Last Day of Clinic

Today is officially the last day of clinic.  I have mixed feelings about this because I don't feel like I can be good enough for patient treatment.  I feel relieved that things are wrapping up for the first semester. 

Patient Day!!!!

Today was my first day of working on an actual patient!  My sweet husband was willing to let me do him for the first time :)  It was such a good experience!  I was so excited to have this day come, and it went so well!  I was able to get through the whole OD procedures and scale 2 quads!  GO ME!! :)

I love clinic time!  I wish this was the whole hygiene program ;)

Provider Day #2

Today I was able to finish up the 2 quads I didn't complete on Monday.  I also was able to selective polish.  It seemed a little easier to do this today than Monday because I could skim over the OD process since it was done Monday.  I still need to practice my adaptation and angulation, but I felt like I did okay.

I missed some sheet calculus on the distal and buccal of tooth #15.  I really liked missing it even though I had a missed spot mark on my taleval because I was able to have one-on-one time with Professor Costley to show me how to remove the calculus on this tooth.  It was a very good experience for me.

I feel like I am ready to have my first patient on Monday!  I am super excited about this :)

LIZZY WAS GREAT!

Provider Day #1

Today was quite an exhausting day!  I got here early to get all set up to find everyone else was already here ready to go.  I felt a little behind even though I was n half hour early.  I ended up being okay on time because I was done before my patient was available to come back. 

I brought her back first because I was the only one who put my patient in my chair,.  I brought her right back and got started.  I felt pretty confident in what I was doing through the whole OD.  The OD check went well.  I was within a mm from my instructor on probings.  I felt like I did well on time.  I could've sped it up just a little bit in order to finish a patient from start to finish, but since  I am still learning I didn't mind too much.

I was able to complete 2 quad scaling and all of the preliminary part of the appointment.  The mandibular lingual teeth were the most difficult to get cleaned.  She had a lingual bar bonded at each tooth from #22-#27 (I actually separated it from tooth #22 while I was flossing during her OHI.. oops!) 

Overall, I felt like today was successful, and I learned a lot from my instructor because they were only in charge of 2 students, so I got a lot of one-on-one time with her!  I was really excited I was able to finally do this!  I can do this for the rest of the time now :)  YAY!

Patient Day #2

Wednesday November 9, 2011

Today is day 2 of beign a patient.  Lizzy was able to finish scaling the other half of my mouth and did well.  There were a few tender areas, but for the msot part, she did really well.  She sped right through the paperwork part of the charting and moved right into scaling.  I felt I got a good cleaning from her, and that the experience was good for her as well.

When she was done, I was able to pass off my instrument sharpening PE.  I only have 1 more PE to pass off which I will do on Monday!  What a great semester!

Patient Day #1

Monday November 7, 2011

Today I was able to be a mock patient for Lizzy.  I was able to feel how a patient will feel when I work on them.  It was a very good experience.  She did well and covered all her bases.  I felt like the instructors were very helpful.  I also learned what the patient will do in order to come back in the clinic.  The have the time ot fill out a HHx and a registration form.  Both of these are important to fill out before having the patient come back so the clinic is aware of which patients are being seen.  I also learned the walkout procedures through the desk.  It is our obligation to turn the patient over to Mr. Saloman in order to get payment and not be charged as the student provider.  Another thing I learned was what information needs to be on the walkout form in order for Mr. Saloman to understand what is going on. 1. the status of the appointment and the reschedule date and time. 2. an instructor's signature stating that the above treamtent was rendered. 

I am so thankful for this opportunity to go through this because it was a growing experience that I will never forget!

Instrument sharpening & Eaglesoft Walkout

Wednesday November 2, 2011

Today I was able to learn how to sharpen my instruments properly regardless of the terminal shank length or type of scaler.  It was a simple concept, but challenging to put into action.  The degree you had to hold the stone or the instrument in order to obtain the sharpest cutting edge was difficult to master.  It will take much practice in order to understand how to do it completely.  I plan on doing it free hand without actually sharpening (or ruining my insturments).
I also learned how to fast walk out my patient's Tx.  This was a simple concept to learn and to do.  I have a lot of experience walking out patients in the office I worked for.  This is just a different way to do it.  I felt very confident that I would be able to do this with no problems.

