Category Archives: Classes

Temple University School of Dentistry Class of 2010

Here is our class photo. I found these while cleaning out some folders on my computer. They were taken a while ago. What do you guys think?  If you don’t already know who I am can you guess where I am sitting? :)
Temple Dental

Dental Physiology Summer Block I and Hamburgers

By Jetalone on FlickrI went to a talent show when I was younger and watched this man attempt to eat a Big Mac. That seems easy enough, until you hear how he was trying to eat the Big Mac. He opened his mouth bigger than anything I have ever seen and tried to swallow the whole thing. Whole. Without chewing. He got half way and almost puked all over the front row. I’m not sure if it is even physiologically possible to swallow a whole big mac, but it somewhat brings me to todays subject: Physiology in the summer is like trying to eat a Big Mac whole. It’s probably easier but you still have to cram it down your throat.

After a short 4 day break from spring semester we have started our summer I session with dental physiology. Physiology is one of our two classes this summer. Our other class is a continuation of Restorative II which we started in January. Restorative is a 6 month long class where we learn all of our major operative procedures. After that, the next time we do them will be on patients…a very scary idea but a challenge I am up to nonetheless. Our dental physiology class will be taught in about 8 weeks. We meet 3 hours a day, 5 days a week during this time and we get physiology crammed down our throats. Hopefully my love of undergraduate physiology will carry over to dental school and it won’t feel like cramming. The book we are using is called Physiology Third Edition by Costanzo. It looks like a decent book and was not too expensive when compared to our periodontology book.

We have a test just about every week (6 total + a comprehensive final) and 6 quizzes along the way to make sure you are keeping up. In a sense I will like this schedule because I only have two classes to juggle around and will have a little more free time. On the other hand it is only 8 weeks and there is a lot of information. Many upperclassman have told me that it isn’t really hard, but we shall see because everyone is different. We have a couple of lab days for this class as well. I am not quite sure what goes on during labs, but my guess is something like testing respiration rates or pulses. My only motivation to survive this semester is knowing that a nice two month vacation is awaiting me which will consist of some golfing, swimming, traveling, family time, and who knows maybe I’ll go get a Big Mac and enjoy it with small bites.

Neuroanatomy in Dental School

The best thing about this class is some of it coincides with the head and neck anatomy portion of dental school and you can learn while using the bathroom. Learning the cranial nerves can be a difficult thing to do. Especially when trying to juggle all the other classes and restorative projects. My undergraduate anatomy teacher Dr. Michael Shively taught a couple of pneumonics to help remember what the cranial nerves are and what general function they perform (motor, sensory, or both).

The cranial nerves in order from 1 to 12 are, olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, vestibulocochlear, glossopharyngeal, vagus, accessory, and hypoglossal. To remember these we were taught a small saying: On Old Olympuses Towering Top A Fine Victorian Gentleman Viewed A Hawk. The first letter in each word corresponds to a cranial nerve. I also realize that there are others out there including some dirty ones, but this seems to work better than the other ones and I have taught it to several of my classmates. To figure out whether the cranial nerve is sensory, motor, or both another small pneumonic was taught to us. Following the cranial nerves again in order from 1 to 12 the pneumonic is as follows: Six Sailors Made Merry But My Brother Said Bad Business My Man. S=sensory, M=Motor, B=Both. So from the above pneumonic the word Six=cranial nerve I is sensory ONLY. The word Brother means that the facial nerve (CN VII) is BOTH sensory and motor. Man=CN XII is motor ONLY. To memorize this I would suggest you print off your own sheet and put this on the wall next to your toilet. You will have it memorized in a week of ‘business as usual’.

Doing things like this can help out in classes like neuroanatomy when there is sometimes an obscene amount of information to get straight in your brain. Learning the basics is the best way to start and a firm grasp on the cranial nerves is a great place to start. So what else do you learn in neuroanatomy? We started off with the spinal cord. Sensory pathways from touch and itch to muscle reactions. For example an itch on your hand has a certain type of neuron. The neuron will synapse in a particular spot and will have its cell body in a specific location. It will take a pathway from the hand all the way to the brain. From here it will initiate a reaction. The reaction will also follow a brain pathway and exit through the spinal cord. Other examples like what happens when you hear a loud sound. CN VIII is stimulated but also your head and neck muscles to turn towards the sound. These things all stimulate specific parts of the brain and you can decipher where the sound is coming from and what is making the sound (a baby or a car horn, etc.)

