Category Archives: Education

Junior Year Dental Outreach

A Juniors one of our requirements is to do outreach.  The school has plenty of outreach days available and they include anything from helping with the Special Olympics to doing screenings on children at various clinics in the greater Philadelphia area.  Two outreach credits are needed and the outreach is done in any two days during the year.  The first outreach I did was a table clinic at some Junior College where we talked to students at a graduate job fair and gave them information about dental school and the scholarships available to them if they graduated from said college.  No one wanted to go to dental school which I thought was insane since the scholarship was for a FULL RIDE. Anyway…

For my second day of outreach I visited my son’s elementary school and talked to a his class about brushing their teeth and how fun visiting the dentist can be.  I had one of my friends help me out.  Here is his picture:
Dental Donkey

I spoke to the kids about the typical things.  The average visit at the dental office, Mr. Tickle (low speed with prophy cup), sleepy juice, how to brush, and my donkey friend helped me the whole time.  I used my son to help all the kids count all the teeth found in a 5 year old.  Here are some pictures, enjoy!

outreach speaking to kids about the dentist

loupes on, donkey sedated

showing the kids the instruments

each one gets a turn brushing. watch out donkeys can bite!

counting how many teeth kids have (my son)

Amalgam or Composite?

Our Restorative V and VI classes are built around reading ‘classical’ literature of basic dental concepts.  We read articles, discuss the topics in class and have writing assignments where we use our brains and come to conclusions and postulate ideas, etc.  A recent assignment posed the following question.  I have already turned in my opinion, so I am not asking you to do my homework, but I wanted to hear the opinions of those that read this.  Enjoy and please comment or form your own questions. Note that I have paraphrased his question from memory, it was taken down from our online access program.

You have recently graduated from dental school and are interviewing for an associate position at your dream dental office.  The senior dentist just stopped using amalgam a few years ago and asks you what your opinion is on amalgam.  Note that he has been practicing for several years and is well aware of the benefits and controversies surrounding amalgam. He can tell if you are BSing him.

We were asked to cite some of the articles we are assigned to read.  I will list them here for your own pleasure.

RT Kao and others. Understanding the mercury reduction issue: The impact of mercury on the environment and human health. Calif Dent Assoc J. 2004; 32(7): 574-579.

JR Mackert and MJ Wahl. Are there acceptable alternatives to amalgam? Calif Dent Assoc J. 2004; 32(7): 601-610.

AV Ritter. Posterior composites revisited. J Esthet Restor Dent. 2008; 20(1): 57-67.

What would you say to this dentist? Back up your answers if possible.

Dental Boards Part I is OVER!

I was going to commit myself if I had to study for another minute. My eyes were going cross eyed all by themselves because I had been reading so much. I studied about 4 hours a day for the first month, then boosted it up to 6 hours a day for a couple of weeks and then 12 hours a day for a week. Then I was so BURNED out that I stopped studying for three days before I took the test. I reviewed a little dental anatomy the day before the test. We also had three classes during this time (finals are next week), add patients and duty days in the clinics and my extracurricular activities and family (who were largely ignored for 2 months) – It has been fairly busy. I was a little disappointed in the test though. It was in almost no way similar to any back test I took. More on this in a minute, here is how my studies went.

I started with Dental Decks. These are a great resource for a number of reasons. They are a good review. Even now, i could pull them out and learn something new. I think in future months I will sort through them and find the ones that are most pertinent Continue reading

First Duty Day: Admissions

I had an admissions duty day last week with a few of my classmates. We basically helped a junior student, also on admissions duty, admit a new patient into the school. Here is how it went:
We showed up on time, signed our name for attendance, and received a 100 page packet on the admissions clinic. We get a packet like this from almost all the clinics totaling about 1,000 pages, or so it seems (about 9 different clinics each with their own packet). I don’t know when we are expected to read all of these packets considering we are getting ready for the boards on top of some random quizzes and tests. They do seem like helpful resources if you can sift through all the filler material.
After we got our packet we started to help out the upperclassman. I must say it is a little nerve wracking. Some good advice I have been given is to be confident even though sometimes you have no idea what you are doing. I was asked to check the blood pressure of the new patient. After fumbling through a small some small brain farts of putting the blood pressure cuff on upside down and not being able to inflate the arm cuff (screw in the valve idiot!) I was able to get the blood pressure. Phew! Some of these things (taking blood pressure, etc.) we haven’t done for a year, and after 40 credits of various classes these things get put into a brain .zip file and are compressed for later use.
The patient obviously fills out a new patient medical history form and this is all reviewed with them. Everything from allergies to hospitalizations and medications. An extraoral examination is performed followed by an intraoral examination in which gross defects are noted in the chart. After everything is reviewed by the student and checked over and written down, the student finds a faculty member and presents the case.
You give the patients age, sex, blood pressure, chief complaint, and a few other things like medications, findings from the exam, and medical history. The faculty member may then quiz you on various things that they find are suitable for you to learn. We weren’t really quizzed for our session, but we did learn some things. Our instructor gave a very good example of a head and neck exam, we auscultated the TMJ, which really isn’t necessary, but it was cool to hear clicking in the left TMJ and nothing in the right. This clicking did not bother the patient by the way and is actually quite common. Then we got to perform the intraoral examination ourselves. This poor patient had about 12 fingers in her mouth back to back for about 40 minutes. The patient was, well, patient and had no problem helping us out.
After we were done we took the patient to radiology and handed their chart over for xrays. That concluded our session. The patient will then be assigned a student over the next two weeks who will take care of their needs.

