Here we go "Explorering"

So I'm not sure if explorering is even a word, I'm guessing it's not, but I'll use it anyways. On Monday we learned how to use our UNC 11/12 explorer. We use the explorer to find and surface abnormalities. These would be restorative margins, calculus, caries, or root abnormalities. I was more nervous today than with probing because the explorer can be sharp and I was worried I would hurt my patient. But it turned out not to be that bad, and I didn't hurt my lab partner.

I still feel like I have so much to learn and catch up on! I'm still not confident with probing and definitely not with the explorer. But that's what practice is for! I have siblings that will have to let me experiment on them, and my trusty typodont is always there for me. He's so reliable! :)

Probing

What do giant marshmallows, candy corn, probing, gingival margin, and the junctional epithelium have in common?

A lot more than you would think!

Yesterday in clinic we learned probing. I was actually able to seat a patient in my chair, hold an instrument and practice/work on my patient. It was pretty exciting even though I was nervous for my lab partner (my patient) who so kindly volunteered to be my first victim. I guess she wasn't exactly my first "patient". We started out practicing probing on a marshmallow and candy corn. I know I thought it was weird/random at first as well--but it turned out to be pretty helpful. The marshmallow feels about the same as the junctional epithelium around a tooth (which is the base of where we probe). So it helped me feel how much pressure is needed when probing without puncturing the epithelium. And I was surprised to find out that very little pressure is needed! This was hard for me as first because I usually have a firm grip on my pens when I write. I am the person that will tear through the paper with the pen while I am writing because of how hard I am pushing. So I really had to focus on keeping my grip light and barely applying pressure. The candy corn was helpful to practice the angles I should be at when probing. The shape of the candy corn resembles the shape of a tooth, and depending on where you are on the tooth the angle you probe at changes.

I then was able to practice on my ever so faithful typodont! He really is the best! He never offers a word of complaint, even though sometimes I think he should! ;)

Lastly I practiced on my lab partner. She was really great as well! I was very nervous as I was getting ready to go in, but she was very compliant and let me feel around her sulci. I have to admit that I did make her bleed a few times and I kept saying "I'm sorry!" but overall I felt pretty good about it. I still need to practice being able to read my probe and positioning my mirror so I can see the posterior areas better while maintaining proper ergonomics.

Yesterday was great and now I am one day closer to becoming a RDH! :)

Open wide!

Today we went intra-orally on our lab partners. That needs a little more explaining... we performed an intra-oral exam today on our lab partner. We got up close and personal while we scoped out our patients oral cavity. The intra-oral exam is basically a oral cancer screening. We do it as a service to our patients to make sure there is nothing abnormal.

Sierra was my patient patient. She let me use her as my trial run of the exam. I learned some new anatomy today as well. Such as the maxillary tuberosity (which is located posterior to the maxillary second/third molars), the linea alba and Fordyce's spots. She had healthy gums and I didn't detect any lumps or bumps, coated or hairy tongue (thank goodness!!) She is missing her anterior tonsillar pillar but besides that she was passed with an "A".

I was also able to pass off my vital signs PE today, which is nice to get that off my shoulders and under my belt. Hopefully by Wednesday I will be ready to pass of my health history, extra and intra oral exams PE's. Whew.. I still have a few to do!

Clinic gets better and better. I learn more each session and I'm starting to feel more like a dental hygienist (even though I'm still 1 1/2 years away from being one). I'm still loving it and I love all the girls and guys in my class. They're all awesome! :)

Head and Neck Massage

Today was a great day in clinic! I received a head and neck massage during clinic--twice! It was fabulous! There was a point behind the massages, it wasn't just to help us relax. We learned how to do an extra-oral exam today. An extra-oral exam is important because as hygienists we are responsible for finding and bringing to our patients attention any abnormalities they may have. As we do an extensive exam we are doing our patients a favor by early detection of lesions or lumps.

