What's the Plan Stan?

On Monday in clinic we learned how to put together a treatment plan. You'd think that after 2 1/2 years working at my dental office (and using Eaglesoft) I would know how to put together and print out a treatment plan. Well I didn't! I know pathetic, huh?

It wasn't hard by any means just a lot of steps. I felt like I caught on pretty fast, which is good that means I can pass the PE off next clinic session. The only thing would be to remember to make sure I schedule everything for the right phase, the right appointment type, the right day, and the right clinician (me :)). When making treatment plan we have to make sure our instructor approves it before we print it off. We then make two copies and the patient, clinician, and instructor all have to sign both. One copy then goes home with the patient while the other copy stays in the patients chart.

After we went over the treatment plan we were able to have to day to get caught up. It was so nice! I was able to get caught up on all my PE's except for intra-oral camera (which isn't hard so I can do it on Wednesday). It felt good to finally get OHI and Dental Screening passed off. Those were the two that were stressing me out for some reason. It's over now and I'm so glad! Now all I have to worry about is my Dental Hygiene test! Piece of cake right? NOT! I will definitely be studying all night and all day tomorrow.

Deja Vu

Wednesday in clinic was like deja vu. We pretty much did the same thing on Wednesday as we did on Monday. It was nice though because I felt a lot more comfortable and I felt like I knew what I needed to do. I didn't feel like a complete idiot not knowing what needs to be done or the order it needs to be done in.

The challenge today was that we had double the amount of teeth to work on! We probed and scaled all lower teeth instead of just one quad. I was actually surprised that I was able to get through the whole "appointment" because we had to do double the amount of teeth and we actually had less time.

Clinic goes by way too fast now, I can't believe we only have a couple more sessions until we see our first real patient! (Ah!) I am glad that after today we don't have to scale anymore. It's not that I don't need the practice (because I do) it's just that I am done having my teeth scaled! My gums are super sore and they just need a break. Plus if I have to be disclosed one more time I may throw up! That stuff is nasty! So I feel very bad for my patients because I will have to make them go through it!

Piece it all Together

On Monday in clinic we were on our own! We went into clinic and we were set free! It was a little overwhelming because we didn't get meet before with our instructors to go over the day. We practiced and OD appointment with our lab partners. We started from the very beginning and went through all the steps. I am very glad we did this because I'll admit I had forgotten a few steps that we have to do.

I did realize that it will take us forever to get through a entire appointment with our patients. The OD alone took me all clinic and I only had to do one quad! So I'll need to let my patients know in advanced to be ready for the long haul and possibly have to come back at least once.

I gave my lab partner some exciting things to look at in my mouth. So I'm a tongue and cheek biter (I know it's bad but I can't help it :)) and I've been pretty bad lately. I chewed some ulcers on my tongue and they have been bleeding for the past week every time I brush and use my tongue scraper. But anyways she was able to practice recording a lesion on the OD form and the Treatment Record. Is it sad when we get excited to record something out of the normal? Maybe, but that's okay! :)

Clinic was pretty stressful but by the end I felt a lot better about what we actually have to do when we get a real patient in our chair. I am glad for the extra practice day we got. The semester just keeps getting closer and closer to ending and we get closer and closer to seeing our first patient. It's crazy how fast it's gone by!

How Many Fillings Do You Have?

On Wednesday in clinic we learned about charting. The patients chart becomes a legal document. If our patient ever got kidnapped (heaven forbid!) and the police needed to check their dental records we could help identify the person as our patient! That is a lot of pressure put on us to make sure we have the dental chart always updated and correct! There are so many different symbols that I don't think I'll ever be able to remember all of them! Good thing we have our clinic manual! That things is like the bible! I would be so lost without it!

After listening to our professors teach us about charting I thought it would be a piece of cake to chart! Oh boy was I wrong! When composites are done well it is almost impossible to see the margins if you don't have radiographs! Plus adding in sealants I just wanted to give up! I still don't think I can tell the difference between a composite restoration and a sealant when looking clinically. :/

A sealant

A composite restoration

I did learn that I still have some sealants on my second molars. My mom had always told me I got them when I was little but I didn't remember. I do have a few (6) fillings, but I can't even remember the last time I had to have a filling, so that has to count for something right?

Clinic just continues to go full steam ahead and doesn't ever slow down! I am always amazed at how fast the four hours go by! I'm pretty sure I could stay in clinic all day long and still feel like I didn't get enough time to practice! I guess that where my trusty typodont and family comes into play! They're always willing to let me practice on them and for that I am very grateful!

Disclosing

Yesterday in clinic we learned about OHI (Oral Hygiene Instructions). This is the most important thing we could do as a dental hygienist. We can work on our patients and get them squeaky clean but that won't do anything if the patient isn't keeping up on their oral hygiene. Brushing and flossing is SOO important and we need to emphasize it for our patients in a manner that doesn't seem like we're nagging them.

