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I am curious as to what experiences people have had doing their first procedure on a patient for the first (or first few times).
Experiences on the first procedure done on patient
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The first experience I had(other than a prophy) was an occlusal on #19. I had absolutely no clue what I was doing. I drilled into the tooth and called the instructor over. She explained to me what decay looked like and how it felt and how to remove it. She was pretty good. I would go and ask her questions throughout my days in the clinic. It's always good to find a mentor who actually has a clue and cares and to stick with them. Good luck.
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I don't know about other dental schools, but here at Buffalo the students are given some ivorine teeth with "caries" in it (soft brown plastic that can be dug out with spoon excavators or a large round bur in a slow speed) that one can practice with during early Sophomore year.
Then when we start comp care clinic in the second half of our 2nd year, we are encouraged to find fellow students with simple caries (such as the buccal grooves on #19 or #30) and try to restore those first. I did my first resin restoration on a fellow student who has a very deep #30 buccal groove with sticky dentin, and it was a great confidence builder-- When I was done I thought to myself, "That's it?!??!? That's EASY!!!"
I like how my school eases the 2nd-year student into operative. For some of the other stuff (such as peds, oral surgery and removable) unfortunately there is no other way but to throw you right in. 😛
Then when we start comp care clinic in the second half of our 2nd year, we are encouraged to find fellow students with simple caries (such as the buccal grooves on #19 or #30) and try to restore those first. I did my first resin restoration on a fellow student who has a very deep #30 buccal groove with sticky dentin, and it was a great confidence builder-- When I was done I thought to myself, "That's it?!??!? That's EASY!!!"
I like how my school eases the 2nd-year student into operative. For some of the other stuff (such as peds, oral surgery and removable) unfortunately there is no other way but to throw you right in. 😛
I did my first extraction on my Mom few days ago. It was her lower first molar. I was so excited. After my dentist did the IA block, I admistered local infiltration for the buccal gum tissue and extracted the tooth. Before the extraction procudure, I did a full mouth perio and several anterior teeth restorations on her with the composite. Couple of buccal cavities near the gum line were tough to restore. Took me several attempts to make the composite glue on. I spent 2 hrs on her for all of my procedures. Whatta Xmass present for her! After new year, I may do 3 unit bridge or RPD for that missing tooth.
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All that, immediately followed by "Dental Class of 2008."
I'm skeptical.
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aphitis, maybe larryt is joking with us.
If not, that's a lot of work for a member of the class of 2008 to do on a patient in 2 hours, let alone the fact it's your mom. I'm class of 2004 and I can't do all that stuff in 2 hours, forget about doing it on my mom. My family members are my most critical patients. I'm curious, where did you learn how to prep teeth for crowns to do a 3 unit bridge? (If you are a foreign trained dentist, then I guess that's a somewhat legit answer...)
My first procedure on a real patient (besides a prophy) was a #21 O. This was in spring of sophomore year. It involved removing decay (thinking back, it might have just been stain) from one occlusal pit and removing the amalgam from the other pit and restoring both with composite. I made the senior student give the block b/c I couldn't visualize where the needle was supposed to go - took me till fall of senior year before I finally got those IA blocks right to effectively numb the patient.
If not, that's a lot of work for a member of the class of 2008 to do on a patient in 2 hours, let alone the fact it's your mom. I'm class of 2004 and I can't do all that stuff in 2 hours, forget about doing it on my mom. My family members are my most critical patients. I'm curious, where did you learn how to prep teeth for crowns to do a 3 unit bridge? (If you are a foreign trained dentist, then I guess that's a somewhat legit answer...)
My first procedure on a real patient (besides a prophy) was a #21 O. This was in spring of sophomore year. It involved removing decay (thinking back, it might have just been stain) from one occlusal pit and removing the amalgam from the other pit and restoring both with composite. I made the senior student give the block b/c I couldn't visualize where the needle was supposed to go - took me till fall of senior year before I finally got those IA blocks right to effectively numb the patient.
