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?)