Stick It!

Today, I saw a 13 year old patient that I learned the most from. He was a 1B and didn't have a ton of calculus build up for me to clean off. I found a few spots with the ultra sonic. It was the perfect day to work on my instrumentation, including my adaptation with the ultra sonic. I have been having troubles getting to the distal on the back teeth. It makes more and more sense the more I work at it and really think about what I'm doing. I have to remind myself that although I think I am adapted, I'm probably not so I need to adapt more. I have also been having trouble identifying decay with an explorer on the occlusal surfaces. I might just not be pushing hard enough into the surface, because I won't feel anything and then Instructor Bunker will come in and find one on every tooth. Instructor Bunker helped me a lot today be telling me where they were and to go back and feel them. I tried to push with the explorer as much as I needed to in order to feel that stick. I am understanding more and more of what a "stick" is and what it is not. Appearently you have to push a lot harder into it to see if that stick will happen or not.

Stars are aligned!

            I can't believe we are already to half semester. The stars aligned this week and we were out early! Yes, I said early. To top it off, we all got to eat lunch. Timing has been a problem with me, so I asked a few of the other students in different classes how they get out on time. They let me know that they go by clinic times. With this, they set times for each patient to be out of their seat. If I have a patient at 9 and a patient at 10, I have 45 minutes to do what I can and get them out. I was under the impression that we had to finish each patient before we got another one. Maybe we should have spoken a little more about times when we started. That would have saved me a lot of frustration. On Wednesday, I saw  2 patients in the morning. The first ended up being another board patient! He was perfect! Not very much bone loss but still radiographic calculus like no one's business. I got the OD done on him for Marie to take him to the clinic on Thursday. I hope the professors up there agree with us that he would be perfect.

               Next, I had an older man who had mostly crowns on his teeth. He had a list of medications that he was on, which I really liked because then I didn't have to try to figure out how to spell them. He was a class II and had one pocket of a 7 on #25. It is so interesting when you are going along probing and then your probe just drops in a hole like that. I don't know if I will ever get used to it. I am getting a lot faster with everything and I like the patient variety here.

This too shall pass... I hope sooner than later!

Today was overbooked again. It is really frustrating when this keeps happening. The morning is rough because we simply aren't fast enough to get all the patients done in that short amount of time. I feel it isn't helping me get faster, because I'm just so frustrated trying to get everything done, knowing there is another pt in an hour and all I have time for is an OD. We also may have found a mock board pt for Sierra. I hope that works out. I have heard a lot of stories about how we are more than just a dental hygienist when people come into our office. I'm talking about those pts who tell you their life story. The problem with my pt, is that he had a LOOOONNNG life. He really wanted me to know everything about everything. This made it really hard to work in his mouth. I didn't want to be rude, but at the same time, I didn't want him to keep talking. He kept talking about his friends and how most of them have passed away. He was younger than 50, so this was kind of sad. I didn't have any idea how to respond to anything he was saying. I tried really hard to not make it awkward, but I would try to keep talking so that I could work on his teeth. He even wanted to start getting into politics, which I don't really know anything about, but I tried to talk about it so that I could keep working. It was a very interesting day. I like the variety of pts that come into MT for a cleaning. They are all really interesting and I feel like I am learning something new with each pt. Although, not everything is related to dental, I still learn something.

Children Everywhere!!!!!!!

Oh goodness! I cannot tell you just how excited I am to have today, and this weekend over. I have seen more children then I know what to do with. I saw 5 children today alone and I've got to say, I'm getting pretty good at it. I hope without this children's health fair going on that we will soon again eat lunch. The children that I saw today were more like 2 1B's and 3 1A's. My problem area is really the lower linguals. I think they intimidate me. Usually, this is where I spend my most time. I have been working on doing what I can and think is good until I get a scale check and it all goes down the drain because I missed one on every tooth. This next week, I'm going to try to figure out a system to getting them clean and fast. Today was my second day using my loupes and I have got to say, I LOVE THEM! How did I work without them?! The teeth are so little when I'm not looking through them. Also, they help me a lot with my adaptation around the tooth, who would've thought? It was overall a stressful, bitter- sweet day. I am excited to see new adult patients.