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Hello guys,
My first dental experience on a patient was an extraction on #25 for an RPD in the fall of 2nd year. My first operative procedure was a MO on #13. I removed a defective amalgam plus some sticky dentin. I did all my own injections. Most of my experiences were on the maxillary teeth. I've been working in the mirror ever since. I feel confident finding decay, but I don't feel confident with some Tx planning situations. Some of my classmates got an easy patient with no teeth who required a denture. I got a patient with a bunch of retained root tips with fractured crowns who needs a ton of extractions then RPD over RPD. Tx planning with professors sucks because if you don't know the answer to a question they hypothetically set up then usually they walk away and don't come back. You have to wait on line with other students to get the professor back after you found the answer to their stupid question. All the while the patient is wasting her time. The professors will have patience sometimes when they don't get a whole bunch of questions from other students. But, they lose their patience and you only have one shot to their questions. The questions I'm referring to are not about composite versus amalgam. They can be about functional occlusion, different clasps on a RPD with indications/contraindications as example. Most times they are topics they briefly covered in class and expect us to know it like the back of our hands. They should give us a break sometimes when it comes to patients who are taking off from work to wait three hours in our seats to get a simple check-up.
However, most of my experience have been pretty cool. Some professors let us do work with little supervision, and others want to hold our hand. Most are like the former.
My first dental experience on a patient was an extraction on #25 for an RPD in the fall of 2nd year. My first operative procedure was a MO on #13. I removed a defective amalgam plus some sticky dentin. I did all my own injections. Most of my experiences were on the maxillary teeth. I've been working in the mirror ever since. I feel confident finding decay, but I don't feel confident with some Tx planning situations. Some of my classmates got an easy patient with no teeth who required a denture. I got a patient with a bunch of retained root tips with fractured crowns who needs a ton of extractions then RPD over RPD. Tx planning with professors sucks because if you don't know the answer to a question they hypothetically set up then usually they walk away and don't come back. You have to wait on line with other students to get the professor back after you found the answer to their stupid question. All the while the patient is wasting her time. The professors will have patience sometimes when they don't get a whole bunch of questions from other students. But, they lose their patience and you only have one shot to their questions. The questions I'm referring to are not about composite versus amalgam. They can be about functional occlusion, different clasps on a RPD with indications/contraindications as example. Most times they are topics they briefly covered in class and expect us to know it like the back of our hands. They should give us a break sometimes when it comes to patients who are taking off from work to wait three hours in our seats to get a simple check-up.
However, most of my experience have been pretty cool. Some professors let us do work with little supervision, and others want to hold our hand. Most are like the former.
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I did an Occlusal resin on 20 - I don't think there was any decay
now thinking back to it - it was a seniors patient who let me do the procedure so I could get some operative points. I did it in the summer between my soph and junior year.
now thinking back to it - it was a seniors patient who let me do the procedure so I could get some operative points. I did it in the summer between my soph and junior year.
Yeah.. I haven't been in dental school yet so can't do any nerve block. Local infiltration is way too easy. After 2 years as a dental assistant and 1 semester into dental hygiene program, pretty much I know how to prep those cavities and perform amalgam and composite. By the way, my dentist promised that he would guide me through each step of 3 units bridge. Our office has several patients come for 3 units bridge per week, so I'm pretty much know the concept and making impression for lab. I haven't able to find any volunteer for MOD amalgam and crown yet. I'm still searching. Hopefully before dental school start, I may find someone to let me do those and RCT. **** I'm in love with RCT for now. 🙂 🙂
By the way, It took me 8 hrs to do perio manually in dental hygiene school because all those ****ty paperwork checks that I had to go through. In real world, it takes around 30 min max using Calvitron.
Perio, prophy and sealants... 30 min (sl periodontitis)
restoration 1hr 15 min
extraction 15 or less. ('cause of my first time)
I did have 1 assistant.
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If you can feel the decay with a "stick" of the explorer it's no longer early stage caries. To catch it early you have to use a bright light, a dry tooth, and then go by color, texture, and radiographs. A Diagnodent can really help by adding another piece of information to the puzzle.
