Our Last Day

I can hardly believe we are reaching the end of the semester.  I have learned so much!  Today in clinic we learned emergency procedures, clinic asst duties, and evaluated our patient day.  It is important to be aware of our patients health histories and to tailor our treatment to the patients needs.  By doing so, we can eliminate 90% of potential problems that could occur in the office.  I take that very seriously.  I am assigned clinic asst duty on the first day that we welcome patients back into the office.  Hopefully Ill be able to take care of things alright.  Next semester is going to be intense.  I really hope Im ready for the pressures.

Real Patient Day!

I got to play with my sister-in-law today!  Sharlene came in as my first patient outside of the girls I practice on every clinic day.  I walked into the day pretty confident.  Ive been practicing my technique in a lot of areas (in scaling, probing, etc) and felt that my second year observation would help me to be organized and speedy.  I completed the health history pretty quickly and got my HHxRx signed off.  Then I went into my OD.  OD takes forever!  How on earth can I get through this faster in the future!  I dont know how hygienists ever get through an appt in 30 minutes.  That seems crazy to me.  I feel like Ill be lucky if I ever get through one quad when I have to perform an OD.  Goodness gracious!  I hope thats not the case.  I realized how hard a time I have determining sealants and restorations that are already present in the mouth.  I felt really dumb when I was being corrected.  I need to let those feelings go and just be really happy that I have educated indls there to help me learn.  I need to focus less on being critiqued.  I also need to research the appearance of these things in the mouth so I am better prepared for next semester.  Can I google something like that?  I did fair on my probing...I dont think my measurements were more than one mm off from Costleys.  She seemed somewhat unsatisfied with my probing though.  I wonder if that was just me imagining things.  I found that Shar had a stillmans cleft!  Cool to actually see one of those in the mouth.  I took fair xrays but one was cone cut.  What the heck?  I never cone cut xrays!  I pride myself on that.  I must have just been really nervous.  No matter.  I passed.  Then I was barely able to finish everything else that was required today.  I think I was the last one to get my patient out the door.  I couldnt tell you how that happened!  I dont know where Im slower than others.  Ill have to pay closer attn to how much time each thing is taking me.  Hard task.  I also want a clock in my operatory.  Its not very convenient having to look over my shoulder at Karlies.  I forget to clock my time in some instances.  In lots of instances actually.  Thats one thing I can work on.  I did well on my paperwork I think. I feel like slime for not fitting in much OHI.  That is so important.  I cheat my patients if I dont educate them.  Thank goodness she is my sister in law.  Ill make up for it on Thanksgiving. ;)  That was my day.  Now I can take a deep breath, and pray to feel more collected and at peace next semester when we take new patients.  I am really really nervous. 

I got another sealant placed today!

Kristie is wonderful and did a very thorough job at cleaning my teeth.  It was a learning experience for me just to see her methods and preferences.  She has some great technique.  Good work Kristie.  Its really strange having a week where I just sit in the chair without having to do much, except for passing off my sharpening PE...it was my last PE for the semester!  I can hardly believe it.  This year is going by so fast!  Yesterday in class Costley told us that we have learned pretty much everything we are going to learn from clinic, and that the next year and half is going to be spent tailoring and perfecting our technique.  It is hard to believe that we have gotten this far already.  But it makes me feel accomplished! 

I fell asleep!

Today was awesome!  Kristie gave me a neck massage, brushed by teeth for me, and gave me some great advise about getting those bacteria bugs away from my mandibular linguals.  While she created my tx plan, I fell asleep in the chair!  She did an excellent job probing and evaluating my tissue health.  She even got a quad of scaling completed!  Yay Kristie!  On to dinner and stats!

