January Schmanuary

I haven't been posting as much as ye olde days. Several reasons: It's freaking cold - my fingers get locked up and cold, typing sucks. I also find myself somewhat bitter as a student currently and really don't want to turn this blog into one giant bitch fest, which it already borderline is. Lastly, I just have been lazy with no real excuse.

The third year is going by faster than I would like. Yea I want to graduate, but the stresses of fourth year just don't seem appealing at all after the proverbial xanadu of third year. Yea things still get stressful, but it comes in waves - where as the first two years felt like a constant barrage of studying power point presentations over and over throughout the semester.

The main problem now seems to be economic. The state is not supporting the college much at all it seems and we are losing faculty this coming August. Faculty is the last thing you should be cutting from this education I am paying out the nose for. There just seems to be too much going on for my liking. I just want to get out of here before the school completely implodes. And in all honesty, this is a state school, so I don't see it closing, but you can't help but get a little paranoid with the current state this country is in.

School-wise is going pretty well. I still lack sufficient endo experience, but one of my classmates has generously sent a patient my way that needs two RCTs. Otherwise I am still pretty happy with my slate of experiences. I am getting tired of all these forced in-house rotations though. How many weeks of radiology are really necessary? We have something like 5 during the third year. Overkill.

The month of february: With rotations, mock boards, clinic and research day, and the mid-winter meeting. I have a grand total of 5 (count em') five appointment blocks to actually schedule my own patients. Once fourth year hits, I will be doing at least 60 days of off-site rotations. It is simply getting tough to see patients. And they aren't too thrilled about it either.

Example of this up-coming week. I'm doing a class II performance exam tomorrow morning, then I'm in OS in the afternoon. Tuesday I have screening (which equates to getting a new patient which I have no openings to schedule for) in the morning and OS in the afternoon. Wednesday the clinics are closed for clinic/research day. Thursday I have a patient coming in with 'a toothache.' and in the afternoon..you guessed it, OS. Friday the clinics are closed for the OSCE examination. What is the OSCE exam you ask? I have no freaking idea. They give us zero imformation, tell us to show up with headphones and two number 2 pencils. We are allowed to bring 'any books' we want, just no personal notes. Seriously? Do you want me to lug like 10 different text books to the school? At least I get a free afternoon out of it.

I'm still improving as a dentist. Still slow as shit, but in reality, I realize that is only partly my inexperience. A lot more of it is just doing stuff no practicing dentist has to do. For example, trying to prepare a lingually tipped #31 for a PFM on a patient with a super-active tongue without an assistant. Not possible by the way although I wasted 40 minutes trying until I actually got an assitant to help - I was able to finish in 15 minutes.

I'm just growing tired of the grind that is 'higher' eduaction. There really isn't anything 'higher' about it. The only thing higher I guess is my age and total years spent learning without actually making any sort of income.

I have become a rather lazy student in terms of book work. We have lots of portfolios and presentations this semester along with a bunch of random BS assignments that seem pretty much mandatory at this point. Where I used to churn these things out..I find myself forgetting about them until the week/day before and scrambling to crank them out. I still get the same grade, so it doesn't seem to make any difference how it gets done.

A turn I don't like is the obsession some of my classmates have on 'production' which is the dollar value you have made in terms of procedures completed. Apparently we are graded on this to some degree although the extent I am not sure. But when all some of these people can utter is "oh man, I made 2 k this week." I just get bored real fast and it ends up making me self-aware of my own production and whether or not I'm getting enough done.

To quote my favorite histo teacher from D-1 year. "Who cares."

But gloom and doom aside, I am satisfied with how things are turning out. I have decided to apply to Chicago based GPRs this coming summer. If I don't get into one (or if I don't like the options I end up getting) I will simply become an associate and start chipping away at the massive load of debt.

And now february begins!

PS. I treated this post much like one of those random assignments. Just had to get one in before January 2010 vanished.