We also learned how these pathways can evolve and learn new things like how to do a crown prep. Each pathway is different with various locations of cell bodies and synapses onto various nuclei. We did have to identify a few histological slides of various structures in the brain and spinal cord. Like distinguishing the caudate putamen from the substansia nigra from the internal capsule. What I found worked well was to get all the pictures and make a quick power point presentation where the picture pops up on the first slide. Then add animation. Make an arrow appear pointing to the structure you need to be able to identify. Then the next animation you add the structures name. So when you watch the slide show this is how it works: Picture pops up, then an arrow, then you see if you know it and the next slide has the answer. Hope that makes sense. If you have a lot of slides, divide the work up with your study buddies.

Neuroanatomy is one of those classes that is initially very confusing, at least to me. At times I was so frustrated that I wanted to vomit on my book and burn it. Words like vestibulospinothalamic tract and latral geniculate nucleus can cause your head to tail spin into remediation. Remember to make it easy and learn the basics first. If you still can’t get it then maybe some more fiber and trips to the toilet will help. ☺ Good luck!

Getting Ready For Finals…

I know everyone is looking forward to some very cool articles and I promise that they are on the way. Right now I am preparing for finals which start THIS FRIDAY! Here is the break down:

Friday: Intro to Periodontology – An interesting class with very specific tests. We meet once a week and have only 9 power point presentations that we are being tested on. The difficulty is learning all the bacterial, viral, fungal, non microbial (viral, fungal) causes, symptoms, and treatments for gingivitis, periodontitis and each of their sub categories (acute vs, chronic). It is throwing my head for a loop to keep everything straight.

Anatomy: Head and Neck, Thoracic and Abdomen. Enough said (and I will talk about this class AFTER it is over)

Monday: Restorative II. This class is actually continuing through the summer, so it is really a midterm.

Tuesday: Neuroanatomy. Also a fun class. More on this later.

Wednesday: Dental Materials II.

I am looking forward to Wednesday afternoon. I will be done with finals and will be heading back home to Washington State for the weekend for my sister in laws wedding.

I have included some pictures of my study desk and some notes, to keep things interesting. I included a shot of the mandibular branch of CN V. See if you can see what is mislabeled. A bigger picture is located at flickr.

CIMG0913

CIMG0916

CIMG0914

Here are some things to look forward to in the next couple of weeks:

We have been busy in restorative with composite projects. I have pictures of those including a massive class IV project (my typodont got his teeth kicked in and I saved the day class IV) AND a fun veneer project we worked on using composite. Along with some class III and class II composite projects.

We started CROWN PREPS today and oh how I loved reducing those teeth. In fact we used our composite restorations to prep the crown. This way we can see if we had good retention in the tooth or not (in a real tooth they would also be cemented). Many people had there composite restorations pop out during reduction, but mine didn’t. I owe it to MONDO retention grooves I placed in the fake teeth with a 1/4 round bur on slow speed.

Some excellent readers have shown me a couple of VERY cool websites along with ones I have already found. I will highlight these (and update the original post) very soon. Among those I also have some half written ideas and articles in the works. I just don’t want to sit down and start writing because then I will forget all about the branches of the trigeminal nerve and the parasympathetic innervation of III, VII, IX, and X!

So stay tuned, hang in there, and realize that I am getting ready for finals! Thank you to all those that signed up for email updates. It helps me know that my knowledge (however skewed) is becoming community knowledge.

Dental Head and Neck Anatomy

One of the most feared subjects in dental school could arguably be the head and neck anatomy portion of gross anatomy. With close to an infinite number :) of terms this class can be physically and mentally challenging. Having suffered and lived through this section and midterm I can hopefully add some insight that will help those that follow.

