Competency and Service Learning

There is only one week left in the semester, and I have only one competency to complete. The competency is the adult prophy, and I hope I will finish this competency in time. Factors that may affect my completion include: if the patient qualify's, I only have 1 clinic session left, I am in oral surgery rotation, and I only get one shot at this. I am very nervous, and I do not want to receive an incomplete grade for this course just to receive a letter grade of a C next semester.

Last week, I participated in a service learning project at Ginter Park Elementary school off of Chamberlayne ave. I was able to demonstrate the effects that sugar has on the enamel. I used a styro foam cup as the model of the tooth, and then proceeded to place maple syrup on the cup for show that this was plaque stuck on the enamel. Afterward, I placed sprinkles on the syrup to show foods that we eat. Then proceeded to place acetone on the cup to show the affect that takes place when you don't brush your teeth. This visual showed the cup dissolving, and the kids loved it. We then began the process to talk about nutrition and healthy foods. We had cards that had food on them and asked the children what was a good food and a bad food. They where knowledgeable and many of their answers where correct. We then proceeded to show the kids proper brushing and flossing techniques. At the end of the visit, we gave the kids all toothbrushes. This week the teacher contacted me telling me that the kids are still talking about the presentation til this day, and during lunch they were talking about which foods where healthy. I am glad that the presentation was able to make an impact on this kids, and I hope that I will be able to go to more schools. The exposure allows the kids to receive some type of education and may prevent what I experienced in pedo "rampant caries".

Pedo Rotation

This rotation has opened my eyes to the lack of education some parents have on dental care in the surrounding Richmond areas. The first day I was in rotation the four year old child had rampant caries. The doctor was able to treatment plan the child for about 80% of the teeth being extracted and the other 20% saved. The second day in rotation I was able to work with a 12 year old girl, who was very shy. She was not very happy to be at the dentist and covered her smile. When she proceeded to open her mouth I noticed why she was shy. The doctor diagnosed her with rampant caries and proceeded to make a treatment plan. He was very frustrated during the whole process because the girl was not able to keep her mouth open due to pain and sensitivity. During the process, the little girl was crying the whole time. She was in so much pain and embarrassment. I proceeded to tell the girl that everything will be okay and we will get things under control. The resident then begins to tell me "no, you do not say everything will be okay, this is not acceptable, her oral hygiene could of prevented this". I do not know why he responded to me in this way, maybe he was very frustrated. But, his response scared me and also the little girl. He was very straight forward with his remarks, and not friendly at all. I don't believe this was the proper way to handle the situation. The girl will have to get most of her teeth removed and have a partial denture. This is very sad, and knowing that this could of been prevented from simply brushing her teeth. Her mom is a single parent,and most of her home care is from her grandmother who is endentulous. Dental neglect is very obvious in this case, and it is a very sad subject. I wish I could follow up with this patient, and see her results.

Rotations

I've finished most of my rotations this semester. Overall, I have enjoyed everyone of my rotations and I have learned from every experience. In general practice many of the dental students where helpful in explaining techniques of local anesthesia. They were able to tell me why you would inject a particular site oppose to another site. Every student had their own technique to giving the injection. Some used topical before and others did not. The various procedures that I assisted in has help me have a better understanding of the procedures and why it would take place. In oral surgery I was able to see patients will their whole face swollen. Mentally disabled patients, and also patients from jail. We were able to work with various individuals with different backgrounds. The stereotype of inmates are that they are scary or bad individuals. But I believed that most where very friendly and where happy to be out of the jail cell. They were very well behaved and nice. In general we where not dealing with people who murdered others, but mostly the ones who dealt with drugs problems. My pedo rotation is coming up this week, and I hope it goes well.

