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.