I have to use a guide...

"What do you need a guide for Leisa?" - you ask...

Sharpening my instruments of course!

Professor Costley, This is for you! :D

The concept isn't the hardest, it is having to be at the exact angle [110*] with the face of the blade.

Having sharp tools will help in so many different ways.

=Especially Ergonomics!=

=It is easier to remove calculus with= (not the math, my husband always thinks I'm talking about Math... ??)

=You are less likely to hurt someone=

=Tactile sensation improves=

These are just a few examples of why it is so important.

*PS. Remember to end in a DOWN STROKE to prevent wire edge... :D

Now go and enjoy your sharp tools! :)

Now Walk IT OUT!

After every patient, you must "walk them out".

[[ literally and through the computer]]

It is really easy on Eaglesoft to walk out your patient.

Basically, you right click everything you did today, say post to walkout, and click on "Fast Walk Out", don't forget save and it will print.

[told you it was simple]

Now is the time to walk out your patient, out to Mr. Soloman. He says a bunch of stuff, asks a few questions, and (my favorite part) he ends with

:D"Enjoy your smile" :D

SEAL IT!

Sealants are a lot easier than I thought they would be. Don't forget your cotton rolls and triangles. :)

First, you have to clean the tooth.
[[ either A/P polisher or with a prophy angle]]

My patient was Kristen
[[She is adorable! Not to mention an amazing patient.]]

Anyway, after you clean the tooth, you just dry it and put the "blue goop" on the occlusal surface for 1 minute.

After, Suck it up with the high suction using the A/W syringe.
*Note: if you cover the tooth with the high suction before spraying water, it will help the patient not taste it.

Dry the tooth again, make sure it doesn't get wet at all
[[ which in the mouth, is kind of hard, but try your best]]

Add in the sealant and using a cure light, cure for 1 minute.

Overall, a very fast process, and I don't think it will be long until they become second nature.

*Bragging Time: I have NEVER done a sealant before and my very FIRST time, I did it perfect!!! WHOOT WHOOT!!!

Polishing, Fluoride, and Varnish

Air Powder Polishing

This is a nifty little thing that I had no idea existed.

It used air to push out a sand like substance to "blast" the stain off teeth.

You must make sure there is enough sand in the container before starting.

Air is always coming out; push a little farther and you will get water;

push the peddle all the way and you get sand mixed with the first two.

You and your pt. must wear an apron, a hairnet, and safety glasses.

[[ Sand get EVERYWHERE!]]

= you can give your pt. a cloth to put over their eyes to help=

[[ Beware: It hurts your gums, tongue, and lips a little]]

Polishing

This is a 'normal' polisher.

[[the one you are use to in the dental chair]]

This is for stain as well. It is for a lighter stain though.

This uses a cup, prophy paste or some toothpaste.

You use a slow speed (between 10 and 20)

Flare the cup to reach slightly into the sulcus, and polish around the cervical third of the tooth.

Don't stay too long on one tooth, we don't want to heat up the tooth.

Fluoride

Dry the teeth.

Insert tray with fluoride into the mouth.

Put the saliva ejector between trays to suck up any excess saliva in the mouth while the trays are in.

Have pt. close mouth and bite together gently.

The fluoride must be on the teeth for at least 4 minutes to be fully effective.

Stay with your pt. the entire time monitoring them.

[[ As we know, Fluoride is a poison; DO NOT SWALLOW]]

After the removal of the trays, instruct pt. to keep the saliva ejector in their mouth.

*DO NOT EAT OR DRINK FOR 30 MINUTES AFTER TREATMENT*

Varnish

Varnish re-mineralizes the teeth.

Lightly dry the teeth with a 2X2 cotten square.

Apply varnish a thin layer in one stroke all over all surfaces of the teeth.

[[ including buccal, lingual, and occlusal]]

Instruct patient to not eat or drink hot, sticky, or crunchy foods for 4 hours.

[[ also to not brush or floss either]]

*Don't forget to record all the treatment that you provide in the TX area of the Treatment Record*

Eaglesoft

This is basically how to schedule a pt. and creating a TX plan.

First things first: SCHEDULING!

* Make sure you are the preferred provider.

* Enter services and phasing using the quick/ service button.

* While practicing, change the fee to $0.00 [we don't want to make our fake pt. pay]

Next: Creating a TX plan!