Still do check my email from time to time, and I do reply to pretty much anyone that isn't trying to sell me something so ask away!

DONE!

The D-3 Experience III

A few days into another nice two week vacation and I unfortunately find my thoughts drifting towards school. While grades have become less important to me, I still have the competitive spirit as well as a personal desire to do well. My last two semesters were frustrating beyond words in terms of final grading. I was borderline in TONS of classes and ended up on the wrong end in pretty much every class. The culmination of those being my restorative clinic grade over the summer (89.7).

This last fall semester was probably my favorite of all dental school thus far. It would have won the honor hands down was it not for a host of TERRIBLE, and I repeat, TERRIBLE lecture classes. I can count on one hand how many valuable lectures we actually received. It was mostly PhD and researchers lecturing us with statistics and numbers. The part that frustrates me is that we would have the same lecture in a different class by a different person and the numbers would be different. I was involved in research in undergrad and my summer prior to school – it is definitely an imperfect system with so many problems that I don’t put much stock in new progress unless there are a TON of papers supporting any given theory/thesis.

But I digress, the other minor gripe I have is that yet again I find myself on the precipice of getting an ‘A’ in all of my classes, yet seem to be getting screwed in a few big ones. Granted, the final grade isn’t up, but my comp care IIIb percentage sits at 91.8 or something like that and of course, this is the one class where you need a 92…sigh. I know there has to be a cutoff at some point, but jeez, help a brother out.

However, in completely opposite fashion, I have cause to actually celebrate. My faculty evaluation this semester went up (albeit a small amount, but up nonetheless) and I consider that the most important grade of all – your own evaluation. I felt as though I had improved dramatically this semester. Not simply in terms of number of procedures – but in comfort level, patient interaction, plain and simple confidence. I have worked with the entire faculty in our clinic at this point (some a lot more than others) but I have gotten positive feedback from each and every one at some point. While my grade didn’t dramatically elevate, it still went up though – indicating that the faculty see improvement as well. Positive reinforcement is always nice.

The point is not about the letter or the percent (unless you find yourself failing or gunning I suppose), but about how you feel about your own dental skills. If you had asked me to extract a tooth last spring, I would have tried sure, but I would have been scared shitless. Now I am jacking them out left and right without a second thought. All the pharmacology crap that I just could never keep straight? It is starting to come around. Yea, I have a long way to go – but I am slowly but surely recognizing medications without having to look them all up. All those first times are gone and now it is experience and practice that I am worried about. How many direct restorations can I finish in one appointment? I started off with one per session regardless of how easy it was. My current record is three, and I realize that with an assistant, I will be blazing through cavities in the future.

At this point in the D-3 year, you need to feel like the clinic is your home at school. The faculty all know who you are, the D-2s are beginning to timidly bring in patients and wear loupes during a routine cleaning. It’s hilarious not because of the utter futility of wearing loupes (with a headlamp even) for a prophylaxis, but because we all have been there. It is part of growing as a dental student and a future dental provider. They will be laughing at the new D-2s next year while I am freaking out about boards.

The D-3 experience is a metamorphosis. You completely evolve into a new type of student. The books and studying still exist, but we don’t really talk about it anymore. Now we discuss whatever tough case we are working on, or help someone out with a denture set-up, or a tip on how to make that surgical guide, and so forth. You find yourself talking about dentistry all the time, for better or for worse. You are slowly changing into a dentist despite still being a student. It is quite remarkable actually. The amount of learning has increased ten-fold while spending less time at school overall. If you blaze through a restoration and finish at 3:30, you don’t have to sit in a lecture hall for another hour, you finish anything that needs to get done lab wise, or you go home.

