Category Archives: General Info

Just wanted to give you an update of the first three months of residency.  IT SUCKS….just kidding, I wouldn’t want to be anywhere else.  We are busy and the hours are long, but the work is gratifying.  People never stop breaking their mandibles at this place and the pus never stops flowing.

1) Out patient clinic:  We see and serve about 45-70 patients a day in our clinic, a couple of days we reached 100 when the scheduling office decided to be morons for a day.  It is absolutely nuts.  It is like Temple’s clinic but we don’t have 10-12 dental students running around, there are TWO of us and a GPR (last month we were spoiled with 4 residents and two GPR’s). It is absolutely nuts (oh yeah, I already said that).  Did I mention we have to get done with morning clinic by 1pm?  Again, NUTS!  I have never done Continue reading →

DONE! DONE! DONE! DONE!DONE! DONE! DONE! DONE! DONE! DONE! DONE! DONE! DONE! DONE! DONE! DONE! DONE! DONE! DONE! DONE!

I officially finished all of my requirements near the end of April and graduated on May 13, 2010.

In two years I did the following: Continue reading →

You may have noticed that for the past year I have had an advertisement at the top of the website (those of you who still do visit the website, thanks READ TO THE BOTTOM TO SEE HOW YOU CAN GET A DISCOUNT.

What you may not be aware of, however, is that I have had one of these powerful little LED lights on my head, and in patient’s mouths for the past year as well.  If I didn’t like this light 100% I wouldn’t place it on this website. I refuse to promote crap products, especially since I am acutely aware of how much debt is racked up in school and how much things cost while in school. This product is well worth the investment. Here are some reasons why this light has made me believe that it is the best ‘add to my arsenal’ investment I have made in dental school. I am not receiving anything whatsoever for this article. This is my own opinion.

I have talked with the founder of loupelights.com and here is what we discussed. He is a recent dental graduate (2009) and was in the same dilemma many of you may be in. He said the lights that were on the market had several problems. They were large and/or heavy, became hot, were incompatible across loupe brands, had short battery life, and had an enormous battery pack. So he solved the problem. He asked everyone at his school what they hated about their light and what they loved about it. He got together with some of his connections and basically designed a light that incorporated EVERYTHING that everyone loved about their light. He also incorporated the things people wished their light had. Here is what he came up with.

Here is a photo of the set-up I have been using:

The size of the unit is what impresses me.  The brightness for the size is also impressive.  It may not pack as much punch as the larger sized lights, but you don’t need a supernova to prep a class II. This bad boy still delivers 39,000 lux, or about 3,600 foot candles (VERY bright). Because the other lights are ultra heavy (because they are large) they become burdensome wearing them all day long.  I have worn these for 8 straight hours and haven’t even noticed they were on.   Here are another few shots of the size of this unit.  You can see that it is about the same size as my iPod touch.  It weighs just a little bit more than the iTouch as well.  It has a clip on the back which clips to my protective gown or scrubs.

The light housing is smaller than a quarter. To be accurate the lens is the size of a dime! Most lights I have seen are almost twice as long and 2x bigger in diameter.

Other lights get as hot as HADES after a few minutes of being ON. I run my light for 1-3 hours at a time and can easily reach up and adjust it mid-preparation. Mind you, it is not cool as ice. It does get warm, but not red hot like the other lights.

Another invaluable feature is the quick release mounting brackets. It takes me about 20 seconds to switch the light from my safety glasses to my loupes. Here is a close up of the bracket on my safety glasses.

I have the same bracket on my loupes (Rudy Project Flip Up) and it slides right on. This light has brackets for virtually every loupe brand out there. The light can also be custom fit to your own pair of safety glasses.

