Wednesday, October 8, 2008

Dr. Martinez (4.5hrs)

I met with my dentist today to ask for some time to shadow her. She was kind enough to meet me during her lunch break. She let me stay for the rest of the day!

Dr.M and I talked about a few aspects of her buisiness. We talked about the low number of dental schools and the difficulties in being accepted. She discussed the difficulties involved in owning your own practice and the patient records, accounting and personell duties involved. To help her keep track of expenditures she doesn't let any of the staff write checks. We also discussed attracting new patients. She advertises very little because she believes that the best new patients are friends of old patients. Dr.M has a rewards system that she uses to encourage referrals.

I got to see:

1. A patient with a fistula on her gums. Looking at the x-rays no damage was evident besides the inflammation. Dr. Martinez explained that this could be an early sign of a problem with the root of her tooth, or it could be a simple bacterial infection. Dr."M" carefully scoured and cleaned the area using dental picks and an ultrasonic water jet. She then irrigated the area with an antibacterial solution. Finally she inserted a powdered antibiotic between the gum and the tooth to discourage infection. She sent the patient home with an antibacterial mouthwash and will see the patient again.

2. Ground down teeth. Dr.M and I reviewed the file for a person with a grinding disorder. They had ground their teeth down flat. Dr.M showed me the extensive crown and veneer work that she did to bring the teeth back to a normal profile. Today the patient was only in for a checkup. During cleaning Dr. M found an area where the gum had receeded from the veneer leaving a ridge to collect debris. She cleaned the area, etched and primed the enamel and then installed a small filling into the area. The epoxy filling was interesting, it uses a UV curing process.

3. A ZOOM bleaching treatment. A patient received an enamel whitening today. The zoon treatment uses a strange contraption to mask off most of the lips and gums, sunscreen for the patients face, and a UV cured resist for the gums. The two part gel is then carfully place on the teeth and spread, then exposed to UV for 15 mins. The gel is then gently removed and a fresh batch is applied and exposed to UV again for 15 mins. This is done 4-5 times.

4. An emergency crown placement. A gent chipped a tooth and came in for an emergency fix. The old crown was removed from the tooth after the patient was anesthesized. A cast was then taken of that side of the mouth using two different rubberlike compounds and a tray. a very thick viscous material is used for the majority of the cast. a thinner lower viscosity casting material is used around the damaged tooth to capture more detail. I asked Dr.M about a powdered casting material that was used for Emily, she informed me that this was algaeset(?) which is normally only used for rough casts for braces and whatnot. After the casting the RDA cast and shaped a temporary crown, testing for fit several times during the process. A small plastic form was used at the beginning.

I really enjoyed watching Dr.M and her RDA work. I thought that mouths might gross me out, but I didn't have any problems with it. Watching the shaping of the crown was amazing, probably even more stunning to see the work that goes into the permanent crown.

It Begins...

I thought that starting this blog would be the easiest way of keeping track of the activities that I engage in for Pre-Dental Experience. Names will obviously be omitted for privacy concerns.

Ever since visiting USC on the 19th I've felt light I am behind the curve. I have kicked life into high gear though, loosing sleep but gaining momentum.