LAT, LA, and Smiles All Around!

Alright, I have a lot I could say right now.  Last Thursday was AMAZINGLY productive, I thought.  My Class II patient cancelled at 10:30 the night before, so I waltzed over to my parents house to gather my moms health history.  I've kinda dreaded having to use her as an alternate because I knew her health history was going to be super labor intensive, but I also wanted for her to see me at work!, so I went ahead and scheduled her.  I collected all the information I needed in order to fill out my TX record Wednesday night, but I wasnt able to enter in drug info till the next morning because my DDR was in my cubby.  My mom is easily on 12 different prescriptions for various things.  She went septic in May of 2010 from a bladder infection and her health just hasnt been the same since.  The medications took me quite a while to fill out, but we finally were able to move forward to xrays.  I really have to pat myself on the shoulder.  I was super nervous about taking xrays last year but it is surprising to me how well they have come out this year on my various patients!  It really is encouraging and I'm grateful that I am getting faster at taking them, finally!  We were in and out of the xray room very quickly.  I was able to probe, chart, and clean 2 quads of her Class V dentition before the morning was through.  (With no errors!)  Not too bad!  I was also able to pass off my blood glucose PE on her.  It was pretty straightforward.

Robyn R came in the afternoon.  I had to dismiss him prematurely at his last appointment because he had a cold sore.  After completing his OD I was happy to find out he was considered a Class III!  I NEED those!  Haha.  Robyn has caps on each and every one of his teeth with implants interspersed so I had to keep a keen eye on my xrays throughout the appointment as to avoid using a metal instrument (or the wrong US tip) to clean the implants.  It was a good experience for me, learning to rely on xrays better in appointments.  After a few glances, I was able to find the tooth I was looking for more quickly, something that has been a frustration in the past.  I get so turned around...LR,RL...bah.  He had significant edema and erythema along his gum tissue, and it was diffuse.  These caps had caused a lot of irritation and the margins were not tailored to his anatomy very well.  My heart broke for him.  I was able to administer 4 injections, that went seamlessly I am happy to add.  I was able to pass off my first LA PE on him!  After his cleaning, we were able to use LAT -- Laser Assisted Therapy to seal off the blood vessels and lymphatics within his pockets that contribute to the irritation his gingiva are experiencing.  It was neat being able to use the CO2 laser on a patient, rather than just a chicken breast and tomato.  Im so grateful for the thorough education I recieve as a student at WSU.  We really do have the best program ever.  We completed half of Robyns mouth and are using the other half as a control when he returns next week for a reeval.  I'm excited to see what results we find. 

I Like Ice Cream

First, lets talk about the important stuff.  Like how sweet Professor Alexander is!  Thanks to her, this ^ is how I will remember my first mockboard experience.  Secondly, lets talk about Mockboards for a sec.  A lot can be learned from these experiences and I'm really glad that our professors give us the opportunity to practice before the real day comes along.  We were able to see, firsthand, the process involved in checking in our patients.  Through the experience of being a student examiner, I learned that I need to improve my exploring methods.  According to Inst. Perry, so do all the rest of us!  At least I'm not alone. ;)  He had a really healthy comment/recommendation that I need to remember...that because I am a leftie, the angles by which I feel calculus deposits are different from that of my professors/peers, etc.  It would behoove me, to explore from right as well as the left, so that I can gain the same perspective as my instructors as they perform scale checks on my patients.  This will be particularly useful on the day of boards.  I was grateful for that advice. 

I learned some other things as well. 
1.  Curved u.s. tips are fantastic and I love them! 
2.  I could use a little more one on one in learning how to use my perio files.  They do me no good right now.
3.  Don't create more work for yourself than necessary when submitting which quads you want to clean.  It was completely unnecessary for me to add two additional teeth beyond the quadrant that I specified I would be working on. 
4.  Be aware that board examiners watch the third molars like a hawk and almost look forward to marking you down for reaching those teeth.  If at all possible, I will avoid seeing a patient with third molars on my board examination.
5.  I can pass...and I did.  Thank the royal heavens.
6.  It is easy to capture third molars in supplemental films by adjusting your POD so that it has a steeper horizonal angle. 
7.  Calculus is stubborn and it needs to be taught a lesson.

Pretty Blue Eyes

My VA patient was beautiful.  Especially his Class III dentition ;)  When Prof. Bossenberger told me that two quadrants were Class III and two were Class II I somehow thought I should be able to finish the patient in one day...I dont know why I thought that.  That's ridiculous.  Anyway, I started by cleaning his upper and lower right and decided at that point that I didnt want to continue any farther.  I think I took on more than I should.  Only clean one quad of a Class III at a time.   I knew that, but forgot that.  I missed a lot of the interproximals, and didnt really have time to get help on how to access them better.  Bahhumbug.  Next time I will allow myself more time on a class III.  My afternoon patient cancelled so I ended up having to CA.  Bah.  Today, I saw a patient who, in times past, has been considered a class III and mostly a class IV.  Instructor Perry helped me to see why this patient, in general, would really only be considered a Class II.  I understood his logic and wouldnt have wanted my patient to be charged for anything more than a Class to SRP in real life, but he had some extremely deep pockets along 10,11,and 18 (18 was 11mm!!!) and I definitely think that for my efforts, this patient should be considered AT LEAST a Class III for the effort.  It is going to be rough!  Gosh, I need this week to end.  Ive taken on far more than I can chew and Im exhausted and discouraged.