Thank Goodness for Calming Influences

Today was my nightmare.  Alarm didnt go off so I slept in till 7:50, the time I am supposed to be to clinic.  I call and Professor Costley was very calm and sweet.  I appreciated that.  I got here late and Marianne had set up my operatory for me.  I am grateful for her.  My pt Kristie had a big smile on her face and reassured me everything was okay.   I appreciate her.  Hemsley made sure I got my HHXRX signed quickly so I could start scaling.  I appreciated her attention.  Hafen was exciting me about learning to use the ultrasonic.  I LOVE THE ULTRASONIC!  Kristie, bless her heart, sat there forever while I scaled and while Hafen checked my scaling.  Im slow, to be sure, but I didnt miss many surfaces, which I was happy about.  I learned how to better scale around lingual bars and I actually feel quite comfortable with it now.  Thanks Hafen!  She is left handed too, so I love when she visits me ;)  Marianne was sweet to let me pass off my sealant PE on Sarah...and when I started crying because I was missing instruments that I needed in order to check my sealant, Marilyn and Sarah were super sympathetic and wonderful calming influences.  Deep breath...okay...I made it through the morning. I didnt get in as much scaling as I hoped to, but I got some good practice in.  I love those ind'ls that I was able to work with today.  Marilyn is amazing...I really appreciate her.  There are so many sweethearts in this program.  When I learned that I had forgotten to chart OD on todays pt, Costley let it slide on the understanding that I would remember to do it next time.  With a really sweet smile, she nudged me and said "You didnt forget OHI though!  Good job!"  I am very lucky to have Prof. Costley as my professor.  She is a really neat, educated, and understanding ind'l.  I hated the circumstances of this day, but I loved that I was able to come to appreciate everyone I associate with a little bit more. 

A day with Kristie

The poor darling!  She had to spend her whole clinic day, back in the chair, mouth wide open, with a sore TMJ.  She cowboyed through it really well though.  We were able to start from scratch with our patients today.  Half of us walked through check-in to check-out.  I learned how easy it is to fit in OHI and how long it takes to probe an entire mouth!  but I do think Im getting faster, and Im feeling alot more comfortable with exploring.  Im excited to scale next time.  Im getting more and more excited to have Sharlene in the chair next week, or soon, whenever that day actually is!

Lovely!

Today was fantastic, especially compared to monday.  I got to work with MeChel again.  We passed off our air powder polishing PE and our fluoride PE.  When air polishing, make sure to stay 3-5mm away from the tooth surface and orient the spray 2-3mm away from the gingival margin.  Make sure you dont perform this procedure when a patient has a composite restoration, on a crown surface, or on a sealant.  You can, however, polish below the margins of the crown where there is a significant stain.  Next week I get to go to town on Kristie!  Hooray! 

Sealants

Holy freak today was a little stressful.  This was my first chance to apply a sealant to a tooth, and I was rushed a thousand miles an hour through it.  I wanted assurances that I was doing things correctly but our professors were just too busy trying to watch everyone.  I hate polishing...Im glad that these days its less recommended.  I just dont see where it does much good and Im not the most gifted ind'l when it comes to doing the rubber cup polishing.  But...working with MeChel was great.  She is really adorable.  And she has it down!  I have full confidence my sealant on tooth 3 will be in place for the rest of time.  I'm going to eat my burned lasagna now.

Air-polishing, Screening PE

Goodness!  This PE was awful.  I will cringe if I have to redo it, but oh well.  I actually did better on rubber cup polishing than what I expected, but I have lots to work on.  I need to improve.  I air polished a penny before working on Marcy and I was amazed at how much gupe it took off.

GOSH IM TIRED.  I dont know if I can make it thru radiology...for reals.  Esp since we are watching a movie.

Turning the Tables

In clinic on Wednesday, I worked on Heather Taua.  What a cute girl.  I started by looking over her health history (there were no changes to be noted).  I took her bp, p, and r.  I performed an intra/extra oral exam.  I am feeling more comfortable with those exams.  I remember working with the second years at the WHC and as I performed the extra oral exams I really didnt even know what I was looking for.  I understand more now.  We took probing measurements.  I found it alot easier to get accurate readings on posterior teeth, which is backwards from what I expected.  I was pleased to have been close to my instructors measurements (well, the TA's).  We charted any changes in dental anatomy and pathology.  I still find it difficult to know what to look for when searching for suspicious lesions (caries, specifically).  Its easy to tell whether they have an apthus ulcer, but not so easy to know whether or not that small spot on their mouth indicates a caries or something else.  I need to learn more about different filling options as well.  I really have a hard time knowing what Im looking for as I chart restoration materials, etc.  My exam in radiology helped to get me more familiar, but I feel Im behind in this regard because I never worked for a dentist.  Continued exposure will help, Im sure.  I charted perio...Heather was healthy, as you would expect.  Then I was able to start scaling.  I passed off my universal instrumentation and adaptation, angulation, and activation PE's.  Not too bad.  It was a great review day.  I was grateful for it. 

Relax!

Today was a cinch.  I got to lay back in the chair while Heather Taaua went to town on my mouth.  From HHX, they had us run through everything up to and including scaling.  We didnt switch so the most difficult thing I had to manage was the dizziness from finally sitting up 3 hours later.  Not too bad.  Heather did great.  I think she was nervous but she was excellent and I hope she knows that.