Today I was also able to pass off my air powder polish, sealants, and fluoride PEs.  What a fulfilling day!

Sealants and Fluoride

Today, I learned how to place sealants and use fluoride in the tray.  I learned how to place sealants in the office I worked at for a long time, so this was just a refresher course for me.  I knew how to identify teeth that need sealants and placed them well.  I learned how to adjust them, so they don't feel high which was a good thing to learn.  After  Idid the sealants on my classmate I learned how to place fluoride gel in the tray.  This was pretty easy, but it takes 4 minutes directly on the teeth to be effective which kind of was a long time sitting in the chair not doing much.


I was able to pass off my Selective Polishing PE today and felt like I did well.  Overall, today went really smooth without any frustrations or bumps in the road :)

Air powder polish, selective polish, and Fluoride Varnish application

Today I learned about Air powder polishing starting with a penny over the sink to get the feel of it.  I then was able to practice on my pod partner.  She did really well even though it tasted very nasty and was hard on her mouth since she bleaches and her teeth are very sensitive.  After I practiced this, I did a selective polish on her teeth.  Even though her teeth don't have any stain, it was nice to be able to practice.  After I polished I placed fluoride varnish on her teeth by using a sweeping motion on each surface like you would using nail polish all over her teeth from distal posterior to mesial anterior.  I felt confident doing this.


I was able to pass of my Tx planning PE.

Eaglesoft Treatment Planning

Today I learned how to treatment plan hygiene treatment and phase it in order of appointments.  I have worked with eaglesoft a lot doing this as an assistant, so I was able to zip right through it and move on to other things I needed to pass off and learn.  I taught the others in my pod how to finish up their treatment plan and started working on the dental screening PE.  I was able to review it a little and pass it off today.  I also passed off my intraoral camera PE today as well.  I felt like today was a good day in clinic because I am all caught up on what I have to pass off to this point.  GO me! :)

Practice Day

Today I was able to work on a new classmate and go through the process that we have learned up to this point.  I checked her HHx, HHX/Rx, OD (extra, intra, dent, perio), OHI (PFI, BFI, behavior, Aids given, Goal).  I felt more confident with the process as I went through it.  I also got my loupes in the mail this week, so I was able to practice with them for the first time today. 


I didn't pass any PEs off today.

Intraoral Camera

Tpday we learned intraoral camera use briefly.  I practiced on my classmate today and was able to go through the whole OD process.  I did an extra oral exam, an intra oral exam, probing on 1 quadrant, charted the dental screening I found, and disclosed with a disclosing agent for the PFI %.  The disclosing agent I used was yellow so it made it very difficult to see the plaque.  I won't be using that again! :)  I also practiced giving her OHI and was able to pass off this PE while I did it.  I described periodontitis and caries formation.  I practiced with the curet again today and was able to pass this off as well!  I felt like today was a very productive day for me and my class mates!

Dental Screening

I learned how to chart existing and suspicious areas on the dental form.  I was able to then practice my skills by charting my pod partner's teeth and restorations.  This was pretty easy for me as I have done it several times with a hygienist I worked with in the dental office.  I liked actually seeing what it looked like in the mouth and finding them.  It didn't take long, so I was able to practice scaling on anterior teeth and practice my adaptation, angulation, and activation.

I was able to pass off my sickle scaler PE and my Adaptation, Angulation, and Adaptation PE.

OHI & PFI

Today we learned how to do a Plaque Free Index and give OHI.  I was paired up with a new classmate (Amanda :) )  It was fun to switch it up a little bit.  I placed 2 drops of disclosing solution under her tongue and had her swish to see what it looked like.  She mentioned she brushed her teeth this morning, so her PFI was pretty accurate.  She looked really good.  She had a few areas, but that is because she didn't brush after lunch because she knew we were disclosing today.After we did that, I practiced giving her OHI due to periodontitis and caries.  I pretended as if she was a teenager because it made it a bit easier.  I felt I did a good job with this.  I had an hour to complete these two things, so I practiced scaling with a sickle scaler on her anterior teeth.  I still need a bit of practice getting the adaptation down so I don't poke her as much.  Hopefully, Stephen will be home this weekend so I can finally practice on a person at home!