The D-3 experience still has its frustrations, but it truly is the best year of school. I see why it was rumored to be so. Especially once you get accustomed to your clinic and faculty, it is just plain fun. Now that’s not to say I’m having the time of my life. It is still school, anyway you cut it. I was about ready to gouge my eyes out by the end of finals. The drag of 17 straight weeks with only three official off-days will bear down on anyone. Now I know all you 9-5 jockies are saying: “hey, I do that ALL YEAR, what are you bitching about.” To them I respond: “At least you’re getting paid.” I am paying for this privilege, and paying quite dearly. I don’t remember exactly how much it is, but I think one of my faculty members told me that it costs me 400ish bucks PER AM/PM session to be in this school. That adds up.

But my time is slowly winding down. I was half-way through school back in July, so now I am well on my way, marching downhill, occasionally stumbling, but marching nonetheless. Only four semesters of school stand between me and graduation.

That brings me to a brief topic that I will elaborate on in a future post. What the hell am I going to do when I graduate? Work in a big dental chain? Work as an associate for a dentist planning to retire in few years? Do a GPR? Specialize?

The only one I am 90% confident of skipping at this point is specializing. I honestly prefer general dentistry as a whole over one aspect of dentistry beaten to death.

I am torn though, a GPR seems like a strong move, but do I end up wasting a year of real profit? Is the experience gained worth missing out on getting a large pile of wampum?

You can argue for pretty much any scenario, but I need to have an idea by the summer because that is when you apply for all these things.

Ahh what am I doing? This is my vacation. And dentistry is NOT invited. Have a Merry Christmas/holiday/whatever.

Fin.

Doing It Yourself

Let's be honest. In Dental School, you end up doing a lot of ticky tack tasks that no practicing dentist would ever do. For example, setting up the operatory is a time consuming task, and let's not even get into cleaning up afterwards. I probably spend a good hour out of ever day setting-up and cleaning up, and this is only for TWO patients.

The obvious aside, what about lab work? Most general dentists aren't mounting every case on the articulator or waxing up crowns. I don't know many that even set the denture teeth either - yet we do it as students. I'm glad we do, because you need to know what good is.

Now the point I'm getting at is that it becomes quite easy to get lazy and complacent. Simply assume the lab can do everything. This is ok sometimes, but every now and again we get a situation that requires some improvisation.

So here is my case. I get a patient on public aid that simply can't afford the partial she desperately needs (missing 7-10). She eventually plans on getting the partial but needs more time to save up.




Clearly that is a space that most people would like to have filled up ASAP. So at the college, we require that the patient's balance be UNDER 100$ before we send anything out to the lab. As soon as I prep rest seats, the partial will be charged (and it costs 600$). She needs other work as well that is not covered so we are looking at a couple months before I even start the partial.

So our options:
1) Do nothing, let this lady walk around like this trying to get a job
2) Send to the lab for an interim partial
3) Make the temp myself (flipper)

I had attempted to make a flipper last summer and while I thought it went pretty terribly, the patient never came back (which is actually a complement in this case).

So the flipper is generally made to replace ONE, count em' ONE tooth. If I send to the lab, it will cost her about 300. If I make it, it costs 160. Given financial limitations and my desire to learn - I decided to get a little crazy and attempt to replace the 4 most esthetically important teeth in the entire mouth.






Here it is after about an hour of work and one helluva a time getting it off the cast. She has all of her posterior teeth, so I decided to go without wires.




Now I will be the first to admit that the gingival shade sucks. In my defense, that is really the only color we have to work with in the lab. This is also supposed to be TEMPORARY. I needed to bring the acrylic buccally for a little extra retention. I would not have been comfortable attempting to have those teeth blend into the natural gum line. Again though, considering I couldn't even fix a toilet prior to dental school, I was pretty damn happy with this result. It looks even better far away.




Her voice didn't change at all after a few adjustments but she does use just a touch of denture adhesive. I probably could have used some wires but I used them last time and wanted to try one without.

This post is not to toot my own horn but rather to emphasize how much you can change someone's life by taking the route less traveled. I will never become a prosthodontist, but I would like to think I can help when the easy lab option is not possible. I delivered this thing in september and it is still holding out great. She is interviewing for jobs now and we will hopefully get her partial going early next semester.