I did get a second to pass off my probing PE.  I havent been able to practice even nearly as much as I was hoping to before passing it off, but by the grace of heaven, I managed it.  I need to work on my angulation as I probe the distals on posteriors.  I will practice on my sister.  This week is going to be exraordinarily crazy.  I hope I can keep my composure and excel through it.

Heres to hoping and praying!

Dental Screenings, ouch!

If there is one thing to say Im most fearful about, it would probably be this.  There are some in class who have worked for dentists for years, and that would recognize crowns, restoration materials, etc with no troubles.  It is for this reason that I suspect we spend little time going over this subject, but for me this is foreign.  I am really nervous about my efficacy in charting what is to be found in the mouth pre treatment...not because I dont know the markings, but because Im not sure what Im looking for.  I hope this will come easier with time.  I wish I had more time to study these things out individually when I have a harder time understanding.  I just feel that we are continually being pushed to the next and next thing and that if we allow ourselves to look back at old material, we miss something important in the present.  I wish we had more reflective days.  It would be neat to have a day where we can study a subject that seems more challenging to us...or to practice that thing exclusively in clinic.  Id ever write a short paper to show what I was learning and why that day was important to me.  I dunno. 

Wednesday

Today we got to practice!  Thank the Heavens!  We also passed off our intraoral PE's.  I was nervous a bit but things ended up working out smoothly.  I was grateful to get all 4's!  I remember seeing that PE for the first time and thinking Id never be able to memorize it all!  It was nice to be able to practice for a bit.  Ryan wont let me practice on him...little stinker.  I need to find a more willing helper.

Oh! and Karlie and I won a bag of starbursts today for being the fastest pod to set up our operatories for pt tx.  We probably had too much an advantage, seeing as there were only two of us.  We worked together though and "gotter done" real fast.

Kim gave a really great pod wrap up today, in which she reminded us to humanize all our pts.  It can be easy to think of them as mouths, and not impressionable individuals.  We should do all we can to make them comfortable, to speak in their language, to build rapport, and to inspire them to take good care of their teeth.  I look forward to being a personable dental hygienist.

My new goal is to throw "really" out of my vocabulary entirely...its such an ucky word.

Get up on your explorers Ladies!

On Monday we learned how to use our explorers.  It is important to maintain appropriate adaptation when working around the teeth and to angle the explorer appropriately given the tooth surfaces to be explored.  On the anteriors we want to use the side of the instrument whose terminal shank is most closely adapted to the tooth.  On the posteriors, we want the terminal portion of the shank to be nearly parallel with the long axis of the tooth while bringing the working end to the distal of the tooth.  Choosing the right end to use can be tricky.  I will need to practice this...but once I got under those sweet sweet gingival margins and into the sulcus, life was wonderful.  IT IS SO FUN!

What do they call these?

"T" stands for our tests, and how rapidly they come. "A" stands for anatomy of the teeth and all the effort that goes into remembering their every cusp, root, line angle, and furcation. "N" stands for narrowness of time left for other activities. "Y" stands for yawning from the lack of sleep on late study nights, ie... Mondays. "A" stands for the grades I better get for all this work!!!! But oh, how I love it. ;)

Kay, Im behind on this blogging thing

WEDNESDAY!  Today, we went subgingively to examine probing debths on our typodont as well as on a patient.  Sarah was a trooper...if her gums were a marshmellow, it actually wouldnt have faired that badly.  I jabbed her a little more than I should, be overall I didnt notice her flinching much and fulcruming was actually alot easier on a real life person.  I passed off my vitals PE and now I get to focus on the hundred others piling up!

Its Monday!

MONDAY!  Today was probably my favorite day of clinic so far.  We had a fun filled day of learning how to position our probes within our hands while navigating around the mouth.  I was laughing pretty much the entire time that Karlie was performing my Intraoral exam.  She gets really excited about visualizing salivary ducts.  It was all in all a wonderful day.  I tried to pass off my health history PE as well.  I have yet to hear if I passed.  I feel confident that I did.

Mirror, Fulcrum, and Positioning, hooray!