* Mark all the the items that are correct.

* Have your instructor approve the plan

* Print the plan and have your pt, instructor, and yourself sign.

* You must have all signatures prior to beginning treatment.

Overall, not a hard concept to grasp.
Here is a little sumthin sumthin (a picture) for you! :)

What you see on the screen...

Coloring Charts

Dental Screening

There is this green paper that we have to fill out, with pencil

[[our pencils are not good. Note to self: get pencils that will sharpen before they are halfway gone]]

There are all sorts of things that can go wrong in someone's mouth

From supernumerary [[extra teeth]] to having a diastema [[spaces]]

We as Dental Hygienists must note everything in the mouth.

This includes any hardware that the Doc put in.

This process evaluation wasn't too bad.

You basically color the chart to look like a pt.'s mouth, noting certain things in the comments section.

The only part which is a little difficult, is knowing which color to use.

[[choices between BLUE & RED]]

What has helped me is to note in red the pathology.

[[that means anything wrong in the mouth]]

Here is a picture of the chart to fill out. :)

*This is my chart, and no I couldn't get the picture to turn... :\

*I think with some practice, this will come really easily.

And I cannot wait until we can chart on the computer.

Radiology

Our WONDERFUL Judges
(just noticed that they are the oldies of the group)
:) we love them!

PB and Banana group.
(The Jiffy was the PID, cute huh!)

Today, radiology was super funny.

So that means I just have to blog about it.

We all had to present one of the different films we can take.

It got a little crazy when we had to get creative with using anything and everything from our skull
                                                          (anatomy) to food. :)

It was very fun and I loved laughing with everyone.  

The winners. This is an old lady... HILARIOUS!!!!

My group. Way cute girls!

Chelsea, she is way cool.

Say Cheese! :D

Today we were suppose to go over the Intraoral camera.
Well, they ran out of barriers, so we didn't get to take any pictures today.

This is not like an x-ray. Say someone has a HUGE lesion on their tongue. You could always describe it with a thousand words, or you could just take a picture and describe it in a few words.

Using a USB cord, the pt. can see what the camera sees. It shows right up on the screen next to the pt. chair. I think EVERY office should get with the times and have both computers in the room, as well as a USB camera to take pictures on that instantly upload. ... just sayin'.

The camera is also very helpful with pt. motivation. We all know that Dental Hygienists are known for nagging and being pushy toward preventing disease. (not the same can be said for the DDS... tsk tsk)
If a pt can see what they are doing to their mouth, it might just help someone stop smoking or brush their teeth more than once a year.

Maybe once we actually get the chance to use the intraoral camera, I'll have a little more to say about it. :)

=Dirty Rotton Tooth=

You are going to have lots of them if you don't pay attention to this OHI.

or ORAL HYGIENE INSTRUCTION as my professors call it.

Let us start off with the mild case: CARIES (or cavities)

- Dental caries are a disease where bacteria damage the tooth structure.

- When eating anything, your mouth turns more on the acidic side.

- If the acid is left on the tooth long enough, this will cause demineralization.

- Once the tooth structure has been compromised, it cannot be fixed.

(this is when the DDS has to drill out the hole and put in a filling, which other than the nitrous oxide, is a bad thing)

Now for the more extreme condition: PERIODONTAL DISEASE

- Perio is caused by biofilm buildup on your teeth. after every meal, bacteria stay on your teeth.

- The bacteria put off toxins. That combined to your body's defense to the plaque, cause your gums to puff up and get red. (gingivitis)

Here is a little production to give you a better understanding of how Periodontal Disease progresses.

 So brush your teeth every day, at least twice a day, if not after every meal, and you won't have your teeth fall out. :)

Curet Scaler

Basically the same as the sickle scaler... with more curves.

To correctly use the curet, you must apply the three A's that we have already learned.

A 70-80 degree angle is still desired.

With the curet scaler, you can use both an exploratory and working stroke.

Exploratory Stroke

This stroke is "looking" for calculus. (AKA tarter for you non-fluent folk)

-lighten up on your grasp

-lighten up on your fulcrum

-lighten up on your stokes

Working stroke

This stoke is removing calculus.

-tighten up on your grasp

-tighten up on your fulcrum

-tighten up on your stokes

*remember to develop your own system/ direction of working through the mouth.