For the exam I start by looking around the patients vermilion zone and border (lips). I start by palpating the supraorbital region, then move along down the zygomatic arch. During the exam I ask my patient to report any tenderness they may feel or have been feeling. I am feeling the lymph nodes and the structure of the bone, noting any abnormalities. I then move toward the temples and the TMJ. I ask my patient to open and close, do lateral excursions (go side to side), and protrude the jaw (move forward). I am listening to clicking, popping, or seeing if my patient is having any pain. I check the pre- and post-auricular nodes. I then move along the mandible and palpate the masseter muscle and the paratid gland. I have the patient clench and release the jaw to feel the muscle better. I continue around the mandible feeling for any abnormalities. I have the patient turn their head to the side while I feel the sternomastoid, along the clavicle and the trapezius. I then feel the submandibular and sublingual glands for any abnormalities.

I felt like I was able to get the extra-oral exam pretty well. And it was fun to feel the differences in peoples anatomy. It was also really relaxing to receive one especially with all the stress I have this week! It has been quite the week and it's still not over! But I'm still loving every minute of it and I am still glad I chose Dental Hygiene as my profession!

Vital Signs

Today in clinic we learned how to take vital signs on our patients. Vital signs include taking blood pressure, pulse, respiration's (breaths), and temperature. As hygienists we don't need to worry about taking temperature, unless our patient is running a fever. Then in that case we can't see the patient. Today was a pretty easy day in clinic for me because I already knew how to take vital signs. I was a CNA in high school so I had vitals drilled into my head at that point in time. I did learn that my vitals were WNL (within normal limits) and in fact they were a little low (which is alright!). 

I was also able to pass off my patient positioning, instrument grasp and fulcrum PE's today. It sure feels nice to be able to get all those out of the way! Now I can focus on Health History and the vital signs PE. I also learned a little about instrument positioning. As I was passing off my PE's my instructor gave me a few tips on how the explorer should be placed on the tooth. She said that the handle should be close to parallel with the long axis of the tooth. And depending on where you are in the mouth determines what side of the explorer you will use. This was very useful information and will be very helpful later in clinic and class. 

Barriers, barriers and MORE barriers

Today during clinic we learned to get our unit ready for the day and how to take it down and close the unit up. We barrier everything. If you touch it or think you might touch it you have to place a barrier. We have sticky tape, headrest covers, tube covers, and tray covers. I never knew there could be so many different types of barriers. It's way different from private practice!

I was able to have my first patient in my chair today. She was very cooperative and let me spray water into her mouth until my heart was content. I was also able to use the Blue Boa on her. It was cool to see how it works on a real patient. She said it was really comfortable. I was able to be the patient later in clinic as well. I sat there while I got water sprayed into my mouth and my cheeks sucked. I tried out the Blue Boa as well, and I really liked it. I barely noticed it was there and it kept me from feeling like I was drowning. 

Clinic seems to be going faster now and we are starting to learn more. Before I know it I'm going to be seeing my first real patient! It still seems so far away but I'm sure in a couple of weeks I'm going to be wishing we were back to the monotony of placing barriers, putting on and taking of mask, goggles and gloves. So I guess I better enjoy it while it lasts.

Wash, Mask, Eye wear, Wash, Glove

Initial wash, mask, eye wear, 3-step wash, glove. This was drilled into my head today during clinic. We learned our PPE (Personal Protective Equipment) PE.It was a little confusing at first to make sure you get everything put on in the right order and placed correctly, but after 100 times of going over it I'm pretty sure I have it down pat!

We also had Ann Arrington come in as a guest speaker to show us how to use the Blue Boa. I think it is a very convenient tool to have! I have watched the hygienists in private practice try to keep their patients from drowning when they use the ultrasonic and it never works very well. The Blue Boa is comfortable for the patient and very easy to use. I plan on telling the hygienists where I work about it, I'm sure they will LOVE it!

We also got to use our typodont today and practice the air/water syringe. It is a little tricky at times to not have the water spray out of the mouth and go all over the place. I just need to practice more on positioning my A/W syringe and placing the suction.

It was another good day in clinic. I was able to pass off my first PE and it's nice to get that under the rug. Now I can focus on the other heaps and loads of studying I have. But I'm still smiling and excited! :)