I didn't pass any PEs off today because they aren't due until next week and I want to practice and get more comfortable with it.

Curet Scaler

Today I was able to learn about the curet scaler for posterior teeth.  I practiced on my typodont and then practiced on my pod partner.  I am trying to remeber to use the "door knob" technique to remove the calculus in a working stroke.  I understand the concept.  I just need to remember it.  I felt like today was successful. 

I was able to pass off my Instrument Identification PE

Sickle Scaler & Adaptation, Angulation, and Activation

Yesterday I was able to practice using my sickle scaler on anterior teeth.  I was the second one to practice, so I was able to feel what Kristen was doing when she was scaling and see the consequences of incorrect adaptation.  Incorrect adaptation makes the gingiva bleed and feel very sore.  I tried really hard to focus on this and learn to get this down before worrying about the other A's.  I feel like I did an okay job; however, I did make her bleed a little bit.  I want to keep practicing so I feel comfortable subgingival.  I think this will come with time.  I do know what Angulation means.  This is the proper degree you hold the instrument at in order to remove calculus (70-80 degrees).  I haven't really practiced this other than when Prof. Costley came over and showed me this.  Activation is a term used for the removal of calculus.  Because my pod partner doesn't have a lot of calculus on her anterior teeth it was hard to actually remove anything.  I was able to use my typodont to remove anterior calculus, but the gingiva on the typodont is rubber and made it difficult to remove deep calculus.

I wasn't able to pass off any PE's today because I helping Kristen pass her's off.  I wasn't really ready for the instrument identification anyway.

Instrument Identification

Last Wednesday I was able to look through all of my instruments and identify them.  They are identifiable by their rigidity, light or heavy calculus removal, functional shank (simple/complex), primary use (anterior/posterior), Terminal shank (short/long), Depth (sub/supra), working end (round/pointed), blade orientation.  I was lucky to have an instructor that taught me thoroughly.  I have a lot to study to learn them by name, but I do know which one is used for each surface/tooth.

I was able to pass off my probing and exploring PE today.  It was a huge relief because I had a busy weekend!

Explorer

Today I learned how to use the explorer.  Before today, I thought using an explorer wouldn't be a big deal or very hard at all.  There are two ends to the explorers we use and finding the right end for the surface isn't easy.  There are specific ways to find which side you use that differ from anterior teeth and posterior teeth.  I learned this.  I practiced adaptation of the explorer on my typodont first then I explored Kristen's whole mouth.  She gave me constructive criticism during the whole procedure which I was very grateful for.  It seemed as though the side of the tooth I was working toward was the side that I usually poked her with because I wasn't adapting closely enough to the curve of the tooth.  I definitely have some practicing to do, but I am glad I learned it and had time to practice for a while.  I feel like with practice I will be able to do it better without causing discomfort or in some cases pain.

I was really nervous before clinic today because I knew we would be working subgingivally.  I really don't want to hurt anyone, but I know I will because I am just learning.  I felt more confident after I explored on Kristen.

Before I practiced exploring, I was able to pass off my Intra Oral exam PE.

Probing

Today I learned how to probe.  I used a marshmellow to feel the pressure and a candy corn for adaptation of the probe around the tooth.  I also practiced readings on the probe with my typodont.  This one was hard for me with the pressure because I used too much pressure.  When I probed on Kristen, my pressure was a little too heavy, so I had to lighten up which made more sense for me.  I probed her whole maxillary arch.  I found the distobuccal probe reading on teeth #2 and #15 were the very hardest to get.  I feel like I was doing okay other than it was difficult to read the mm on the probe.  I am getting use to it, but that was definitely the hardest part of the probing.  I am definitely planning on ordering loupes this Friday to I can read the probe depths easier and quicker. 

I wasn't able to pass off my intraoral exam PE because I tore down my chair before I thought to.  I also noticed many othr students passing off things, so who knows if I would've even got to it today since there are some that are due today.  I feel good about the introoral exam.  I will pass it off next Monday.

