Last Clinic Day

It was a weird feeling today walking into clinic knowing that this would be my last time ever seeing patients in here. It was also crazy to think that these would be my last patients I see until I am out in clinical practice! My morning patient was not coming until 9:00, so I was able to do my air powder polishing PE on Stefanie (Thanks Stef!) My patient was a recall class V who had not been in for a year. I was anticipating a very easy cleaning but he actually had quite a bit of calculus buildup. Everything went really well with his cleaning and with his x-rays. I am proud of how much better my x-rays have been these last couple of months. I guess it really does just take practice. My afternoon patient no-showed, so I was able to see a walk-in patient. She had a lot of bleeding on her mandibular anteriors. She showed me that even when she pushes on her gums lightly, they bleed. She explained that she sometimes wakes up with blood in her mouth and on her pillow. I removed the calculus from beneath the gums and I explained that she should see improvement as I explained the etiology of gingivitis. I really am feeling more and more like a "real hygienist".

I want to thank all of my professors and instructors from these two years. I have learned so many things from each one of them. I am so glad to be graduating from such an amazing program with amazing staff. I also am lucky that I am part of the class of 2012. I love you girls, I could not have asked for more amazing and supportive friends to go through these two years with. GOOD LUCK EVERYONE!

BAM!

I miss you ultrasonic!

I passed my clinical DH board!!! I am so happy, I found out yesterday! We were not really supposed to find out until finals week, so I was very surprised to get the e-mail, and even more surprised when I saw the result. I guess I need to have a little more faith in myself :). My morning patient today was my board patient, I was able two finish his last two quadrants. I ran into the exact same problem I had with my board exam, his anterior teeth are SO sensitive to the ultrasonic no matter what I do. I did a pretty good job with his cleaning, but his calculus is just so tenacious and it was difficult not being able to use the Cavitron. He was a good learning experience patient for me. In the afternoon, I saw a new patient from the resource list. She had just had her lingual bar removed so there was tons of lingual calculus on her mandibular anteriors. Again, this patient was pretty sensitive to the ultrasonic on her mandibular anteriors. I used the ultrasonic on low for a minute, and then went to hand scaling. Marilyn taught me to always do a horizontal sweep in the distal of the back molars to smooth any roughness and to not miss those line angles. Also, she taught me to not be afraid to get out my little wimpy Nebraska for tight contacts in the mandibular anteriors. Doing that will help me get the little grainy pieces that the larger anterior scalers cannot get. I realized today how much I love the ultrasonic when I wasn't able to use it much at all. One clinic day left!

Kiddos

Today for my morning patient I saw a recall patient with maintained mild and moderate periodontitis. I was able to get 2 quads of a class III and 2 quads of a class V because her upper quads had some slight subgingival calculus and she had quite a bit of BOP in those areas. For my afternoon patients, I had saw two adorable sisters, and Jamie saw the other two sisters. These were probably the best 1A appointments I have ever had, the kids were so good and I could tell that my speed has really improved since the last time I saw two 1A's. I learned a good trick taking x-rays when the child's tongue will not let you slip the film near their teeth. Joy taught me to place the film up near the maxillary molars, and then have the child bite down. It worked well for this little girl who was not wanting to bite down at all. It was a very good day overall. I am happy that I am pretty close to having all of my requirements and PE's finished. We never believe the professors when they promise us that it "will all work out somehow," but it always does! I think we need this promise in huge letters on the clinic wall. I can't not believe how close we are to graduation. When I think about graduating I feel 80% excited and 20% freaked out. Some days I do not feel ready to be out there doing dental hygiene on my own. Other days, I realize how much I really do know and how much I have learned in these two years. I also know that increased confidence will come after time in clinical practice.

A much needed easy day

This morning I saw a recall class V patient. Her tissues have responded really well to periodontal maintenance and she has good home care. Also, her probe depths and bleeding sites have really improved, except there are still two sites where there is a 10mm pocket and 7mm pocket. I placed arrestin in those two areas. Instructor Wold gave me a good tip for placing arrestin. She recommended I use the probe first to visualize the best angle to go into the pocket and then go in with the arrestin syringe the same way I went in with the probe. It was rewarding to see a patient I had seen earlier in the program and to see the improvement at her recall appointment. It proves to me how important patient compliance and home care is in non-surgical periodontal therapy. For my afternoon patient, I saw an older gentleman who had 4 mandibular teeth and had lost the rest of his teeth because of periodontal disease. I think he must have been pretty lonely because he talked the entire appointment. He had not been into the clinic for a cleaning in about 4 years so I discussed with him the importance of a frequent recall for the maintenance of perio and keeping his remaining teeth. I was given one quad of a class V for him. I also was able to get some conventional PA's and my Velscope PE. Overall, it was a good day which was much needed after this very stressful Spring Break. My goal for the rest of the program is to really pick up on my speed and watch the clock so that I am aware of the areas that I can save time.

