Fall 2011 semester is already over (almost - I still need to take my local anesthesia final).  Our last VA day for the semester was last Thursday.  It was a scary drive down to Salt Lake with all the wind and debris flying around.  On my last day there I saw 2 patients in the morning, a 5 and a 1B, so nothing too exciting.  One of my patients just returned from Afganistan this last summer and I could tell that he is having a hard time being home.  It was interesting to have to rearrange how I talked with him because most patients seem to want to chat and listen to what you have to say, but this patient just seemed to be going through the motions.  It was a good experience for me to learn how to work with those kinds of patients. 

It also must be noted that we actually left on time for our last day! 

Last Clinic Day

I can't believe that yesterday was already our last clinic day for the semester.  It feels unreal.  Thankfully I had a great day for our last day.  I saw a 1B in the morning who needed a FMX (yes!).  That was the first FMX I have ever done in clinic.  I now am not panicked about PA's.  I only had to redo 2 of my x-rays too.  I think that it is so much fun to watch myself progress.  I remember being scared taking x-rays last year, but now I think it is a lot of fun and I enjoy learning new tricks and improving my own technique.  I have come to really like the Snap-A-Ray to do posterior PA's.  I definitely use the ORA for the anterior PA's.  I also scaled my patient in 20 minutes!  In the afternoon I finished a patient that has generalized moderate perio (I just used my "Patient First Language" skills there).  I got to do 4 injections.  I read through Malamed on Monday night to prepare myself for injections yesterday and it really helped.  Kayla was also kind enough to let me practice on her with a q-tip.  So, I plan on reviewing injections as much as I can so that I can give the best injections possible.

How Could I Forget to Mention...

We had a lab yesterday afternoon which was sweet, especially since I was not feeling 100%.  I would have been upset if I forgot to put this in my blog.  We got to learn how to do wheelchair transfers, which was fun and somewhat awkward.  It only took me 4 times to get Kristie into the seat, no big.  Once I figured out the proper way to do it I did much better.  We also got to take turns pushing each other in the wheelchair and at the very end I pushed myself.  I think I should invest in a wheelchair because it is a super good workout. 

No Voice = Difficulty Doing OHI

So, being a hygienist with practically no voice is harder than I thought it would be.  I had two 1A patients in the morning and I could tell they were having a hard time understanding me, so I tried the best I could to speak to them without my mask on so that they would know what I was saying.  I felt like I didn't give as adequate OHI as I would have had I not lost my voice.  However I guess in the real world if you lose your voice you can't just not show up to work, you just do the best you can. 

My first child patient was super clean.  He told me that he brushes morning and night and that he only (only?I'm thrilled when someone flosses at least 3 to 4 times a week) flosses once a day in the morning because he is too tired to floss at night.  I told him that I thought it was fantastic that he brushes 2x a day and flosses 1x a day.  I encouraged him to continue.  What's even better is that I actually think he does brush 2x a day and that he does floss some of the time because his tissues looked good and he hardly had any calculus and just a small amount of plaque.  My afternoon child patient was almost the complete opposite of my morning patient.  She hardly brushed and never flosses and boy did it show.  I showed her the plaque I was getting out of her mouth and she thought it was disgusting and seemed a little more motivated to at least brush 2x a day.  I also didn't know kids could have the kind of sheet calculus she did.  It was crazy.  I feel like we, as dental hygienists and dentists, need to launch some huge, wonderful program for parents and kids (especially parents) about oral hygiene because if parents don't know how to help their kids the problem never changes.  So when I figure out a way to change the world I will let you all know.

Another Day at the VA

Yesterday was my VA day.  As usual I saw 2 class V patients.  I almost had 3 class V patients, but thankfully Sarah was kind enough to do the extra one because I was not feeling well (I have a cold and am really tired).  One of my patients had had a gum graft on his lower left and needed one on the right side.  Bossenberger asked him if he would consider having a gum graft on his lower right and his reply was, "only if I start drinking some whiskey."  He was such a fun patient to work with.  Sometimes I am reminded by patients like him that whatever the hygienist and/or dentist say does not mean the plan will happen.  I always feel like if a hygienist or dentist makes a suggestion it should be done because we know the benefits of whatever we are suggesting, but unfortunately patients may not have the same view we do.  So, all we can do is give them the info and let them make the choice. 

Lunch this afternoon was wonderful.  Sarah had this awsome coupon deal for Biaggi's, so we had a big salad, tons of pasta, bread, and pizza for lunch.  It was a lunch to remember.  I'm not sure if any of us said more than a few sentences until after we were done eating because we were so hungry and the food was so good!  :)

Busy Afternoon

I had a pretty slow morning yesterday thanks to the fact that some setting on the scan-x machine was not correct and I had to retake my 6 x-rays using conventional.  (I later learned that the reason my x-rays were so dark was because some setting was changed to pano and not intraoral.  I didn't even know the settings could be changed, but I do now and hopefully won't ever let that happen again.)  Anyways, after redoing the x-rays we discovered my patient had an area of concern and most of the rest of the morning was spent addressing that.  I am so grateful to have such great teachers to consult with about issues so that I can know how to handle issues with patients when I am on my own.  Mr. Solomon was so nice to help talk to my patient about everything.  We only made it through the OD and then it was time for her to go.  I only had one opening to reschedule her and the day didn't work for her, so I came up with this crazy idea to do her after I saw my dad in the afternoon.  Let's just say that I was semi freaking out at lunch thinking about cleaning my dad and her and getting everything done in time. 

