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THE NEXTDDS Student Ambassador Blogs

Five reasons why I love blogging

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As dental students, we are always studying, which means half the time we are actually browsing the web for funny memes, Facebook updates, or YouTube videos. It also had lead to more and more integrated dental news, education and communication on the web. Social media and in particular, blogging, has a presence stronger than ever. I started blogging about three years ago, and continue to love it for many reasons. I enjoy being both an author of, as well as a spectator of several dental blogs. As I began the interview process when applying to dental school, I created my very own first blog, SayYestoDDS.  (http://sayyestodds.tumblr.com). Throughout my first and second years of dental school, I blogged almost everyday. Once third year started, I decided that was the end of my personal blog. In my late first year of dental school I was appointed to the Editorial board as the Electronic Editor of Mouthing Off, the national blog of the American Student Dental Association. Since then, I have been an avid blogger and found the NextDDS. I wanted to take this time to appreciate the presence of dental blogging and its amazing growth in the last couple of years. This idea of blogging about blogging came to me as I was reading the American Student Dentals Association's blog, Mouthing Off (http://www.asdablog.com/what-dental-blogs-do-you-read/). Their post talks about popular dental blogs and then asks their readers to comment on blogs they enjoy. 

1) Self expression: Blogging allows the author an outlet for self expression. As a student I think it's important for dental students as well as any dentist to self reflect. Seeing your work and being able to critique it and notice where you should improve is a great skill. It also allows you a time to be proud and show off your work! I remember in my first two years of preclinical work, I would get so excited about trying a new skill for the first time. It was constant learning and the blog was a really enjoyable way to track my progress.

2) Ask questions: While in school, and even after school, dental professionals will run into questions that require advice from someone more experienced. As a student, it's obvious that dental school can not possibly prepare us for every dental patient we will see. Often times for more difficult cases I will have to learn the hard way and then think, "I wish they had taught us/told us that in dental school." It's just part of the continual learning in dentistry. Concepts and ideas are always changing. The entire profession has many grey reason where only the most experienced dentists could understand its complexity. Many blogs often have forums, or sections for followers or readers to comment. For that reason, professionals can comment, offer advice, and give opinions about posts that asks questions or need clarity. 

3) Communication: Stemming from my last point, dental blogging has stirred up some incredible communication across the world. We even incorporated dental blogging into our schools curriculum. In my school's restorative class, we we're require to do a blog reflection on some of our pre clinical work. The blog was Diastemas.net and had many international bloggers in its audience. We discussed bonding materials we had used, different design preparations and logic behind them, and through that we had learned so much! It was incredible to be able to communicate pretty much effortlessly despite our geographical differences. Blogging is certainly a fantastic communication tool to send news and up to date, easy to access, affordable information and knowledge pretty much anywhere in the world. 

4) Free education: Like the NextDDS, many blog sites are tools of free education. Of course readers should always be certain that the educational sites are reputable. The idea of the dental blogs being free, or at least free to sign up, allows for a more open communication and invites readers to take a look. Being free allows all people interested in dentistry to access it. A large portion of questions may stem from predentals and dental students, looking for dental advice. The fact that most blogs are free is great in encouraging this communication to be possible.

5) It's fun! If you are reading this right now you already know that blogging is enjoyable. If you don't lIke writing them perhaps just reading and making occasional comments on dental blogs is your thing.  If you like expressing yourself and teaching others, maybe you should consider getting your own blog. I'm thankful that there are so many great outlets for dental blogging, and I hope you enjoy taking a look at some of my favorite dental blogs here:

Career of Constant Learning

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Career of Constant Learning


Knowing you know nothing

By Emma J Guzman


As I complete my first semester of my second year of dental school, I feel accomplished but at the same moment I feel like I still know nothing. If I compare my knowledge from a year ago today I know so much more about dentistry and I feel that I am truly becoming familiar with this field. Taking classes such as direct, indirect and removable restorations, I know how to prep and restore plastic teeth beautifully. I look at my preps with close to perfect dimensions and my restorations with pride. But this is without a living person’s tongue, saliva and nerves in the way.

I can look at a radiograph and point out obvious defects and tell the difference in the type of caries a patient may have. I can look at a crown preparation and list the items wrong with it with confidence. But, a new method of testing is being implemented at my school and it is showing us students that we have so much more to learn.

We are now having interactive exams where we must treatment plan, list uses for instruments and list steps of a laboratory process. This style is referred to as the OSCE or An Objective Structured Clinical Examination. It is a modern type of examination often used in health sciences and it is designed to test clinical skill performance and competence in skills such as communication, clinical examination, medical procedures / prescription, exercise prescription, radiographic positioning, radiographic image evaluation and interpretation of results. This is a timed, rotation to various stations exam. This seems pretty simple; we get a lecture on these items in class so we should know it just like we know everything else we study. But, actually being able to look at a radiograph with no caries or fracture and be able to see the problem is that the tooth is tilted is not something I notice easily. Listing the exact steps of what occurs for a procedure clinically versus in the lab for pre-clinic is something I am not used to. I believe these OSCE style exams are super useful and help us prepare for clinic and boards but the first round was a bit rough. I think a little more than a 45-minute lecture is needed to get the treatment planning abilities flowing. At this point in our (myself & my classmates) careers we cannot recognize certain things but it is a learning process and I absolutely believe that this style of exams will make us better dentist.

