Wednesday, February 10, 2010

He's A Bleeder

Well since I'm not really doing much dentisty this week I have time to reflect on a pretty cool OS experience. Why am I not doing dentistry? It is mock boards this week. That means I am forced to assist the D-4 students taking the mock boards. This entails assisting from 8am until 5pm with no lunch break for three days. Now luckily I was an examiner assistant one day so that at least allowed me to walk around and wrap about 50 chairs.

What have I learned? Assisting is HARD. It kills the back, you are getting ordered around constantly, and worst of all - it is the most boring job I have ever performed. Maybe it's because we are assisting students. Maybe it's because our chair set-up is NOT condusive to having an assistant.. maybe I just am bored of not seeing what I am suctioning, or maybe even more appalled that I would even care to see what I am suctioning because I don't enjoy suctioning in the first place. At least it served as a chilling foreshadow of things to look forward to next year.

But back to the topic at hand. I got a new patient early this semester with about 14 remaining teeth floating in the most gross batch of perio disease I have ever seen. Basically an immediate denture will not be possible so we are doing full mouth extraction, possible gingivectomy, followed by F/F. This guy is a doo-wop singer so he clearly needs teeth for all that smiling. Unfortunately this process is likely to take some time. I have finished a few arches of dentures (although not for awhile), but the main issue I am foreseeing is whether or not his soft tissue will heal up well enough after the extractions.

That will be a future though. So at this point, I am capable of doing most any extraction outside of impacted thirds. This is a huge perk here at UIC. You do a TON of OS. We get 8 weeks of rotation througout the third year and the faculty here let you do a LOT. As in, surgical extractions/biopsies/tori removal. Laying flaps and suturing is actually pretty damn easy if you have instructors that will let you do it enough to get proficient.

Now this gentleman has 14 teeth I need to get out. I have three left after three appointments. Two were horribly ankylosed which really took up a lot of time, but the other major issue I've had is blood. The most blood I have ever seen. I took three teeth out in about 3 minutes that were not really in bone anymore, but the gingiva was so diseased and inflammed that he literally started dumping blood out by the buckets. I was packing surgicel/gel foam, jamming gauze in, suctioning..and thinking I was going to kill someone the entire time.

The first time this happened I got an instructor to help me out. He showed me a few tips to really packing the gauze as well as getting those first few sutures in during the worst of the bleeding. Last time I did it all solo without any complications.

This was just an awesome experience overall. It helped me learn to manage a somewhat abnormal scenario. It also is pretty satisfying doing these extractions myself and not having to refer him to the 3 month waiting list in PG OS.

He comes in tomorrow to finish the last three, then I will wait about 2 weeks to assess the healing..and maybe take initial impressions for dentures.

ooo boy.

And yes, I remember I was supposed to keep a really accurate log of my first F/F last summer...but I mean, are you really surprised. You can file that in my 'failed mini-series category' along with the vocabulary building and teaching my cat how to use the toilet and anything else I may have forogotten about that is now buried in the 100 some posts I have amassed over the years.

Tomorrow I might actually get to start my second RCT....keeping my fingers crossed on that one!