If you placed a bet on whether or not the afternoon went fantastic or a complete disaster I hope you picked it went fantastic because it really was fantastic.  My amazing dad came in this afternoon because I originally couldn't find a patient for the afternoon and he agreed to let me pass off some PE's on him.  I did blood glucose, diagnodent, and nitrous.  (The nitrous didn't take any convincing though because he loves it - so anyone looking to pass off nitrous he is your man.)  I also cleaned all four quads on him, and had him out the door at 1:50.  I then cleaned up, reset up, and brought my morning patient back and cleaned her four quads and was done at 3:15!  After a day like today I feel like I will be able to make it in a real office.  I learned a lot about time management today.  I made sure that I had everything out and ready to go so that I wouldn't waste time looking around for something I forgot.  I also reviewed everything with other girls and in my head to make sure that I knew what I was doing to complete the PE's quickly and effectively.  I also feel more confident when I'm not worrying about if I forgot anything, which helped me to get through the appointments on time.  I sure hope next Tuesday goes this well.  :)

Make Up Day

Yesterday I finally made up my clinic day from a while ago when I had a migraine.  My morning patient was an easy class 5.  Alexander and I worked to suggest dry mouth products for her to try.  Her tissues are extremely sensitive so I didn't even use the prophy paste on her.  I used her own toothpaste that she brought to polish her.  I was reminded by this patient that every patient needs to be treated individually.  Every patient deserves to get the best care, which includes being knowledgeable about different products and conditions.

My afternoon patient was a new patient and had x-rays back in May so I did not take new films.  My patient told me that he was seeing one of the Midtown doctors.  So while Dr. Hanson did the OD I went to get his x-rays.  When I came back Dr. Hanson had set out everything I would need to give maxillary and mandibular injections.  I was someone shaken up to see all of that stuff out, not because I am scared to give injections, but because I was not prepared for it.  It ended up being a good experience, mostly for me and not really for my patient.  While doing the IA I hit his bone twice.  After hitting it the second time I withdrew and asked Dr. Hanson to give the injection.  So she sat down and then she hit his bone.  We determined that my patient had some very different anatomy because that needle wouldn't go in very far, so Dr. Hanson got the needle in as far as she could and gave him the injection.  He stayed numb for his appointment so I would say it was a success.  After this experience today I realized that I need to be constantly reviewing how to give an injection so that I always feel confident and prepared even if I am surprised that my patient needs anesthesia like I was today.  I also worked really hard at keeping the instrument against the tooth, going toward the toe, and twisting.  I think that my efforts were a success!  :)

Thoughts from Tuesday

Tuesday seems like it was already a long time ago, but I wanted to share what my day was like.  Tuesday morning I told Kayla and Madi that I hoped my morning patient would be a class 3 patient and he was.  I was very excited.  I finished his entire mouth (which Dr. Hanson called 3 quads because he was missing a lot of teeth).  It's amazing to me how class 3's can be so different.  Sometimes the calculus comes off easy and sometimes it will not come off like my mockboard patient.  His calculus came off fairly easy, so I learned that I do not need to continuously crank on a tooth just because he was a class 3.  I also realized that I didn't need to use as much pressure since his deposit came off easier.  My patient had a partial denture for his maxillary teeth, but didn't have one on his mandible.  I discussed with him the benefit of getting a mandibular denture, but he was convinced that he did not need one because he could still eat just fine.  After trying to explain the benefits to him I finally left him alone to let him use his autonomy to make his own decision.  Hopefully he considers getting one one day. 

My afternoon patient was my grandma.  She is such a fun person to be around that the afternoon flew by.  She didn't have a lot of deposit so I did my best to explore carefully so that I could find and destory any pieces of calculus I found.

3 Patients!

I saw 3 patients while at the VA today and loved it!  I was so busy, which was so nice.  Two of my patients were class V's and the other one was a class II.  After seeing those three patients I went up and above my II/V requirements, which is a big relief.  I hope Dr. Hanson reads this blog post because I thought of two things that we really worked on together on Tuesday and I employed them today.  I "repelled" off the backs of the last molars when exploring to make sure I didn't leave any calculus on any of my three patients.  I also used the V of the hand grasp to work on the anterior teeth.  I love the V of the hand grasp.  It was so much easier to me to access the area I was working on and I was more effective when using a working stroke.  I love using new tricks I have learned.  I also love when I can use a trick and see it work because then I will remember that it worked and then use it again.  I also only left two pieces of calculus between my three patients, which I consider a success.  (Of the two pieces I missed I knew one of them was there, but couldn't get it and just needed some help.)  So, after having such hard patients it was nice to have a little confidence boost day.  I plan on continuing to use my new tricks and keep getting better and better.  :)

Today

I finally finished my mockboard patient today!  Yay!  I can honestly say that I have improved in my skills (mostly because Dr. Hanson said I had improved and I could tell I was doing better, which was pretty rewarding).  I feel good when I can get into an area and use my "twist" to get a piece of caluclus off.  Dr. Hanson reminded me to use the V of the hand grasp for certain areas.  I wish I remembered to use that more because it really helps me to stay parallel to be able to correctly remove deposit.  I still had 3 areas that Dr. Hanson had to remove because I couldn't, but that was a big accomplishment for me on that patient.

