11/29/07

You know you're not as fun when your titles are no longer "ode to Joni" but just dates. I feel sucked dry of everything that I have and I am ready to enjoy some fun. I think a vacation is somewhere in my near future.
Today I learned that you can't just generalize patients. I saw a four-year old this morning and just figured that she didn't have any calculus. Well she did, and I looked dumb. So make sure that each patient is thoroughly examined.
I also was reminded that since I am a health care professional, it is my responsiblity to see more than just teeth. I need to observe the whole body and treat the whole patient. Who knows, I could do some good in the world that way.
I am excited for next semester to be over. I will miss everyone and this environment and I won't miss everyone and this environment. It's a love/hate relationship at times. I just feel that i am ready to be the responsible hygienist. I think that I still use the instructors as a clutch. I am ready to get out and start really thinking for myself. However, I still feel that there is so much that I need to learn and that I will go through a period of feeling inadequate. But I will do as Joni tells me to, "FAKE IT TILL YOU MAKE IT".

11/15/07

Today was most interesting. It was just an off day for me. I couldn't seem to get everything off again. I realized yet again, that I need to be more thorough when I work. It's hard to keep going when you feel crummy, frustrated, and tired.
I got to practice some of the additional skills that I have acquired and it worked!!
I also got to administer anesthetic today. I did all right on the left IA, but on the right, mmmmmmmmmmmm....not so good. I learned that when achieving osseous contact, instead of withdrawing and repenetrating, you must swing more laterally until you pass the bone then swing back out to the premolar region.

Mocking bird

We completed our mockboard exams this week. I passed which was a relief, however I realized how easy it would be to fail. I have learned that you have to be absolutely sure your patient qualifies, that you x-rays are diagnostic, and that you paperwork is complete. You have control over these variables and have the opportunity to not loose any points for these. It would also allow you to mis 4 deposits of calculus.
I have also learned that exploring is an essential skill to have. If you are not good at this it is likely that you will miss areas you could have gotten off. I missed two deposits last time, but none of which I could actually feel without some assistance. The other difficult thing, was that they were spicules, hardly anything, maybe .005% of the tooth surface was covered by it. You have to make sure you explore each place to ensure success.
I also feel slightly more confident. I passed. With multiple large deposits on each tooth, all that was left behind were bery small amounts. The thing that worries me however, is the subjectivity of the examiners. What if one feels something that feels like calculus, but really isn't? Doesn't really matter, I get docked points. That makes me a little nervous. I know that as a student examiner, I wrote down teeth that I thought had deposits but really didn't.
A good strategy for cleaning is to take a larger ultrasonic tip and go after the large stuff a little more agressively. Another is to have really sharp instruments. Also, you need to be agressive when scaling (not enough to cause tissue trauma -5 points), lastly, explore carefully and take the time to make those areas smooth.

Costley is hereby the queen of deposit finding!

To start off, I have to mention this morning, it was quite the learning experience. My patient was a class 3 with plenty of calculus, but even post administration of LA, she was so extremely sensitive. I had to be very careful with my strokes and I also couldn't use the ultra-sonic. So I instrumented with my hand instruments and it was very difficult. I leaned that sometimes you just have to get down and dirty when working on your patient. Of course it is optimal to cause no discomfort, however that is not our number one priority. Our goal is to remove all calculus deposits. From now on, I will focus on that primarily along with focusing on patient comfort.
Also today, I learned that no one can find calculus like proffesor Costley can. She is a very detailed oriented individual and she can get that explorer to do things I've never seen. She found 6-7 residual deposits. Not only could she find them, but she could get them all off too. I hope to be that good one day!

October 18

Today I had a patient with extemrely tenacious calculus. I was happy to use my right and left ultra sonics today. They really helped instrumenting the deeper pockets.

October 11, again

Today was a very successful day. I was able to complete to class 2 patients and I passed off two PE's. I believe that I am starting to understand the reasoning and that I am able to apply my skills. I feel that I am improving and I feel a lot more confident. However, I have not yet completed a class 3, so I am sure that there is still plenty for me to learn.
One day, I missed a bunch of calculus on a patient, and ever since then I have been a lot more thorough. I have found that it is better to clean in control than to just scale around in an unorganized manner. I am glad that the las few patients I have done have had no remaining calculus.
My goal is to instrument more efficiently and to know which instruments are used where. I also aim to be able to detect calculus more proficiently.

September 20

So, I pretty much need to forget that today ever happened. I made almost every charting mistake you could make today. I alos scaled a patient and left calculus just about everywhere. Of course, I have used my defense mechanisms described by Freud and made the situation seem like it wasn't me. So now I feel much better. I just learned from my mistakes and am moving on.