Explorers are at best passe and you could actually be doing damage. That stick actually might be just the explorer wedged in the groove of healthy enamel. You might fracture some demineralized enamel rods that could have remineralized by themself and if you poke the caries on #30 and then take the same explorer to a caries free #31 you might spread the disease. You could also get no stick on a tooth with dentin caries if the healthy enamel walls of a deep groove prevented your explorer from getting to it.
If you go by explorer stick alone you're going to treat a lot of teeth that don't need it and miss a lot of teeth that do.
JMHO
Rob
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Uh, I'm gonna go ahead and call BS on this one. You don't have a dental degree yet your dentist allows you to do operative and extractions on your mother🙄 LMFAO!! Just because you watch your DDS perform those procedures doesn't mean you can go ahead and then do them. Not to mention the fact that I don't think any sane DDS would risk his licensure that way. And by the way, if you can do perio/prophy/sealants in 15 minutes, there is no way in hell it should take you 1 hr and 15 minutes to do a restoration. If your gonna feed us BS, at least make it believable
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Originally posted by larryt
Hey, take it or leave it. We are here to share our experiences.
Larry,
Isnt your dentist officially considered for malpractice if he is letting you do these procedures on patients?
15 min ? I didn't say that ..... Average 30-45 min. Using flowable composite as sealant will take me only a min to seal all premolars and molars and another min to dry. No need to etch and bond. Same for those composites, I used i-bond so it elimated the etch and bond steps.
Of course all that steps need to be done. When it comes to isolate the caries from stain, explorer tip is the best tool. If we can identify the caries with your above methods, It kidda stupid to poke the explorer into it anyway --> My professors really hate those students doing that.
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Larryt,
There is only one self etching primer that etches uncut enamel and iBond is not it. Without etching the enamel you will not get a good bond and your sealant will leak. The way this usually presents itself is as a sealant with a quetionable margin that when you remove it you've got a big mess that was hidden by the sealant.
If you're going to use iBond, which I don't recommend for other reasons, you need to cut the enamel with a diamond bur.
Rob
Sorry Rob... I didn't explain it clearly. For sealant, I used self-etch flowable composite made by Fuji (forgot its whole name). I just dried the enamel surface real good, patched them on then let it dry for another min.
For anterior teeth restorations, I used iBond with composite after prep'ing those caries. much quicker, 'cause nobody likes to taste those nasty acids during etching step.
For anterior teeth restorations, I used iBond with composite after prep'ing those caries. much quicker, 'cause nobody likes to taste those nasty acids during etching step.
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no2thdk999, you explained very well what I was trying to mull over in my head about the explorer not always being the best diagnostic tool to detect caries.
sterichind69, I feel your pain about professors walking away when you can't cough up the right answer off the tip of your tongue. I used to try to prepare for clinic but it always seemed like I didn't read the one little section the teacher decided to question, and then they'd walk off. So I realized it was a waste of my time and I rarely prepare for clinic anymore. It took part way through senior year before professors stopped treating me like a complete idiot and realized that I know what I'm doing most of the time, I just can't spit out the info on instant demand, it takes me a few seconds to process an answer.
larryt, I'm still wondering (and probably others are too), who would let you practice dentistry without a license - and put their license on the line at the same time? I know assistants in different states have varying levels of responsibility, but I didn't think they were trained to prep teeth. What do you know about prepping teeth - do you learn about GV Black's principles of cavity preparation in assisting or hygiene school? (Maybe you do, I'm just asking.) Do they stringently grade your preps down to tenths of a millimeter, thus forcing you to learn better handpiece control? About administering anesthesia as an assistant - here in NY only hygienists, not assistants, can get special training to administer infiltration. Your dentist will guide you through prepping a bridge? My first crown prep on a typodont tooth looked AWFUL; it didn't matter how many crown preps I'd seen or read about, doing it on that plastic tooth was something else. You've got your entire life ahead of you to do dentistry, you're not any cooler if you enter dental school having practiced dentistry without a license.