 

ps. If our quads start to count for 'real' clinic, I will be covered in children up to my eyes! I will have seen enough for myself, my peer pal, and her peer pal. It has been a crazy couple of weeks!

Flu Season! :(

This week was very frustrating. First, one of the girls was sick so we went from being a little overbooked to really overbooked. On most days, I am pretty good about getting everything done in a reasonable amount of time. I am not as fast as I would like to be, but in all reality, it takes me about 2 and 1/2 to 3 hours to finish a 1B from start to finish, depending on the patient. Now we add into the mix a 1A in 3 and 1/2 hours total. Not to mention the charting that is not my strongest point either. My last patient did not leave my chair until 12:20 in the morning portion, and not until 4:30 in my second. I did not get to eat lunch because of the time restraints. Also, I did not leave until 5:30 because I had my charting to get done which I had patient after patient so I couldn't get any of it done before. I cannot wait to get into a real office so I don't have to probe a 13 year old. I feel like I am wasting a lot of time on things that don't need to be done, especially on the children I've been seeing. On the bright side, I finished my last patient of the day, which was a 1B, from start to finish in a little over an hour. I did miss some spots but overall, I did what I could and didn't second guess myself. I spent most of the time on OHI and I finished scaling in about 20 minutes. This is huge for me. It was definitely the highlight of my day. I definitely increased my skills on being faster and efficient at the same time.  Another high note, My x-rays are getting better. I only had to retake 2 out of the whole day because of closed contacts.

Some People's Children...

What a day! I feel like I was running around without a head for a while. I saw 4 children.  3 in the morning  and 1 in the afternoon. I am very excited for the day when I can be in an office! The challenge that I faced today was x-rays. Children are hard to take radiographs on, and the sensor didn't help with it either.  Instructor Bunker taught me a few techniques that I haven't used. First, she taught me to have the children bite down in a smile, and to keep smiling. This worked so well. It made the children not open back up and move the sensor. Also, I could see where the bite tab was to line up the tube. Next, I learned to tell the child to breathe through their nose. I never thought about it before, because I've regularly taken x-rays on adults, who naturally just do that. The contacts would not open up for me today, so Instructor Bunker helped me by having me place the tube and she would move it slightly and they would be open. It was very frustrating day. Very busy in the morning with 3 children. I hope with practice and experience I can get faster and more accurate.

I had 2 patients today! They were very interesting, and I will tell you why right now. :)

PT1: 1Q CII Ultra/hand scale, 4BWX

Yes, I had a patient today, 2 in fact. I saw a lady in the morning who spoke Spanish. I was very intimidated by this. I have not seen a patient who speaks Spanish and very little English before without a translator. After I pulled her back into my chair, I honestly didn't think she was understanding anything I was saying. Every time I would say something she would nod at me, with a confused look on her face. Cleaning her teeth was very hard for me. Not only because the x-ray machine was not working or because the ultra sonic I had wasn't very good, but because she seemed to not understand when I said "open" or "close", or pretty much anything.  I really need to learn some Spanish to help me with this. I tried to talk to her, but I ended up not knowing what to say or what she would understand or if she just thought I was an idiot the whole time because I know she speaks Spanish and not much English. I ended up just kind of sitting there and trying to say things but getting a little frustrated at the same time that I didn't know how to teach her how to brush or floss. Or why she might be having some discomfort. Today was a great day for me to work toward my goals and learn something new about the underserved population in inner city Ogden. This patient has taught me that even though I am intimidated, I can't show it. Instructor Bunker taught me to keep talking even though they might not understand. This will calm my nerves, and she probably knew more than she led on. The patient was probably just as scared as I was. After all was not said but done, I have promised myself to not be intimidated by this language barrier anymore.