The battery life in this unit is very impressive. One of the longest on the market. I have easily used this for three weeks (2-3 appointments a day in dental school) on ONE charge. If I were to turn it on max and let it go then it would give me 100% brightness for eight hours. Since I don’t use it for every single appointment it allows me to use it for so long with out a recharge. How do I recharge the batteries? I simply plug in the adapter that is plugged into the wall. I don’t take batteries out and fumble with a recharger. The unit plugs directly into a wall. The following picture shows this. The middle ‘hole’ is for the charger to plug into. The light cord comes out of the outside hole and the adjustment knob allows you to choose the brightness of the light.

Here is a shot of the brightness. I am shining the light onto a quarter from about 1 foot away:

Here is a shot against the wall with natural 75 WATT GE REVEAL (nice light bulbs) as the background. See how this little light powers through the natural light! This is from about 3-4 feet away from the wall.

Here is a shot into my son’s mouth. The camera does not do justice, and the light is not so bright as to blind you. With my eyes I could see every detail in the mouth. I didn’t feel like messing with the exposure/f-stop etc. on my camera.

Some other things from the website:
- LED lasts for 50,000 hours (that’s like turning the light on 24/7 for >5.5 years)
- Made with aircraft aluminum – cool I guess – not a selling point to ME
- Weighs 0.13 oz compared to .5oz of the next lightest light
- 6000K color corrected true white light (whatever that means)
- Comes with a detachable flip up composite filter
- Takes 3 hours to charge

Check out the FAQ page for other features such as 45 day TRIAL, limited warranty, etc.

As always I am trying to hook you up with the best deals and best products available to make dental school and dentistry easier, so…..

IF YOU DECIDE TO ORDER THIS PRODUCT MENTION www.DMDstudent.com AND GET A DISCOUNT WHEN YOU CALL!

SCROLL TO THE BOTTOM FOR A LINK TO PICTURES.

For the past year, ever since the last trip to Haiti, our group has been planning, fund raising and gathering equipment for one of the greatest trips I have ever been a part of.  March 7-14 was one of the highlights of my four years of dental school.  After the earthquake, it was uncertain whether or not our trip would go on as planned.  Most of our group still wanted to go, and we already had plane tickets, but we didn’t know if commercial flights would still be traveling to Haiti.  After much discussion with Temple University and the various risk management groups we got the green light. I will try to explain what our trip was like in words and, of course, many pictures.

We met at the house of one of our group leaders at 4:30 AM with all of our luggage and waited for the chartered yellow school bus to drive us from Philadelphia to JFK International airport.  Our driver got lost a few times but we made it in time to board our flight to Port-au-Prince (PAP).

After our two hour bus ride we checked 28 bags onto the airplane without any hitches.  Most of our checked luggage was over 50lbs, but we were a big group and offered enough chaos as to check every bag without paying a cent more for the extra weight.  Our flight to PAP was about 4.5 hours and we landed OK.  The airport was small and we took a bus to baggage claim.  Baggage claim was very interesting.  It was a large room where our bags were unloaded from a truck and scattered all over the place. I was surprised we didn’t lose a lot of bags.  Only one cooler was lost…it was full of food and probably stolen.  We then waited outside of the baggage claim to take a small bus down the street to another charter airport to take a twin prop airplane to Jeremie, Haiti where we would be staying with the Haitian Health Foundation (HHF) for the week.  This leg was chaotic.  There were dozens of taxi drivers and baggage guys all trying to grab our bags and shuffle us off into taxi’s.  Everyone wanted a tip and was grabbing at our bags.  We finally got a hold of everything and took three SUV’s with our stuff in it a mile down the road and loaded up into our charter plane.  Our flight took us over PAP where we got a bird’s eye view of the destruction.  We could see 100′s of tent cities amidst the destruction.  After 12 hours we finally made it to the HHF where we unpacked all our gear, food, and got settled into our rooms.

