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THE NEXTDDS Student Ambassador Blogs

Preparation Tips

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In my first 3 years, dental school has been full of stressful situations, cram sessions, surprise quizzes and joyful rewards. I have taken boards, skills assessments, exams, and fulfilled requirements (all with the associated stresses and challenges). This past week my school hosted CITA (counsel of interstate testing agency). It is the organization that administers testing for dental license exams for certain states. Although I am only a D3, I have taken part in this exam in various ways over the past few years. I would like to share some insight into one of the most stressful and challenging events that dental school has to offer.


CITA is broken into two parts: the manikin portion and the patient portion. As a D2 last year, I had the opportunity to be a "runner" for the CITA exam, which involves shutting the patients for the patient portion from the grading station back and forth to the testing station. From this, I learned to appreciate patients! They are willing to give up an entire day of their lives to be carted around, poked and prodded, examined and re-examined all while wearing a rubber dam. I also realized that the phrases "time is money" and "preparation is the key to success" could not be more fitting for this exam. There are certain time points you must hit in order to pass the exam. If you do not pass, you must pay to retake the exam. Preparation is what kept everyone on their time points. Those that had read the manual, filled out paperwork in advance, and set-up their operators early were those that hit their time points at ease. 


This year, the D4 class at my school took their patient portion. I had the opportunity to be an assistant for a schoolmate. Here, I learned the key to patient selection. Dependable patients that will show up on time, are willing to stay as long as you need them, and are committed to only you for the day are essential. Patients who committed to more than one student, although had the best of intentions, caused a few students to fail due to missing their time points.


Also this year, I challenged my own manikin portion of the CITA exam. My advice for this is: 1) read the manual 2) know the manual 3) practice the manual! That proved to be key for me and my classmates this year. Anything you could possible question about the rules, the criteria and the timing of the exam is answered in the manual. I started reading it and memorizing it a few months before the exam and allowed it to guide my practice. I attribute focused and concentrated practice time in the simulation lab to my success on the exam.


Best of luck to all the "younger" dental students as you embark on the dental school journey. Whatever challenges and stresses you have, just know that it is part of the ride and that you will get through them. 


Interprofessional Patient Care

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While we hear all the time in dental school about “treating the whole patient” and “comprehensive patient care,” I learned a lot today at a required Inter-professional Meeting involving several other student healthcare professionals at UNLV.  While we are all aware of the connection between oral and systemic health, and we have open lines of communication with the patient’s physician, cardiologist, etc., implementing a care team that routinely includes the dentist in the plan is a challenge.

In my assigned group at the meeting today, there were student professionals from the fields of Social Work, Nursing, Psychology, and Physical Therapy, as well as Dentistry.  All of the other professions expressed their surprise at our presence at this meeting and wondered aloud what we as dentists could contribute to a complex patient’s medical care plan. 

Many false assumptions that we all had about each other’s professions were rectified and we all left with a greater understanding and respect for what each contributes to our common goal which is the health and well-being of our patients.  When presented with a complex case study, it was natural for all of us to approach it from our own area of specialized training.  Combined, we were able to synthesize care plans with breadth and depth that none of us could have come close to on our own.  It is surprising the things we don’t think about because we are so focused on our specific piece of the puzzle.

While we all agreed that this meeting was enlightening and inspiring, we struggled to come up with ways to actually implement a care team involving all of us on a regular basis.  While a care team that focuses on health and prevention can save money in the long run by minimizing ER visits and deteriorating health conditions…  How would we all make time to consult with each other?  How would reimbursement work?  Is this even economically feasible for a patient to have access to this many providers?  What we came up with is that while patients are unlikely to seek out care from a “team” of healthcare professionals one appointment at a time, utilizing technology can make it more plausible.  Online consults between professionals on the Team, with one person as the coordinator of the Team who is ultimately responsible for overseeing that all goals are being accomplished as well as acting as the liaison to the patient is the only realistic option. 