 

Pt2: 4Q CII Ultra/hand scale, sel pol, df, Varnish F

My afternoon patient was a first for me. He was a man who was mentally impaired. This man had a condition where he was a low functioning member of society. It took me a minute to realize what was going on. After this, I remembered an ethics class I had first semester last year where a woman came to talk to us who was physically disabled. She let us know that she was the patient and we should treat her like one. We should talk to her like she can understand everything, as a regular patient. We let her know how important her teeth are and not assume that she "can't" do something because we don't know anything about her. This is exactly what I tried to do. I tried to let this man know how important his teeth were and how he could keep them clean. I gave him a toothbrush and taught him how to brush. This might have gone a little smoother, I'm still working out the kinks. He kept saying to me "I'm just here to get my teeth cleaned". I really stressed the importance of overall health, and how this is connected to us cleaning his teeth with the best possible service. He was a class 2 patient and almost every tooth was a crown. I got my fair share of cleaning under the crowns today. I learned how to use my graceys finally, and I would dare say I'm getting the hang of it! This appointment helped me with 2 of my goals: 1. Developing a treatment plan for patients with disabilities; 2. Increase speed and accuracy in hand scaling while using more lateral pressure. I was scaling to the very last minute but I finished him. At the end of the appointment, this man seemed very thankful for us to clean his teeth and happy with the service he received. I hope he continues to come back regularly and understood the importance of clean teeth.

Goals!

I have made some goals for this year of what I want to accomplish! Here they are! These are my goals and how I plan to achieve them mixed with the clinical experiences I will need to have while I am accomplishing them. :) Can't wait to see the end result at the end of the year!

1. Increase speed and accuracy in probing

Action plan: Read, discuss with peers and supervisor/ assistants/ dentist ideas to address this goal. Also look for any opportunity to practice my probing skills.

 

Clinical Experiences: Try new seating positions and fulcrums to increasing my speed and accuracy of hand scaling while maintaining an ergonomically correct posture. Look for new ways and advice to help as well.

 

2. Increase speed and accuracy in hand scaling using more lateral pressure

Action plan: Read, discuss with peers and supervisor/ assistants/ dentist ideas to address this goal. Also look for any opportunity to practice my hand scaling and lateral pressure skills.

 

Clinical Experiences:  Try new seating positions and fulcrums to increasing my speed and accuracy of hand scaling while maintaining an ergonomically correct posture. Look for new ways and advice to help as well.

 

3. Develop treatment plans for clients with disabilities

Action plan: Read, discuss with peers and supervisor/ assistants/ dentist ideas to address this goal. Also look for any opportunity to practice these skills.

 

Clinical Experiences: Develop treatment plans for clients and  try new dental chair positioning techniques. Also, talking to the patient instead of the caregiver while working with a client with a disability.

 

4. Increase my confidence of being a dental hygienist in staff training, patient screening, and referral in a long term care facility.

Action plan: Read, discuss with peers and supervisor/ assistants/ dentist ideas to address this goal. Also look for any opportunity to practice these skills. Help other dental hygiene students around me increase their confidence as well.

 

Clinical experience: Voice my opinion when I know it is correct in clinic or at Midtown Dental. Also, ask questions, to help me know what others would do in specific situations.

 

5. Understanding of the dental needs and methods of providing services for residents in the inner-city Ogden community.

Read, discuss with peers and supervisor/ assistants/ dentist ideas to address this goal. Also look for any opportunity to practice these skills. Help other dental hygiene students around me increase their confidence as well.

 

Clinical experience: Develop treatment plans for clients. Learn some words in Spanish for those patients who do not speak a lot of English.

Another Year

Well, another year has come around and I will be blogging on a weekly basis about something I have learned or done in each week. :) So here we go. This week was my first week at Midtown. This is the way we get experience and credit at the same time. Some go to the VA hospital and some go to Midtown. We will switch next sememster.


8.29.12
I had my first "no show". It was nice to not have to scramble to find a patient. There was lot of stress taken off, like in a real office setting. Instead of probing and scaling today, I learned a little more about the computer program. Open Dental computer system is a very different program from Eaglesoft. Although I really like that everything is paperless. Being CA was a great opportunity for the first day. Sierra's patient had a lot of medications he was taking, and a few lesions in the mouth. What I didn't know is there is no place on the periodontics page to chart lesions. It is in a completely different place. I was able to become more familiar with how the program works and how to best probe while by myself. After all was said and done, my patient not showing up was really a blessing in disguise.

I'M DONE!!!!!

1ST YEAR = COMPLETE!

I am finally done with my first year! It is amazing how much I have accomplished!

I am both excited/ scared for next year!

What will this adventure bring my way next year?!