When I walked into clinic after lunch I wish I had had my camera.  Kristie would have had another priceless picture.  She was typing on her computer with her toothbrush sticking out of her mouth.  Ha ha.

In the afternoon my patient no showed so my wonderful mom came in at the last minute.  (This is where the V grasp came in handy.)  It was so cool to be able to get her all finished in a little over an hour, whereas it took me at least 2 appointments to get her done last semester.  When I think about how slow I used to be it encourages me to keep working harder because I am getting better, even when I may not realize it. 

In pod wrap we discussed what everyone had learned that day.  Some good things to remember:

* V of the hand grasp
* Bump to the back (on the explorer so you use the correct end for the area you are instrumenting)
* Use your Graceys, which I did this morning and I even sharpened them during my appointment (it made a huge difference in their effectiveness)

In Case You Were Wondering

Just so everyone knows last Friday when we gave each other 7 injections Sam and I did good and used a minimal amount of anesthetic so that we could actually enjoy lunch.  I got to take impressions for the first time and only had to redo one of them.  I was happy about that, but sad I didn't get to take any on myself since I have braces.  (I'm hoping the braces will be off at the end of November though!)

The Jackhammer

That's right I'm going to invent a new dental tool and it will be called The Jackhammer.  The Jackhammer will be a mini version of the real thing because while working on my morning patient on Tuesday I didn't know if some of those pieces of calculus would even come off.  Thankfully Dr. Hanson has more muscle than me and was able to crank the 2 pieces I couldn't get off off after a few minutes.  My morning patient was my mockboard patient last week and I'm happy to report that I did much better on her this time around than last week.  I really tried working on the tip that Pro. Alexander gave me and they worked.  I worked on adapting more and getting that last good twist in.  I also got to give my patient injections!  I was so excited and yet so nervous at the same time, but as soon as I got the needle in my patient's mouth it was pure excitement.  I can't wait for her to come back next Tuesday so I can give her more injections and so I can totally rock on cleaning her mouth (her last quad - finally!). 

My afternoon patient was perfect board potential.  As Dr. Hanson said in pod wrap, "it was mouthwatering" good.  However my patient doesn't know if he wants to wait until March to get the other half of his mouth cleaned, which I don't blame him.  March is a long ways away.  I told him I would call him in a few days to see what he decided.  I was a little overzealous though in doing 2 quads when he was a new patient.  Let's just say I missed a few too many areas, which hopefully won't happen again.  I think I need to see an easy 1B or class 5 to boost my spirits.  Ha ha.  Well, look forward to next week's post because I am seeing two class 3's next Tuesday. 

I have to add this into my blog so that I don't forget Marianne's wonderful comment during pod wrap.  Instructor Wold asked Marianne if she wanted to share what happened to her today.  Then Marianne said, "Which thing do you want me to share?  Because I have done so many stupid things that it's hard to keep them all straight."  I couldn't agree more with her comment.  I feel like I'm doing a good job and then all of a sudden I've done something dumb.  I guess that's why we get so much practice right?

Stacking

Just a quick few thoughts about instrumentation.  Let's start from worst and end with best.  That way when I'm done typing I will be thinking about what I do well at the end. 

Adaptation - most of the time I do a good job at this, but sometimes adaptation doesn't even seem to occur to me.

Recently I have discovered how wonderful it is to get a piece of calculus off by getting it from the facial and lingual side.  (Sometimes I wonder how I didn't ever try some of these amazing instrumenting techniques.)

One of my favorite things I have heard in the last few days was when Dr. Hanson told me I had a nice stack.  Wahoo!  I am actually keeping my fingers together.  I really struggled with that last semester.

I was pondering about how far I've come since last semester and I feel like I have grown in leaps and bounds.  In fact, I wonder why it ever seemed so hard before since it feels so natural now.

Oh, one more thing.  I was very ergonomic on Wednesday and even Pro. Alexander noticed.  (I still want to be able to put on my earrings when I'm old you know?)

The List

I'm going to copy how MeChel did her post the other day because it was direct and to the point by making a list of everything that happened (or should have happened) on Tuesday during clinic.

1) Class 3 = way hard (it's hard for me to feel accomplished when I only get one quad done for the appointment

2) I discovered a new love for my triple bend that I didn't really feel like was very useful before.  I now realize it didn't seem useful because I never had a real reason to use it until today.

