Today was Janette's first day as a dental hygienist. Who is Janette you ask your computer screen....well she is the newest member of the Cedar Dental Center's team. She graduated from Dixie State College in May and has successfully procured a job at my office about 1 day before I knew Candice was moving down (but do not worry about Candice-she beat out 4 DSC girls for a job at a really good office here in Cedar! Way to go girl!). Back to Janette; since today was her first day it reminded me of July 6, 2006 which was my first day. It has been a great year. I cannot believe how fast it has gone. I have had so much fun at work that it does not seem like I have spent any time there at all. I have had backaches, finger cramps, wrist throbs, neck tweaks, shoulder twinges and my share of bad breath....from my patients not me.... but it has been a great 365 days.
Even though I have graduated and passed all the board exams I learned more this year that I ever thought possible. Luckily I have had some great mentors and friends who have helped give me advice through this blog and over the phone. Thank you to all you ladies who have helped me. So here is yet another question I have been trying to deal with. I had a patient who had 11 mm of recession on the palatal of 15. Pretty much that whole palatal root was exposed. The pocketing was 9mm on distal and mesial with 4mm on straight palate. There was not any mobility-HUGE roots. Anyway the root surface was covered in this soft substance. It did not look like calculus or feel like calc but I did my best to remove it anyway. I fear that I was removing cementum. This brings up the quandary of when are we removing cementum-which the PDL needs to reattach to the tooth- and when are we removing calc? I know we have all seen the aggressively scaled root surfaces and know that we can and do cause damage. So when do you leave that roughness on a root surface and when do you scrape that root smooth? In school I was taught to remove EVERYTHING, to get the roughness off and to have perfectly smooth teeth before getting a scale check but in perio class we were taught that Scaling and Root Planning was a procedure that could be too aggressive and going out of popularity.
Today I clean teeth to the best of my ability--which is SO much better that when I was in school! I try to get every deposit off of each tooth and I try not to be too aggressive on those fragile root surfaces. I hope I am doing an ethical and professional job.
