Requirements...

Are coming easier than I expected.  I am so grateful for this fact.  I thought that getting all of my requirements was going to be an absolute pain in the you know what!  So far I have been really lucky.  Despite having patients cancel the night before and one not show up, I have had a patient in my chair every morning and afternoon for the first 6 weeks.  I am up to 4 quadrants of a 1A, 6 of a 1B, 26- class II, 11 class III/IV, 6 sets of bitewing x-rays, 33 PAs, and 9 root debridements.  Most of my fellow students have met the 1B requirements, but I am not worried about getting 6 more quads during the last 9 weeks of the semester.  My 7 year old still needs to make it in for a cleaning. He will count as 4 quads of a 1A.  The VA has been a great place to get requirements as well.  Dr. Hanson has been great about helping me pass of PEs.  She is usually the one to suggest ones that I can pass off because she was watched me complete them through out the appointments.  She is also so complimentary on my skills.  She makes me feel so competent and like I actually know what I am doing.  Thanks Dr. Hanson!  You ROCK!

Some Good Experience

Last week I made a valiant attempt at seeing two patients in the morning.  One was my wonderful husband who needed a cleaning desperately and the other was my patient needing to get an a transplant list.  I got Trevor in and out of there within an hour and 20 minutes.  Feeling good!  My next patient shows up and still all is going well.  By 10:30 I was getting close to being done with him.  I called him a class III because of everything going on in his mouth.  Had my scale check.  All was well.  Polished, flossed, and added fluoride.  He was on his way to getting on the transplant list.  One unfortunate thing did happen during the appointment.  The amazing thing is that this very thing happened with a patient in the spring.  A composite filling came out of an anterior tooth!!!  I couldn't believe that this very thing would happen twice to me.

My afternoon patient was supposed to be a young woman.  When I called to confirm the appointment the night before, she told me she was expecting Medicaid to pay for this visit.  I had to inform her that we do not take medicaid and that she would be responsible for the visit.  She made it sound very bleak that she wouldn't be able to come up with the money.  I called my dad in a panic and informed him of the situation.  It is a little hard for him to take off on such short notice, but he was able to make it work for me.  I was able to get his cleaning down relatively quickly and then we did some laser therapy on one area.  I hope that it helps to rehabilitate his tissues and close up a pocket.  We will see him back in 2 weeks for a tissue evaluation and to laser the area again.

A Good VA Experience

I have to say that today went very well.  I saw a class V patient in the morning.  I took and pano and 4 bitewings on him as well.  He does an amazing job at keeping his teeth clean, so it really was very easy.

My patient in the afternoon was a little trickier.  First of all, he was hard of hearing.  I felt like I was shouting at him every time I said something.  Next, he couldn't be laid back very far.  I had to do a lot of the scaling standing up.  My back was already hurting me from the moment I woke up, so scaling unsupported was a little hard on me.  But I made it through.  His lower anterior teeth were horribly malpositioned and I didn't feel like I could adapt my instruments very well.  Next, I didn't probe because it had been done 2 months previously.  But there was one pocket that was a lot deeper than the person had recorded.  Unfortunately, I should have caught that by virtue of scaling down into the pocket.  Prof. M was really nice about helping me get to these areas.  We were able to clean off the stain for coffee.  This gentleman even said that it is enough to make him want to quit drinking it.  We'll see!

Staying on the Positive Side

I had a really strange feeling on Friday night after speaking with my afternoon patient.  I just had this little thought in the back of my mind that she was going to no show.  Well, sure enough, she no showed.  But let me start at the beginning of the day.

MeChel was so sweet and let me have her second patient for the a.m.  My patient had cancelled the week before and MeChel knew of my predicament.  Thank heavens for helping friends who are willing to share.  So, I saw the most wonderful, accommodating patient.  I took bitewings and 4 PAs!  She was a class V, but had furcations as well.  I got her completely done and out the door by around 10:40.  I was feeling pretty good about myself.  I didn't even miss any spots!  Woo Hoo!