sterichind69, I feel your pain about professors walking away when you can't cough up the right answer off the tip of your tongue. I used to try to prepare for clinic but it always seemed like I didn't read the one little section the teacher decided to question, and then they'd walk off. So I realized it was a waste of my time and I rarely prepare for clinic anymore. It took part way through senior year before professors stopped treating me like a complete idiot and realized that I know what I'm doing most of the time, I just can't spit out the info on instant demand, it takes me a few seconds to process an answer.
larryt, I'm still wondering (and probably others are too), who would let you practice dentistry without a license - and put their license on the line at the same time? I know assistants in different states have varying levels of responsibility, but I didn't think they were trained to prep teeth. What do you know about prepping teeth - do you learn about GV Black's principles of cavity preparation in assisting or hygiene school? (Maybe you do, I'm just asking.) Do they stringently grade your preps down to tenths of a millimeter, thus forcing you to learn better handpiece control? About administering anesthesia as an assistant - here in NY only hygienists, not assistants, can get special training to administer infiltration. Your dentist will guide you through prepping a bridge? My first crown prep on a typodont tooth looked AWFUL; it didn't matter how many crown preps I'd seen or read about, doing it on that plastic tooth was something else. You've got your entire life ahead of you to do dentistry, you're not any cooler if you enter dental school having practiced dentistry without a license.
C'mon people ! As I said before, we are here to share our experiences. Of course I'm not better or cooler than any of you in dental school. That's why all of us have or will have to spend 4 crazy years in dental school. Prior training experiences always have advantage in dental school and in any professional program.
If you're mature,confidence and good enough with ya hand skills, there are many lame dentists out there willing to risk their license for you. They even let you do some fillings on them and their relatives. They're willing to pay for all your dental school's living expense and will offer you job after dental school with competitive salary and befenit.
just my 2 cent 😉 😉
Please share some of your experiences too.
By the way, I just got back from ICU at my hospital today. I was scare the heck out of me when assisted the oncologist first time with her bone marrow procedure. Dark ICU room, those foot-long needles into both of patient's pelvic bones, the crazy screams from the patient and other man next room. Those 20 mins really drove me nut. I don't think I wanna be a doctor at all. 😀 😀 2 more hrs to go home.
If you're mature,confidence and good enough with ya hand skills, there are many lame dentists out there willing to risk their license for you. They even let you do some fillings on them and their relatives. They're willing to pay for all your dental school's living expense and will offer you job after dental school with competitive salary and befenit.
just my 2 cent 😉 😉
Please share some of your experiences too.
By the way, I just got back from ICU at my hospital today. I was scare the heck out of me when assisted the oncologist first time with her bone marrow procedure. Dark ICU room, those foot-long needles into both of patient's pelvic bones, the crazy screams from the patient and other man next room. Those 20 mins really drove me nut. I don't think I wanna be a doctor at all. 😀 😀 2 more hrs to go home.
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Watch out, you may very well be replacing those in a few months due to staining around the margins. That's the one thing that I've noticed with I-Bond. The cavo-surface margins in a significant portion of the restorations I've placed with I-Bond (I'm talking in the 20-25% range exhibit some brown staining at the margins when I see them at 6 month recall. When I talked to the reps at Kulzer about this, their best explanation had to do with the lack of bonding to uncut enamel. 😱 Whenever I'm placing a composite(anterior or posterior) I always place a heavy bevel at my cavo-surface margin (generally 0.5-1mm posterior and 1.5-3mm anterior) and then liberally apply whatever bonding agent I'm using and then overfill the prep past the cavosurface maegin and finish back with either discs or burs and I consistantly end up with undetectable, smooth margins. I adjusted my bonding agent application technique to I-Bond specs, but kept my prep/ finsihing the same, and have had to replace many "clinically acceptable" anterior restorations, and even a few posterior ones if after I show the patients and they want me too) due to the staining. I've also had mixed result with just trying to "polish out" the I-Bond flash as I call it.
On the flip side, I find that I-Bond is incredible when it comes to lack of post-op sensitivity!