Each day we would split into two groups and travel on a bumpy road for anywhere from 45 minutes to 2 hours.  When we got to the village we would set up our chairs, get out our equipment and instruments, and start seeing patients.  One of us would start taking blood pressures and everyone else would start seeing patients.  We learned a few phrases in creole to help us communicate: “Which tooth hurts?”, “Open your mouth”, “Spit in the bucket”, “Take these three times a day”, etc. Half the time I don’t think they understood what we were saying.  One of our group leaders who has been traveling to Haiti for about 8-9 years thought that he had been saying take these three times a day (medications), when in reality he was saying “crap on my shirt”.  We got a kick out of it since he would hand the patient a bag of amoxicillin and then proceed to say, “Crap on my shirt” in Creole.  Every day the two groups treated anywhere from 50 to 130 patients.  We saw about 1000 during the week and probably extracted around 3000 teeth.  If you divide 3000 by the 14 of us who went, that’s about 210 extractions each in 5 days.

A few of these teeth were periodontally involved and were extracted with finger tips and gauze. The majority of the teeth however, were very challenging.  I don’t know what it is, but Haitian bone is very strong.  It’s not like your typical cancellous bone surrounded by a cortical plate.  I would argue that most of mineral content of Haitian jaw bone is made up of granite.  The teeth we saw had been necrotic for quite a while and were quite brittle.  The sugar cane habit turned the crown into a shell of enamel so when it came time to elevate or apply the forceps, the crown would come off as a perfect ring.  A ‘shell’ of only enamel.  What was left was long, brittle, retained roots, embedded into this granite bone.  We had no suction, no x-rays, and it was 95 degrees out.  It was one of the best experiences of my life.  We were perched under palm trees, in the middle of the Haitian jungle, removing bone with hammers and chisels, extracting teeth for some of the best patients I have ever had.  These were the toughest people you will ever meet.  I guarantee 20% of the people we saw were not fully numb…but they just sat there and the loudest noise they made was a barely audible whimper.  Much different than the emergency patient from North Philly…

After the long days we would clean up, play with the kids in the village for a little bit, give away some prizes, and then drive back to the HHF.  We would spend the rest of the evening relaxing.  We would eat dinner, go star gaze on the roof, play games, chat on the balcony, etc.

We were planning to fly out on Sunday, but our flight got canceled.  We were stuck in Port-au-Prince for the night.  After about eight hours in the airport, trying to figure out what to do, we met a reporter from the LA Times who was also stuck.  She recommended a place for us to stay, the Crown Plaza.  It was a block away from the Presidential Palace and is the same place where a lot of doctors and nurses and reporters were staying.  It was guarded by 12 foot barbed wire walls and armed guards.  We had a view of tent city from the hotel balcony.  It was absolutely surreal.  My words or photo’s won’t accurately describe what we saw, but Haiti is in a very poor situation.  I hope I can return on future trips.  If you are interested in helping our group, please visit www.templehaiticlub.com and click on the DONATE link.

Enjoy the photos:

PHOTOS TEMPLE HAITI TRIP 2010

It’s good to knock one of senior years stresses off the list of ‘things to do to graduate’. There is a big scare going around the dental student community of the increased failure rate of Part II NDBE.  I have heard failure rates jump from 5% last year to 13% and even 30% at some schools this year!

Here is my experience:

I started ‘studying’ mid February. Motivation to study was pretty low.  I started with going through the dental decks.  These are a great way to quickly review material in a short amount of time.  If I knew the card I would discard it.  I didn’t look at it again.

DECKS: I reviewed the perio section in three hours – what a dry subject!  I didn’t even look at the pharmacology section.  I DID review pharmacology however, just not with decks.  I looked at every oral pathology card at least twice, some more, and took lots of quick review notes for oral path.  I noticed a lot of ‘quick and dirty’ topics in part II back tests like what syndromes have multiple impacted teeth, or which of the following will show congenitally missing teeth, etc.  I avoided learning extreme details for most things, like age of onset, etc.  Just the ‘nitty gritty’.  I breezed through the OSHA cards and ethical cards.  These cards were really straight forward.  I went through the orthodontic cards thoroughly (learn SNA, SNB, etc. angles!). Radiology was pretty straight forward, and I took a few notes on some of the details (what happens when a certain setting is increased or decreased, etc.) Oral surgery was straight forward, but this topic is a personal interest of mine and was not hard to study for.  Another dry subject was prosthodontics and I forced myself through these cards over the course of three days. If you go to a dental school where you actually do dental work then operative was a breeze to go through, except for the questions on gold foil?!?!  Endodontics I went through once, and I skipped pedodontics for lack of time (even though I would learn the difference between apexogenesis and apexification if I were you.)