This will not only make you faster,

but if you are like me and can't even remember what you had for lunch,

you will also be able to know where you have been and where you are heading next.

A. A. and more A

That's Right! :)

Adaptation, Angulation, and Activation!

These is the basics for any great Dental Hygienist.

"What do they mean?" you ask.

Just hold onto your horses and I will tell you. ;D

Adaptation

the movement of the toe/ tip moving around the tooth.

-this means you turn the tip around the tooth so you don't poke into the surrounding tissue.

Angulation

the angle of the cutting edge against the tooth.

-best is from 70 - 80 degree angle.

Activation

the movement you are making.

-this is an up and down movement, while going around the tooth.

(you can use either a horizontal, vertical, or oblique movement)

Now you are a pro at the three A's. :)

@ least on paper.

=sickle scaler=

Sickle Scalers are used for the anterior teeth.

UNFORTUNATELY, the PE expected us to scale
3 maxillary and 3 mandibular teeth in 3 minutes...

I laughed too. :P

There is a lot of goals that are reachable, however, for me, this one was not.

On this one, you don't really need to know the working end.
They are both the same.

There are also a few steps to remember when you are scaling the anterior teeth.

1. know how to use your mirror...
(I have yet to get the hang of this.)

2. adapt the toe-third of the cutting edge.

3. roll the handle between the thumb and index finger to maintain adaptation.

4. use short, controlled, overlapping strokes activating the instrument with a wrist/arm motion.

5. know the sequence you are going to scale.

There are many many more but my brain is already hurting.
:)

Design and Class

That's right! I'm talking INSTRUMENTS.

Wednesday, we went over all our instruments and what the difference is between them.

We have 10 different instruments that actually touch a tooth.

There are differences between each one that the untrained eye can't see.

Now that my eye has been trained, I can tell the difference between a Nevi and Nebraska.

and I'm not just talking the color of the handle.

Some differences to look for include, but are not limited to:

1. Is the working end RIGID/ NON-RIGID?

2. Does the instrumentation remove LIGHT/ HEAVY CALCULUS?

3. Is the tool primarily used on ANTERIOR/ POSTERIOR SURFACES?

4. Is the TERMINAL SHANK SHORT/LONG?

5. What is the ORIENTATION of the blade?

A few things stuck out to me during this clinic session.

All the blades are a 90* Angle, excluding the Gracey's (70*)

The explorer is the only subgingival instrument with a pointed tip instead of a toe.

Today Professor Costly got CRAZY with her lesson and had a contest.
Whoever could set up their pod for Pt. Tx. fastest, would get a treat.

Short story long, I WON! 
... because I'm awesome!

overall: pretty chill day. Now to memorize all these instruments. :)

take a look around... go ahead. explore!

I learned how to explore today ... with an explorer, of course.

Danielle was my lucky victim today!

This was soooo much better than probing. Maybe just a little less frustrating.

With an explorer, you have to find the correct end to use. The anterior and posterior teeth have two different ways of finding this end.

Anterior: lay the working end on the facial side of the tooth. make sure the curve of the shank is along the tooth, if it is pointing up, that is not the correct end.

Posterior: use the interproximal space for this one. Watch your wrist as well as the shank of the instrument. The shank will be parallel with the tooth, and your wrist won't be all crazy trying to make it parallel. If you're getting all crazy up in there, switch the end.

After you find the correct end to use, you can start by going subgivivally and using upward stroking motions. Keep the toe (or tip) on the tooth. I think this feels like I am scratching the tooth.
Following the toe will help you not push your instrument into the tissues surrounding the tooth.
This will help you find the calculus on the teeth, both supra and sub gingival.

All around, sounds pretty simple. Putting the words into practice, is a little different.

UDHA Convention

Yesterday and today is the UDHA convention. I was required to go yesterday and today I am going to help out in the SADHA booth for 2 hours. This will fulfill 1/2 activity requirements for the SADHA program.

There are classes to fulfill your CE [[continuing education]] requirements for those who already have a degree. They go over new techniques and products to better help in the clinical setting. A lot of people were there including 6!!! schools. It has made me very worried for the availability of work once I graduate.