3) When seeing a class 3 you may as well open every bag of instruments you have because you are going to need all of them at one time or another.

4) Making sure I can look at the x-rays while scaling really is wonderful and I'm not sure how I forgot to have the x-rays up while working occasionally last semester.

5) When you think you have adapted properly, adapt some more.

6) My afternoon patient was a class 5.  I thought the appointment was going wonderfully because I took x-rays (with no retakes), finished all 4 quads (with no errors), and had a decent discussion with my patient about OH.  Then Pro. Alexander came over and found a lesion in the palate that I had missed and suddenly everything else that had gone so well the whole appointment didn't matter any more because that lesion should have been what caught my eye and taken precedence over the entire cleaning.  Pro. Perry came over to take a look at it and we got out the intraoral camera to take pictures to show my patient what we were looking at.  Then I took a PA of the tooth that the lesion was above and the x-ray showed an abscess.  I showed my patient the x-ray and explained what the dark circle around the root of her tooth was to her.  I also stressed that she needed to see a dentist ASAP to get it taken care of.  I went home yesterday feeling defeated.  I hope that that lesson always stays with me and helps me to make sure I really do make a thorough investigation of each of my patient's mouths.  I want to be a great hygienist and I think yesterday was a very good lesson in how to be a great hygienist.  I really do want to help my patients and I have made a commitment within myself to slow down and really think about what I'm doing.  If my patients were asked to say one thing about me I hope that it will be that I care.

Injections

Wow, I need to remember to blog, especially because I feel like I know what I'm doing now so Clinic is more interesting and more exciting.  However, my post today is not about Clinic.  It's about local anesthesia.  So the last 2 Fridays we have given each other injections.  2 Fridays ago we gave and received 4 maxillary injections (PSA, MSA, Greater Palatine, and Nasopalatine).  Sam and I were partners and I have to say that I think we did a pretty good job.  I have to be honest I have never been a fan of needles and last semester I didn't know if I would have the courage to actually give an injection, but oddly enough I loved giving the injections.  I was excited for the next Friday to come so I could do it again. 
Well, a week passed and it was Friday again.  Last Friday we gave 3 mandibular injections (IA, long buccal, and mental).  I was amazed at how well the landmarks in the mouth help to find the correct injection site.  It was nice to have more confidence while giving the injections.  I thought it was kind of crazy how far in the needle goes to give an IA, but the more I think of the anatomy of the mandible the more sense it made.  One of the most important things I learned that day was if you want to make sure you're going to get numb you should have Sam give you your injection because I was numb for a good 3 hours.  Next week is nitrous, which I'm not too excited for, but the week after that we get to numb half a mouth.  Then we get to start numbing our patients.  Wahoo!

First Day Back

When I woke up this morning I was so nervous for today, but when I sat down and  picked up my instruments most of my skills came right back.  I actually had a great day.  Second year is wonderful and the instructors are awesome!  My first patient I saw was a 1B and I did x-rays and did half of her mouth.  I used my new instruments, which was a lot of fun.  I also got to use the ultrasonic on some mandibular anterior lingual calculus.  I forgot how fun it was to watch the calculus fly off.  I learned several nice ways to fulcrum from Instructor Would.  I felt like everything she said just clicked with me.  In case anyone who is reading this cares... my afternoon went even better.  I saw a Class 5 patient and was able to finished everything.  That's right, everything!  To top it off my patient was a lot of fun to talk with and made sure that it was stuck in my brain that I need to give her a call in January for her next cleaning.  Don't you love reliable patients? 
P.S. - Extra oral fulcruming is great.  I wish we learned more last semester.  So, all in all today was great.

Busy Busy Day

Today was very busy as my blog title says.  I was able to have my first patient walked out by 10, including doing my selective polish and sealant PE on her.  Her mouth  was so clean and I felt great getting everything done so quickly.  Then I did a sealant on Sarah (she was so nice to let me do it so that I could meet my requirement).  I have decided that I really enjoy doing sealants and I would like to do more of them.  I passed off all 3 of my sealant requirements this week too.  After morning clinic I came home, played with my cute dog, and then went back to the clinic to do a full mouth set of x-rays on one of my wonderful friends.  I did 16 PAs and 4 BWX on her and I didn't have to retake a single one!  I was dang proud of myself!  :)  It's been a great day.  Oh, and in case anyone was wondering I did get to take that pano on Monday, so my pano requirements are done.  :)

I'm not sure what to call this one

Today was supposed to be the day my wonderful class 3 patient came in, but she cancelled about an hour before clinic started.  No class 3 patient = no good.  So instead of screaming and running out of the building I decided to be more productive and figure out who else I could get to come in to make my day a productive one instead of a wasteful one.  My wonderful dad ended up coming in again and letting me do a sealant on him.  He was also generous enough to let me do 11 PA's on him since he has never had any PA's taken on him before (at least he never remembered ever having any done).  I have not been using the shick, so today I used it. 

STINKING GOOD NEWS!  I am hopefully going to take a pano for midtown if the patient shows up!  Yay!  I now have to go wait for her, so wish me luck!

