I am VERY Thankful!

I have been in Delta for 3 days! I used to think Pharmacy hours were great but I think I LOVE dental hours! It has been so nice to be here with my family and know that I get to be one of the first to arrive and last to leave. It used to kill me to be the first one to leave. All I would think about was what my family was doing without me....I just knew it would be fun!

I am ashamed to admit that I have eaten enough food to feed a small Peruvian village for 1 week! It sure has been fun! I have played Old-School Electronic Battleship, made it into the top 10 on MahJongg, shot my dad's new Czech .221 fireball rifle--which I love! My bros have been trying for years to teach me how to thorw clay targets/skeet. I FINALLY learned how to flick my wrist just right to send the skeet soaring into the air...now if I could just aim ha ha ha. I shot skeet and 2 liter bottles filled with water-no air so they exploded when shot! We just finished watching Cars and Superman Returns (thanks AJH-who hooked us up with an early release copy) We have cheered for the Jazz--Go Jazz! And last of all we ate again!
I hope your Thanksgiving was as great and wonderful as mine!

Hey Perio experts....

On Friday I saw a patient who had been scheduled by the dentist for SRP. He did not have xrays, probe depths etc. The Pt requested that we only do BWX. I did and while they were developing I began to probe. So here I am on #2 I get a 4 3 7. I immediately think to myself ok here we go.... Then I get to #3 and I get 7 12 5. I was a little surprised to find a 12 on the straight buccal. So I reprobed the tooth and got 7 12 5. I continued probing #4 was 6 9 6 #5 was 6 6 6 #6 was 5 9 6 etc. All the buccals were so deep. # 8 buccal was a 9. I sat him up and strongly recommended that I take a FMX. He then told me he had received perio tx 4 yrs ago from another dentist in town. He asked me what his probe depths were so far and I told him. He admitted that they were deeper that before and agreed to the FMX. I finished probing and throughout his whole mouth all buccal/palatal/lingual readings were significantly deeper that the interproximal. I have not seen that before. The xrays showed bony defects in all those areas-consistent with my probe depths. I told the pt I recommended he go to a periodontist---in St George. He was not excited about going out of town for treatment. Then my dr came in and told him we would keep him in office. I was a little mad. This pt had depths on all first molars of no less than 10 and my dr wanted me to get down there into those furcations and guarantee that he would not loose his tooth. I am trying to become a ninja scaler but I have a hard time with furcas especially that deep. Later my dentist said that whenever he sends someone to the periodonist in St George the come back and ask to have their teeth removed and dentures put in. So he thinks it is a waste of time to send them down there. So I cleaned this patients mouth. I worked on him for 3 hours. I did not have any patients coming in later and he had time so we scaled on. He did not want to be numb. I told him that I was not going to be nice because he was trying to tough it out. He said ok. So I went for it. I admit I brought tears to this man's eyes. I hurt him but he claimed that it was better that being numb. So that was my day.

My question now is....what causes bony defects to be on the buccal and palatal/lingual but not interproximal? There was no radiographic calc and it was light/moderate. I was confused. It must be from a systemic problem rather than a local (calc) one. The pt claims to have no health problems and stopped smoking 4 months ago. I figure his perio state is due to his 35 years of smoking-but it was a little unusual. Let me know if you guys have seen anything like that before.

The Dianodent

Ok so one of my Dr's just got a diagnodent. You know it has been a while since I had to pass of a PE about that and do you think I remember how to use it???? NOPE. I wonder if I still have that PE or if it went up in smoke with my lab jacket....hmmmm interesting. Anyway, my Dr was saying how I would be using the diagnodent on non-filled teeth. Then he would come in and look. So in my little inexperienced mind I am thinking that during my patient treatment I need to save time to play with the diagnodent (which will take me 5-10 min once I get the hang of it) and then he will come in and look with an explorer. It seems to me that we are doing the same thing. I know I cannot diagnose caries but I can read the numbers on a diagnodent. I guess I am looking for some advice from someone who actually uses it in their office right now. What do you do? Do you have it sitting out for every patient like the ultrasonic scaler? Does it really help the dentist? Do the assistants use it more since they are the ones who see the people with 'aches'. I could really use some help......

Another couple of first....

I remember my friend Maria telling me one day that working as a dental hygienist is awesome. She then went on to tell me how hard it is also. One night she got off work and could not use her right arm to steer her car. She had such a dead arm. I have been waiting these few months for that to happen to me. Today it did. Wed I worked for 3 hours on one scaling and root planing (S&R) patient. My arm was pretty dead after that. Then on Thursday I had the day off and I did everyday stuff-laundry, cleaning, blah blah blah- Today when I had 3 hours scheduled again with other S&R patients I cringed. Today my arm is pretty sore!

Also, one of the dental chairs fiberoptic light went out and since I am the one who does not use the fiberoptic light on the high speed I got sent to that room for hygiene today. Now I am used to jumping from room to room and going with the flow but this particular room is not able to have the ultrasonic hooked up to the water supply. I knew I had 3 hours of S&R and I needed the ultrasonic. I begged to be allowed in another room but today of all days all three dentist were there and fully booked and so I had to dig out the old school Titan scaler!!! I have never used one of these before. I had heard about them in school but never even looked at one. So here I am with dead arm and scary Titan scaler! I really am impressed that my office has a cavitron magnostrictive ultrasonic, a piezo ultrasonic, and a titan scaler! So I figured out how the Titan works. I brought my patient back and after getting him numb I started using the mighty mighty Titan! Holy Cow that thing in an animal! It is huge and quite aggressive! The calc flew off! I was kind of afraid to go deep into his pockets because it is such a large bulky thing so I did not at first, but after failing to get a deposit off after hand scaling I reached for the Titan and sunk it into his pocket. I am not sure how well it worked all I know is that the deposit came off during my next hand instrumentaion. I guess it loosened it or something. Anyway, I cannot wait until the new office is complete and I can have my own operatory stocked with the stuff I like to use.

I am really quite impressed with the amount of different things I am learning from ONE office. I am excited for the learning to continue!