Competencies

So there's is only about a month and a couple weeks left until this semester is over. At the moment, I am very worried about not completing all my competencies. Since there is a shortage on patients, I feel as if every time I complete a competency I must pass it on the first try or I won't be able to meet the expectation of competency fulfillment set by the school. It is very frustrating at times, when we don't have patients which leads to not enough practice. I remember a senior telling me, "don't worry about failing your competencies, I failed my hard tissue competency 10 times before I passed". And in my head all I could think is, "I wish I had 10 patients to fail my competencies 10 times with". Shortage, shortage, shortage= less practice, which makes me feel if I don't pass the first time then I am SOL (so out of luck)! I just hope things pick up within this month.

Radiology

Keys to having a successful day in radiology. The best time to learn about how to take a film is during patient screening on Wednesdays. When taking a panorex you have to make sure the patient neck it straight, they are close to the machine, make sure you align the lights so that the patient face is even, all jewelry must be taken off, and least but not last make sure the patient tongue is pushed up to the palate to prevent air space. If you follow these steps you will most likely have a successful radiograph. Taking bite wings, periapicals radiographs just take a lot of practice, and you have to make sure you use the correct angles.

Blood Pressure Cuffs

We are currently using the Omicron automatic blood pressure cuffs. It a nice device, but I think that the readings are only accurate half of the time. I think the problems occurs with the cuff not being a soft cuff and the way it fits around the arm. In two occassions, I had to take my patient to oral surgery to get their blood pressure read. If the cuff was more accurate we would be able to save alot of time, and perhaps finish the appointment. I guess we are in the phase of trial and error. Hopefully we can purchase new soft cuffs for our machines.

First Official Day in Clinic

We have currently seen our first patient. It was a great learning experience. She spoke very little english, and was 30 minutes late to the appointment. But she was a great patient. When she came to clinic, she brought 5 new medications. The medical history took up most of our time during the appointment. We end up having a recall, and finishing the appointment the second time around.

Another patient of ours, we were given the wrong chart. I believe this patient has been charted in the wrong chart before, due the fact that some of the same medications where charted and also the same nasal cancer was charted in both charts. This was a great learning experience, and I am glad we caught the mistake earlier. Also with this patient, the medical history took most of the time but she will come back for a recall.

POH

After not passing my POH by 1%, but later on passing my POH, I would like to put up last minute tips for passing your POH. I would recommened getting an electric toothbrush. Brushing with listerine combined with toothpaste, and getting the thick floss.

Competency

I am very happy that I passed my first competency mirror, explorer, and probe. I am now able to identify the working ends on the 11/12 explorer. Our next competency is on Friday, we will be working on all scalers. So far to prepare for the competency, I have been working on a typhodont and trying to identify the lower cutting edges on the instrument. After, practice in clinic I feel pretty good about the use of the area specific gracey, universal, and sickle scalers. I hope I can pass this competency on the first try. I feel as if every time we have a competency I get very nervous and end up making a goofy mistake. I need to remember to take my time, look at the working area, make sure I have the correct working/cutting end, and remember the correct patient positioning. Overall, if I remember these things I think I will do well. I will keep you updated on how the competency goes.

Overwhelming

Lately, this course has been overwhelming. I feel like we are just getting tons of information thrown at us. All the exams happen to fall on the same day, one after another, they continue to roll in. On a brighter note, I finally feel confident in using the 11/12 explorer. My trouble's started with finding the correct working end. But with extra clinic time, and more practice I feel very confident and I am ready to retest for my competency. We are curently working on sickle scalers, and curets. I do not feel comfortable with these instruments. There are many of them, and so many cutting edges. But in time, I believe like the explorer, I will begin to feel more comfortable and confident. With time, practice, and effort we will get through this course.

Clinic

I really enjoy clinic compared to the time spent in the classroom. Lately we have been working on the explorer, mirror, and probe. The hands on experience has really helped me understand what was implemented during the lecture. Working on other students is so much better than working on the model typodont teeth. The other student is able to tell you if your hurting them, and also give you tips on what works best with them. Also practicing the mock SOAP notes has been a great. So far I have worked in the Douglas clinic, and I love it there. Overall, I have enjoyed time spent in the clinic and I am looking forward to learning more instruments.