Day 16

Memorial Day :)

I went home to see my husband, family, and my parents-in-law.

Was an amazing break and I enjoyed it very much!

Day 15

Today I assisted with a complex surgical extractions and bilateral tori removal by Dr. Fleenor. Assisted with another full-mouth extractions as it really helps me see everything close up and personal.

Dr. Fleenor uses continuous sutures and they look something like this but much better ;)

Then I extracted teeth #6, 7, 8, 9 and 10. Patient had very dense bone and I have learned to use the rongeur to extract fractured roots. I also delivered a set of dentures. Patient was very satisfied and said they fit much better than his old set of dentures.

Day 14

Placed amalgam fillings on #18F and 18O. Then saw another patient who had a fractured #15DOL and restored with amalgam.

Extracted six teeth- 2, 4, 5, 15, 28 and 29 and sutured the sites where primary closer was possible.

Had another patient who had 2 large cervical caries on #22F and 27MF and his partial depends on these two teeth so he was hoping to have them restored. We discussed the benefits of amalgam vs. composite and he said he wants amalgam to keep his teeth. Dr. Schmidt checked my preps and helped me establish better retention by using 90 degree cavosurface in addition to retention grooves. I am really starting to like using amalgam in areas such as subgingival margins where isolation is almost impossible. The results were good and the patient was very happy to have his teeth restored.

Day 13

I extracted a few teeth today. One of the patients kept talking about how he would come back to get all of his teeth extracted by me even though it was not needed. It was uncomfortable but I was quick to let him know that I was married and he apologized for talking like that. I also assisted Dr. Fleenor with a big case. His patient has hemophilia and needed to get cleared by his hematologist to get all his lower teeth extracted. The procedure also included alveoplasty and removal of bilateral mandibular tori. Dr. Fleenor did a great job providing hemostasis using gelfoam in every socket and continuous sutures in addition to collagen dental dressing on top of the ridge to assist in tissue healing.

When I was cleaning up, I think the scalpel possibly hit my finger. I didn't realize the scalpel was still on the blade holder while handing. I looked at my glove but did not see a cut. Later when I was cleaning my hands with a hand sanitizer I felt a slight burn and thought back to the scalpel and the possibility that it may have slightly nicked my hand earlier :(. There was no bleeding but I did follow the exposure control plan provided by the VA to be safe. I also completed an incident report and did baseline blood lab work. The patient is staying at the VA until Saturday so that they can be sure he does not have excessive bleeding. He was also informed of the incident and consented to the exposure protocols.

Day 12

I started the day with a large restoration on #20DO. The patient was a very sweet gentleman who needed his wife in the room with him. They told me that they were married for 67 years and had an amazing story of all the things he's been through. He was so happy with his experience and kept saying I'm so thankful to have you and we told him no we're thankful to have you and for serving our country- and he said "well that's a good point too hehe".

I delivered a set of full upper and lower dentures on the next patient and she really liked them. She said that her new teeth look just like her teeth before.

Then the patient that I performed pulpotomy on came back for the RCT. We placed rubberdam and I removed the occlusal IRM and located 3 canals. I found the ML canal to be calcified and the MB canal was curved. Dr. Snyder told me that it could be due to the incomplete instrumentation of the canals. He used RC prep as a decalcifying agent and was able to open up the calcified canal using rotary files. The patient was told that prognosis is not excellent and we just have to wait and see if it heals properly.

I also saw another patient for final impressions. I have learned to check for overextension of custom tray and learned how to take it down quickly in the lab using a rough stone wheel. Dr. Fleenor showed me a great way to see if the tray is sitting on attached tissue. He places the tray on the ridges and then takes the lower lips for example and stretches them upwards. If the tray completely dislodges, we know that the it is over extended.

Day 11- Extractions

Monday- I was told that I will be getting a lot of experience with extractions this week. It was true. I started with one extraction and then observed faculty extract all upper teeth. The patient was African American and had very dense bone. The molars had to be surgically extracted, followed by alveoplasty to get him prepared for full dentures. I also had more extractions. I learned a new technique while using the elevator and also putting my fingers around the tooth to get a feel for how much movement and bone expansion I'm creating. I also used the cowhorn that was pretty helpful for mandibular molars. Dr. Fleenor showed me how to seat the cowhorn deep in the furcation and by applying pressure to the handles of the forcep and moving it mesially and distally I can have the forceps seat all the way down in the furcation. Then buccolingual movement is used to extract the tooth.

Day 10- NCDS Annual Session at Myrtle Beach

Friday- I attended A 360◦ Slam Dunk Guide for Successful Teams by Mark Hyman, DDS, MAGD

PM: Program continues

CE Credit: 3 hours each session

ABOUT THE PROGRAM

“Change is inevitable – growth is optional.”

In this fast past, ever changing world, dental teams must commit to taking a serious look at every aspect of the practice. With a comprehensive feedback process you gain insight into your performance, which allows you to identify opportunities for growth. Learn how to diagnose, treatment plan, and deliver optimal care, whether single tooth, quadrant, or full mouth rehabilitation. Enjoy this fast paced, fun filled, dynamic seminar that will super charge your practice today!

– Understand the urgency to lead and re-align your practice today

– Rank the doctor and the team in the 35 key leadership issues for peak performing teams

Click Here for the ranking guide

– Consider key communication barriers, and how to overcome them

– Learn how to blend high tech and high touch relationship-based care

Saturday-

Saturday- Quick and Easy OSHA: Training Doesn’t Have to Hurt by Laney Kay, JD.

CE Credit: 3 hours each session

ABOUT THE PROGRAM

Let’s face it…most OSHA training courses are anything but fun. Join us for a class that will change your mind forever. Its fun, it’s fast, it’s informative, and it satisfies your annual OSHA requirements. We’ll also cover the newest infection control guidelines, new disease information, HIPAA highlights, and other relevant regulations.

The participant will be able to:

– Recognize that the dental office is government by many different government regulations.

– Understand various regulations and learn how to incorporate them painlessly into their own offices.

– Understand the importance of standard precautions and the use of PPE in the dental office.

– Recognize the importance of the CDC’s infection control guidelines and training for the dental health care worker.

– Identify strategies that can prevent occupational exposures to blood and body fluids, ALL without being put to sleep

Click here for the handout