saturday in the 'burbs
i'm off today, but i pretty much have to kiss my saturday's goodbye, since both offices want me to work on the busiest day of the week. they fill up fast, let me tell you, even faster than those cherished evening appointments. but that goes with being the low woman/doctor/mommy on the totem pole. the other docs that i work with at both offices are starting to scale back themselves (and i'm picking up the slack, lucky me!) but they've been at it for a number of years so they've paid their dues. hopefully it will soon be my turn to get a break!
it was back to work on thursday, and i had a nice, calcified root canal ready to greet me. i had already taken out the nerve the day before canada day when he presented to the office with a nasty infection (it actually stunk when i opened it up) so he came back so i could finish the job. two of the four canals were blocked and i had to instrument for about 45 minutes to open them up. and after all my hard work, my last rotary file separated in the mesiolingual canal. damn it! so i told the patient, and my boss, and filled the remaining canals as beautifully as i possibly could. at least it was the last file and it went all the way down to the working length, so i know i adequately cleaned and shaped the canal. hopefully the separated file will act as a sufficient enough obturation material. we'll cross our fingers and hope for the best, no? worst comes to worst, i'll send him to and endodontist to have a look.
the list of projects that probably won't get done anytime soon is as follows: clean up trash that previous owner left in backyard, such as speakers, oil cans, and for real, a 50 pound bag of cement that got wet and set; take out the cigarette butts that said owner also left from the planters in the front of the house and replace with pretty, hardy marigolds; hopefully not kill the marigolds in a record amount of time; replace light fixture covers in upstairs bathroom and put up a shower curtain so that our guests don't get everything wet; replace nasty flourescent light in master bedroom with nice, soft incandescent lighting so that i don't look like i have jandice and/or plague every time i venture into my bedroom. am i forgetting anything else? probably!
it was back to work on thursday, and i had a nice, calcified root canal ready to greet me. i had already taken out the nerve the day before canada day when he presented to the office with a nasty infection (it actually stunk when i opened it up) so he came back so i could finish the job. two of the four canals were blocked and i had to instrument for about 45 minutes to open them up. and after all my hard work, my last rotary file separated in the mesiolingual canal. damn it! so i told the patient, and my boss, and filled the remaining canals as beautifully as i possibly could. at least it was the last file and it went all the way down to the working length, so i know i adequately cleaned and shaped the canal. hopefully the separated file will act as a sufficient enough obturation material. we'll cross our fingers and hope for the best, no? worst comes to worst, i'll send him to and endodontist to have a look.
the list of projects that probably won't get done anytime soon is as follows: clean up trash that previous owner left in backyard, such as speakers, oil cans, and for real, a 50 pound bag of cement that got wet and set; take out the cigarette butts that said owner also left from the planters in the front of the house and replace with pretty, hardy marigolds; hopefully not kill the marigolds in a record amount of time; replace light fixture covers in upstairs bathroom and put up a shower curtain so that our guests don't get everything wet; replace nasty flourescent light in master bedroom with nice, soft incandescent lighting so that i don't look like i have jandice and/or plague every time i venture into my bedroom. am i forgetting anything else? probably!
posted by Dr. Mommy, D.D.S. at
3:43 PM
2 Comments:
Welcome back Doc Mommy! Sounds like you are ahving a fun time at work! :D
I have to do saturdays as well but my boss is a real workaholic imagine 7:30 am to 5:30 no breaks, every patient half an hour. If I were her I'd have a nervous breakdown. So since she takes up so much slack, work for me has been good and I can do all my work to my best ability. I have been having a few odd ball patients though and others that claim the receptionist quoted them something different to what I do before I commence my work. They grumble and I am like "well they could only give you a range but you're here now and your filling is this big" and they grumble some more and say since they are here they might as well do it! Grr don't you hate getting patients like that a few in a row!? They always come in twos or threes. I had another one claim that he hadn't been to the dentist in 40 years because he "went mad" they last time he was in the chair "as a young man" when they tried to treat him. I asked him to elaborate and he shrugged claiming it was probably the LA and he just said he trashed around and didn't know what he as doing. Err ooookay. I sent him to get allergy tested. heh. We'll see what happens.
By
Rachel, At
Thursday, July 13, 2006
Re: the broken instrument and subsequent referral.
I can't speak for all endodontists, but I know that most of us would prefer to see your patient without any gutta percha in the tooth.
Here's the rationale:
1. Because your referral to us transfers responsibility of the tooth to us, we need to treat the tooth as well as we would any tooth we would see for initial treatment.
2. Depending on the amount of infection associated with the tooth, we might decide to manage the canals differently from the way you did and so we would need to remove the gutta percha that you placed (especially if orthograde removal of the instrument fragment is possible).
3. Some referring dentists charge patients for obturation of the canals that don't contain the obstruction. This leaves the patient with less options (under insurance) when they arrive at the endodontist.
4. Although apical surgery might be an option, prognosis of surgery is less than that of orthograde treatment or retreatment (again, depending on the retrievability of the inst frag). I've left some comments here that you might find interesting.
By
Unknown, At
Friday, July 28, 2006
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