What a great day!

I had my fabulous patient come back into to finish her up today.  I used my ultrasonic scaler to doing the scaling today and loved it!!!  I will continue to use that on patients because of how quickly it took care of any calculus.  I only missed one spot, which I felt was great & I passed off two PEs.  Today was a really good day.  I actually got her done within a quick amount of time.  She was out of here by 9:20.  I was very pleased with that.  I have my mom coming in on Monday and am very excited to have her come.  My goal for Monday is to be able to get her scaling at least started.  I don't have to take x-rays, so I will hopefully be able to get lots done.  I know that she would appreciate it if I got her done in one appointment.  My goal is to do freaking awesome!!!  (and not forget some things, like I have done on every other patient I have seen.)

My Little Man

I had the privilege of working my sweet little boy today.  I have to say that he did better than I expected for being 3 and a 1/2 years old and he had to be there for over 3 hours.  That is a long time for little guys.  Heck!  It's a long time for me.  So, I was supposed to have another patient, but she told me the morning of that she was going to be late and that she needed to leave an hour and 40 minutes early.  So, I told her I needed a patient that could be there the whole time and cancelled the appointment.  My little guy was willing to take her place.  I was able to take x-rays, scale, toothbrush polish, floss, and apply fluoride.  It was a great experience having a young child come in.  He did keep asking when we could go home, but that was to be expected.  I feel that this helped me better understand about scheduling children into my schedule.  I will make sure that I have children come in on my short day until I am faster at cleanings and I will schedule more than one child her clinic day.  Prof. Costley said we should be able to get two children done in one clinic day by the middle of February.  I can't wait to do that.  I can't wait to start getting better at this and feeling more confident with my skills.  Goal: don't knock off any more composite fillings from my wonderful patient who is coming back in to see me tomorrow.  Thank heaven she seems to have forgiven me.

Only Mishap

I am really hoping that last Wednesday was my only mishap that I will have on a patient.  At least to that extent.  I had my pt come back to start scaling her teeth last week.  I was doing pretty well and had completed one quadrant.  I had gone back over some teeth to make sure that I hadn't missed any calculus.  I didn't feel like I was applying very much lateral pressure, more of an exploratory stroke, yet as I moved toward the incisal edge from the gingival margin, a chunk of composite filling came off!!!  I audibly gasped and terrified began trying to find where it went in my pt's mouth.  I couldn't believe it!  My instructor was right there with me and got into my pt's mouth and felt the area.  The reason it came off so easily is do to some decay.  So, really it could have happened to anyone!  But it happened to me.  I feel so bad.  My goal for next time is to not make fillings come out of my patients teeth!  I think that is a pretty good goal.

First Full Mouth

A full mouth set of x-rays takes forever to take.  I realized how important it is to look at the bite tabs for placing the tube of the x-ray machine.  It is also important to talk to your instructor and clarify which x-rays need to be retaken.  I thought I needed to retake 5 and did just that, but my instructor only wanted me to retake 3.  Oops!  I will clarify that one next time.  That would have saved me some time.  Also, if I had been looking at the bite tabs I would have noticed that I was going to cone cut the x-rays.  I am so grateful for patient patients that are willing to sit in an x-ray room for about 45 minutes while I get things ready, take the x-rays, have them checked by an instructor, and then retake them.  My wonderful friend Rock helped me out on Wednesday.  He was once in this position and understands what students go through while learning.  Thank heavens for people like him.  I can't wait to get him finished up next month.  I am going to work on being more efficient for me next patient.  I am going to be very specific about how I set things up before my patient gets there and try to stick to my schedule.  I know that I am going to have some learning to do since my patient on Wednesday is a Class II.  I will have to learn how to use my Gracey's and scale subgingivally without seeing what I am doing.  I will be going strictly off of feel.  Wish me luck!

Thanks Darling!

My dear, sweet hubby came in today for me to finish scaling and polishing his teeth.  He was wonderful and patient with me.  I know that his jaw was getting sore and that he was just plain bored, but he stuck with me and let me complete his scaling.  I am just so glad that I was able to get everything finished and that I didn't have to reschedule him for yet ANOTHER day.  I think he was glad too.

He came in and I greeted him with a smile and a hug.  I started with HHx- no changes since____.  HHxRx- no alterations to Tx.  Sign and get instructor signature.  Check- everything going well.  OD- lesion still present, refer to DDS.  OHI- PFI: 75%, big improvement over the last visit.  Way to go, babe!  Next came scaling.  I completed one quadrant and had it checked by my instructor.  I missed a couple of areas.  Rescale and have it checked again.  Fine, so move on to the rest of the mouth.  I was really amazed at how hard it is to get calculus off of teeth.  I felt like I was scraping and scraping and scraping on just one surface to get it off and it still felt rough.  I just need to apply more lateral pressure and use the right instrument.  After scaling for an hour and a half, I was finished and ready for a scale check.  Trev was pretty tired of my hands in his mouth at this point.  He really needed to get back to work as well.  Once again, I missed a few teeth.  I was able to get the calculus off of one area really well, without any help.  The other two spots I needed some extra advice on how to get it.  I realize that I need to utilize my air/water syringe to dry the teeth to check for calculus.  That was really helpful.  I toothbrush polished my hubby, applied varnish and got him the heck out of there.  I did forget to write "complete" on the patient walk-out form.  I can fix that one quickly.  Trev is such a wonderful man!  Only a man truly in love would let his wife stick her hands in his mouth for 2 and a 1/2 hours poking his gums.

My goals for my next patient are to continue to solidify certain concepts in my head.  I need to make sure that I truly get the order of how I chart things.  What order to perform certain tasks, making sure to get the correct signatures.  My goal is it get at least OHI and one quadrant done of scaling.  I am setting my sight high on my short day, but I hope that I can do it.  I may not be able to if I take a full mouth set of x-rays.  I will see if I can talk Rock into it!

Patient Numero Uno

It is a new semester, and I feel totally unprepared.  I feel like having the last month off has turned my brain to mush!!!  I can't believe how many things I forgot over the break.  I hope that I get back into the swing of things quickly, or I will be SUNK!

I had my first patient experience last Wednesday.  I hadn't met her until that day.  It was a little rough.  I thought I was being super efficient by get the name and mg of all of her prescriptions the night before.  I looked them all up and had it typed out, line by line, of how it should look in the chart.  I get the chart to my instructor and I had forgotten to write down where I got the information from.  First thing forgotten.  Next, I took a couple of x-rays.  I love our new system for keeping track of things.  We don't have to fill out a paper any more to get our x-rays taken.  The front desk people just take our word for it.  I got her x-rays taken and all is well.  I moved on to probing and recording all of the work she had previously had done.  My instructor comes over to do the OD (oral diagnosis) check, and I had measured many 4-5 mm pockets and she was getting a lot of 6 mm pocket depths.  (Must work on getting accurate probe readings!)  We don't have much time for scaling at this point, so I  start on oral hygiene instruction with my patient.  I dye her mouth and record her PFI and BFI scores.  But guess what?  I forgot to record them on the green and blue sheets.  I only wrote it in the chart.  After I excuse my patient and start to fill out the chart, I realize that I forgot to get a signature from my instructor that the x-rays were ok to release to my patient and have my patient sign saying that I gave her the x-rays.  What a day of forgetting!

I learned a lot from that day.  I came home a made a list of all of the things that were very easy for me to forget.  I need to type it up and laminate it so that I can prevent these mistakes in the future.

My goal for my next patient is to simply try not to forget anything.  I will write about that next.