There were definitely a lot of laughs today as we disclosed our patients. The disclosing agent shows where there is biofilm on the teeth. If it turns pink that is new biofilm and purple is older biofilm. We then used the PFI (plaque free index) to calculate how many surfaces had biofilm/plaque. It was a big eye opener to see the spots that I am frequently missing. I frequently miss my mandibular lingual premolar and molar region. But overall I'm not doing so bad (but that shouldn't be too much of a surprise since I am in dental hygiene school!). I did look a little hypoxic because my lips turned blue (we forgot to put vaseline on before!).

I was also able to get a lot of practice on scaling which was great becuase I definitely need all the practice I can get! We had about an hour of practice time and I became more comfortable with anterior and posterior scaling. This gives me hope that I one day I will be able to do it perfectly! :)

Scaling Away

Wednesday in clinic we learned posterior scaling. I like posterior teeth because they are easier to adapt to, but some spots are harder to see. It was also hard for me to get the correct angulation. I think I am overestimating how wide 70 degrees is. While scaling you are to keep the face of the instrument at a 70 degree angle to be able to remove the calculus. The face on a universal curet is 90 degrees so in order to get the desired 70 degrees I have to angle my instrument. I kept bending my wrist in all sorts of weird ways and I still had a hard time getting the correct angle. I sure hope it comes easier as I get more experience because if not my patients will hate me! :/

I passed off my probing and explorer PE on Wednesday as well. I probed the lower right quadrant and I did it in 4 minutes 30 seconds. We were supposed to try and get under 3 minutes but not to many reached that. That good news is I passed and now I don't have to stress about it any more! I do need to work on adapting sooner and rolling my instrument in my fingers in the anterior teeth. I made my partner bleed once again (big surprise right?!).

In radiology Wednesday afternoon, we had a little surprise as we walked in. Professor McConaughy and our TA's Tori and Sam had decorated the Dexter's for us! It was fun and got us in the mood for Halloween. We took 1/2 a FMX with the Schick sensors and 1/2 a FMX with Scan-X. I am still trying to get used to Scan-X since I have only used Schick but I am liking it. I think the patients will appreciate Scan-X more since the plates are a lot smaller than the Schick sensors. But I do like how instantaneous the Schick sensors are. You don't have to load them into the drum.

All in all last week was LONG! But that because we learned a lot and it felt like too much to take in. I still feel behind and I think that is always going to last. I am just relieved that I got three PE's passed off today (two in clinic and one in radiology). Oh boy will I be glad when I don't have to do PE's anymore! :)

The time has come....

After much anticipation and waiting patiently, I was finally able to clean a tooth yesterday! I was able to hold a sickle scaler in my hand and remove calculus. It was great!

I feel bad for my first patient, he really took a beating! My typodont was quick to volunteer himself to be my first patient (what would I do without him?). He had a lot of calculus for me to remove as well. The bad thing with that is I started to focus more on removing the subginigval calculus than on my grasp, technique and posture! (Not good!) The poor guy probably has all his enamel scraped off! But I did get all the calculus so that has to count for something right?

My lab partner was my second patient, and considering she actually has feeling and can talk I was more careful with her! I started out very hesitant because I'm sure I've made her bleed enough these past few weeks with probing and exploring, and I didn't want to make her bleed again. After a little I felt like I was getting the hang of it and felt pretty comfortable. She did have a mandibular lingual bar which made scaling the lingual surfaces a little more difficult, but it was great practice since they are so common now. I practiced probing on her once again and I feel pretty confident with probing. I did get a 4 mm pocket and that was pretty cool! I was surprised at first because the probe just kind of dropped. I didn't have to push at all, it just dropped nicely! Her's is most likely as pseudo pocket since she have generally healthy gums, and is not a candidate for periodontal disease. 

Tomorrow we get to work on posterior scaling which I am excited about! Clinic just gets better and better, but more stressful as well. I have what feels like 20 PE's to pass off! They just keep piling up. Tomorrow I pass off my explorer and probing PE, and hopefully I get a few more passed off as well. But life is great and I am still enjoying every day of my dental hygiene experience!

Instrument Classification

Last Wednesday in clinic we learned all about our instruments. We got every single instrument out that we had and identified them. We found out which ones were rigid and non rigid. Rigid instruments are good for heavy build-up and deposits, while non rigid instruments are great for light build-up. We learned what instruments had a long or short functional shank. Typically anterior instruments have a shorter functional shank while posterior instruments have a longer functional shank so it's easier to reach to the back of the mouth. We learned the difference between a toe and a tip. A toed instrument is used subgingivally and is good for root surfaces, these are called curets. A tiped instrument is used supragingivally and is used around the margin and crown area, these are called sickle scalers.

We also were able to practice a little more on probing and exploring which was good because I need it! I feel like I am getting better though and it's getting a little easier for me. I'll still have to sneak home an instrument pack so I can practice over the weekend on my family! They're such good sports! :)

At the end of clinic we sterilized all our instruments so they will be ready for us next week. I had forgot how much we actually had! I'm excited to finally be getting into using our instruments and actually feeling like a hygienist. I love it! Clinic has become a lot more fun and goes by fast, sometimes too fast!