Do/Did you feel you are/were adequately prepared for your very first patient?

[dreaming2k5]

We're almost halfway through the second year, and I don't feel adequately prepared to see a patient in less than a years time. I don't see anything on the schedule of coursework that would prepare me to be prepared to see patients. I don't think any of the hardships I've been through did anything for me except to take exams.

Seriously, I should be ashamed of myself ~ but if a clone of myself suddenly appeared before me and about to do some MOD or fixed prep, I'd punch my clone in the face and runaway.

Is what I've done in the lab really clinically "acceptable"? I don't think it is. I've prepped tooth that got marked clinically excellent but when I took it out, and it looks like total ****. Gingival floor isn't flat, the margins are all crooked, the walls aren't smooth... wtf?

We've all seen thousands of slides of bad dental work, of horrendous arches that beg to have some work done... but all I've worked on are perfect ivorine teeth on a patient who have no saliva, no tongue, no feelings of anger when I poke him in the eye with my hand instruments. Hell, would I even be able to place a rubber dam without a problem?! Lord knows I probably would make the gingiva bleed like crazy just trying to invert the stupid dam into each tooth.

So yeah... I'm halfway done with the second year, and I'm not feeling it. Do you feel it? Does your inner python scream out, "hot damn, look at this prep! I am going to be a GREAT DENTIST !! " ?

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[crazy_sherm]

Don't worry too much. A lot of those small details they dinged you on in preclin won't matter when you get to clinic. There's no such thing as an ideal prep on a real tooth. You just have to make sure to understand the key principles from preclin and work from there. The hard part about clinic is patient management and dealing with clinic bureaucracy.

 

[Elipar]

There's no such thing as an ideal prep on a real tooth.

There is too an ideal prep on a real tooth. You've been given enough dimensions and directions to know what that ideal form is. What you meant to say was that no two teeth will have the exact same form, but that's not the same as saying it does not have an ideal form.

To the OP, you're just nervous. Most people are before seeing their first patient. The feeling of not knowing enough is certainly real. But, who really knows everything when you first enter clinic? You're there to learn and practice. Just do what you can, and be as prepared as possible. You'll find that even when you graduate, you won't know 1/10th of what you know 5 years later. And that trend will continue for several more years. Don't worry about it. Everyone is experiencing the same thing. And if they say they aren't, then they are either lying or don't know it yet.

 

[rocknightmare]

i would have to disagree with the above poster... the ideal prep that we all have been taught doesn't really exists. everything has to be done to accommodate the tooth you are working on, and try to make everything possible to make sure that the restoration will last

to the poster - the first time you will see a pt most likely you won't be thrown anything you don't know how to handle.. and btw it is okay to feel nervous but try to be as prepared as you can by figuring what that patient needs that day before hand, know what type of materials you are going to use, etc.. and you will be fine just remember thousands of other people did this before.

 

[HuyetKiem]

You will have a great deal of frustration, madness, drunkeness and a little bit of tears in the first 2 months in the clinic. Just ask as many questions as possible to your instructors. Things will get worse before they get better.

 

[dreaming2k5]

I understand that it's all relative and I will seriously learn a lot more as I progress in the clinic ~ but I'm worried about the consequences of making a major mistake. Someone bumped into me the other day as I was refining my MO posterior composite prep on #3 and I cut deeply into #4 on the distal side of the lingual cusp. If I could have done the python swing then and turn back time...

Like our mentor said earlier today, "never say 'whoops'" in front of patient, right... They teach us about how to manage the patient when honest mistakes are made with legit excuses and be protected by jotting down everything on the patient's record... but what if the excuse isn't legit? What if I trimmed the mesial of #3 instead of #2 for a FGC because I was too stupid to realize I was cutting the wrong tooth?

Yeah, I guess I'm just not cut out to be a dentist at that point eh?

Thousands were here before me, and thousands will come after me. It'd be okay. Right.

 

[Elipar]

i would have to disagree with the above poster... the ideal prep that we all have been taught doesn't really exists. everything has to be done to accommodate the tooth you are working on, and try to make everything possible to make sure that the restoration will last

If an ideal prep does not exist, then what criteria do you use to determine what the design should look like? If you and another dentist look at a tooth, both of you should end up with the same design --- that's the ideal prep. You should be guided by principles such as minimum depth in the central groove, minimum clearance interproximally, etc. Those are guidelines that apply to every tooth. And while the EXACT design will look different for each tooth, the underlying principles are the same. Thus, there is an ideal prep design for every tooth.

 

[armorshell]

I hope you all realize you're saying exactly the same thing, just using conflicting terms.

 

[v&andy_yankee]

The only thing that schools never prepare you for is how emotionally involved and attached you can get to patients.

There's really no class you can take where you can learn how tell your 80 year old patient (who is a gentle old man with no kids and a wife that passed away years ago) that Medicare won't pay for his crowns, so he can either pay for himself or he'll have to have his remaining posterior teeth all pulled out before you can do a partial denture. And then he asks you with a docile smile, "I don't think I can afford crowns, but let me talk to my family and see if someone can loan me the money." Shiiiiit Situations like that eat away at me far more than worrying about my margins.

Dental skills and crap? It's all overrated. 90% of dentistry is all about patient management.