TIP 1:

Don’t become overwhelmed! This will only lead to stress and anxiety and soon you will be thrown into the depths of despair! Well, this may be more dramatic than it has to be, but there is some seriousness to it. Chances are many of your classmates are feeling the same way. The key is to work hard at learning and memorizing all the new terms, names and functions as well as you can. So even though you will feel overwhelmed, the trick is to fight that stressful uneasiness with some good old fashioned work. Nothing beats stress more than going to bed at night knowing that you learned a lot (or at least tried to learn a lot). Remember that there is a lot of information being dumped onto you in a short amount of time, which leads to the next tip.

TIP 2:

Don’t fall behind. We were given two packets of material at the beginning of the unit and at first glance they didn’t look like much. After taking a second look though, they are crammed with information. Every page is condensed with muscles, nerves, vessels and glands and their intricate functions. A goal should be set to study anatomy everyday, even if sometimes it is learning only one concept or term. Take advantage of your dissection days and learn as much as possible, because while you are there you might as well memorize something. Some days you will be swamped with other classes, or a test the next day. Even so, you should at least memorize something. Maybe one term. Just make sure you keep your head above water.

TIP 3:

Remember the three R’s. Review, Review, Review. When it comes to within a week of the test, you will thank me or this advice. What I tried to do was pull out my notes from the day before and review it for ten minutes. Start on page one and just soak up the previously studied material. Then after ten minutes I would mark my spot and return to it the next day. Every couple of days I would catch up to where I was currently studying in my notes and then start over again. By the time it came to within a week of the midterm I would have reviewed the material 4 or 5 times and it made it that much easier to remember.

TIP 4:

Draw on a chalkboard. Find a room with a chalkboard and draw out pathways, arterial flow, dural venous sinus flow, charts, diagrams, etc. You will find that this change of pace and different technique will help you to remember the material in a different way. It has also been said, and I am not sure if this is true, that writing on a rough surface (chalkboard is slightly rough) can help you to remember things better. Also while you are at the chalkboard, get your friends attention and teach them the facts you are writing on the board. This helps to get the concepts down and if you are wrong, or don’t quite have a grasp on the concept, your friends (or you) can explain your case better. It has happened on multiple occasions in a test I was able to recall the diagram or words I wrote on a chalkboard and figure out the right answer that way.

TIP 5:

Simplify your notes. Have you ever read three long paragraphs and found out that there is only one concept those three paragraphs are trying to convey? Write down that one concept in a summarized sentence or two. Do this for all the notes and some of the reading (I would argue it is impossible to do it for EVERYTHING in dental school) and when it comes time to take the test all your notes are condensed in a small stack of papers instead of 5 chapters in a book and 15 power point lectures. This will also boost your confidence because page for page you have less to study than before, even though all the material is the same. I did this for a couple of the pathways of blood in the brain and the cranial nerves. Instead of looking at a complicated paragraph of what each cranial nerve did, I would simply draw a small diagram of the cranial nerve and its various branches and what each one innervated. During the test I could then mentally visualize this picture in my mind and see all the branches and which structure(s) they innervated.

If you do these things you will be fine. Whether you want the A or the C depends on how much time you spend doing each of these tips (and the ones you like). After the class is all said and done, and you learned as much as possible you will be on your way to becoming a proficient dentist (work on those hand skills), and you will realize that anatomy wasn’t as bad as you thought…right?

Welcoming Spring Break With Open Arms!

I have received a couple of e-mails from my excellent readers asking me if I was still alive. The answer is that I was half alive over the past two weeks. We have had an onslaught of midterms starting with Intro to Periodontology, Restorative Dentistry II (along with two quizzes and two practicals) Dental Materials II, Neuroanatomy, and we topped all of it off on Friday at 5:00 pm in the Head and Neck unit of Gross Anatomy. As you might imagine I am exhausted and ready for a week to recuperate. It doesn’t end though because after spring break we only have three weeks of class before finals. Here is a small break down of each class and how it is tested:

Periodontology: We had only five power point presentations which introduced us to the gingiva and the diseases associated with it as well as the microbiological factors and causes of these diseases. Even though we had only five packets it was a very specific test and some effort had to be put in to this class.

BOOK: Carranza’s Clinical Periodontology

Restorative: We had about 400 pages of reading, a couple articles, 10-12 power point lectures (or more?) and a packet of projects for this class. The test wasn’t as bad as preparing for it, but it made everything else that much more stressful.