And I'm not talking about tevery day run of the mill restorations here, but those huge, monsterous, pink, pulsing pulpal floor restorations where as the patient walks out of the operatory you're thinking that you'll be doing endo on that tooth in the near future! 😱 I've made notes in the chart to take a peri-apical at recall to see if the tooth by chance suffered a painless gluteraldehyde induced quiet death, and just about all of the really deep ones I've placed have been apical lesion free, and responding normally to pulp and thermal testing. In this respect, I-Bond has been amazing- Joined
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To my knowledge, there's currently no such thing as a self-etching flowable composite. Fuji does make a product called Triage that can be used as a sealant but it is a glass ionomer material. I think Triage is nice for partially erupted teeth where proper isolation for a resin sealant would be impossible. However it can wear faster than resin so I try to do composite where I can.
I'm not a big fan of sealants for everybody anyway.
Just so I don't hijack the OP's thread my first experience with a live person was while I was in middle school on my aged grandmother. Just kidding, it was 2nd year fall, big MLF composite on #22. DDS got them numb and I sat there and beveled the enamel edge for about 30 minutes scared to go any deeper for fear of pulping the tooth. I got the proffessor to check it and he scooped out lots of brown leathery dentin with the spoon and he winked and said "alright looks like your almost done" I was just happy nobody died that day. 🙂
DrJeff check out Clearfil SE. CRA and Reality have both given it high marks. I've also had literally no sensitivity and none of the staining at the margin. I've heard similar complaints about the iBond
JMHO
Rob
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larryt, I have not been around these boards long enough to know if you are for real or not. Are you joking or is this an insider joke I don't get? From your other posts, I have gathered that you have been accepted into a dental school. If that is correct, I am at a loss for words... Are you telling me that there is a dentist out there that would let his assistant extract a tooth on a patient? Please tell me that it was all a joke. The dentist in question would not only lose his license FOREVER, but would probably end up in jail if something had gone wrong.
As far as you my friend, if the dental school in question finds out that you have been practicing dentistry without a license, they would kick you out immediately. The state where you live would also flag your name so you would never be able to get a license in that state.
Everyone makes mistakes, you are lucky you've have gotten away with one. Please do not make the same mistake twice!
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I've switched to Clearfil SE and have been using it for about 4 months now (I purchased I-Bond at it intro about 1 year ago, saw the staining in July/August at recall, figured out the problem then, and went to Clearfil, or also back to my "old faithfull", Jeneric's Bond-1). The one thing though that I really liked about I-Bond vs. Clearfil, given that I'm a big suscriber to the KISS (keep it simple stupid) principle, is I-Bond's 1 bottle system vs the 2 bottle system for Clearfil. It's just less steps for error to occur (or more importantly assistants to forget😱 😀 😉
Originally posted by DrJeff
On the flip side, I find that I-Bond is incredible when it comes to lack of post-op sensitivity!
My niece was in same situation with MIFL of #8 couple months ago . I will defitely check her PA at every 6 month interval check up. Fortunely I did scare her enough to take care that tooth. So far, no stain and no problem. She is 13 right now so I will save her as my crown patient for my 4th year dental school. What is the cut off age for crown patient in dental school ? At my office, we don't do permanent crown for anyone younger 18. My professor has his cut off age of 21 in his office.
Opps.. my son just had his first tooth eruption....
probably last nite.... I'm getting so excited.😛 😛Thanx for your info, very helpful. I was taught that way too. Do you use same techniques for those cavities near or at the gum line too (mesial and lingual)? or just using malar strips ? how about buccal at gum line due to gingival recession ?