It takes years of learning and experience to gain the knowledge of the great dentist who we meet and who teach us. Us students now know what we are expected to know and how we are expected to think and it gives me a greater appreciation for the field. We must obtain a wealth of knowledge to be competent dentist and this will only come with practice. So at this point I am content with the little I know and embrace this career of constant learning.

Complex Case Presentation

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Have you ever had a patient that you did not know where to start or how to proceed? This blog is a step by step walkthrough of a complex case that was encountered at a dental school.

Before the patient was seen for the first time, the x-rays were analyzed and, after charting existing conditions, it was determined that every tooth in the mouth had caries with multiple teeth completely decayed off with no clinical crown. The patient is a 23 year old female with a history of Type 1 diabetes (uncontrolled) and anxiety/dental phobia. Her last dental visit was 3+ years ago, current dental habits were non-existent, and there was a possibility of drug abuse.

During treatment planning we came up with multiple options:

The first and best option, we felt, was to extract the hopeless teeth (15 teeth total), replace the missing teeth with implants, and restore the remaining teeth with glass ionmer, control caries, and subsequently restore with permanent fillings. This option was very costly (around $25,000) and the patient could not afford this even with the help of her family.

The second option was to extract the hopeless teeth and restore the remaining teeth with glass ionmer until the caries was under control. Then restore with permanent material, and fabricate a partial denture for maxillary and mandibular.  This option had limitations because the non-restorable teeth that needed extraction included #6, 7, 10, and 11. In order to make a partial denture for the maxillary arch, the ideal scenario would be to have a clasp toward the anterior to hold the denture in place. Implants could also be placed at sites #6, 7, 10, 11 for aesthetics, and would help stabilize the partial denture. This plan can run from $5,000-$10,000 depending on if the patient chooses to have implants.

The third option was extract all of the teeth and make complete dentures. This option may have been best considering the patient does not brush her teeth and may have a drug problem, in which case any work that was completed would not last long and sooner or later all her teeth would have to be extracted. The problem with this option was that the youth of the patient. When this option was explained to her, she was upset by the idea of removing all of her teeth. The cost of this option ranges from $2500-$8,000 depending on if the patient chooses an implant supported denture.

Option 1 and 2 would only be successful if the patient could be motivated to brush her teeth and floss. The possible drug abuse would also need to be addressed. The patient stated that she does not take drugs, but with her mother present during appointments she may be less inclined to admit to this. Many ethical issues apply to this scenario. Informed consent is mandatory for the patient to practice autonomy in her decision making. The problem is that the patient is making a decision based on emotion. She does not want to lose all her teeth, but in reality many of her teeth already have a poor prognosis based on the caries risk factors present. The first treatment plan would be effective because if she lost some of her other teeth down the line due to caries, she would still have the implants which could be used to make a hybrid prosthesis or partial denture. The prognosis of the second treatment plan was poor because it is completely dependent on her retaining her remaining teeth, which may cause continued problems for the patient in the future and add additional costs. The third treatment plan addresses the issue of her high caries risk factor, but may cause a psychological burden to the patient. Which treatment plan would you choose and why?

CAD/CAM Technology in Simulation Lab

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 This past month, I witnessed first-hand the dynamic field of computer aided design/computer aided manufacturing, also known as CAD/CAM. For the first time, second year dental students at the University of Maryland School of Dentistry were offered the opportunity to use this state of the art technology. Using omnicams and a lab grade milling unit, this technology will help dental students in self-assessing how to properly prepare teeth for inlays and onlays. In pre-clinic, our teeth preparations are evaluated on typodont manikins for criteria including tapered proximal walls, axial and occlusal reduction, rounded line angles, and precise margins. Improvement of our skills when prepping teeth will continue to increase as we become aware of our mistakes and are able to self-assess our own work using this technology. 

CAD/CAM technology allows for the capture of tooth preparations and the eventual manufacture of a crown, inlay, onlay, or other restorations. Capturing the tooth preparation allowed us, as students, to assess a digital, three-dimensional picture of our prepared tooth. When imaging my own tooth preparation, I noticed aspects and mistakes of the preparation that I would have otherwise overlooked. Obtaining a three-dimensional image of my tooth preparation was almost as if I was looking at my preparation through someone else’s eyes. After imaging, milling the ceramic crown was the next step in the process. It was really interesting to see the CAD/CAM machine at work and the step-by-step process that it followed to create the restoration. After 13 minutes, the milling component of my ceramic crown had finally finished. This hands-on experience was one that gave me an insight into the ever-changing field of dentistry. As a dentist, it is important to keep up with developing technology and learning this new technique now will allow us to be prepared to embrace technology when we leave dental school.  

Proficiency in CAD/CAM helps students practice restorative dentistry more efficiently and accurately. Students now progress through their education while learning digital imaging, restoration design on software, and milling of ceramic restorations. I was very impressed with the work of the CAD/CAM machine and my milled ceramic restoration. The measurement of marginal fit, axial contours, proximal contacts, and occlusal contacts were of superior clinical quality.   


The fact that this same system is used in the clinic at the school where students design and mill restorations in a single visit for a patient enhances this pre-clinical learning experience. This training is directly related to improving student performance in the clinic. The advancement of technology in dentistry will always shape our clinical education as well as our future practice. This technology allows for the creation of unique restorations as well as conservation of sound tooth structure, supporting the future of dentistry as it moves towards a philosophy emphasizing minimally invasive dentistry. As the first dental class to experience this technology hand-on, we are all very enthusiastic about this addition to the curriculum at the University of Maryland School of Dentistry. I hope that every dental student is given the opportunity to gain an experience and insight into this field just as we did.