Accidental Dental

   I realize that I don't write much about school in here, and there is a reason for that.  Well due to the sheer fact that students spend nearly 9 physical hours during the day in that building plus an additional 2-5 hours at home just learning dentistry and medicine, I hardly doubt anyone wants to be writing about the subject in their free time.  But mainly, these past few months in clinic have been the most challenging times for me and the overwhelming frustrations that have manifested inside would probably be spewed out in a highly inappropriate and irrational manner if I tried to write about it as they happened. 
   
   I've always known that I'm a bit clumsy and tend to drop a lot of things (understatement).  I've faced lots of disappointment in my past when I caused more work for myself....especially that first summer at West Point when I would drop my rifle during (every) road march and had to pay for it by doing push-ups with a ruck on my back (lots of pushups for me that summer).  For my H.S. senior art project I spilled ink all over a piece I'd been working on for 2 weeks, and then just last year I dropped a provisional crown and rolled over it with my chair 20 minutes before the practical exam was over (I failed). 
   But really, when things really counted, I always thought I could rely on myself to pull through.  After all, I never dropped my babies on their heads or anything, although they managed to do that themselves by rolling off my bed once or twice (wonder if it's a heritable trait?)
   Anyway, all the times that I've fallen, gotten hurt, or dropped something, has really just affected me.  Now that I am in clinic as a 3rd year student, all my mistakes and errors suddenly began having grave implications for other people, too...and had I known just how bad it would be, I am not sure I still would have thought this profession would be good for me.

   Let me introduce you to Patient A: Mrs. K.  Mrs. K. has been waiting for her partial dentures (both upper and lower) for over 2 years as she was passed on from student to student before coming to me.  She was so embarrassed of her teeth that she quit working entirely, and she pleaded with me to try to get them to her by Thanksgiving so she could get a job to start right after Christmas.  I filled her cavities and got her free of infection within 2 appointments, and now I was ready to start denturing.  This was in June, she was my first real patient, and I thought I was awesome.  So of course I told her "Oh yes, maybe by October!"  It is now late September.
   
   Now onto Patient B: Mrs. J.  Mrs. J came to a fourth year student who already fulfilled his dentures requirement and asked me to do the case with him.  Therefore, I got to jump right in as a co-therapist to work on her case without all the prior paperwork that typically takes weeks to get through.  She needed a complete upper denture and a lower partial.  That was in later June, she was my second real patient, and I still thought I was awesome.  So of course I told her "Oh yes, maybe by October!"  Guess what?  It's still late September since I wrote that last paragraph.

   For you readers (that would be Andy, and my mom) that don't know dentistry, let's just say that the first appointment, all you do is make a mold of the patient's mouth.  With that mold, you make a custom tray to make an even more accurate of the patient's mouth.  Then you have a second appointment, where you get a final impression of the teeth, make a final mold, and that is what you work with to make the dentures or to send it out to the lab.  In total, a complete dentures can ideally be delivered to the patient in 5 appointments from start to finish.  
   Between Mrs. K. and Mrs. J, I've had over 11 appointments, and technically only got to the "second" appointment each time.  I had uneventful first appointments for both, but I repeated the second appointment 5 times with Mrs. K and 3 times with Mrs. J.  It has been a long road.
   For Mrs. K., the final cast mold came out with a broken tooth.  Obviously, no good.  

Yep, there was a tooth in that big space!

   But I wasn't entirely upset because these things happen.  So I brought her back for another appointment.  This time, the cast came out great, then when I went to trim it, I dropped it onto the counter top and a tooth went flying away (zing!)  I held back some tears as I called to explain what had happened.

The premolar had broken off....here it is sitting on top of the cast.

   Somewhere in between these appointments, I saw Mrs. J.  It was at her appointment when I was doing a final impression when the custom tray slipped from my hand and I watched it agree with gravity (in slow motion, of course) as it flew gracefully through the air and cracked in half on the hard floor surface.  Since this was my first screw-up with this patient, I wasn't all too upset at this event and managed to keep it together.

My custom tray.  Bye-bye, 2 hours.

   Back to Mrs. K....by the third appointment, I had some help.  My dear friend, Andrey, is totally a lab-rat and he assisted taking the cast out of the mold.  I was ever so grateful, that I completed the design and was walking up the stairs to get it checked by the lab tech guy and wham!  Faceplant up the stairs.  A different tooth fell off.  I cried a single tear.  I went to the lab tech guy and asked him if he could use the different casts I had, each with a different tooth that had fallen off.  He said no, and I shed another tear.  I figured I may push graduation back a few months.

   For Mrs. K.'s next visit, things went well during the appointment but up in the lab, disaster struck when my knife I was using to peel away the mold slipped and cut off a lower incisor.  I tried to glue it back on, but it was a little obvious and was easily called out when I went to the lab tech guy.  I'm pretty sure I cried in the bathroom.  I decided I'd make it up to Mrs. K. somehow, even if it meant baking her some cookies as a consolation prize.  And then I realized she had no teeth to eat them with....and that was all my fault!

See that crack on the front middle tooth?  Yeah, so do I.

   I will spare the rest of the details of how each appointment went.  You can clearly see a pattern forming.  My faculty forbade me to come to an appointment without an assistant.  My other lab-rat friend Wes helped me that last day with Mrs. Kim, and I flew through that appointment.  By then I had gone through that same appointment 8 times between 2 different people, so I felt pretty confident I could at least go through the motions.

   The last appointments I had for both patients was just this past week.  And finally, FINALLY, today I can say that I'm making progress.  After pouring up and separating the cast molds, I probably put in a good 3 hours combined readjusting the designs, doing the paperwork, working with the faculty and getting the approvals I needed to get things moving and sent to the lab.  And ever so carefully, I tucked these casts in bubble wrap that I brought my house, stuffed them in my lab coat pocket, and slowly made my way to the elevators upstairs to print out my lab form.

Lab order on the computer.

 Then I took this bucket and placed the casts in there, and ever so carefully walked to the lab office to turn it in.

My two casts for upper and lower with design approved.

 I was greeted by Mr. B., who saw what I had and said, "OH!! Wow!! You're getting somewhere now!!" Apparently I'm well known in the prosthodontics department as someone to NOT accept to their post grad program.

The awesome lab tech guy who was wondering why I was taking his picture.

Mr. B let me take a photo of the final lab order printout.

    I couldn't believe when I headed back to get my bags that I had DONE it.  I had FINALLY done it.  Something was finally getting done.  I was so overwhelmed (and hungry), that I decided to celebrate my achievement by treating myself to an overpriced cheese and tomato sandwich from the Student Center.

Seriously, 7 bucks for this??

   I know that this is only a small victory.  For the month and a half that I'd been working on the same appointments over and over again, I'd brought in zero dollars to the school in terms of production because they were all no-cost visits for obvious reasons.  So in that sense, I've accomplished nothing.  Also, there is MUCH work ahead once the lab sends me back the framework...since after all, it's just a piece of metal with no teeth on them.  But to me, I've just climbed a dental school mountain.  There sure is another valley with a larger hill up ahead, and many more after that, but I really don't care right now.  It's these small blessings I need to start counting and celebrate these little "hooray" moments with myself.