IntraOral Exam

Today I learned how to do an intraoral exam.  My pod partner is Kristen who I practice every new thing on.  She is such a trooper :) I learned all the anatomical markings of the mouth.  I felt pretty competent with the intraoral exam.  I had to do it several times to have it click in my brain, but I like to think it helped Kristen as well.  Once it was time to switch and she was going through it, I learned even more.  Clinic makes me feel like I am actually learning and doing something productive that I learn throughout the week.

I passed off my Vital Signs and Extra Oral PE's!!!  YAY!  I am caught up now!!

Extraoral Exam

Today I learned how to do an extra oral exam.  First you start off by the supraorbital area and papilate.  Next papilate around the zygomatic process and the suboribital area.  Use firm pressure on the sinus to see if there is discomfort.  Moving laterally, papilate around the auricular pre and post nodes checking the ear for any abnormalities.  Check the TMJ.  OPen close left and right and protrustons.  Clicking popping is termed crepitus.  Have patient clench for the masseter muscle.  Move down under the chin to check the submandibular glands and nodes.  Have patient turn head left and right checking the muscles and nodes down to the clavicle. Check the Trapizod muscle along the next and nodes.  Finally check the thyroid cartilage for any abnormalities.

I passed off my Flucrum and health history PE today :)  YAY!!!

Vital Signs

Yesterday I learned how to take vital signs... jeez it was tricky!  Well the blood pressure was.  Once I did it a few times, I got the hang of it.  It seemed interesting to me, and I was so glad when someone else took the blood pressure on the same person it came out the same :)  It didn't take long to learn how to do it.  I was thankful for that because the other PEs that I have to do have been so time consuming and hard to memorize... The health history and charting forms mostly!

I have clinic tomorrow and with a stressful life filled with exams and missin' my husband it's hard to stay motivated to keep going and not throw my hands up and say forget it!  Actually that's true for my personal life, not really my school life.  I fee like I have a pretty firm grasp on school :)

Health Histories and proper charting

This was a day of information overload.  There is so much to know, and there is no way someone could possibly know how to chart everything by the end of today.  I have a good idea, but I'm not perfect.  I am glad that if I have questions I can apporoach my instructors, and they will guide me.

1st I learned that the health history must be filled out to it's fullest.  I have to go over the whole thing making sure there is nothing blank, then sign the back.  After this, I need to circle every "YES" answer in red and have the patient ellaborate on the topic guided by my questions.

2nd I get a form that I then write the day's information on.
       date, the HHx  Blood pressure, pulse and respiratory belongs on the first line followed by the responses to the "YES" questions.  For example, if there is an allergy it is stated, or if there is a health condition that is stated.  The health conditions and allergies are underlined in and printed in the top right corner of the form in red.  Next item is drugs/medication the patient is using with information such as, what it is, dosage, what they use it for, and what oral effects come with the drug and if they experience any of them.
      HHx/Rx  This is where you would address alterations to "flag" the next clinician of special precautions for following appointments this patient would come for.

3rd once everything is complete a signature from the instructor and student is required before moving on.

Special note:  If anything needs to be altered or changed on the form, there must be a single line drawn through the error and then re written.

This was a lot of information and difficult to understand until I went through it myself.  Once I could practice it and be corrected by the instructor, I understood it a little better.  It actually helps go through the steps in this post to help remember all this information.  Another thing I learned is that this can be done at home if I know the patient which will help with time when I start seeign patients in the clinic.

I hope I can do this in a timely manner so I can get to the more critical things and what the patient came for (x-rays or the cleaning).

Clinic Day- Using the mirror, probe, and explorer

I'm posting about clinic August 31, 2011.  I am a little late, but I do remember a lot of what went on that day and my feelings about it since I haven't been to clinic since then. 

I learned about the proper positioning of the dental hygienist with the mouth of the patient in the chair.  The positions are described as 12 o'clock to 8 o'clock.  Each with a specific purpose to scale, probe, or explore in the mouth.  These surfaces and positions are exactly opposite for a left-handed clinician and a right-handed clinician.  It seemed very confusing for me when I was trying to understand during the explanation and what the book was saying; although, once I tried it myself, it made perfect sense to me.  I understood that the surfaces toward me I would be below the ear and surfaces away from me I would be above the ear to be ergonomically correct.  I am thankful for the knowledge I have for this because my body will gain muscle memory in order to stay healthy and avoid injuries caused by poor positioning. 