With all that said, making your own temps is pretty time consuming. We were never taught this in the pre-clinic so you end up with a little trial and error. With that said, this result completely trumps my first attempt (which I wish I had pictures of) and was quite honestly, a far more difficult case.

Will I be making my own interim partials all the time? Of course not, but it feels good to know I can should the need the arise.

Happy thanksgiving all!

Experience?

I obviously can’t really compare UIC versus other dental schools because I can only go to one. I have received numerous questions from randoms and friends/family about how much experience I am getting in the clinics.

So I decided - what the hell, why not just run a production report and find out. I could care less about HOW much production I have made in dollar values but I do care about WHAT I have done or how many procedures.

So I am fairly deep into my time as a D-3, why not see just how much experience I have gotten thus far. I will probably do a follow-up towards the end.

Quick note: I am not including EVERYTHING – pretty much just procedural dentistry. I am also leaving out radiographs because I don’t get credit for the ones I do on rotation and I get credit for simply ordering them but not actually doing it. Needless to say, I feel fine with radiographs for the most part.

I am also including things I haven’t finished or will be (hopefully) starting shortly.

RUN DOWN:

7 – Periodic Oral Evaluation (6 month exam)

34 – Urgent Cares (about to become 35 this afternoon)

12 – Comprehensive Oral Evaluations (new patient work-up)

9 – prophylaxis (mostly on kids)

5 – fluoride application (all kiddos)

5 – class II amalgams

1 – MOD amalgam

15 – class V composites

1 – class III composite

2 – three-surface posterior composites

1 – PFM crown (still in process, 4 more in the near future)

1 – FGC (planned, starting sometime next month)

1 – SS crown

1 – 3-unit FPD PFM (not guaranteed yet..but keeping fingers crossed it doesn’t fall through)

1 – Direct pulp-cap

4 – core build-ups

1 – cast-post/core (still need to cement it)

1 – pulpotomy on a screaming child

1 – RCT pre-molar

8 – Quads of SRP

3 – Arches of Full Dentures

1 – RPD (currently at framework try-in phase)

22 – Extractions

1 – Surgical Extraction (which was awesome)

2 – occlusal guard (one done, one planned)

1 – unilateral space maintainer (planned and on the horizon)

So there you have it. This is what I have accomplished so far. While the list isn’t that massive, I am feeling quite content with my current level of experience. While I am definly lacking in Endo and Fixed, I have done a ton of directs and feel pretty good about them. I also have plenty of fixed on the horizon. The only trouble-area is endo. Hopefully I can pick up another one sometime soon.

My experience obviously is going to be quite different from anyone else in my class. I know someone that has done a ridiculous number of endos already and someone else that has been really dealing out the crowns. However, I also know people that haven’t done an amalgam yet, or a denture. It is completely unique and based almost entirely on your patient pool.

Being a D-3 can be frustrating at times. You go through good streaks and bad, but all in all – especially once you start to feel at home in the clinic, it just kicks ass. I see all those silly D-1s running around to with their bone boxes or skulls and just shudder. Thank god I am done with that. 19 months and I’ll be graduating.

Wow.

Performance Exams

I have made mention of these types of exams on several occasions but I felt compelled to give them a post of their own. Anyone that took science classes in high school or college probably had tests known as ‘practicals.’ For example, in high school we had an anatomy practical on the frogs we dissected. Up until dental school, the dreaded lab practical was probably the most stressful type of exam I had ever taken.

In dental school, we still have the standard lecture exams (which are almost exclusively multiple choice). I remember getting really stressed out during the first wave of these back in the D-1 year. However at this point, they are more of a nuisance than anything else. We also got a good dose of practical exams during the first two years. While these were definitely more of a pain on the nerves than the written exams, they still weren’t much different from the crap I did in college.