They had only 1 class specifically for students at the end of the day. They talked about different ways to use a degree in the USA, including everything from the military to working on pt.'s who are in prison. This is a very well paying job where ever you are, it's just getting the job that is the problem. :)

They had a ton of booths there that we could get fit for loupes or test out some ultrasonic scalers. My very favorite was the massage station. They gave us massages for 3-5 minutes and they felt AMAZING! Everyone gives you free stuff that you get to try out for yourself. Many come to Weber and do a Lunch and Learn for us. They bring us all lunch for free and we get to learn about their product, and give us free product again! In April the man from Sonicare (electronic toothbrushes) told us that he would be visiting and everyone gets a FREE SONICARE BRUSH!!!!! This made me want to bow to him to say the least.

Anyway, here is a picture of all the free stuff I got,

just in case you didn't believe me. :)

This might pinch just a little...

Well... when I am probing, it pinches a lot!

[[ you probably shouldn't be my pt. for a while]]

I had a hard time maneuvering the instrument
...apparently you aren't suppose to probe the lip.

We practiced on marshmallows for how hard to push and candy corn for the correct angel to hold it at.

Poor Misty, probably regretted her decision to let me probe her when I was digging around in her gums trying to find the correct angle.

="ouch" was her favorite word that day=

Reading the probe is really hard, because someone thought it would be a good idea to put a mm length on the probe so no one can read it without focusing really hard.

This is why the professors recommend buying loupes.

Problem with buying loupes: they are lots and lots of money. I have never seen a pair of glasses for $1000!!!
... plus you look like a weirdo when you wear them. :)

Positive about buying them: You can see what you are doing without compromising your body position.

All in all, I think probing will come with time and I am very excited for it to be that time.

OPEN UP!

On monday, we performed intra-oral exams. This is where we just look inside the mouth.

[[We are not yet trusted with sharp objects in there.]]

We go over everything from the vermilion border to the uvula and back to the filiform papillae.

Lots and lots of structures to name, this part worries me a little. I'm getting more used to the medical terms as the semester goes on.

It was really cool to have a pt. in my chair that could open their mouth without a lever. :)

With every clinic session, I get to learn more and more about my career and lots of different things that I will be performing on a daily basis.

Can I feel your face real quick??

No... This isn't weird at all. Well... maybe a little.

This is an extra-oral exam that we do to check for anything that might be wrong, like cancer.

You feel the pt. face and neck down to the collar bones.

[[definitely have to talk to your pt, so they don't think you are going to do anything inappropriate]]

I am pretty familiar with the structures, it is just remembering them all as I'm going.

Another weird part is that if you don't feel anything, that means they are good.

The part I have a hard time with is feeling the sub lingual and sub mandibular nodes. You have to reach under their chin and grab the excess skin, pull it up and around the mandibular bone. Then you let it slip out from your hand and try to feel the node. I can get it after a few tries, so it's just working on getting it on the first try.

Tip: talk to the pt. and joke around a little bit, this will relax everyone. :)

120/80??

I was very surprised to find out we take pt. vitals... AT THE DENTIST! Weird right?

That being said, it is really easy. I personally have taken vitals before in a pediatric hospital when I was interning there. It was a long time ago, so I had to reach into my memory quite a bit. :)

I first struggled with finding the radial pulse, but my pod partner, Danielle, told me to use 3 fingers.

This was Genius!!!!

[[don't know why I didn't think of that before]] 

After that, I was having troubles hearing the thumping sound.

So I had my pt. make a fist, and that seemed to help a lot too.

My husband is now very sorry that I have to do this because he is now my model at home. :)

HHX & HHRX

Starting with the Health History and knowing what to write for everything was very stressful. After you know what you are doing, charting isn't the worst thing in the world. I was very overwhelmed when we started talking about it. After I had done about 2 or 3 I started getting the hang of it.

I am not excited to memorize all the different situations that my pt. has to pre-med for.

This is going to be the roughest part for me.

We are now getting into the things which are specific to what I will be doing in the office setting. 

I am starting to feel like a Dental Hygienist finally. :)

Instrumentation

This has to be the worst PE there ever was for me.

I am one of those people who hold their pencil like a crazy person.

My thumb doesn't even touch the writing utincle.

So you can see how I am having a lot of trouble with instrumentation.

