Sensitive aggressive brusher

My patient today was again a good experience. She needed LA... I realize more and more how much I need to practice LA. My patient was a class II. She doesn't get her teeth cleaned regularly which is causing the accumulation of calculus. She is very concerned about brushing enough. She brushes very aggressively causing her roots to be exposed and causing sensitivity. We put fluoride on those areas and I taught her a few different ways to hold her TB to lessen the aggressiveness of her brushing.

Working with interesting patients

Today the patient that I saw was schizophrenic and He wanted to be called She. He felt that he was a woman born in a man's body and and now in the process of getting a sex change. It was a very good unique experience to work with this patient. But this patient was very particular about his oral hygiene. He was so concerned that he was brushing very aggressively. He showed obvious signs of abfraction. He stated that the electric toothbrush did it. We talked about ways he could brush to minimize the wearing away of his teeth.
My afternoon patient was interesting because there was a lot of inflammation but very little calculus. We came to the conclusion that even though there was not much calculus he had Diabetes, sleep apnea and was on asprin which all can cause the bleeding and inflammation.

Production Day

Hum... My production day kind of flopped. I was able to see two children and I was just going to do a tissue evaluation and get area's that were missed with a class III patient I ran out of time with at a previous appointment. and then in the afternoon I was going to schedule two 1Bs. Well the two children came and that was a wonderful experience. They were very well behaved. I did struggle getting the 6 yr old to take x-rays but it was a good learning experience... I think I'll try a snapper ray next time. I also learned that there is quite a bit of plaque around a child's molars... so to remember to focus on those areas. My next patient was unable to come because of the snow. In the afternoon the two 1B patients weren't able to come... so to keep my chair full I scheduled class II I was able to take x-rays, OD and finish scaling all in that appointment. Even with a couple mishaps... the air water syringe broke off and I couldn't get the broken piece out... but finally got that taken care of and my suction kept on coming out and falling to the floor... it ended up being quite comical. My patient was a good sport. One other thing I learned was distinguishing between remineralization and actual soft stickiness of caries.

FMX

Both of my patients today needed FMXs It was great. My first patient was wonderful. I used scanX and I did not need one retake. He was a 1b so I was able to start and finish him in one appointment. That was a good feeling realizing last year I struggled to finish a 1b with just bitewing x-rays. My next appointment wasn't as easy. She is my board pt. so I took a FMX of x-rays on her also. Going into it I was all confident knowing that I just took a FMX with out any retakes. Humm... her mouth was so small... Wow... I had a bunch of retakes. I was hoping to get her out of there as soon as I could but man those x-rays were a struggle. But i think I learned by trial and error. Hopefully my next PAs won't be as bad.

lingual bar

Boy do I dislike lingual bars... I had a class II patient with plenty of calculus all around her lingual bar on her Mandibular Anterior teeth... Wahoo. This was great practice for me. I also learned I need to learn to drop handle and curve around root to get inter proximal for maxillary. Reach up into pockets and try to visualize where I'm taking my instrument. I also need to sharpen... that is something I really need to work on... I tried the other day and I don't know that I am doing the best job and that makes me nervouse. I don't want to ruin instruments.

Arestin

Today was a pretty productive day... I finished a class III. She is such a doll. I have been able to see her all three semesters of clinics. She accumulates calculus really fast. I'm noticing how the rate of disease and accumulation is so different for every person. I will be encouraging her to come back for 2-3 month appointments. My next patient was a class V with a couple deep pockets that I decided to maintain her oral health we would place Arestin. I learned that I really need to angle in instrument like a probe to get to the base of the pocket. I also learned that the care for Arestin is no brushing for 12 hrs and floss normally. Good experience.