Finishing Up

I finished my class 3 this week.
Costley classified him as a class 3 because of missing teeth.
(?? right??)
I am very happy to be done with my quads.
It took me both monday and wednesday to finish up this man.
He was very nice and came back 3 times.
I missed 4 spots in his whole mouth. This was very exciting/ rewarding for me!
It has proven that I am getting better! :) YAY!

CLASS 4!!!

This is it! I found someone to qualify for my class 3 requirement! :)

[[you can use higher classes for lower classes, just not the other way around]]

It took me an hour to finish his health history. My brain hurt the rest of the day.

He is 82 and a sweetheart! He speaks spanish, and I don't. So that was a problem.

Good thing his wife came with him and could translate for me. :)

She was also very nice.

He kept falling asleep in the chair, so I take that as a compliment. :)

His tongue and lip are very strong so I had a hard time seeing what I was doing or keeping my mirror in the right spot. :/

I only finished OD the first day. This leaves all 4 quads left. I am hoping I can finish him in only one more appointment so he doesn't have to keep coming back.

I JUST LOVE FAMILY!

My sister came in to help me out. I saw her last sememster and was finished with OD.

All I had left to do was scale. :)

I was confident that I would finish her pretty quick.

So I only planned for a 2 hour appointment. Which was plenty of time.

I finished my brother up with some sealants after to make it so I was done with my sealant requirements.

One more day down. Only 2 weeks to go!

HARD

I had a class 2 patient who seemed to have an opinion about anything and everything.

Not super excited to see him, since it is hard to get him to stop laughing while in the chair.

On the other hand, I am excited to get another class 2 done. :)

It was a great lesson on patients and how they are all different personality types. With all patients, you have to be nice and try to keep your fingers in their mouth so they can't talk very much. :) ha ha

I missed 3 spots but I was able to feel all of them... after someone pointed them out! :) YAY!

My Cute Niece

After finishing up a sealant on my nephew, my niece was able to come see me.

She is 3. I used a scaler on her and it only took me 1 hour to finish her completely.

She was so cute! 

She enjoyed getting her teeth cleaned.

Her father has pretty big hands so it is hard to floss a 3 year olds mouth.

I gave him a Reach floss holder to help him get in there a little better.

I also told him how to get her to hold still while you floss your teeth...

[[you'll have to come see me if you want to know this secret!]]

Overall, a pretty relaxing day. :)

My Best Friend!

He is cute. He is funny. He is smart. He is 6.

He is my

Best Friend.

I wasn't nervous because he is always really nice and listens really well.

I didn't use and scalers on his teeth because he didn't have any calculus on there.

Anyway, when the Instructor came over she asked me about using one, so this made me think about being ready next time.

I finished him on about 2 hours. This I thought was really good.

After him, I was able to take a pano on one of my friends.

There is a lighter spot in the middle of the jaw, this is because of the shield.

I am going to try really hard to find the exact point to put the shield in the perfect place.

Class 2.

Another family member came to help me out and let me clean her teeth. I struggled a little with it because I kept hitting calculus when I was trying to probe. I really wanted to get out the ultrasonic and just blast the few chunks away so I could get accurate readings, but I pushed through and even felt myself starting to pull away and go around them.

It was interesting telling my own family member she is a class 2. I felt bad because it is a very sensitive subject and It is hard to tell someone you love that they aren't taking good enough care of their teeth. She is just fine at brushing, it is flossing that is a problem.

In the end, I finished at OHI. I really wanted to teach her why it was sooo important to floss. Her X-rays were a big help in educating her on the bone levels and how it is important to keep it from getting worse. From what I have learned about Dentures, I would not like to have them ever. I know she wouldn't either. As this disease keeps progressing, it will eventually turn into that. That is why we need to get a hand on it now.

It was interesting to see the bone loss on the x-rays and to diagnose her as a class 2. It was a great lesson on how to be compassionate while teaching the important facts about periodontal health.

Hey Hot Man!

I know what you are thinking! "Who could Leisa have possibly brought that was a Hot Man?"

That's Right! RYAN J. ALSOP! My one and only husband!

He was such a great patient. I took 4 BWX on him and passed off my Anterior Scaling PE.

Instructor Jeff V. taught me to use the nevi. and I LOVE IT!!! It will help me to become faster at what I am doing.