Our school handed out a big packet of back tests which I sort of went through.  I saw a few questions from the back tests on the real thing, but nothing to get excited over.  The back tests serve mainly as a good guide to gauge the real thing.

MOSBY: I used this book for a couple of sections: Orthodontics and Pediatric Dentistry.  I read through it once, took some notes and reviewed the notes before the test.

FIRST AID: I read through most of the book.  This is NOT a detailed book, but it does let you review in your mind the things you have studied and it solidified a lot of things from the decks. The cases in the back of the book were a 2/10 stars.

I obtained a great pharmacology review packet from some classmates that helped to solidify pharmacology in my brain.  In 30 pages I learned more about pharmacology than I ever did in my pharmacology class.  Everything from topical to antibiotics to heart medications…in 30 pages.

The test is broken into two parts taken over the course of two days.  The first part is 400 questions with an hour break (I think, I didn’t take my break), in between.  I finished both sections with about 45 minutes to spare and did not feel rushed at all. The second part on day two are the clinical based questions. There were 10 cases with about 10 questions for each one.  The test gives you a couple of intra-oral photos, some radiographs, and a crappy med history.  It is pretty easy to tell what they will ask you when they say the patient is allergic to penicillin and needs prophylactic antibiotics.  Some of the questions showed a perfectly normal tooth and wanted to know how you would restore the tooth…use common sense! For this section I used all but two minutes as I had to think a little bit more. I walked out of both sections not knowing what to expect, I would not have been surprised if I had failed because I felt that a lot of the questions were very subjective.  There is more than one way to restore a tooth!  One more thing checked off of my list of things to do to graduate.  I wouldn’t put this test off until last minute, it really feels good to be done with it.

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A little more than half way done with D4 year here at Temple and I must say that the last 2 years of dental school are very busy here at Temple.  This final year has been busy mostly because of applying to a residency program.  In May 2009 I started filling out the PASS forms for the Match.  This included gathering undergraduate transcripts, dental school transcripts, letters of recommendations, filling out forms, paying fees, researching programs, etc.  During this time we were taking about 12 credits of classes, had patients full time, and was juggling the organizations I was involved in and my family time.  I submitted my application in the beginning of July when my D3 grades were finally released.  Then the waiting began.  My first interview was from Temple and was followed by Thomas Jefferson, Arizona, Houston, Galveston, Cook County, Long Island Jewish,  Christiana Care, and Lincoln hospital in New York City.  Lincoln is the only interview I did not attend, only because I could not see my family living in the city. (toomuch$$$$$ and concrete)  Some of the interviews were back to back.  One night I was in Houston, the next in Chicago, the next night in…..lot’s of traveling and plane tickets, hotels, rental cars, etc.  The whole application process from the PASS application to travel expenses cost about $5,000-$6,000 dollars.  My credit card is still feeling the hurt.

