Post and Core

I would like to tell you the story of a post and core. 
Actually, it was a great fun experience. 
I know, you are raising your eyebrows , " you were having fun in assisting????"

Yes, that is me. I can find fun in many ways. (I was not laughing loudly though). My new Dr.X was doing a post and core. Actually the tooth got RCT done a long time before. Now, the tooth is broken. So, a post and core is necessary before the crown.

I am much familiar with Dr.X's fillings and extractions. But, this is the first time she is doing a post and core with me. So, it must be hard on her to ask for everything...

First Dr.X removed some of the GP. I was pretty sure that she needed a heated instrument to remove the GP and may be going to take couple of Xrays to make sure how much she needs to remove. 
I was also sure that she might needs the GGs. When she asked for all of those things, I patted myself, "Atta Girl, Me!!".

The patient was a very chatty one and very comfortable with the treatment. In between, he just asked me what I am doing and how I learned to do what I was doing. I was happy to explain about my schooling and the my duties in the office. 

Dr.X decided to use metal post and composite core. Since I was pretty sure about Dr.X's favourite filling instruments, it was easy too.
I am glad to tell you that it was a successful procedure. 

Introduction to tooth fairy

I love the kids who visit the dental office.  With a little chit chat with the kids is very pleasing for the dental assistant. Guess, most of you like that.

In North america, most children know about Tooth Fairy. When the baby tooth fells off, they get money from the Tooth Fairy. Toronto, having a lot of immigrants, some times I get the chance to introduce the fairy to them.

Recently, when Dr.X was chatting with the mother, I got such an opportunity. The pulpotomy failed and the next option is extraction. While Dr.X, (the associate dentist) was busy explaining to the parent, I was telling the kid about the fortune Tooth Fairy can bring. She told me she never tried giving the tooth to the Fairy yet.

Now the kid is very excited about getting the extraction done. She is going to keep the tooth under her pillow to get money. 

This particular location of office is not my regular work place. The mom was giving me the evil look and I know she is not that fond of the Fairy. Anyway, the child is going to come next week for the extraction. I will not be there on that day.  

Lidocaine 2%: How dentist finds out how much to use

Without knowing details about the dentistry, the assistant can survive. I need to know the dentists' choice of instruments for the usual procedures and how to sterilize everything along with taking the X-rays ordered by the dentist. 

Sometimes, I can be just curious to know how can you understand how much is too much anesthetic and things like that. I don't dare to ask such questions to Dr.X anyway. As the X indicates, the Dr.X mentioned in the blog is not one particular dentist, I think, you must know.

Now, let me assume the child on the chair is just 60 pounds.
That is the child has weight of  (60X1/2.2) =27.27kg

Maximum dose of Lidocaine is 4.4mg/kg.

Weight of child X maximum dose = 27.27kgX4.4mg/kg=120mg 
One carpule of2%= 20mg/ccX1.8cc = 36mg

Maximum no. of carpules can be used = 120mg/36mg, which can be rounded to 3 carpules.

REf: doctorspiller.com
http://student.ahc.umn.edu/dental/coursearchives/2yr_Spring/DENT5201/Lectures/2008/Local_anesthesia_pharmacology.pdf

Miserable life of a tooth.

The patient was nervous... I saw his hands were trembling. 
The usual chit chats to the new patients is not working, I could clearly see that.

The dentist hasn't yet finished writing the notes in the previous patient's chart and the receptionist is waiting to ask something about the procedure codes. That and the instruments needed to go to the Statim is making me more pathetic along with the sweating new patient. 

Asking questions about his teeth may make him talk. Before I even ask him about it, he blurted out, "I have pain on my this tooth", pointing to the upper right side 2nd molar. Mentally I was telling to myself, I must be ready to take 17 PA. Then told the patient,  Dr. X will be with him soon and will do something to help. I could clearly see the stained teeth and can be sure, he never get a cleaning done. The smell from the mouth was another thing. 

Dr.X decided to take out the tooth after discussing the options by presenting the X-ray. The nervous patient going to have an extraction... That is going to be interesting...
 I don't have to worry about it. I am just an assistant, makings things ready is my job. A short and Lidocaine; I don't want to annoy Dr.X and the next patient. So, when the word extraction fall in to the room, I had the short on the syringe. Lidocaine carpule was placed in the syringe just before he finished it. I felt very proud of me. (Who said I can't appreciate myself!!!)
The forceps, the elevators.gauze....The tooth was not a trouble at all to come out. 
Dr.X placed it on the white tray paper on the counter as usual. It looked like it was so happy to be out of the moth. With the dark tartar around it, it was telling the story of working hard and taken for granted. It was attacked by the acid, and eaten by bacteria. The gums once protecting it was giving up on it. The plaque turned in to tartar and started slowly suffocating it. Now, the end is here!!!!

It might not ever got a gentle brushing experience, I could tell from the abrasion mark on it. It never saw a piece of floss, I thought.  May be it is saying last farewell to the mouth and wishing good luck to the rest of the teeth...It looked so pathetic against the white paper. When scooping it along with the paper to throw with other biohazard waste, I sent a prayer to the tooth and apologized that it is not my call to instruct the patient about brushing and flossing. Not at least today, not right now, in this office....
I sorry tooth, I am not doing any favour for your previous neighbours. Really I am sorry.

DIY Dental Filling

I saw this video the other day. It is about Dentidrill. How the mother does the filling at home ... Just watch it.

It looks so easy on the video. In reality, how many parents struggle to just brush the kids teeth properly? 

I am just wondering, what will happen, if the  mother, who is not trained to do the job, make a mistake by removing too much of the tooth structure? What if the child accidentally close mouth?

I just know that I am not ready for the DIY dentistry yet. 

Dental Office with wiFi

I was just browsing the web on the other day. Obviously, I got interested in new things about dentistry. That is when I stumbled on the idea of dentists providing free WiFi for patients. 

Since most coffee shops, restaurants and many other businesses are giving free WiFi, why not dental offices too, right?

I think, it will be great and patients will love it. By the way, the staff will also love to use the free WiFi. Who doesn't love to have quick look on Facebook during lunch time(if you have one)?

It can be used to advertise the special cosmetic services offered by the office too. 

When there is a family dental appointment, patients will be especially thankful for the service. Think about a typical young family. The naughty pre schooler can be comforted by a game on dad's smart phone, while the older sibling is getting a cleaning. 

How is it going to work out for the dentists in Ontario? Are they allowed to charge more for the  extra service? Let us wait and see... 

Dental Assistants and Lunch time

There is a Facebook page for Ontario Dental Assistants Association.  I have seen a discussion there about the DA's lunch time.

Many busy offices, do not schedule lunch time for assistants. The law requires to give half hour break if the work day is five hours or more. 
On the Facebook page, many said, they just munch on some thine, while running around to finish the work. 

I was given unpaid lunch time in one of the offices. The funny thing was, while I was unpaid, I was not allowed to leave the work place and was required to work during that time. Long story short, I am not working there anymore. 

At my new place, I get time to have my lunch. Reading many of the comments on the Facebook, I know, I am just better off.

Why you are not getting the time to have lunch?