BOOK: Sturdevant’s Art and Science of Operative Dentistry

Neuroanatomy: Not only does this class have tons of information but I think it has been the most confusing class I have taken yet. Don’t worry I am not whining. It was confusing because every thing in the class was new to me. About 90% of the terminology I had never heard before. For example the term thalamus was familiar to me, but add the term ‘medial geniculate nucleus’ to it and my brain did circles. Basically this class is about memorizing the assortment of sensory and motor pathways from one point to another. A road map on what would happen when you look at an object or touch something hot or learn a new dental procedure with the drill. It was difficult, but as with anything difficult in life, some work has to be done. I would recommend the neuroanatomy book by John H. Martin called Neuroanatomy: Text and Atlas. It was required for last years class of 2009, but was not recommended for us, the class of 2010. I had already bought the book before we were told we didn’t need it and decided to keep it anyway just in case I needed a good reference book. It helped out a lot.

BOOK: Neuroanatomy: Text and Atlas

Head and Neck Anatomy: There is an enormous amount of material in this class and my only recommendation is to not fall behind, memorize, memorize, memorize, and don’t fall behind. Much of this class overlaps with neuroanatomy because both courses will cover the cranial nerves and their paths and innervations. This makes it easy to kill two birds with one stone.

BOOK: Head and Neck Anatomy for Dentistry

FLASHCARDS: Netter’s Anatomy Flash Cards: With Online Access
Materials: There was also a lot of material for this class, but our instructor gave us a good review and the test was straightforward and reasonable.

BOOK: Dental Materials and Their Selection

In the end it was a difficult two weeks, but it was manageable as long as you stay organized, don’t fall behind, and don’t stress out about it! I just hope that after a week of doing nothing I will be able to jump back into school for another month until finals. After our finals in April we drop down to two classes for the first part of summer. Physiology and the continuation of Restorative Dentistry II, the 6 month long class that started in January.

Directional Terms to Memorize

Starting dental school with a little bit of knowledge can help to decrease the new stress of having to learn a large amount of new material. I hope that this new section called ‘education’ will provide a good overview of concepts and terminology you can use before or after you start dental school. I figured I would start on something simple and increase the knowledge bank from here.

These terms are basically beat into you the first semester (at least at Temple) of dental school and if not, then you should know them by the end of the first year. They are pretty basic and knowing them ‘cold’ will help in all aspects of dentistry. In fact they should be second nature after your first semester of dental school.

Facial – towards the face. The facial surface of a tooth is the side next to the cheeks or lips. The side you see in a normal smile.

Buccal – another term for facial usually denoted for posterior teeth, or teeth located next to the cheek. Do not use this term for incisors or canines. Bucca is Latin for cheek.

Labial – the term used for the facial aspect of anterior teeth, or incisors and canines. Do not use this word for posterior teeth (premolars or molars). Labia is Latin for lips.

Anterior – nearer to the front. A canine is more anterior than a premolar or molar. Anterior teeth include the incisors and canines.

Posterior – in the back. A molar is more posterior than an incisor. Posterior teeth include premolars and molars.

Occlusal – the chewing surface of posterior teeth. The top ‘flat’ part of the tooth. Anterior teeth have an edge and are designated differently.

Incisal – The edge of anterior teeth, used to cut food.

Lingual – The tongue side of the tooth.

Palatal – Only used for the teeth in the maxillary arch (upper teeth) and also refers to the tongue side of the teeth. This term can also be used because these teeth are adjacent to the palate.

Proximal – the sides of the teeth that usually are in contact with one another. The side in between adjacent teeth.

Mesial – The proximal aspect of the tooth closer to the midline of the face.

Distal – The proximal aspect of the tooth further from the midline of the face.

These are the general terms and during your first semester learning these will not be difficult. What gets difficult is putting everything together. All those terms come together at line and point angles of every tooth. For example, where the distal and lingual aspects meet, they will form a line angle called the distolingual line angle. This line angle will ascend and meet with the occlusal surface to create a corner or point called the distolinguoocclusal point angle. Add varying anatomy to each of the 32 teeth in the human mouth and your brain starts doing tricks. Also add that every cusp on the teeth also get a designated directional term along with the anatomy in that tooth. Triangular ridge of mesiolingual cusp for example, or mesial cusp ridge of distobuccal cusp.