A few points to remember with holding your instruments:

• Thumb and index finger opposite one another (not touching or overlapping) bent in a relaxed grasp, should make a circle, no blanching.
• Middle finger should rest lightly on the shank
• Ring finger and pinky rest on each other forming a stack (pinky is not lifted in the air, we are not drinking tea)
• Ring finger is the fulcrum, or rest finger

Hand is held a little high, but you get the point. :)

I won't lie, I had to take home my typodont and instuments to practice. Another thing that is helping to get the finger hold down is to start holding my pencil and pens this way. My hand gets tired really fast because I am focusing on it so hard. Hopefully it will come with time and I will be able to make the instrumentation natural.

They Leave, You Clean

After the appointment there is a lot of steps to take to keep the operatory clean. I was very overwhelmed with this PE at first. After practicing and reading through it a few times, it has come pretty natural. There is a reason for everything we do, like waxing the metal portions of the operatory. You can tell by the little things we all do before and after every appointment, how well the space has been kept. I am looking forward to when I can clean up after an actual patient. :)

Sit Straight

Wednesday 8/31

I have never thought about having posture while cleaning teeth. After hearing the stories of the instructors, I now know it is a very important part of the job.

There are a few key points to remember:

• Adjust stool so thighs are parallel to the floor
• Position patient chair in supine position
• Adjust patient chair so operator's elbows are at waist level while performing instumentation
• Position bracket tray and unit light within easy reach
• Direct light to illuminate the area of treatment
• Back and shoulders in a relaxed position
• Do not bend over patient or cross your legs
• Keep at least one foot flat on the floor

You are now able to swivle the chair in the correct position to make it easier to remain in the correct posture while performing treatment.

•  Maxillary/ mandibular right facial and maxillary/ mandibular left lingual- 9:00
• Maxillary/ mandibular left facial and maxillary/ mandibular right lingual- 10:00
• Anterior (maxillary/mandibular facial/lingual) all surfaces toward- 8:00
• Anterior (maxillary/mandibular facial/lingual) all surfaces away- 12:00

While working in the mouth, let the patient help you out (turning their head). This will make your job a lot easier while saving your body by being able to stay in the correct posture position.

If you are not use to this position, it might take a while for it to feel normal. It is hard for me, personally, to not bend over the patient to see into the mouth.

I have trained myselp the wrong way and it is a long hard road to retrain my body.

 





 

Set Up and Tear Down

Monday 8/29

Clinic has been really simple until today. Our PE for today was how to set up and tear down your station. I am having a really hard time with remembering what goes where and when.

SET UP: You start by dusting all the equipment in your station withwith a damp paper towel and PPE on. I have never done this before in the office I worked at. We had a lady who cleaned the office weekly and would dust everything. I can say this definitely makes the station look REALLY good and clean. On the patient's side, I like it because I'm not worrying about how the office isn't clean. Next we sterilize anything we might touch, and run the water from the A/W syringe line (2 minutes) to clear out any germs that might be caught.

Barriers= Overdone
Before putting any barriers on make sure to take your gloves off and disinfect your hands. With all the equipment we have and precautions we take, we use more barriers than is needed. We put a cover on anything that we might touch (or even look at: jk). This includes: counter top, operator chair adjustment levers, bracket tray, A/W syringe, evacuator and saliva ejector heads, pt. arm-rest buttons, light switch, mirror, mouse to computer, and much much more. It is nice to know that we are taking every precaution to keep our patients, loved ones, and ourselves as healthy as possible.

The patient then comes into the office and rinses their mouth for 30 seconds with mouthwash. This helps eliminate aerosols. While the patient is doing that, we open the sterile instruments without touching them with our bare hands. (if you open before pt. gets there, cover with bib.) Seat the patient, and provide protective eye wear that has been sterilized. After that put back on your PPE and avoid direct gloved-hand contact with contaminated surfaces (especially mask, eyewear, hair, patient chart). After the appointment, remove gloves, and sanitize hands. Avoid contact with dropped instuments.


TEAR DOWN: Now it's time for the hard part. After the pt. walks out and charts are done, we start our cleanup by putting on our PPE. Run water through the blue boa and detach. Remove and discard A/W syringe and evacuator tips. Next you put all your biohazards in the correct waste container. (fluid soaked in a contaminated disposable supplies in biohazard bag)

Now you want to place the instuments in a cassette and take to the clean-up area on a tray. Run them through the ultrasoniccleaner for 15 minutes. After, wipe down the tray and put take it back to your station. Go back after 15 minutes and take out the cassette without placing hands in the solution. rinse and blot with paper towel. Put the instruments into the correct size bag, write your name and number on it, and place into the sterilization bin so it's standing on edge.