Today was fantastic!  I worked with Karlie and Sarah, performing extraoral exams.  When you perform these exams, you palpate the face, nodes, and glands, taking note of any irregularities that could clue you in to a problem.  According to my reading, there are a great number of lymph nodes throughout the head and neck region.  If a person has cancer in this region, it is quite easy for it to spread to lymph nodes and throughout their body.  We can do a lot of good for our patients by taking 5 minutes to search for these potential problems.  My patients were very cute and patient with me.  When you grasp onto a method that works for you, the fear of missing a spot goes away.  Im getting closer to feeling that way.  Then we passed off the positioning PE.  I was nervous about it at first, but it wasnt a big deal at all.  It comes so naturally.  I love this major!  I really came to appreciate the convenience of using recommended clock positions when using a fulcuming technique while navigating through mouths with my mirror.  Now I have to focus on mastering HHX.  Im so scared!  I think that doing my case study will help to put my hesitations to rest.  Ill practice on my fam too.

Vitals

This was a chill clinic session.  We had lots of time to study our PE's and to pass them off.  I really should pass off my positioning PE but I think Ill give it another good lookover.  I passed off the equipment maintenance PE.  My blood pressure was really low today...curious.  I feel fine though.  Today has been a good day all in all. 

Per last clinic

I wasnt lucky enough to find a web lab computer last wednesday during lab.  We were able to take vitals for the first time ever.  I expected it to be difficult but Karlie has good veins...haha.  She made it easy.  I need a more appropriately positioned clock though. haha.  Its hard to be stealthy about watching for respirations when I have to look behind me to see the clock and back around to the patient to watch her stomach.  I wish my watch had a second counter.  Other than that, we prepared patient histories.  I get nervous that Ill forget things.  Ill have to deeply study this PE.

I was bitten by a dead person today!

Clinic gets greater and greater!  I love it!  I passed off two PE's relating to setting up and taking down my operatory.  The only thing I will really have to watch is making sure I wipe down the adjustment levers for my chair.  Out of sight, out of mind.  I'll make sure I remember them for next time.  We practiced ergonomic positions relating to our patients.  I am left-handed so I circumnavigate from 11-4pm (book answer).  In clinic, we never went farther than noon position.  In radiology I took my first bitewings ever!  Dexter bit me once but I wont let that happen again!  Naughty Dexter.  The x-rays were alright...no coning, which I was happy about.  I need to move the film forward and decrease the angle with which I take the premolars, but those are easy fixes. Anyway, that was my day.  

Im liking clinic more and more!

I was really blessed today!  I was able to work with McCall!  We are the only two girls in our lab group who havent been employed by a dentist so we are novices when it comes to intraoral procedures.  But, we did pretty great!  I think I sprayed her more than she sprayed me!  Im starting to feel more comfortable working in the mouth and I like working with people so much more than working with typodonts.  Im going to try to pass off my second PE so I'm out.  ;)

Passing off my first PE

Whew!  What a day.  I felt kinda inadequate today in clinic.  Ive had soooo many  hours of volunteer experience in the dental office, but today made me kinda frustrated that the hygienists didnt allow me to do simple things like navigate a suction tube in the patients mouth.  Its not rocket-science, but I still felt self-conscious about it.  Im really grateful that we have a professor that is left-handed so she can help me since everything for me is backwards.  Maybe that factored into my self-consciousness.  I am finding it a little inconvenient being shoved into the back corner...its harder to collaborate with the other girls and to hear what TA's and instructors are saying.  I feel a little forgotten sometimes.  Ill have to make my voice heard by asking more and saying more.  In spite of it, I managed to pass off my first PE!  Navigating around Eaglesoft isnt rough at all.  I really enjoyed meeting the lady that invented the blue boa.  She was so nice and helpful. 

My First Day!

I'm so happy that there was nothing to be nervous about!  Everything went really smoothly and the teachers are more than eager to help us!  We settled into our pods today!  I got the only lefty pod that exists here...I feel pretty special, but me and Karlie are in outer darkness in Pod 4, "the forgotten pod."  At least I get a window!  We shared our first kiss story and our most embarrasing moment.  It was fun bonding with the girls a bit.  Professor Costley managed to sneak up on me today...that was pretty much amazing.  Now she knows my scream so if theres ever a problem, she'll know right where to go.  In terms of Eaglesoft, its pretty easy to navigate.  I dont expect Ill have any trouble passing off my PE.  Maybe the research project I did on Eaglesoft last semester helped with that...i dunno.  Anyways, life is swell!  What should I eat for dinner?

This is Happening!!!

Just setting up my blog and super excited for all that is to come!  These girls are awesome, I have my own instruments, and I have a medical journal in the making!  I am so so happy!