Now though we get to the granddaddy of all of them – the performance exam. Essentially these are the exams that actually test your physical ability to perform dentistry. In other words, if you can’t do these, you picked the wrong career and now must pay off 200,000 in student loans working in retail. What makes these things the worst type of exam in the history of my educational career is how morale-crushing they can be. There is nothing worse than failing a performance exam. An essence, the instructor is telling you that you fail at being a dentist, which is a tough aspect to shake. Granted, we are still learning, and failure is part of the curve – but it is easy to forget that when you are stuck in remediation.

Now in fairness, they break us in to this new testing format pretty slowly. The performance exams in the D-1 year were all quite easy. We had to cut class I prep on #19 the first semester (and our grade was 100% self-evaluation). In other words if you made the shittiest prep in the world, you still could get a perfect grade if you pointed out why it was shitty. The second semester was a bit rougher, introducing the good old class II prep and amalgam fill (which of course is the same thing we have to do to get licensed). Still, the grading was lenient enough (my amalgam carving was average at best and I still got good grades).

The D-2 year was when things really got crazy. While the summer wasn’t too bad, once we hit the fall – the remediation waves starting hitting the class. I know very few people that didn’t have to redo something during that semester. Whether it was an endo, or a crown prep – pretty much everybody failed something. While I did well on all my endo exams, I remember the absolute terror of those exams. After you do the access, you have to get it graded before you cleanse/shape and fill. So you are standing in this grading line hoping you made it. If you fail the access, you STILL have to finish the exam AND remediate later. I can’t imagine how crappy that would feel knowing you already failed but still have to keep your shit together and continue.

I have plenty of posts on that crap so you can look them up if you want to read about my tortured soul last year. However, what brought about this post is the new breed of performance exam I just experienced yesterday. This semester we have three patient-based performance exams. One is a tx planning exam which is annoying only because it involves a lot of busy work. The other is an SRP exam which I have yet to attempt, and the last is a ‘caries management’ exam which I finished yesterday. The difference obviously is working on real people, but you must also find a good patient to perform the exam on. If you have no patients that have the specified issue, you need to mooch off of your peers.

Ok so what makes this the mother of all stress? The pure fact that you have very little control over another living human being. If they decide they aren’t going to show up on time (or at all), you pretty much got all pumped up for nothing and have to attempt to reschedule. This is particularly nerve wracking towards the end of the semester when you just don’t have enough openings. Another stressor is the fact that some of these exams must be completed in a different clinic. This is the first year they are implementing this and it is an attempt to eliminate bias and favoritism which I can understand. If I was doing an exam with an instructor that likes me because we have worked a ton of cases successfully already, then he most likely will give me the benefit on border line stuff. Still..would have been nice to have the advantage every other class has had up until I got to the clinics…sigh.

So I here I am setting up a chair in another clinic, not knowing any of the faculty, trying to find where they keep all their shit, and praying my patient shows up and the lesion gets approved.

Fortunately for me, the patient showed up spot on time. I got him seated, took BP/P and so forth. Then I had to find TWO instructors and have them sign off that I could do the exam. For this particular exam, we are allowed to pick ANY tooth that has caries on it. Doesn’t need to be a specific class, just has to have decay. I have done nearly 20 class V composite restorations, so I figured go with something I have done a lot of. So I tracked down two faculty I had never met before and had them look at the tooth. Thankfully, they both approved and gave me the green light to start.

Quite honestly, that was the most stressful part of the exam – knowing whether or not I could start and figuring out who would be evaluating me. I had to remove a GIANT restoration and was getting a little freaked out about hitting the pulp, thankfully that did not occur. The prep itself went really well and both instructors gave me the go-ahead to fill. I was feeling confident at this point, filled with composite, and started cleaning up the margins. The only real problem I had during the exam was getting the gingival margins smooth. This usually equates to slashing the crap out of the gingival tissue with the finishing burs. I did notice on the grade sheet however that there is NO category for soft tissue trauma. This was good because this guy’s gums were looking pretty roughed up by the time I finished. Despite having cord placed, there is not much you can do to avoid some tissue damage. I mentioned it to both instructors as they came by to grade, and they both essentially told me: “don’t worry, you can’t avoid it on these restorations and it will heal quickly.” So feeling pretty confident, I gave myself a perfect score on the self-evaluation. Only because both the instructors gave me positive impressions each time they dropped in.

