Today I saw a patient. He was scheduled for SCRP. His pocket depths were 5-7mm. He was high strung and wanted nitrous. He did not have very much deposit and what deposit he had was really deep at the base of his pockets. He told me he previously had SCRP completed and knew he needed it again. So I didn't even have to go into my speil. He had scheduled 2 hours with me. I thought to myself...ok this guy wants scrp I will give him scrp. I hooked up the nitrous and proceeded to start and intra oral exam when I discovered he had some huge exotosis. They were form 4-9mm deep. The patient also had large mandibular tori. I know you are thinking so what, the man has bone gowths-who cares. What made this patient unique was this was the first patient I had to give maxillary injections too. It was such a challenge to get the PSA right. I tried to give a MSA but the patient said not to try again. It was really hard to get around that deep bone. Luckily the nitrous and PSA was enough for him to tolerate the procedure. I really wished my office had Oraqix-it would have been so much easier. Fellow RDHs let me know how you handle this. I am too afraid to bend the needle and I thought about giving an infiltration at 90 degrees but I just could not do it. I need some advice....
On a lighter note. I went to Hogle Zoo last weekend. My niece and nephew as well as all my siblings (except Army Dave) and mother went with me. We had such a great time in the rain. All the animals were great. I loved the black bears and the baby orangutan. I love being out of school! I love having time and money to go on little trips like this! Now if I could just get a little sumpin-sumpin life would be perfect ha ha ha!
3 comments:
Thanks for your kind words on my blog, I have to say I would have just gone for the 90 degree infiltration (or just up in the vestibule at the best angle you can muster), I know it seems crazy, but it is really really hard to mess up and infiltration, so you can pretty much stick the needle anywhere you want (hopefully no pts read this right!), even though it is nerve racking. I only feel this way because in NY you cannot do blocks so I have to infiltrate the mandibular, which is totally crazy but has really made me realize the "stick it anywhere, anyway you can" concept. Sorry if that is bad advice! Take care!
I am so glad that my 7 weeks at the VA are over. It was a nice experience (no class 3's), but I hated driving down there! I have all my requirements filled except for 8 quads of class 3, so hopefully I can find those last quads soon!
Our first anesthesia labs went great! I loved it so much! I'm not looking forward to doing the IA, but only because they hurt!
Well girl, thanks for keeping up on your blog, I totally love knowing you're only a click away!
Hi, I read your blog and it makes me salivate for my own graduation. VA is over for me too. I sure did like it. Take later.
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