Found a board patient!

I found a board patient on Thursday! YAY! I can finally breathe for a minute. This morning I saw back my class two patient. He requires anesthesia so I had his treatment plan broken into two appointments. I did miss some spots today. Alexander walked by as I was scaling and reminded me when I was scaling anteriors to really be right over the patients nose and staying up up on my fulcrum. I did some really good OHI for this patient. He has so much gingival inflammation and bleeding from the calculus and biofilm that were in his pockets. This afternoon I saw my board patient to get his x-rays taken and to scale a quad. Alexander classified him as a class III because his bone loss is right between a class II and III, and because he has so much subgingival calculus. I will be cleaning the upper left for the board. I also learned that when I was probing a couple of his teeth, I was tilting the probe a little too much which was giving me a deeper reading. I learned that the probe still needs to be mostly parallel with the long axis of the tooth, but slightly dipped into the col on the interproximal areas. Alexander commented that his calculus was definitely heavy enough and it was a bit tenacious. He also has bulbous crown anatomy which makes the scaling a little more difficult. This worries me, but at this point I just need to be grateful I have a board patient. His anterior teeth were very sensitive to the ultrasonic, so next time I will use more anesthetic on the infiltrations. I really hope everything goes okay for the clinical board. We got all of our instruments ready today after clinic. It is all happening so fast, I can't believe the real boards are here. Wish me luck!

Cancellation

This morning I saw a new patient who ended up being a class II. He has quite a bit of subgingival calculus but not quite enough for boards and has multiple restorations. I was able to get a pano and a film set of bitewings on him. He had lots of plaque and bled a TON! I polished before I scaled to try and save some time and get rid of most of the plaque. The injections went well and I had one calculus error. I learned that I need to really explore those line angles, and use a horizontal stroke to feel them. I also learned that it is best to not use my thumb to retract when giving a left PSA. When I use my other finger to retract, I have more room to get my angle right. Instructor Wold also taught me to feel the vestibule before entering the mouth with the needle, to feel the soft little depression where I want to insert the needle. My afternoon patient was supposed to be seeing my class IV patient back, but he called and left a message during my morning appointment saying that he found a job and he cannot miss work and he needs to reschedule. I am worried that I won't be able to get him back in to finish his cleaning and my Eaglesoft patient assignment. His teeth are very mobile and I worry that if he does not come back to get them cleaned, they will fall out very soon. Hopefully I can get him rescheduled. I really can not complain too much, I have been pretty lucky when it comes to my patients confirming and keeping their scheduled appointment times. The search for a board patient continues! My goal for the upcoming weeks is to be more active in my OHI and try to really get my patients involved in their own treatment.

Final Mockboard!

Yesterday was our final mockboard! I can not believe that was our very last practice run before the real deal. I am glad it was a success. I almost died of shock when Adrienne told me that I had no calculus errors and no probe depth errors. I love seeing improvement, it makes me so happy! I gave my patient a little thank-you note is his toothbrush bag becasue I am so grateful he came in for 2 of my mockboards, and kindly came in for Karen when her mockboard canceled. He was so reliable, and I am so grateful for patients like that! Now on to finding a real board patient, which is my main stressor right now. I really wanted my final mockboard patient and my real board patient to be the same person, but that did not work out. I hope I find one soon so that I can at least clean one quad and see how the calculus is or how the patient's tolerance is before the day of the real board. Monday was my Process of Care Exam, I am not so sure how I feel about it. It was more subjective than I thought it would be. I just have the National board on March 10th, my clinicals the next week, and then I think I can finally breathe easy. It is really sinking in that I am not going to be around all of these girls and instructors in a couple short months and it is making me sad! I love everyone here! My main goal for next week is to find a board patient!