It is difficult at first and hopefully a list like this can give you a head start on learning the language of dentistry. One day it will click and by second semester you should be using these terms and associating them with the anatomy of the teeth like it was tying a shoe. When was the last time you had to think while tying your shoe? Exactly. :)

First Gross Anatomy Test in Dental School

Hit the ground running for this class. The first day of school we were given a few small packets of information and a syllabus with the required reading. It didn’t seem like very much material considering we were given a whole trees worth of paper for biochemistry the previous semester. Our first test covered the back, shoulder and upper limb. If you have never taken anatomy then you would think to yourself, ‘How hard could it be?’

I stopped counting the amount of terms we had to memorize after 1000. That was the first packet out of three. Not all of it is plain memorization, monkeys can be taught to memorize. Half of our test was identifying the structure in a cadaver that a fellow classmate had dissected and the other half was multiple choice. You had to be familiar enough with the structure (nerve, muscle, and its function) to be able to identify it in a cadaver that you had not dissected and then be able to figure out the right answer on a seperate paper test.
Every muscle in the back, shoulder, and arm had to be known along with its origin and insertion (where it connects to on the body <– for those who haven’t taken anatomy) and what the muscle is innervated by. For example, the pectoralis major muscle. It originates on the medial clavicle, sternum and some costal cartilage and inserts on the greater tubercle of the humerus. It is innervated by the medial and lateral pectoral nerves which are C5-T1 coming off the lateral and medial cords of the brachial plexus. It has a couple of actions too, like inner rotation of the humerus among others. (I hope I got all that right…going off of memory) During the test they could put a string around any one of those structures just mentioned (pec major, lateral pec nerve, medial pec nerve, lateral cord, medial cord of brachial plexus, and say identify (and then you would identify the structure) or they would say, what is its action, or what does this innervate, etc. Then on the paper test they would test you on how well you knew the information.
After about 10 muscles you can see that there is a lot of stuff you have to know about the back and upper extremity. Add the spinal cord to that and part of it’s function (we learn a lot more about the spinal cord in the next anatomy section of head and neck and in neuroanatomy) and you have yourself a pretty daunting test. If you are thinking to yourself that that is easy (there are a few who will walk through classes like these without batting an eye [jerks...j/k :) ]) then wait until the head and neck. The next test covers three times the amount of material and covers 4-5 weeks of lectures and dissection on even more complicated things like cranial nerves and facial muscles.

This next stuff IS more pertinent to what dentistry is all about and should be more interesting to study as opposed to one of the muscles in the hand like the abductor pollicis brevis muscle. I took anatomy before I came to Temple and would highly recommend it. Not the anatomy for grasshoppers though (anatomy + physiology combined) but a general gross anatomy class with real human cadavers and a hard teacher. I know that most people want the high GPA to get into dental school, but it does help to work hard in a class before dental school and come somehwhat prepared. Either way anatomy at Temple is passable, but I think it is easier if you have some background. Now I have to go do some reading…

