Dr. Mommy Dentist

Sunday, July 08, 2007

bombed out teeth!

okay, i've been getting a crapload of teeth with horrid subgingival caries. i've sent, like, six people to the periodontist for crown lengthening in the last two weeks! i've been kind of obsessive about the crown lengthening thing lately. i see so many teeth that should have had the surgery that didn't, and i think of all the crowns that i did that may or may not have needed it. i'm taking no more chances.

i had a guy shadow me over the last few days, a dude who is applying to dental school for next year. i liked having him around as i loved explaining all the stuff i was doing. i'm pretty textbook, but i was REALLY textbook when he was watching, i.e. using rubber dam for even the smallest occlusal cavity prep, not taking any shortcuts. i don't want this guy picking up any bad habits before he starts, know what i mean? friday was pretty busy as i'd sectioned a bridge (had to refer that one for CCL!) completed a pulpectomy on #16, final impressed a crown, completed anterior restos, and did two new patient exams, so there was plenty for him to see. he hovered over me wearing a white coat that was too big for him and holding a clipboard while taking notes. he reminded me of a USDA meat inspector, for some reason. and he followed me around everywhere, to the point i had to say, "hey, i'm going to the bathroom this time, i'll be right back, " because he followed me anytime i got up to get anything, be it a chart, an instrument, anything. anyway, yesterday was busy, but packed mostly with new patient exams and emergencies and only one extraction. so he says to me, "well, it doesn't look like you're doing too much, so maybe i won't come in tomorrow or i'll just come in to see the extraction." so i said to him, "hey, that's not true, there's a lot to learn from new patient exams, such as taking an accurate and thorough medical history, diagnosis, and most of all, patient management, seeing how we interract with people on the job. the main thing is learning to deal with patients, it's not only all about the procedures. you'll learn all that when you get to school. you don't have to answer to me, you can do whatever you want, but you may be missing out on a lot if you don't come." i think i scared him, as he was there bright and early and it was true, there was quite a bit to see, even if i wasn't "getting my hands dirty." i saw an 87 year old patient who unfortunately has to remove all her anterior teeth and add them to her partial because of endo abcesses, perio disease, and internal resorption. we saw some recall exams that were works in progress of my colleague, one of them a really great anterior implant case that was a treatment a of motorcycle trauma. overall, i think he had a really good experience, as he said he learned a lot and had a good time. it was fun having him around, and i think it made me a little more aware of the quality and thoroughness of what i was doing. and he'll be back next week, so that's a good thing. at least we didn't scare him away!

at some point i really do want to get into teaching, once i'm established and have a few more years under my belt. i think i'd be good at it and would really enjoy it.


  • Are the patients giving you a hard time to agree to go for the CL?

    I freaked out the last couple of dental students that came over to observe a few weeks ago. I don't practise what I preach, so they saw me using gates gliddens crown-down and rotary Profiles on my slow-speed (non-endo) handpiece to remove gutta-percha. These are very dangerous things to do if done with inexperience.

    Although they won't be doing such things themselves, seeing how people do things differently is always a good learning experience.

    I'm just not sure how much a pre-dental student will retain...

    By Blogger Ameloblast, At Sunday, July 08, 2007  

  • of course the patient isn't happy that they have to have another procedure, but once i explain what can happen if it's not done, they are usually cooperative - nobody likes the thought of paying $950 for a crown that bleeds constantly and eminates a foul smell when flossing. it also helps that i am sending to a specialist and not doing the procedure myself - that way it doesn't look like i'm "just fishing for more money", the concept which is more of a concern for the patients in one office in particular.

    as for the dental student wannabe, i kind of wondered why he was writing all that stuff down. before i applied to school, when i shadowed and asked a lot of questions i found the answers very fascinating but had no intention of using them during my dental school education. i remember when i was 19 i had #36 extracted because the dentist told me it needed a root canal and crown lengthening and i couldn't afford it. she explained what everything was because she new i was applying, but it wasn't until i took my perio courses four years later that i thought, "oh, THAT was what she was talking about!" maybe if i took notes i would have gotten that A instead of the B+ so maybe he's on the right track? or maybe he wants to write things down because it may be helpful during the interview process as some like to ask very detailed questions. who knows?

    gates gliddens on a slow speed. now that's really living on the side of danger.

    By Blogger Dr. Mommy, D.D.S., At Sunday, July 08, 2007  

  • p.s. i thought you were punished.

    By Blogger Dr. Mommy, D.D.S., At Sunday, July 08, 2007  

  • Punishment time is over!

    It's the crown down with the GG's that's dangerous. To crown-down with them you have to use them aggressively and doing so risks perforating the root in a really bad way.

    By Blogger Ameloblast, At Monday, July 09, 2007  

Post a Comment

Subscribe to Post Comments [Atom]

<< Home