For the IA... aim high, look for the triangular fold and just do it. Anticipate a long procedure? Do septo/marcaine combo on the IA.
- If you're allowed to, use septo 27 Long. Septo allows you to have a higher margin of error, if you hit bone and it wasn't too premature, using septo will still get the block done. If you hit the bone prematurely, reangulate the needle and advance forward.
- Anticipating a shallow fill or very conservative restoration from 1st lower molar to 1st lower molar? do 30 x-short prilo/septo infiltration into the periosteum of target tooth. Prilo so it doesn't hurt so much, septo to give the profound anesthetic effect. It's too unpredictable on 2nd molars
- If you aspirate blood on IA, go forward and if you don't aspirate anymore, inject. If you cannot go anymore forward and you're at the hub, pull back slightly, aspirate, if no blood, inject.
- Our clinical training was a bit different. No one was there to watch us or hold our hand while numbing up the patient. Just youtube the procedure(s) you're not familiar right before the procedure (and don't let your patient see you watching the video). Patients can sense if you don't know what you're doing and if they ask you straight out whether you've done this before, you always say yes, lots (or hundreds) of times.
Rubber dam... my favorite is the hygienic flexi-dam non-latex. Super easy to use, very forgiving. Best clamps? I hate clamping anteriors but 212 is what I use, premolars, 1 clamp, molars, 14A. Always go winged clamp.
If you're forced to use Ag/Hg in restorations, use spherical amalgam and IIRC, there's a "firm condensation" version for amalgams. Makes your life easier in terms of set time, initial strength, and initial polishing.
If you have flexibility in triple-tray impression techniques, I'd read up on the H&H impression technique. Essentially, you pre-impression with a very hard setting impression material such as bitereg, then line the margins of the impression with light body (do not put it into the impression itself) and have them re-bite on it. The stiffness of the material pushes the light body into the sulcus w/o packing cord. Just ask the lab to add extra die spacer just in case.
Make sure you know who to work with and who not to work with. Saves you a world of headaches if you work with all the easy instructors. Usually, part-time faculty that have their own practices are the best ones to work with. The worst ones are the full-timers that have no concept of real world dentistry. YMMV, observe who's easy and who's not. I remember one semester, I only had one day of good instructors, so I had to double/triple book patients just to make sure that I was in clinic only on that one day. That's how valuable it is to work on those days only.