I also learned to proper way to hold an instrument.  I couldn't believe there really was a proper way to hold one, although I am very thankful I learned because it will keep my hands strong and decrease the chance of cramps and pains.  They refer to the proper way of holding an intrument as "the stack".  The pointer finger and the thumb need to be directly apart from each other on the shaft of the insturment, the middle finger rests on the shank, the ring finger is the flucrum finger, and the pinky finger is just there for extra stability should that patient make a sudden movement. 

These techniques are hard to get use to, but I have ben practicing and they seem to get a little easier as I go.  I know with time, it will come second nature and all will be well.... it's just getting there without doing it wrong that's the hard part! :)

Exposure Control and Equipment Maintanence

Today I learned about exposure control including proper barrier use.  It seemed pretty confusing, but once I figured out the reasoning behind everything and my way of remembering exactly how and where to put everything, I seemed to do okay with it.  New things are hard to remember exactly, but I think I have it down okay after practicing.

I passed off my Personal Protection PE!  YAY!

I was also able to practice using my Blue Boa (with both attachements), slow speed suction, and high speed suction on Kristen.  It was a good experience to feel and see how things work in a patient's mouth.  Her feedback on the comfort and tolerance of it was very helpful!

Overall, today was a success!  I have great insturctors who have a lot of patience with me and other classmates.  They were very helpful in guiding me how to use all of the equipment properly to fit my left-handed needs :)  I hope that this semsester will continue to be a success as I learn to stay organized and on top of all my class work.

Blue Boa and Personal Protection Clinic

Today was all about getting aquainted with the typodont (model of the mouth with teeth that have calculus on them) and the Blue Boa, learning personal protection, and passing off PE (process evaluation) Eaglesoft.  I also met the new instructors for the Wednesday Clinic. 

The typodont attaches to a special device which is attached to the chair in the laying down position.  I learned how to set it up, prop the mouth open, and manipulate it as if it were a real patient.  Once it was stablized, I attached the Blue Boa to the HVE and put a special suction tip on the end.  This helps especially when using the ultrasonic alone.  I learned how to manipulate the suction tips to work for me in every situation.  I practiced this a few times.  I think the Blue Boa will be an asset to my dental hygiene kit.

Personal Protection starts by securing your hair back conservatively away from the face  so there are no loose strands, wearing scrubs and close toed shoes that are wipeable, and wearing a lab coat over top.  When you enter the clinic area you wash your hand well (you would get your patient from the reception area at this point).  Placing your mask and safety glasses on is next then properly washing your hands 3 times before you put your gloves on to touch the instruments and treat your patient: 1st just the front and back side of the hands, 2nd the interdigit, and 3rd the nail and cuticle area.  Once all of these things have been completed in this area, your patient will feel confident that you made the necessary steps to protect them and yourself.

After practicing with the Blue Boa and going over the personal protection protocol, I reviewed the eaglesoft PE.  My instructor came over and I passed this off.  It was fairly easy because I have previous experience navigating through Eaglesoft.

Overall, I think today was very successful in the clinic, I feel confident that I can do the things that I have learned so far.  I have a little anxiety for the future but always hope for the best.

August 22, 2011: First Day of School and Clinic

Today was all about getting aquainted with the clinic, the clinic students, and the instructors.  It has been a pretty mellow day.  I feel like I am pretty lucky to have the experience I had with the dental office I worked for.  The software we use is Eaglesoft which is the same as the dental office.  I have quite a bit of experience navigating through the system; although, this one has been updated.  It is official:  I am in the system here at the dental hygiene program!  I know that the next few months will be pretty hectic, but I have a positive attitude that I WILL MAKE IT :)

Orientation Day!

Today is the first day back to hygiene school since the Welcoming Dinner.  I'm super excited about hygiene and what it will bring to my life.  Monday will be my first official day into the world of hygiene.  WISH ME LUCK :)