Thursday, June 18, 2009


So far, I have been pretty lucky with patient’s actually showing up on time for appointments. Most of them have been making all payments as well, so yea – good fortune. I have had a few patients’ cancel their appointments but they have always done so at least a day in advance. True it isn’t always enough time for me to fill the spot, but at least I have a chance.

So today, of all days I had my first patient failure. This equates to the patient not showing up, not calling, and you simply can’t get a hold of them to find out why. I was going to do one of my performance exams on this patient so I am justifiably pissed. Not only did I waste my afternoon (which costs about 150 in tuition), but I have to find a new patient to do the PE on. School policy is that I can dismiss this patient because she failed the initial exam (normally we have a 2-strike policy after they have been coming for awhile).

I am at a crossroads. This patient cancelled the previous initial exam last week but called the day before. She also made her own FMX appointment and got the x-rays taken without me having to do anything. So I don’t quite understand how to take the situation.
If she doesn’t call back by tomorrow, I will most likely dismiss her as a patient. Just sucks that I was all ready to get some requirements out of the way and now am back at square one. On the plus side, I have scheduled a transfer patient for an appointment who is a veritable gold mine of directs and crowns. So I will finally get some consistent operative experience.

Funny side note:

We are required to call our pedo patients the day prior to our rotations. I have pedo on Friday..hence calling on Thursday. We don’t have to actually schedule them, we just verify that the scheduled patient still plans on coming. Well, it seems that 2 out of every three kids I get does not speak English. I don’t speak Spanish. So when I call and mom answers with: bueno, I naturally get a bit off guard. I totally half-assed my way through, and she seemed to understand. Needless to say, my classmates around the phone area were laughing their asses off. Get your jollies now people, it will happen to you to.

Tuesday, June 16, 2009

Cutting REAL teeth

Today was my first foray into the operative component of dentistry. It was definitely a nice change of pace from the constant stream of perio problems, dentures, and RPDs. It was the perfect starter for any newbie like myself – a very conservative prep on the distal of the left second premolar. I didn’t even need to provide anesthetic. I rarely used round burs on the plastic teeth, but that was all I used this afternoon to make a nice little slot in the side of the tooth. Got my instructor to check, and he said “looks good.” Sweet. The hard part was placing the composite. You really don’t understand what working in a wet mouth is like when you practice this stuff on plastic teeth. Composite resin requires a DRY field to work in. Placing a rubber dam is not always practical (especially when the patient lacks any posterior teeth to clamp). So I just loaded her up with gauze and the suction tip.

The placement went ‘ok.’ I had a bit of excess that I didn’t notice until after I cured everything, but my instructor showed me a few good tips on how to really take advantage of the finishing burs. I finally had her bite down on some articulating paper to check if the restoration was too high. I hear this horrible crunching sound. SHIT! Thankfully she only fractured a tiny bit of the marginal ridge off, which was the high part anyways. I just smoothed it off, checked occlusion again and sent her on her merry way.


Sunday, June 14, 2009


Ok, here is my first post in a bit. I really haven’t had any reason not to post, outside of rediscovering what having a life is all about. I actually have time to do stuff…it is a crazy feeling.

That’s not to say that things can’t get stressful. In fact, I would say that school itself IS more stressful in the clinics, but you get used to it, and then you go home and drink a beer or scotch. I mean let’s consider: on the one hand, you are sitting in a lecture hall fighting to stay awake while you learn about kidney stones or something. Yea, not stressful. On the other other hand, you are running around the clinics like a chicken with its head chopped off trying to find the vitrebond, or locate a professor to help you use the facebow or do something else you vaguely remember being taught in a half-assed fashion eons ago. Yea, stressful.

In fairness though, things would be much smoother if all the damn construction wasn’t conveniently scheduled for my entrance into the clinics – again, something that would have been nice to know during interviews..cough cough. Would I have gone somewhere else? Probably not, but it still sucks.

So clinic craziness aside, things are still great. You learn a billion things a day and you feel the experience growing with each and every patient encounter. I no longer am timid when rooting around someone’s mouth. I am slowly improving my operator positioning as I learn how much easier it is when you can have the patient move their head to one side or the other (the mannequin head lacked this quality).

My major complaint as of now is that I STILL have not cut a tooth yet…seriously. I have classmates that have done tons of direct restorations, crowns, ect. I have been doing initial exams and dentures all day every day so far. All my initial patients seem to have zero caries and tons of perio issues which will require either more dentures or RPDs. However, good things are on the rise. A recent transfer patient needs about twelve, count em’, TWELVE directs. Not the crappy class V’s either. I’m talking class I’s, II’s, and III’s. The stuff we get tested on for boards. Hopefully he returns my friendly phone call for an appointment. Keeping my fingers crossed on that one.

OK, time for the gist of this post. How hard would it be to sit us down during one of our ‘comp care’ lectures and outline exactly WHAT we are expected to accomplish/turn in this semester? This course is run by so many different people that clearly don’t communicate with one another and it is impossible to get a straight answer. We have FOUR performance exams that MUST be completed before this quick 12 week semester ends. Yes they aren't part of the comp care course, but we also have no lectures for these when else are we supposed to find out? Two of these are for perio and two for restorative. Yes you can find all this information if you dig around on blackboard or ask an upperclassmen. But why can’t there be one big sheet of paper they hand out during one of numerous lectures that says: “THIS IS WHAT YOU HAVE TO DO BEFORE FALL.”
There is some random endo exam we must take in July also. What should we study? Who knows.

Ahhh but complaining feels stupid when I am still in such a good place. Yea I spent 6 hours at school this weekend doing assorted lab work and filling up my scheduler. But I even impressed myself at how easy making record bases and wax rims was this time around (first time in 6 months..must be like riding a bike). I can only pray that this technical carry-over applies to operative procedures as well.

I was going to whine more, but I see no point. This is how dental school goes, just suck it up and learn as much as you can. There are plenty of great teachers and opportunities to really develop. These last two years are what count the most towards getting off on the right foot in the real world. Real-time job training.