I had promised my 4 year old that I would clean his teeth that morning and then we would have lunch together.  Well, I was short on time, so I wasn't able to squeeze that in.  I called preschool to make sure that he wasn't sad since I had told him that was what I was going to do.  They said he was doing fine.  Lunch comes and goes.  I let some friends have the things I had brought for my son.  Right before patients are supposed to be there for the afternoon, I get a phone call from preschool saying that Zach is feeling bad because I was supposed to pick him up.  Broke my heart!!!  I talked to him to see if that would help him feel better.  Well, next thing I know, my patient no shows.  Emergency back up?  You guessed it!  Zach Morris.  No, not the guy from Saved By The Bell.  My son.  

When I picked up Zach and as we were heading into my building, he remembered that I had brought him chips to go with this lunch.  When I told him that gave the chips away, he started to whimper.  Mr. Soloman was right there to pick up the pieces.  He promised Zach that "if he would let his mom clean his teeth that he would buy him some chips."  Thanks Mr. Soloman!  That was so awesome of you to do for him.  So, we went back to my unit and cleaned his teeth.  He lost two teeth over the summer, so I took an occlusal film to check where those permanent teeth are.  They're there.  After all of that, he got his Doritos.  I called my sweet hubby to see if he could come in for some x-rays as well.  The stud came up and let me take 18 x-rays.  What a trooper!  

Overall, it was a productive day.  I took 2 sets of bitewings and 19 PAs.  I can't complain about that.  Let's hope for no more no shows.  It sucks!

Not a Very Good Day

I have to admit that today was a little rough.  First of all, my AM patient was pretty foul and kept telling dirty jokes and swearing a lot.  Honestly, the guy wouldn't shut up!  I kept thinking to myself, "just be patient with him."  But deep inside I wanted to tell him to SHUT UP!  I felt like things went ok on him.  I probably could have utilized my time a little better on him (I would have finished more if he hadn't been talking so much).  I only finished two quads of a class 2.  He did have some areas that were tenacious, so they were hard to remove.  I got all but one spot, so I was pleased.

Next, my PM patient was a nightmare.  The poor guy is needing a cleaning to get on the liver transplant list.  Because of his liver failure, I needed to get a Physician's Consult to find out about premedication.  Well, I got a hold of his dr.'s office and they gave me the fax number.  I told them the patient was in my chair, waiting for treatment.  I thought that would have sped things up, but oh no!  They were taking their sweet time.  As a matter of fact, they never got it faxed back to me.  While we waited, I charted existing dental problems in his mouth, but I couldn't do anything subgingivally.  I did get a Scan-X pano taken on him though.  So, 1 pano down and 5 to go.  I had to reschedule this patient for next week, so that we can hopefully complete the cleaning so that when he meets with his doctor next Friday, he can be put on the transplant list.  The whites of his eyes were completely yellow and so was the gingiva of his mouth.  I had no idea that liver failure could cause yellow gingiva.  Now I know.  Here's hoping to a better week next week.

First VA Experience

I had my first experience at the VA all day today.  I didn't sleep well last night.  I think I got a total of 3 hours of sleep.  So, on top of having a boring morning, I as exhausted and ready to go to sleep any minute.  Each of us five students got our patient names.  I was assigned a woman.  What made me nervous was that there was no answer on this woman's phone the day before to confirm the appointment.  I was hoping she would show up.  I was going to be able to take a pano and 4 BWX, do full perio & dental charting.  But I wasn't going to be that lucky.  I was fortunate though, because 30 minutes after my first patient no showed, a very nice gentleman came in for a cleaning.  I was able to take 4 BWX on him and for not having taken x-rays all summer long they looked pretty darn good.  We also have to take them with Schick.  One set of bitewings down and 19 to go.  I completed his perio and dental charting and cleaned one quadrant as well.  I was very pleased because he is a class III.  I did pretty well.  I missed one spot, which was very obvious.  For some reason the area looked like an amalgam filling to me.  I was really mad at myself for missing it, but overall I was very pleased that I was able to complete as much on this patient as I did.  Overall I felt that it was a very good day.  Oh, one thing I will never forget...I forgot to fill my ultrasonic attachment with water before I put the insert in.  I bled it for one minute, but forgot to fill it before putting in the insert and the instrument got really hot because the water wasn't in there.  I didn't realize this was the problem until Prof. McCaunaghy asked if I had done that.  Oops!