Screenings

So, I went up to the clinic yesterday to do some screenings in hope of finding a class 3 patient.  My first patient who seemed promising didn't show up.  Then my grandma came in (she is one of the most awesome women I know) and I was able to take a pano on her, which was wonderful.  Then my last patient came in and there was some success there.  Kelsey and I were both very stressed about getting a class 3 patient because that's all we have left to do, but then I found a "possible Class 3" patient in the screening folder.  I asked Costley about it and she said that the lady is a class 3.  So, after getting the ok from the senior who screened her she became my pateint. Wahoo!  I called this person and she is suppposed to be coming in on Monday (after I volunteered to pay for half of her appointment).  Double wahoo!  In order to help Kelsey out I gave her one of the girls I screened. 

I have to say I love all of the girls in my class.  We all work together to help each other out, which I feel like it boosts team spirit and we're all able to accomplish more than we would if we were all only focused on ourselves.  Go class of 2012!

My Wonderful Parents

So on Monday my mom came in and I finished her up and on Wednesday my dad came in and I finished him up, along with doing 3 PE's.  I really don't remember if my Monday patient canceled or I just couldn't find someone, but I'm so glad that my mom was so willing to come in.  She is not a big fan of the dentist, but she was a great patient for me.  Everything went pretty smoothily too (except for waiting 25 minutes for my final scale check).  On Wednesday I cleaned 3 quads on my dad (I did the first quad at the end of January I believe) and I was so glad he was able to come in.  My patient canceled on me on Tuesday afternoon and after calling to find someone and having no success I called my dad and he came in for me.  He asked me if I was going to pass off any pe's on him and I told him I wanted to do at least 3.  He said, "Good.  Pass off as many as you can on me so you can get them done."  I love my dad, can you see why?  My parents are very encouraging and so willing to help me and I appreciate it so much.  Now you may be wondering, what pe's I passed off.  Well, let me tell you - I passed off my blood glucose, air powder polisher, and diagnodent pe's.  I chose to do those because #1 I needed to get them done and #2 I think those would be the hardest ones to convince some random patient to do if they didn't need it done.  I honestly would like to pass off pe's on patients who really need it, but who knows if I would get a patient in my chair that would need one of those three by the end of the semester. 

I can't believe I forgot to mention... my loupes came!  I love them, but I am having to adjust to using them.  I wore them for 20-30 minutes on Monday and Wednesday to start breaking them in.  I love being able to see those dang molars now.  I also feel really good about using my explorer to feel things.  I have been working really hard at feeling with my explorer and using my air to find and remove all of the calculus.  Practice is working it's way towards perfect.  :)

I was also CA Wednesday afternoon, which went really well I thought.  We several big things happen - unit 15 began leaking water, which Mr. Solomon cleaned up and as soon as he was done cleaning that up I walked into put instruments away and the autoclave was open and the fill switch was on and water was leaking out of that, so I turned it off and Mr. Solomon cleaned that up.  Then we had to move some of the storage stuff because of the leak in the ceiling.  I also got to help a lot of the girls with probing today.  It was nice being busy.

Congratulations to those who stuck it out to the end to read my blog.  It was a long one today.

Monday Make Up... Again

I always forget to blog on Mondays it seems like, but I couldn't skip what happened on Monday.  I was able to do 4 quads of a 1B in one appointment.  Hurray!  Seeing myself make progress is so encouraging.  I have been keeping myself organized and coming to clinic as best prepared as I can for what I'm going to do for the day.  I am also learning how to instrument better and more effectively (I think).  The funny story of the day award goes to Pro. Costley though.  I went to ask her if she would come do my scale check and she was standing in Karlie, Heather, and Tanya's pod and she was talking to Heather.  She meant to say she wanted to sit down, but accidentally added an h in the word.  We all had a good laugh about it, including Pro. Costley.  Ha ha ha.

Goal: Work on being faster and just as effective so I can keep on finishing patients in 1 day (1Bs and 5s).

Getting There

So, today I did x-rays and 3 quads on a 1B in one appointment (instructor Hafen was kind enough to help me finish up since my patient said she couldn't take off another day of work).  I was very proud of myself for this accomplishment until I read Marianne's blog and now feel awful.  I know I left around 11:50 and I really do feel awful that I was not aware enough of what was going on to help.  After a good kick in the pants I vow to make sure to help anyone who needs it before leaving clinic.   

I Saw the Calculus Fly

So, even though it's Wednesday I still want to blog about Monday because I had some cool experiences with my patient.  My patient was a Class II pt and had a bunch of calculus on his mandibular anterior linguals.  I used my orange tip for the ultrasonic to get it off and boy did it come off.  I really like the ultrasonic, but I haven't even really gotten to see a whole lot of calculus come off with it until today.  I feel like I learned how to better use my ultrasonic after today because I had a lot of calculus to get off.  I learned how to angle it better for certain areas, which helped me be more effective.  I am now a totally firm believer of using the ultrasonic.