Study Skills for Life

In no particular order a small list of essential items to help you study well:

  • Lots of pens and pencils. I think I have used 20 pencils this past semester. Those cheap Bic mechanical ones that cost like 5 bucks for a box. I love them. I used pencils more than pens.
  • Paper. I bought 10 packs of staples paper for $1.00 each. College ruled high quality and best of all, flat! Don’t know if you can remember something for a test? Put your notes away and start writing down everything word for word (or darn close) and compare. I am going to make up a motto: The three S’s: If you can Say it and Scribe it, then you can aSe it! It was a stretch, but it works.
  • Is it time to study or is it time to browse YouTube? If it is time to study, then put away the internet (look at me the hypocrite right now), turn the cell phone OFF – sorry socialites – you’ll survive, and study! YouTube is not going anywhere, your text message from Slacker-Stan can wait.
  • Eat it! Your mind melts quickly without a break and some glucose running through your veins. I try to eat something at least every two hours. By the looks of my dental belly you may think I eat every two minutes. My goal is to keep my metabolism running so I can concentrate in class or while reading a riveting perio lecture.
  • Stay focused
  • Don’t procrastinate. Even if you think C=DMD. The stress of waiting to the last minute sucks.
  • Study with friends who keep you focused.
  • My last piece of advice: Before beginning, clear your mind, take some deep breaths, lean back in your chair and stretch out your arms. Put your hands out to the side so they are in your peripheral vision. Let your arms relax, but keep your eyes focused peripherally so you can see ‘everything’ in the room. The clock, Slacker-Stan at the drinking fountain, Gunner-Gary already studying for next years exams, your notes, the ceiling, the window, etc. Let everything soak in and just RELAX. You are already in dental school. When you are ready, begin studying.

What are your study methods?

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.

Palatal Press and Roll Anesthesia Technique

Has anyone ever heard of this before? I found it during a late study night when taking a break. I don’t remember how I found it, but I downloaded an article by the inventor of the technique, Joseph Kravitz, DDS, MS. The article was featured in Practical Procedures & Aesthetic Dentistry pg. 242 Vol. 18, No. 4. The website for this peer reviewed journal can be found here. The article is an editorial of the procedure which involves rolling the handle of the mirror near the area to be anesthetized. According to the article and a google search this is a great technique at alleviating pain. A palatal injection can be one of the more painful oral injections and something as simple as this can be a lifesaver to the nervous patient.

It seems simple enough. The idea is to refer pain to another area of the body to ‘confuse’ the nervous system. Many dentists will slightly squeeze the cheek while giving an injection to distract the patient from the real pain. It reminds me of the movie Major Payne. The main character is running through the battle field and comes across a fallen comrade who has lost a leg. The fallen soldier is screaming, “My LEG, OH, MY LEG!”. Major Payne comes up to him and says something along the likes of, “Let me help you take your mind off that leg.” He then breaks his finger. The next shot is classic. We are shown the guys face with his hand in the air with one finger bent at 90 degrees. He is screaming, “My FINGER, OH, MY FINGER!!”

I have attached the three page article, enjoy!
Palatal Press and Roll Anesthesia Technique

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 the National Board Dental Examination

Are you one of those students who took the DAT and said to yourself, “I am done with that stupid test and never have to remember anything about the Krebs cycle or gram positive bacteria ever again!�?

I was.

You are in for a major disappointment when you get to biochemistry and realize that that stupid circle on the chalkboard with carbons and water going in and out of it has a message next to it: Memorize this for the test. Not only that but it will be more detailed and have all the other major systems going into it….pentose phosphate shunt, amino acid derivatives, what happens in hypoxia, you know, stuff that will help you save your patients life. To ease the pain of this newfound realization I will say that anything to do with PLANT respiration isn’t in dental school. SO if you got that silly question on the DAT about the reproduction of a sea anemone, then don’t worry, you CAN forget that information.

