The VA has been such an excellent experience! The range of pts is broad in their needs, medications, and personalities, which affords great opportunities (and sometimes challenges!) to expand DH skills. Today was a day of IVs and more LA injections. The IA injection used to cause me to pause, b/c I lacked confidence in finding the proper landmarks, but this is no longer the case.
My WSU AM pt turned out to be a IB instead of a II or a V, as I'd hoped. It is good to see the way so many recall pts progress after their initial cleaning at WSU. Many become impoved classifications, and though this may make finding certain pts more difficult, it's still good to see.
In the PM I was able to trade pts with Shandee and get some quads of a II and a III, which she didn't need. Again, I was impressed with the teamwork of my classmates. And, she expressed thanks for the IB, because she had not had one in a while. The program works!
Sunday, April 20, 2008
Wed., March 26, and Thurs., March 27
My AM VA pt needed a pano as well as local anesthesia as he was a class IV. I notice a distinct improvement in administering LA as I gain experience, which is a wonderful thing. Applying knowledge of root morphology is so important when working on these pt types!
OK, today was my Clinic Simulation Day! I began by completing a IB by 10AM and then seeing a pt for subgingival irrigation and caries risk assessment. I wonder how many DDSs actually use this system. I did see a Diagnodent in one of the offices during my mentor experience, but my mentor said they don't often use it.
In the PM, I saw a delightful IA for BWs and a prophy, and next kept busy with placing sealants on another IA.
It was a good experience, and the time scoots when I'm so busy. Ah. Shades of real life?
OK, today was my Clinic Simulation Day! I began by completing a IB by 10AM and then seeing a pt for subgingival irrigation and caries risk assessment. I wonder how many DDSs actually use this system. I did see a Diagnodent in one of the offices during my mentor experience, but my mentor said they don't often use it.
In the PM, I saw a delightful IA for BWs and a prophy, and next kept busy with placing sealants on another IA.
It was a good experience, and the time scoots when I'm so busy. Ah. Shades of real life?
Wed., March 19 and Thurs., March 20
OK, back to the VA. AM pt was a class V, and I was able to place arestin. Prof. Alexander says she sees it actually used about 50-60% of the time. My mentors use it 20-30% of the time. Of course, this will vary a lot from practice to practice.
My PM pt was 2 Qds of a III and 2 Qds of a IV. Much more challenging with the deeper pockets! Thank heaven for ultrasonic instrumentation!
Back at WSU, my AM pt was my Board pt, so I did his OD and took 14 PAs of the film variety. So far he's been great to work with, very punctual and easy to communicate with.
My PM pt surprised me by being a IB, but it's all good experience for me. He was a new pt and spoke little English, though he understood a bit, so between that and my bit 'o Spanish and Nicholas' help, we did fine.
My PM pt was 2 Qds of a III and 2 Qds of a IV. Much more challenging with the deeper pockets! Thank heaven for ultrasonic instrumentation!
Back at WSU, my AM pt was my Board pt, so I did his OD and took 14 PAs of the film variety. So far he's been great to work with, very punctual and easy to communicate with.
My PM pt surprised me by being a IB, but it's all good experience for me. He was a new pt and spoke little English, though he understood a bit, so between that and my bit 'o Spanish and Nicholas' help, we did fine.
Monday, March 17, 2008
SPRING BREAK WEEK!
I don't know why this blog is not getting saved so I can edit it and then post it, but it's giving me problems, and quite frankly I don't have any more time to expend on this, so i will try for the 3rd time and click on the Post button. Hopefully it will work.
Spring break was great even though we all felt the specter of the LA and BIG BOARDS hanging over us. I'm so relieved to say I passed my written and clinical LA exams. Russ was my pt., and I was his the next day. This worked well for both of us, and he did a good job and passed his tests also.
Now, it's into the final stretch for the BIG BOARDS on March 25!
Spring break was great even though we all felt the specter of the LA and BIG BOARDS hanging over us. I'm so relieved to say I passed my written and clinical LA exams. Russ was my pt., and I was his the next day. This worked well for both of us, and he did a good job and passed his tests also.
Now, it's into the final stretch for the BIG BOARDS on March 25!
Thurs., March 6
What an interesting day! I had it all figured out. My AM pt. would be a II, and my PM pt. would be a IB.
Well, it wasn't long before it became evident that my AM pt. was not a Class II but a IB! She came late and had to leave early, so I did 4 BWs and an OD. She was scheduled to return March 27.
