Lifting Soloman!

In our afternoon lab yesterday, we discussed the proper care of patients who are bound to wheelchairs.  Sometimes it is necessary to treat them from their chair and other times it is possible to transfer them to the operatory chair when using proper technique.  Note** It is always advisable to ask the caregiver to move the patient, if possible, rather than to do it yourself.  I struggled moving Tori to the chair but things went swimmingly with Mr Soloman.  I can't explain that one at all.  Neither could Dr Hanson.  She seemed a little shocked.  But I got 5 grace PAs for the feat!  We also reviewed protocol for emergency situations, MI paste and other medicaments.  It was good to see what these medicaments looked like and we were able to practice inserting them into hotdogs.  Our professors are so fun.  They bring things alive for sure. 

Finally, my husband becomes my patient

Today my husband came in because my morning patients cancelled.  I was going to see two children but that didn't pan out.  This guy hasn't been in for a dental cleaning in 5 years.  I can't even believe that some people live that lifestyle.  I haven't always known I wanted to by a hygienist, but I always valued dental visits and made sure to see the dentist at least two times a year.  My parents were really good about making sure that standard was kept.  For individuals and families without dental insurance, it can seem a considerable burden to make it to the dentist regularly.  It is our responsibility as dental providers that our patients understand the links between oral health and overall wellbeing.  Professor Perry has made the joke a few times that people seem surprised when they learn that they have developed a cavity in 6 months.  They say, "how could I have a cavity.  Everything looked good 6 months ago?!"  He comically replies, "You can practically create a baby in 6 months!  You can definitely develop a cavity."  That really puts things into perspective.  Ryan, my husband, must have pretty great genetics, because his calculus buildup was miniscule after that 5 year period and I know from first hand observation that it feels like pulling teeth getting that boy to floss.  I'm lucky if I can get him to floss once a month.  I told him that his days of no dental visits were over.  You cant marry a hygienist and not expect to see the dentist regularly.  That's like a boarding an airplane and not expecting to fly.  Anyways, I passed all sorts of PE's off on Ryan (3).  We performed a caries risk assessment on the poor guy and it turns out that his saliva does an excellent job of buffering the pH of his oral cavity.  That boy has a lot of good things going for him.  We made him a dental appt and look forward to hearing what his dentist has to say about his perfect smile (thanks to me!, haha).

Robin Returns

My title sounds like a quote from Batman...haha.  Kay, its really not funny.

Ada returned today for the rest of her cleaning.  I was initially nervous that I wouldnt be able to complete three quads of her class III dentition in one appt for a variety of reasons.
1.  Sometimes cleaning one quad of a Class III can take one hour for a very experienced practitioner.
2.  I didn't want to anesthetize bilaterally. 
3.  She needed NO2, and LA, and those take time as well.

I was happy to find that I did have sufficient time and that I was able to clean one quadrant without anesthesia, which was the best scenerio I could have asked for.

I passed off my nitrous PE.  I remembered that oxygens international color is green, even though in my head it should be blue...like the sky.  Oh well.  I accurately titrated the ratio of oxygen to nitrous and remembered to start at 1 lpm of nitrous to 5 lpm of oxygen. 

Ada was wonderful and I look forward to having her back next semester.

Reflections of the past week

Ive been craving the opportunity to blog for some reason!  Its a pity that the craving comes now because I really don't have anything interesting to say!  Haha.  I'll just try to start jabbering, I guess.

Thursday the 27th I had an interesting learning experience in clinic.  I had the opportunity to treat a patient that was severely visually impaired.  The appointment started out fine and xrays went smoothly.  I wasn't expecting any difficulty but as we moved into the cleaning, things got rough.  Matt had a very powerful lower lip and he refused to allow it to relax in order to probe his teeth accurately.  His tongue followed me everywhere and he struggled to keep his mouth open at all.  I had to borrow my peers' biteblocks, but he kept spitting them out on the floor so I had to go and find another students' biteblock so I could see in there!  I definitely earned my lunch that day.  It took a lot of patience and patient management to get through that appointment.

Oraqix and Premolars, not necessarily related

Nov 2nd was VA day.  I was able to pass off my Oraqix PE on Bonnie S in the morning.  I love the idea of Oraqix because it causes less anxiety for the patient than LA...but the more I work with it, the less faith I have in it.  I deposit the periodontal gel below the gingival margin just as I am instructed, but my patients (in most cases) continue to have sensation of the tissues.  I will have to ask pointed questions relating to patient perception of its efficacy at future appointments.  I want to believe in this stuff, but right now I feel like I'm forced to be skeptical.  In other news, I was able to take another pano!  I find it so much easier to meet our requirements this year!  I love it.

Eric was my afternoon patient and most of his teeth were missing.  We proceeded through his cleaning very quickly and it broke my heart to have to let him know that his remaining teeth looked to have a lot of decay.  I cleaned his partial denture and gave him some very detailed OHI.  We provided his oxygen throughout the appointment and that was a new experience for me.  He was a very nice man.  I felt really bad at one point in the appointment because I accidentally pulled out one of his mustache hairs.  It would appear as though that hurts.  ;)

I need to reach the distals of premolars  better...that's always where I'm fouled, particularly from the left quadrants.  Dr Hanson advised that we use a "wrist pop" technique with the nevi on each tooth before asking for a scale check so that we are never left with deposits along the CEJ...and I tried to utilize her counsel but still got banged on my premolars on thursday.  In the words of Phil Dumphy, "Come on Tanya!"  BUT but but...I was able to use my perio files finally!  They are a lot easier to use than I thought!  I really didn't understand them when we first practiced using them on our typodonts but our professors assured us that given the right situation, we would find them really useful on our patients.  I found that to be true on Thursday.  My patient had burnished calculus deep within the pocket of the distal of a first molar (I can't remember what quad I was working on anymore).  We used the file for two seconds and the initially stubborn calculus came off with one quick working stroke of my 13/14.  Cool beans.  It really didnt take much pressure at all with the perio file to reach the desired effect.  I can see how these are useful.

I need to sleep now.  Tanya out.