If I had failed, I would have been informed instantly – so things went well. Thankfully it is over.

Another hurdle cleared. Now I need to find a perio patient for that other performance exam. It never ends.

So this rambling went on for a while, but I noticed many of my family/friends asking me about how we are tested, and I find myself constantly explaining the performance exam – so there it is.

Can’t wait till I’m a D-4, where the year is essentially one GIANT performance exam.

Hospital Dentistry

Back after another long sabbatical I know, but typing these things eats up a lot of time as one might imagine. Excuses aside, I did have an experience that inspired me enough to cement it for all time in the annals of the internet. As I have explained in prior posts, as D-3 students, we go on a variety of rotations (most of them in-house). For example, we rotate through radiology, urgent care, screening, and oral surgery to name a few. Now as D-4 students, we still go on rotations; however these are OFF-campus and should be interesting to say the least. I will go into those more as my time draws closer. Yesterday I went on a very unique rotation which sent me off to Masonic – a hospital found a ways north of the school. We had an entire day for this rotation so it felt in essence like an old-school field-trip. This, along with a geriatric rotation are the only outside experiences we get as D-3s.

The day did start at the college as I had to plow through a 15 question radiology final which was thankfully easy. Afterwards, one of my peers also on rotation offered me a ride and we decided to skip the now defunct practice management course – which has been quite useless up to this point. The director of the course took a job at the up-and-coming Midwestern College of dentistry and consequently left us high and dry for this course since it is pretty hard to manage a class when the guy who was in charge of everything jumps ship the same week the class starts. Honestly though, I doubt it would have been useful even if he was still here – the material is geared at stuff I need to know after graduation. Unfortunately, I am so fresh in the clinics and so far from graduating that I honestly cannot process this information at all right now – nor do I really want to. Let me figure out how to do some dentistry before I start learning office politics. Is it important? Of course. Am I learning anything? No.

But I digress; we left around 9:15, ate some disgusting McDonald’s breakfast, and arrived at the dentistry building affiliated with Masonic around 10:30. After taking care of a bunch of hospital paper work and getting I.D. badges, we finally get to see some dentistry. Now I have mentioned being interested in a GPR several times, and I still am. This was my first actual experience SEEING a GPR in action and getting to talk to the residents. Let’s just say I am even more set on doing a post-grad residency at this point. Granted, Masonic is probably one of the better GPRs in Chicago, but it just seemed quite beneficial. They do IV sedation for special needs patients every Thursday, so we got to see some cool cases and really learn what this particular GPR is all about. The bottom line is that you get to experience a TON of different things all the while improving your technique and skill. It isn’t like another year of dental school because you don’t have instructors breathing down your back. HOWEVER, if you need that extra bit of help or advice – you have experienced attendings to fall back on as necessary. To put things bluntly, you also get another year to screw up and not lose your license or get sued. Not to mention you can defer your loans and get paid for a change. So I would make 30-50k which is peanuts compared to an associate position, but you also must consider that getting a job straight out of school isn’t all that easy – especially getting a good one. Having a year of residency on the ol’ resume really beefs things up and puts you ahead of anyone that just graduated.

Now unfortunately we only spent about an hour and a half in the actual dental clinic. After lunch we spent our time in the main hospital. Three of us go to radiology and one goes to the E.R. I ended up in radiology which I was actually interested in. However, once we sat down in this dark room with one of the radiologists, I quickly realized how boring this was going to be. The guy didn’t really talk to us that much, we just sat around him as he dictated a few cases, took some phone calls, and bull-shitted with the other radiologists. We saw ZERO maxillo-facial cases. It was just one brain CT/MRI after another. That was the LONGEST hour and a half of my life.