Back at the station, you will reglove and disinfect all surfaces that may have been contaminated by touch or aerosols. discard all disposable items and wax the metal equipment. At the end of the day, run the lines with solution for one minute.

* This PE was very difficult to me. Although I have already worked in an office and have the experience of set up and tear down, it is intimidating to learn it all in a new place and to remember every little step. This one will take a lot of practice in order to pass this one.

Rinse and Repeat

~WASH~WASH~WASH~

Who know washing your hands could be so detail oriented? I have heard of singing the ABC's or counting to 30, but I have never heard of this method. Three 15 second intervals.
     1- Focus on the palms and back of your hands. Rinse.
     2- Focus on the inter-digital. Rinse.
     3- Focus under the fingernail area. Rinse.
     4- Dry hands completely before putting on your gloves. (We don't want any hands chaffing)
You never knew there could be so many steps to a "simple" wash, did you?

~CLINICAL ATTIRE IS ESSENTIAL TO LIMIT THE SPREAD OF GERMS TO YOU AND YOUR LOVED ONES~

     1. Hair must be pulled back into a bun, no strands of hair falling in the face area, and no more than 4" hanging down in the back. (Failure to comply= hairnet, aka: unattractive)
     2. Earrings may be worn, but they must be studs and easily wiped off.
     3. Scrubs, hemmed to not touch the floor. Shoes only worn in lab and also easily wiped off, lab jacket (pressed) to be worn in all clinical area's.

*We  take all these precautions in order to keep our patients, ourselves, as well as our family safe.

~WASH HANDS~MASK~GLASSES~3 WASH~GLOVES~

This is the what happens every time we enter the clinic. We wash our hands, put on our mask, get our protective eye wear, wash our hands with the steps above, and finally put our gloves on. Now we are ready for treatment. :)

~Blue Boa~

Ann Arrington is the inventor of the Blue Boa. This is a saliva ejector. It hangs on the patients cheeks during intra-oral procedures to keep the water and saliva from gathering in the back of the throat. You tilt your patients head toward whichever cheek the Blue Boa is sitting in. This is a BRILLIANT suction and I would definitely recommend it!  Go to http://www.theblueboa.com/ to see the awesome video.

~Typodont~

Today we got to use our typodont for the first time. They are pretty crazy! They are basically a mouth with lips around it so it "holds" any water you shoot into it. This is what we used for our "patient". The only bad thing I thought about the clinic was that we had about a half hour to play around with the A/W syringe. There is only so much you can do with that thing. :) Overall, pretty chill clinic. At first I thought it was creepy. After "working" on it, I think it's awesome!

First Day!

Today was the first day of our Dental Hygiene studies. I will not lie, I was very nervous and barely slept last night. I had to keep reminding myself that others have survived and I would too, as long as I worked hard.

I live about an hour and 10 minutes away from WSU. I had an early start so I could have some time to relax when I got to the school. Long behold, I got about a half hour away and realized I had forgotten my lab coats. Ryan, my husband, was very kind and met me half way between. Good thing I left early!

Moral of the story:

Get everything ready the night before

and

Everything will work out if you give yourself some time for mistakes.

7:50am - Radiology Lab:

Today was a pretty chill day in Radiology. I have a little experience with the x-rays so I figure this as a review.

We watched a video on the different parts of the Radiology operatory equipment and how the x-rays are taken.

Continuing to the lab, we met "Dex", our plastic model, and took a few x-rays on him.

12:20 - Pre Clinic:

The day started out with us introducing ourselves. It turns out the Dentist in the midtown clinic that will be helping us out, is the brother of the dentist I worked for as a Dental Assistant.

We had a few different activities today to help us find our way around the clinic.

Our scavenger Hunt had us find area's in the clinic like glove and mask storage, and Emergency Response Kit.

This was very helpful to me because now I know where different items and tools are located. 

I struggled a little with the Eaglsoft program at first.

Once I got a hold of what I was doing and slowed down a little, it made more sense.

I had the most trouble with making myself someone's "Preferred Provider". After the teacher came to help, it was all good.

The advise that stuck out above the rest:

"The teachers are here to help you. They are not your enemy's".