Patient Swap

Have you ever seen the show Wife Swap?  Well, today Kristie and I did Patient Swap.  We had already started cleaning a couple's teeth.  I had previously done the husband and Kristie had previously done the wife.  Well, we each needed the other person's classification so we swapped patients today to help each other out.  I am so grateful I have such good friends who are willing to help me out.  Those of you who remember the lady who told Kristie, "I don't need some 20 something year old telling me how to brush my teeth," well, she was my patient today.  She definitely has a strong opinion about what is to be done, but a very nice lady.  I was able to finish her up today and have my first real experience with a patient who does not want to be given any education or pointers, did not want fluoride (because the insurance companies won't pay for it because fluoride doesn't work), and who told me she didn't like the blue boa or suction and that she would just rather swallow the water (and junk in it) while I used the ultrasonic.  Ha ha.  It was quite the day and I really did enjoy it.  Even though I was frustrated that she wouldn't listen to my sincere suggestions I still felt like it was a good experience at learning to let a patient choose what they think is best for themselves to be autonomous.  Since I finished her up early my wonderful mom came in and I passed off my Intraoral Camera PE on her.  I wanted to do that PE on her because of her mandibular tori to let her get a good look at them.  After I showed her the pictures she said that she isn't sure she wanted to see them because she thought they looked "so gross."  Ha ha.  I told her how they are considered "normal" because so many people have them and that they are not a big deal as long as they do not start growing again or if she needs dentures (which she is no where close to).  I'm pretty sure she is still not convinced. 

Goal:  Continue to work on being as productive as possible (like having my mom come in today after my other patient so I can be getting as much done as possible).

Early Out

Early out for my patient, not for me unfortunately.  My patient had to leave at 9:15 today.  I got through an OD and probably could have gotten through OHI if we hadn't chatted so much.  Ha ha.  I think that the only problem with having friends come in is that we love to talk.  My patient was super cooperative and fun to work on.  My goal is to finish her up when she comes back in a couple weeks.  My patient's gums were pretty sensitive in her maxillary arch.  I asked my patient how often she flossed and she said maybe 1 time a week.  I encouraged her to start trying to floss 4 times a week (or if she really wants to achieve a great goal floss every day) until I see her again to see if the flossing helps her gums feel any better.  I really hope my patient achieves her goal so that we can both be excited about her gums feeling better.  :)  It really is so rewarding to watch patients take charge and want to improve their oral health, which improves their total body health.  I would really like to get a 1B in my chair and see if I could do them in one appointment (in all honesty I am probably going to need a very easy 1B to do this).  I think I will jump for joy the day I do one patient in one appointment.  Since my patient left early I for sure got my chart in on time.  Ha ha.  It's also nice knowing that I am all cleaned up and ready to go, so now I can help others when they get done to return the many clean up favors done for me.  I am even getting my blogging done before going home.  Wahoo!  I am now just waiting for Stephanie so that I can pass off my instrument sharpening PE.  Wish me luck!

Goal for next time: Be organized in my steps and finish my patient.

I Finished My Patient!

My patient yesterday was a returning patient from a few weeks ago.  My patient was half Class II and half Class V and I scaled one quad at the last appointment.  I was able to take my first (and only) PA on my patient yesterady and I finished scaling the other three quads.  I felt so good being able to finish her and to have done it all on time.  I really like using the ultrasonic to start and then going back and fine scaling after.  I really enjoyed having my patient leave, knowing I did all that I could to help her have a clean mouth (including OHI), and seeing how pleased she was with the work that I had done.  When she left her appointment she thanked me, which made me feel great.  I feel like I had such good success today because I had everything arranged and set up that I thought that I might use.  I also reviewed my patient's chart before my patient came in to help me know what I would need to do to best help my patient (things like reviewing where her restorations were so I did not ultrasonic them).  The more I work on people the more confident I feel and the more determined I get to do a better job than I did the time before.  I am excited to keep getting to see new people and figure out the best treatment options for my future patients.

Goal: Continue to have anything I could possibly need out and ready to use.

P.S. - I think that the majority of everyone got done on time today because we got out pretty early.  It was awesome!  (I'm pretty sure we finished pod wrap between 4:10 and 4:15).

I Must Remember to Blog

Blogging seems to take the back burner all of the time and then I forget to do it.  Almost every day after Clinic I have to write blog on my palm pilot (the back of my hand) so that I remember to actually blog.  In fact, I only remembered to blog today because I just noticed the word blog on the back of my hand.  I am starting to like blogging more because I will be able to have all of these wonderful, and some days not so wonderful memories all typed up for myself to reflect and enjoy. 