We returned to the dental clinic and discussed how to analyze blood reports which was pretty useful as I don’t know what I’m looking at when I see these things. At this point it was 4:30 and we were done for the day. I really wish we could have hung out in the dental clinic the whole day instead of wasting time in the main hospital. I know that GPRs send you on hospital rotations as well, but you will never be reading brain scans in a radiology room…EVER.

So my resolve to keep the grades afloat has been refilled. GPRs in general are not super-competitive in comparison to other post-grad residencies, but if you want to have choice and go to a specific location, you can’t be a total schmuck. I figure I’m probably in the top 30-40% or so which is reasonable and my board scores are ‘ok.’ So I just need to keep doing my best and see how things land.

I definitely see myself in a GPR though; it just feels like the right move for me.

In other news, the clinic life is going smoothly. I finally got an endo case and the patient has paid for half of it and showed up for both appointments so far. Single canal on a pre-molar, hope to finish next appointment but I am really struggling with the x-rays. I had the instructor take WL pics for me last time because I missed them on my first try. HE even missed the apex so I felt better despite having to retake them AGAIN.

I am chugging along with most things. I feel like I have gotten a good deal of operative work in – but am definitely lacking in the fixed department. However, I have THREE crown preps coming up in the next two weeks so things are progressing.

Basically I love the D-3 year in comparison to the first two. It still is dental school and it still has its ridiculous moments – but all in all, I can safely state that this is the best year of dental school BY FAR. The fourth year will just be too stressful with all the licensure crap so I can already rule it out.

And with that, I’m off to enjoy the rainy weekend.

Getting Adjusted And Pulling Teeth

I am slowly becoming fairly acclimated to the clinic lifestyle here at UIC. I feel pretty confident with basic restorative work (amalgams/composites) and full dentures. I still have had ZERO endo experience which absolutely blows because we have to do a case presentation this semester. As you might imagine, doing a case presentation when you have no case to present sort of makes things impossible. Hopefully I will get something soon..but I have been thinking that for the past 18 weeks now, and I still have seen nothing. I also have done zero fixed work..but I do have several patients on the horizon so that experience is on the way.

So this semester started out with a bang. I am currently on an Oral surgery/medicine rotation that lasts for an entire month. So half my days are spent extracting teeth now which is actually pretty damn fun. The rotation is great because not only do you learn the basics on extraction, but you also get a hefty dose of simple patient management skills, a crash course in pharmacology, and a great place to improve your local anesthetic techniques. I have no desire to be an oral surgeon, but I love this rotation. Outside of third molars, I plan on doing most of my own extractions in practice anyways.

You would be surprised just how much force you actually have to apply to get the tougher teeth out. It is pretty exhausting actually – especially for a tall fellow like myself because the chairs refuse to raise high enough for me not to hunch horribly. The oral medicine rotation is hit or miss. Sometimes I learn something, other times I don’t. The OM faculty do love to talk though – which is good in certain instances, but bad in others. I have seen a potential carcinoma (waiting for biopsy), a salivary stone, and about a million TMD patients (which usually have some form of myopathy rather than TMD). We meet in this clinic on Wednesdays and we meet in OS on the other days.

Now outside of the rotation things are going fine. We have way more classes than I thought we would which sucks, but at least we always finish by 10AM. The actual clinic itself is becoming almost like a second home. The faculty is getting used to us and I honestly feel pretty confident doing basic stuff at this point. I really don’t even feel like I need faculty supervision anymore for certain procedures which is great. Each composite I do looks better than the last, each prep is smoother, and everything is clicking.

Obviously there is MUCH to learn, but I love the feeling of progress – knowing I am inching ever closer the realm of competent dentistry and graduation….ahh graduation.

Sorry for the lack of posts, I just find myself consumed in other activities when I’m not at school.

Feel free to continue emailing questions and I shall reply as promptly as I can.

Transmission End.