Ryan had a blast with me cleaning his teeth. I didn't get too far because I ran out of time. I will bring him back in March to finish him up.

Ryan is my little Muffin! :)

Sick....

Feb 1st.

Today I woke up and was super sick.
I had my brother coming in to help me.
It was going to be an OD with Quadrant Scale.

I called professor Costley around 7 and tell her I couldn't come.
After that, I called my brother and freed up some time in his schedule. :)

I layed in bed the rest of the day. I was better the next day.

Lame post I know! but that is what happened. :/

ANOTHER CANCEL?!?!?!?

RIGHT?! Can you believe someone would cancel again on me this week?
[[I understand that you have other things to do, but we have been planning on this since December and you knew what you were getting yourself into]]

That being said, I am sooooo happy that my family lives close!

I would be lost without them!

Crazy Crazy Day!

I had my neice Kaitlyn come in and cleaned her teeth.
[[she is 3]] [[and the cutest thing you've ever seen]]

She was soooo good and sat in my chair the whole time!
I didn't know what to expect with a child. It was nice to do everything and then get a Scale Check all at once.
[[No OD Check Necessary!]]
I like children. Kaitlyn was in and out and she even took 2 BWX.
[[I had to re-take one because she moved on me, but she held really still for the second one.]]

After Kaitlyn, I had Ashley come back to finish her up. She only had one quad left
[[I know! She had to come back 3 times!!!! LAAAMMMMEEEE]]

I just wasn't fast enough the first two times. :\

Oh well, this was good to have a busy day.

Long story short, I finished Ashley and Kaitlyn up in one day!
[[however stressful the day was, I was very  happy to have this done]]

I also had my polishing PE done. It's going to be stressful trying to get all these done, you definitely have to plan for it!

Family, Family!

I am soooo lucky to have my family living close by so I can practice on them!

My brother came in and kept joking about how he can bite really hard!
[[ I just reminded him that I will have very sharp objects in my hand and he better be careful]]

I was not expecting to take a full mouth x-ray on him, but it happened. Honest, it did!

He was the perfect canidate for us to take a look-see at his entire mouth
[[which looked good, and I had to tell him that, :\ it just hurt my pride a little]]
ha ha

I had a really hard time actually taking a FMX on an actual person. Dex is all that I knew.
It is a little harder on a person because you are forced to move quickly and find the different angles by yourself. No more lolly gagging around and taking 500 on one Dex anymore. :\

Good News! I only had to retake 2 out of 20 so yay! AAAANNNNDDDDD I got all the way through OHI!!!! WHOO WHOO!!!! it would seem like I'm getting faster. :)

Patient Cancel

My pt cancelled on me today. Lame I know!

This was a very stressful thing to happen.

Good thing I have awesome family who will step up when I need them too! :)

My cousin Adam came back in to let me finish him up.

I honestly had no clue what I was doing.

[[I couldn't remember how to scale!]]

The instructor was very helpful and 're-taught' me how.

I finished Adam just in time for him to leave at 1045.

That wasn't the hard part.

We have to have all our paper work in by 11.

[[Yes, only 15 minutes to write up everything, less if you get your pt out late]]

This may sound like a lot of time, but it really flew by!

I was late with my paper work, but the instructor wasn't too worried about it.

[[after all, we are just learing and getting a hold of how things work]]

Overall, it was a very nice day. A big change from the last week where I felt like I was going to break down in tears at any moment!

Ultra Sonic Scaler

I was suprised at how easy this was to use.

*Continue to use a modified pen grasp and appropriate finger rests.

*Don't forget the light and mirror... yes, you still need to see.

*Suctioning is a must! No drowning patients at WSU on my watch! :)

*Get your water/air pressure right before starting.

[[you want a constant drip]]

*Adapt to the tooth, without puting the tip right on the tooth surface.

[[ putting the tip on the tooth will ruin the enamel, so don't do it.]]

*Always keep the Ultrasonic moving.

[[vertical, horizontal, and oblique as needed]]

*Check your work with an explorer

Well, there you  have it: A few things I have learned about the Ultrasonic. :)

We only worked on our typodonts, so I'm not so sure about how great it will go on an actual patient, I guess only time can tell. :)