Now for what you really want to hear about... my patient yesterday and my experiences with it.  My patient came in with his wife yesterday (who Kristie treated).  Kristie was actually the one to line things up with this couple, which I was very grateful for.  My patient was such a nice man and I really enjoyed working on him and talking with him.  Kristie had explained to them over the phone that they were more than likely going to need to come in for 2 appointments and they said that was fine.  I got done with one quad today and will be finishing my patient up at his next appointment.  Yesterday was such a good day.  I passed off a PE, had a good patient experience, and did I mention that I didn't have any spots to go back and redo?!  Oh, yesterday was also such a great day because Instructor Allen (that sounds too formal since we all called her Jeanie in Radiology) was there and she was in my pod!  I miss seeing her and having her be one of our instructors.  It was such a fun day with her there.  I got to use my orange ultrasonic tip yesterday on my patient.  I have decided that I really like it, especially the swivel tip.  I felt like I had a good sequence for cleaning yesterday too.  My last happy moment of the day is when Jeanie was talking to me after my patient left and she told me that I had good patient skills.  I felt so good after talking to her.  :)

My goal for last time was to explain to my patients and make sure they totally understand that I will most likely not finish them in one appointment, but Kristie kind of made sure that they already knew that so I can't take credit for accomplishing my goal quite yet and my patients for the next few weeks are returning patients, so hopefully at the end of February I will be able to accomplish my goal. 

My new goal is to continue to work on my cleaning sequencing so that I can get a familiar routine down to be as efficient and effective as possible. 

It Was a Day

Wow, where to begin for today.  Today was definitely a new learning experience, in a good way.  My patient wanted to be numb for his cleaning, so Instructor Vining numbed him up and I went to work.  However, within 10 minutes my patient wanted more anesthesia because he said it was wearing off.  After Vining numbed him again the same situation happened.  So, with the patient's permission we put him on some nitrous, which worked like a charm.  I was able to do a much better job without being nervous that I was going to zing the hypersensitive spots on his teeth.  Vining kept coming over to make sure I was doing ok, which I surprisingly enough was doing ok.  I really found today to be a good learning experience because at some point during school and/or in my career I will have patients like my patient today, so I say bring it on... just not until next year.  I also passed off my anterior instrumentation PE today and that went well. 

My goal for this next week, well really for the rest of the semester, is to really make sure my patients understand that I am a first year student and that I do not have all of the skills necessary to finish them in one appointment.  I want to be fair to my patients so they know what to expect.

P.S. - My patient today really was such a nice person.  He shook my hand after I walked him out, told me I did a good job, and to keep it up because I will do great.  Since he was so nice I think that's a big reason why I did not feel totally stressed about today.  I did end up passing my patient to a second year so that he can get the other half of his mouth done quicker and more efficiently.

P.S.

P.S. - For those who care to know, I passed off my Exploring PE and I did quite well on it.  After the pointers from Instructors Hemsley and Hafen I really have a good feel for exploring, but I know practice, practice, practice.

Not Bad for a Wednesday

Most Wednesdays do not go well for me, whether it's because I woke up 3 times in the middle of the night afraid I was going to be late, having nightmares about me being late (actually just nightmares about dental hygiene stuff in general), or the fact that I am so tired and slow in Clinic because I got up so early.  However, today went pretty good.  I was pleased with what I was able to do.  My patient was such a nice person, making today much more enjoyable.  I had everything I needed where it needed to be and ready to go, which helped me be more efficient today.  I hope I can keep that up.  My patient needed to have some topical anesthetic in order for me to probe and I used a plastic probe to try to keep my patient as comfortable as possible.  Having a patient need some anesthetic was a new experience for me.  I also tried to be super careful with my probe. 
Goals: I am still having a hard time seeing when I'm probing those darn back teeth, so I think a new goal for me to work on is learning how to get the best vision I can when probing those back teeth.  I am getting better with looking in my mirror, but not where I would like to be so that is something that I want to work on as well.  So my patient next Wednesday better look out because I plan on practicing. 

Well...

So, today did not go as smoothly as Monday unfortunately, which was frustrating for me.  I was only able to get one quad done today and this was my pt's second visit.  I had a hard time getting the calculus off.  The other time that I have scaled the calculus was easy to get to and popped right off.  Today that was not the case.  I felt frustrated that I was having such a hard time even though I know I am still learning the tricks of the trade and I haven't built up my hand muscles enough yet.  I also did not do as well on my PE as I would have liked.  Ok, let's be honest I failed my PE and have to redo it.  I failed 2 PE's last semester and both times I really did feel like a failure.  I thought that might change this semester, but I still felt like a failure today (feeling like a failure doesn't inspire much confidence in myself).  After this failed experience I am setting a new goal: before I decide to pass off a PE I will for sure make sure to check with an instructor to see if I am doing everything correctly and if I am not doing something correctly I will learn what I need to do to fix what I'm doing wrong.  Instructor Hemsley really did help me out after my pt left and helped teach me what I needed to do correctly.  She gave me a good tip and I really appreciated it.  I plan on practicing on my typodont this weeked.  Wow, with that off of my chest and out in the open for everyone to read I feel a whole lot better.  Maybe blogging isn't so bad.  Actually, it is kind of theraputic. Well, I had better get to studying for my other 2 tests this weekend.  Until Monday blogging friends.  :)

Monday's Pt

Oops!  I forgot to blog about my experience on Monday.  Normally I would just move on and make sure to keep up on my blogs, but I had a great day on Monday so I wanted to make sure that I blogged about it.  My pt on Monday was awesome.  I was able to do x-rays, get all the way through OHI, and scale one quad!  I was so excited!  Days like today make me feel like one day I really will be able to finish a pt in one appointment.  Not only was I able to get through one quad, but my pt was so interested in how to better take care of his mouth.  After I showed him calculus and how it forms in the mouth and how to prevent it he was asking me for more techniques and information than I gave him.  It was very rewarding for me to see my pt take such an interest in his oral hygiene.  Since he was so interested I really think that he will work to improve and meet the goals that we set.  I am excited to see him at his next appointment to see how things go.  I have also been wanting to improve on organizing my area and I felt like I really had everything organized and looking good.  My goal that I set for today was to try to do things as smoothly as I did today.