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Sorry LarryT, I'm still not buying that your DDS lets you pick up a handpiece and prep teeth. I could be restorations, but not the preparations. Like someone above said, it doesn't matter how much hand control you have or confidence. It doesn't matter how many times you watch something, nothing is the same as when you attempt preparations for the first time. Not to mention, it's hard enough on a typodont, I highly doubt this guy is gonna sacrifice his lic. and let you pick up a handpiece for the very first time on a virgin tooth. You can talk the talk since you are an experience assistant but I'm still not buying the rest 🙄
hehehe I love your word ..."virgin tooth" .... When those teeth come to me, They ain't virgin anymore..... Of course you can't have good sex first time without practice .... heheh
Nice try to start the flame again. 😀 😀- Joined
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larryt, I see that you ignored my post and did not respond. I would like an explanation please. Did you really get accepted to Case Western? It's not hard to find out the roster for Case. Where did you say you were from, Texas? Larry T, eh? 🙂
Come on man, tell us that was all a big joke...🙂
Come on man, tell us that was all a big joke...🙂
I'm not ignoring your post. A big joke or not ? You are the judge. If you think it's funny then laugh, if not then don't laugh. ahh I'm a lousy joke teller. I'm thinking of repharse my other posts to make them sound funnier. 😀
How about this ending ? ... Then I woke up.... arrr 7 more months to wait before dental school start.
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You've been around long enough that I don't think you're a troll, Larry, but you're seriously killing your own credibility here. I don't think there's a person on this thread who believes you, and for all your arguments to the contrary, the claims you're making leave a pretty substantial burden of proof sitting on your shoulders. You haven't done anything to meet it.
Thanx aphistis for your concern. I think this is my best defensive tactic. If I prove I could do all that, you folks will accuse me with "hm... practice medicine without license". If I take my Fifth, you will bash me as a liar, troll or a whole thing's just a big joke. To please everybody, I will have to repharse my other posts and make them as a big joke.😉
If anyone interest ...
I have spent average 2 hrs per day in the last 2 years prep'ing caries, crown prep, root canal prep with real extracted teeth (couple of buckets) on manniquin and typodont. With 3 mentors that I can ask question anytime, plus my professor (Prostho guru) and dozen of other dentists in my organization. My dental hygiene program right now is training me in perio. Great program. Do you know how much time did I spend practicing my explorer,probe and mirror alone? My final comp test, if anyone couldn't probe with indirect vision to about 10g -20 g pressure on the scale and our instructors' gum would fail the class and be kicked out of the program. This kind of training will prepare me for the tough dental program ahead of me.
By the way, my next challege: build all 32 teeth from scratch on stone model with white stone (quick dry),cavar, spoon, high speed and white composites (dry within a minute after mixing). This practice will improve my speed. The dentists at my office will reimbursh my family's vacation airplane tickets if I finish in 8 hrs. This Sat is my day. I think I'm ready.
I have spent average 2 hrs per day in the last 2 years prep'ing caries, crown prep, root canal prep with real extracted teeth (couple of buckets) on manniquin and typodont. With 3 mentors that I can ask question anytime, plus my professor (Prostho guru) and dozen of other dentists in my organization. My dental hygiene program right now is training me in perio. Great program. Do you know how much time did I spend practicing my explorer,probe and mirror alone? My final comp test, if anyone couldn't probe with indirect vision to about 10g -20 g pressure on the scale and our instructors' gum would fail the class and be kicked out of the program. This kind of training will prepare me for the tough dental program ahead of me.
By the way, my next challege: build all 32 teeth from scratch on stone model with white stone (quick dry),cavar, spoon, high speed and white composites (dry within a minute after mixing). This practice will improve my speed. The dentists at my office will reimbursh my family's vacation airplane tickets if I finish in 8 hrs. This Sat is my day. I think I'm ready.
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I think you're probably right on both counts. The moral here, then, is "think before you post."
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Oh just go away... You are already annoying and dental school has not even started. Do you know how many great clinicians fail in the business of dentistry? My staff always makes fun of me when I say: any monkey can do dentistry. The point is to find an ethical monkey . Ethics, my friend, are not learned. You can't practice it on a typodont. Get a hold of your ego and bring it back down to earth. Don't make everyone in your class hate you. Keep a low profile dude. (heard of lo-pro) Drilling teeth is not that hard. Study anatomy and biochem if you want to be ready. Oh I forgot, you are probably up for the Nobel prize in Chemistry this year.
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larryt, this is not the way to gain professional respect from your colleagues. You might want to re-think this "sense of humor" of yours before matriculating into dental school. Additionally, don't think that you know everything before you get to dental school, or you will surely be hated while in dental school.
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