Now that I matched, I do feel a huge sense of relief, but at the same time I have many things left to do:

• Take NBDE Part II
• Take regional boards (WREB for me)
• Graduate

To graduate I need to complete a few requirements:

• 3 more crowns (need 15 total)
• 3 more dentures (actually 7 but I am currently in the process of making 4) (need 11 total)
• I need some more class II amalgam points – about 3-4 two surface amalgams.
• Class II amalgam competency
• Maxillary denture competency
• Crown competency
• Treatment planning competency
• Outreach days at satellite clinics
• Pediatric operative competency
• Oral surgery competency (extract lower molar under nitrous)

I am done in the following:

• Radiology: this includes taking multiple FMX’s and panoramic radiographs
• Admissions: This includes EO/IO admit exam and a medical history plus some tests, etc.
• Endodontics: I ended up doing 5 anteriors and 3 molars. At Temple we don’t count canals, we count actual teeth.
• Periodontics: I cleaned more mouths than I cared to.

I think all this is attainable by the end of May.  My goal is to be done by the beginning of May so I have time to transfer my patient charts, drop patients that don’t want to be seen, and get cleared from all the clinics.  This is a fun process all on it’s own.  Last week I dropped 4 charts. It took the better part of an afternoon to call the patients, get all the right paperwork and letters sent out, and officially drop the chart out of my name.  I have about 35 patients left.

My classmate helped to start an Anesthesia Honor Society here at Temple University and for the past couple of weeks we have been practicing placing IV’s into one another.  If this is something you would like to get started at your school I would suggest talking with your oral and maxillofacial surgery faculty/anesthesia faculty or another trained faculty member to help you with this activity.

Our activity consisted of a presentation by a student that reviewed the armamentarium, anatomy, and procedure of venipuncture.  We then split up and started practicing.  Here is a small review/video I made of our meeting:

WATCH VIDEO OF HOW TO START AN IV

Anatomy:
In theory, venipuncture may be done in any superficial vein of a sufficient size
Sites for venipuncture on the arm:

• Dorsum of the hand
• Wrist
• Forearm
• Antecubital Fossa

Veins of the hands and palm drain into the dorsal venous network.  Veins in this network include the cephalic v. and the basilic v.  At the antecubital fossa (inner part of arm opposite the elbow) we find the cephalic, median cephalic, median, median basilic and basilic veins.  These end up draining into the axillary and cephalic veins to the subclavian to the brachiocephalic and finally to the superior vena cava (SVC).

Venipuncture:
Make sure to get pre-op vitals. Dilate the veins using a tourniquet as seen in the video about 6 inches above the site of venipuncture.  This will dilate the veins because it stops the venous flow back to the heart, but does not stop blood flow in the arteries.  Blood can still come into the arm, but it does not exit = dilation.  Patient may make a tight fist or pump fist to help the veins bulge.  Look and feel for a vein.  The feel is like a rubbery rebound. Cleanse area with alcohol.  Hold the vein steady by pulling on the skin below the vein in the opposite direction that you will be inserting the needle.  Bevel should be up. Hold at a 30 degree angle and insert into skin and hopefully the vein.  There will be resistance followed by an easy penetration feeling…like you have entered into a small tunnel.  Advance the needle or if using a catheter, advance the catheter while removing the needle at the same time.  Release the tourniquet.  Confirm that the line is in a vein.  You can now hook up the IV bag.  When removing make sure to place firm pressure on the penetration site so stop the bleeding.

Complications:

• IV bag not running: Bag is too close to the heart, tourniquet is still on the arm, the IV is infiltrating the tissue.  May lead to a hematoma.
• Hematoma most common) Improper application of pressure.  Painless discoloration under the skin.  Management: Remove tourniquet and needle.  Apply pressure to area.  Ice can be used to constrict vessels.
• Venospasm: A protective mechanism…vein appears to disappear when irritated.  May cause a burning sensation.
• Intra-arterial injection: (most significant). Although rare, this can be very serious and should not be taken lightly.  Arteries have a band of muscle around them which will constrict upon irritation.  Indications: Pulsating return of blood into tubing. Brighter cherry colored blood. Severe pain. Decreased radial pulse.  Color/Temperature change from lack of blood.  Management: Leave needle in place. Administer procaine 1% 2-10 ml (anesthetic, vasodilator, dilutent) accompany patient to ER.

Good luck!

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