Pt No Show... Mom Saved the Day

So, on Wednesday around 8:10 Marianne and I went out to the waiting area to call our patients because they had not shown up yet.  I had called my patient the night before and she told me she was planning on coming and she actually sounded pretty excited about coming, so I figured she would be there.  Unfortunately my call in the morning only went to her voice mail, so I left her a friendly message asking if she was still planning on coming and if she couldn't make it we could reschedule her.  She didn't call back, so I decided that I had better find someone and get them into my chair.  (Since the start of the semester I have dreaded people not showing up because I thought I would be a complete wreck if that happened, but somehow I was able to remain calm.)  Stephanie was extra nice at trying to help me find someone from the resource list, but after calling several people I figured I was wasting too much time, so I called my mom and asked if she would come in for me and she said yes.  My mom immediately left her house and saved the day for me.  She got to the clinic and was in my chair by 9:10.  I somehow managed to get all the way through OHI still.  I was really excited about that!  :)  I really love and appreciate my mom for coming in.  She was the hero of the day.  Since I was able to get all the way through OHI even though I got started an hour late I decided that one day I really will be able to finish a patient in one appointment.  I can't wait for that day to come!  I'm not sure if you can count this as a goal or not, but my goal for Monday is making sure my patient really grasps the importance of actually showing up or at least being kind enough to call and give me a heads up that he can't come, so I can find someone else.

Retakes...

Today went well over all except I had to do retakes on a few of my x-rays.  My patient had a couple molars that were malposed that I couldn't get open until Instructor Hafen showed me her floss trick.  For those of you who would like to use the floss trick here is what you do, while your patient is in the chair and you are checking out their mouth you stick a piece of floss in between the malposed teeth and then remember the angle that the floss was at so you can align the tubehead to go the direction that the floss stuck out.  I hope that made sense and if it didn't then feel free to come talk to me and I will work to better explain it in person.  I was really hoping today that I would be able to at least scale one quad, but the malposed teeth set me back a little.  I am hoping that as long as my patient next Wednesday (not Monday since it's Martin Luther King day and we don't have school- Yay!) is a 1B that I will be able to get to one quad of scaling on her.  I will be working on organizing myself and mentally preparing myself to be able to achieve my goal for the rest of the week.  I have to say that I am amazed at all of the tricks that the instructors have learned since they have worked in private practice.  I really enjoy learning these tricks so I can use them and be able to give the patient the best care that I can.

Actually Calm and had Fun

Today was a great day.  I actually felt calm before my patient arrived and during the whole appointment.  I felt so good knowing that I was calm.  I finished up scaling my husband's mouth today and I loved knowing that I got his mouth clean and as free of bacteria as possible.  It was also fun seeing his progress since the last time I was here.  I only had 2 spots of calculus that I missed and I was really proud of myself for that.  I am still learning at how to see and feel for calculus, but I feel like the more practice I get at it the easier it will be to detect.  I can tell that the interproximal areas are the areas that I need to work on detecting the most.  I also noticed that as I looked through his mouth again I am beginning to be able to notice different restorations faster and more accurately.  I was also able to get everything done on time - a definite improvement from last Wednesday.  :)  I am excited for my patient on Wednesday even more now!

Deja Vu

Wow, I can't believe we're already back in school.  Christmas break felt like an extended weekend almost, but it is good to be back.  I have to be honest I was pretty nervous about seeing a patient today, even though it was my wonderful dad, since we had been gone for a month.  However, the appointment went a lot smoother than I thought it would.  I was also less stressed than I thought I would be (I would like to think I was less stressed because I went over everything I would be doing for forever last night.)  One goal that I have made for myself is to become better at getting the correct angle everytime and faster at probing.  I was actually quite pleased with how well probing went today.  I was within 1 mm of Instructor Caldwell's measurements and was really excited about that.  Stephanie helped me make sure I did my angles correctly as well, which made me feel good.  After I disclosed my dad's mouth during OHI I had him spit into the suction and he couldn't stop laughing.  He said that it looked so funny to him since he could see himself spitting in the mirror.  Then I couldn't help but laugh too.  He was such a good patient.  :)  I am feeling a lot more confident about seeing people that I don't know now.  I was very impressed with those who had people that they didn't know in their chairs today.  So, overall today was a good day and I'm excited to keep working on people!