As I looked in my PM pt's mouth (the 16 yo male) I was shocked. I had never seen tissue so inflammed, red, and bulbous, except in some of my books! It amazed me that he reported no pain or sensitivity. He also had enough bone loss and calculus to be a Class II. This was very sad to see in one so young. Needless to say, we spent a lot of time on OHI, and I tried to educate him about perio dz and how it relates to tooth loss. I stressed his need to take better care of his teeth NOW, or be at risk for losing his teeth in the future. He seemed receptive, and I can only hope he'll comply. I did let his mom know that he needs to brush 2x/day and floss 1x/day, even though I know that at his age her influence may count for less. I also recommended Listerine, and he seemed to think that was good.
So, there you go. You never know exactly what you have until you look in the mouth, and not all teens are IBs!
Well, it wasn't long before it became evident that my AM pt. was not a Class II but a IB! She came late and had to leave early, so I did 4 BWs and an OD. She was scheduled to return March 27.
As I looked in my PM pt's mouth (the 16 yo male) I was shocked. I had never seen tissue so inflammed, red, and bulbous, except in some of my books! It amazed me that he reported no pain or sensitivity. He also had enough bone loss and calculus to be a Class II. This was very sad to see in one so young. Needless to say, we spent a lot of time on OHI, and I tried to educate him about perio dz and how it relates to tooth loss. I stressed his need to take better care of his teeth NOW, or be at risk for losing his teeth in the future. He seemed receptive, and I can only hope he'll comply. I did let his mom know that he needs to brush 2x/day and floss 1x/day, even though I know that at his age her influence may count for less. I also recommended Listerine, and he seemed to think that was good.
So, there you go. You never know exactly what you have until you look in the mouth, and not all teens are IBs!
Tue., March 4 at VA
This week I was at the VA on Tue. instead of Wed., because I traded with another student so she could be with her daughter for something.
My AM pt. was a Class II. I did 4 Qds. with 4 exams.
Later, I placed a periochip in a pt. with a deep pocket on his facial lateral incisor.
My PM pt. was a Class V, and I did 4 Qds with 4 exams, 1 pano, 4 BWs, and 1 PA on a max tooth that had a fistula. The DDS examined pt. and X-rays and determined the tooth would need a root canal. This is the second fisutula I've seen now. They are relatively painless/asymptomatic (except for some bleeding or suppuration) since the infection isn't trapped inside.
My AM pt. was a Class II. I did 4 Qds. with 4 exams.
Later, I placed a periochip in a pt. with a deep pocket on his facial lateral incisor.
My PM pt. was a Class V, and I did 4 Qds with 4 exams, 1 pano, 4 BWs, and 1 PA on a max tooth that had a fistula. The DDS examined pt. and X-rays and determined the tooth would need a root canal. This is the second fisutula I've seen now. They are relatively painless/asymptomatic (except for some bleeding or suppuration) since the infection isn't trapped inside.
Thurs. Feb.28
Oh boy, it's mockboard time for local anesthesia!
I'd thought ahead on this one, and my pt. was a fellow student, Russ. It was great not having to worry about someone not showing up.
Everything was going well until I said "I'm at penetration site" and I heard "Stop and hold."
I'd been so intent on putting the needle into the correct area that my wrist rotated leaving the BIG WINDOW down. Poo!
Well, it was an excellent experience because I was able to practice and complete both injections as well as have a real sense of all the factors involved and my need to concentrate on each one.
My PM pt. no-showed, which was the first time that had happened all year. Fortunately, a pt. was available in the waiting area, so I took the 16 y.o. male thinking he would be another IB. Since I took him in later and he had never had any X-rays in his life, his mom OK'd a full mouth series. There was visible calculus on the radiographs. Something I will be sure to do in the future is look inside pt's mouth before doing X-rays. This pt. had no problem other than a minor gag reflex, but he could have had tori or something else. For some reason I'd gotten out of the habit of doing an intraoral before X-rays, but on reflecting I think in the future I'll make sure I look in the mouth before taking radiographs. I rescheduled him for cleaning the next week.
I'd thought ahead on this one, and my pt. was a fellow student, Russ. It was great not having to worry about someone not showing up.
Everything was going well until I said "I'm at penetration site" and I heard "Stop and hold."
I'd been so intent on putting the needle into the correct area that my wrist rotated leaving the BIG WINDOW down. Poo!
Well, it was an excellent experience because I was able to practice and complete both injections as well as have a real sense of all the factors involved and my need to concentrate on each one.
My PM pt. no-showed, which was the first time that had happened all year. Fortunately, a pt. was available in the waiting area, so I took the 16 y.o. male thinking he would be another IB. Since I took him in later and he had never had any X-rays in his life, his mom OK'd a full mouth series. There was visible calculus on the radiographs. Something I will be sure to do in the future is look inside pt's mouth before doing X-rays. This pt. had no problem other than a minor gag reflex, but he could have had tori or something else. For some reason I'd gotten out of the habit of doing an intraoral before X-rays, but on reflecting I think in the future I'll make sure I look in the mouth before taking radiographs. I rescheduled him for cleaning the next week.
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