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.