Restorative Dentistry II Projects – First Three Weeks

When comparing this class to Restorative Dentistry II class I would say the only difference is that in this class you have to hit the ground running. It helps if you are a fast runner. The first day of class we were given a packet of papers that describes the projects we will be doing over the course of the semester. We also were shown how to access the syllabus and all the required reading. Last year in restorative we did a lot of wax-ups, some acrylic temporaries, some composite restorations and some amalgam restorations. Last year when we were told to do a Class II prep in the ivorine tooth, we just kind of carved away and filled the tooth. This year we are learning the mechanics involved in doing all the types of preperations. We need to know the depth to go, the width, the different burs to use, the various instruments involved, etc. When they are talking about motor skills in dental school, it really means that you need to develop motor skills. (You don’t have to have them before dental school, in fact no one does), but this is why there is a pre-clinic in dental school. It is one thing to play the piano, or be able to build a model airplane (Some of the many ‘hand skills’ people put on their dental school application), it is another to drill exactly 1.5 mm into a tooth in the maxillary arch and then ‘drop a box’ that is supposed to meet perfect dimension. D2-D4 and current dentists may think this is childs play now, but just remember your learning curve. Also from what our Restorative teacher tells us, there are still some 3rd and 4th year students who struggle with this. It is difficult but possible. To get good we get to practice, practice, practice! We started practicing with an ivorine block. This is a plastic rectangular block of plastic. It has been stamped with the outline of teeth on all four sides. Our first goal was to drill exactly 1.5-2 mm into the tooth and follow the tooth anatomy. We practiced this on all four sides. Here is how some of mine turned out. I will also mention that all initial cuts were made using a #330 bur and followed or finished using a #245. All these projects had to be checked by our row instructor before we could move on. If you messed up horribly or your row instructor thought you needed more practice you have to go buy another block/tooth/etc. and redo the project before moving on. :)
DMDstudent.com

DMDstudent.com

The idea is to get good at producing the ‘ideal outline form’. This means that when drilling into a tooth you want to produce an ideal outline that follows the anatomy. After this ideal outline is formed, you look for caries and remove it accordingly. It is a several step process that I will not discuss here as I do not yet fully understand it. The idea is simple though. When making a cut into a person in any health profession it is very wise to measure twice and cut once. Make the small ideal outline form, at the correct depth, using the proper instruments, and if more cutting needs to be done then you do it. I think a lot of people don’t understand what goes into dentistry. It’s not as simple as drilling out a crater into someones tooth and filling it with some material that is supposed to last a lifetime. It involves a great deal of skill and technicality. This is one reason why we students get to practice on so many teeth before we get to see a patient.

After the ivorine block looked somewhat decent our next task was to practice on some real teeth. Not real teeth in real patients, but real teeth that USED to be in real patients. We were asked to collect teeth from our local Oral Surgeons over Christmas break and bring them to school on the first day. We sorted through the teeth, picked the best ones, sterilized them, and set them into dental stone. Then we proceeded to drill. Here are my results:

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Restorative Dentistry II, Quiz 1

typodont imgWhen you are in undergraduate class and the professor tells you you have a quiz tomorrow, you usually go home, watch three hours of TV, play with your kids, or hang out with friends, then go to sleep at 10pm. In the morning you wake up and 10 minutes before class you cram 15 facts into your brain and get quized on 10 of them. If you are good, you miss none.

I would change this habit before dental school or else you are in for a rude awakening! We had our first quiz of the semester in Restorative Dentistry II last Tuesday and although it wasn’t a beast, preparing for it was. Some reading this may disagree with the amount of reading I and fellow classmates may have done, but I do pay close to 300 dollars a day (every day 24/7 for four years) in tuition, etc. so I might as well make the most of it.

Here is the reading our quiz was centered on:

Reading from ‘The Art & Science of Operative Dentistry’ by Sturdevant (A 1000 page textbook on various dental procedure from posture to application of rubber dam to drilling and filling):

Chapters 2, 3, 6, and pp. 449-452, 419-430, 435-446, 690-702, 709-720, 778-782, 463-492, 737-749

Also reading from a packet: Sections 1-4, 10

5 Powerpoint lectures

2-4 articles (I didn’t get time to read these)

Various online resources (glanced through them)

This is two weeks worth of reading. Granted it is EASY for the 2nd, 3rd, and 4th year dental students because of their exposure, but to a young grasshopper as myself and my classmates, it was pretty extensive. New terminology, depth of cuts (like memorizing that the gingival wall ideal outline form should be 1.5 mm in width from the proximal surface to the axial wall. (I just lost all the pre-dental students on that one – you guys get the idea) to the proper bur selection for the cavity prep. All good things to memorize, but very extensive.

After cramming in all the reading, memorizing my little review sheet, looking at back quizzes (one question remained the same) I still missed one. 4/5. 80%

I am not sharing this information to discourage anyone, nor am I discouraged. This is a good grade and it was (in a sadistic way) fun to read, after all, we did CHOOSE to do this and it is FUN, even if it includes reading 400 pages in two weeks. :)