I have strayed from my point, which was to point out that even though you were finished with the DAT you still need to retain some of that information, as it will make learning in dental school easier. If you were like me and thought that you would never have to know the stuff on the DAT again (I know naïve…) then you probably thought similarly to me on another issue, never having to take another test like the DAT again!!! You thought wrong. In reality I DID know I had to take another test, the National Board Dental Examination (NBDE). I just didn’t realize how quickly the time would pass before I actually had to take it. I have finished a year of school (with a summer I block ahead of me until June 30, 2007) and it seems like I got my acceptance letter a week ago. So with that heartfelt introduction out of the way I have gathered some good test taking information. I am hoping that some of the more experienced dental students out there who read this or come across this will add their personal experiences in the comments section.

NBDE Materials and Guidelines
I have been looking at various study materials and gathering advice from many people over the past six months about the materials they found to be the best to use for the NBDE Part I. In my opinion there are four things you need to rock Part I. Maybe five if you add personal skill.

1) First Aid for the NBDE Part I by Steinbacher and Sierakowski.
The authors both went to dental school so there is the first sign of credibility. One author is a dentist and the other one is doing an Oral Surgery residency in Boston. This adds more credibility because these guys more than likely used the same material presented in this book to get the scores they did (I am guessing in the 90′s). I have looked at it in the health science bookstore and it looks to be a very good resource. It is filled with definitions, charts, key words, figures, diagrams and it is organized very well. The pages look clean and uncluttered so everything can be organized into your brain better. The price also made me smile (and a little jealous…can I become an author of this book please to make some extra revenue?).
Buy First Aid for the NBDE Part I
flipped67
Sorry for the crappy picture, I took in in the airport with my computer.

2) Dental Decks
These are more pricey but have been recommended to me by 100% of the people I have talked to. Everyone also had the same recommendation: Just memorize the decks and you will be fine. Seems simple enough. What are the ‘Decks’ you may be asking. I did a little looking through google and found the website that sells them. ******* They are flashcards. Even better I thought, flashcards are awesome. Remember those flashcards you had for the DAT? 200 flashcards that were pretty simple to memorize. Well, the Decks are 1300 flashcards that are professionally done, almost like baseball cards. Pretty simple to memorize indeed…each card is packed with information covering all subjects needed for the NBDE. Here is their website: deckscorp.com, and here is another link to the NBDE specific site. My friend ordered these and he got them the next day in the mail. This company is very good with what they do.

3) Personal Notes
Take the best notes possible while in school. Maybe flashcards and some cool charts and graphs. My friends and I have done this for many subjects this semester. We would take a 30-50 page power point lecture and condense it by taking out all the fluff and retaining the main points. We could then reproduce this new material into a 1-2 page sheet of paper that had all the stuff from one lecture on it (not size eight font either, a normal page). I have dubbed these sheets Ninja Sheets (I will write an article on Ninja Sheets I have decided). Why Ninja Sheets? Because like a ninja, these sheets are stealthy and the information you learn from them will help you slay and defeat the enemy: your test. It is easier to study for a test when you have a stack of 20 papers vs. a stack of 100. When it comes time to cram for the NBDE and a concept comes up that you don’t quite understand or remember, bust out your Ninja Sheets.

4) Released Exams
There are packets you can buy that have questions from previous tests. These are an excellent resource and many questions you see here will be repeated on the test. I have searched many places and can’t find where to buy these…anyone know? I know I have seen some sell on ebay.

5) Personal Skill
I have a friend at UoP who had the amazing ability called RETENTION. We would be studying for Histology in undergraduate and a concept would come up that none of us could grasp. We would all look at him for an explanation and he would search the archives of his brain for an answer. He would usually say something like this, “Remember two months ago when our teacher said such and such?� We would look at him blankly while he explained the concept and we would move on with studying. Well, I have found that retention is so much easier if you learn something with out cramming. Learn the information early and review it often. It gets incorporated into long-term memory better. Retention is also easier when you are not stressed out about it. I find that the more stressed out I am for a test, the harder it is to learn the material and I usually do worse on the test. Start retaining the information you learn in dental school from day one. Even the material from the psychology class you take will appear on the Boards!

The sooner you gather material and start reviewing and learning new material the easier it will be to get ready for the NBDE. Review while you eat breakfast, on your way to school, while you sit in the bathroom (at least once a day right?), and anywhere else where you have some downtime. My personal favorite is during commercial breaks while watching 24. I realize I still have until September of 2008 before I have to take Boards Part I, but I had to take the DAT twice because I wasn’t prepared the first time and I don’t want to anything else more than once again, unless of course it is memorizing the Krebs cycle. ☺

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.