When asked how WE, as new graduates, the future of our professions, could facilitate this type of care model, lots of ideas were tossed around and they all seemed kind of vague.  I think just as general dentists routinely form relationships with dental specialists for whom they can refer and confer on patient care, so should they form relationships with other professionals.  I would like to establish a relationship with a social worker in my community who can put my patients in touch with available resources.  I would like to work closely with a nurse practitioner, a physical therapist, and a psychologist that I can send my patients to or confer with on common dental issues such as diabetes-exacerbated periodontal disease, TMD, chronic pain, stress-related bruxism, nutritional problems, eating disorders, xerostomia, etc.  Sharing in the total health care plan of our patients builds value for the patient and dramatically increases the quality of care being delivered by each of these professions.  

The Importance of Obtaining an Orthodontic Consult at the Correct Age

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According to the American Association of Orthodontists (AAO), 3.8 million children received orthodontic treatment in 2008. This number represented a 46% increase over the course of the preceding decade. The rise in the number of these cases (among individuals 17 and younger) may be attributed partly to the initiation of treatment at earlier and earlier ages. Traditionally, braces were loosely associated with middle and high school students. However, their prevalence among elementary school children has been continuing to grow. There is no doubt that parents’ wishes to obtain perfect teeth in their children at a younger age is a contributing factor to earlier initiation of treatment; many parents believe that earlier intervention may reduce treatment later, or prevent the need all together. Other contributing factors include better diagnostic technology and increased insurance coverage. With the number seeming to creep lower and lower, parents with children or general dentists with a wide pediatric population may be uncertain about the correct age at which children should obtain their first orthodontic consult. Furthermore, parents may be left wondering why it is even important. Both of these issues are addressed below.


Orthodontists currently appear to agree that an occlusion/orthodontic assessment should be done before a child reaches age 7. This allows specialists to determine whether the child needs no treatment, early treatment, and/or late treatment. The terms “early” and “late” themselves are controversial. Some define “early” treatment as one that is started in the primary or early mixed dentition stage (permanent first molars and incisors present), while others consider it “early” if it is initiated in the late mixed dentition stage (before eruption of second bicuspids and permanent upper canines). This ultimately affects whether children receive a one-phase vs. two-phase treatment.


Research has shown that certain conditions are treated more effectively using early treatment. On the other hand, for other conditions, there seems to be no benefit via implementation of early treatment. Orthodontists generally prefer early treatment for most functional habits, which include thumb sucking, mouth breathing, and tongue trusting. Proactive treatment for these conditions are favored since lack of treatment may lead to unfavorable growth of jaws and/or protruded upper anterior teeth capable of trauma or speech problems. Aside from treating functional habits, early treatment is also effective for correcting anterior crossbites, lateral crossbites, and arch constrictions. These problems are best targeted early since it permits orthodontists to take advantage of the still-growing child. Once a child’s main growth period is completed, for example, it becomes very difficult to compensate for narrow maxillary arches. In contrast, one of the most common conditions, class II malocclusions, sees no benefit from early treatment. Patients with class II malocclusions (even if they obtain early treatment) will frequently require a second phase of treatment, so studies have shown that it may just be better and cheaper to wait until the late mixed dentition stage.


Indeed the research is controversial, and every case needs to be assessed individually to determine the best treatment protocol, yet it is prudent for children to receive their first orthodontic consult by 7 years of age. Pediatric/general dentists should be aware of this recommendation and instruct parents accordingly. While early treatment is by no means appropriate for every child, it may be extremely beneficial for some.




Aldrees, A., Tashkandi, N., AlWanis, A., AlSanouni, M., & Al-Hamlan, N. (2014, December 8). Orthodontic treatment and referral patterns: A survey of pediatric dentists, general practitioners, and orthodontists. Retrieved January 24, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4273289/


Al-Shayea, E. (2014, October 1). A survey of orthodontists’ perspectives on the timing of treatment: A pilot study. Retrieved January 24, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4238079/


Keates, N. (2010, November 16). The 8-Year-Old With a Perfect Smile. Retrieved January 24, 2015, from http://www.wsj.com/articles/SB10001424052748703326204575616460332062620


Pietilä, I. (2007, October 25). The European Journal of Orthodontics. Retrieved January 24, 2015, from http://ejo.oxfordjournals.org/content/30/1/46.long


If Measles Walks Into Your Clinic...

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As a dental student I often forget about what is going on in the world around me, mostly due to the demanding course schedule and studying that I am sure we are all familiar with.  The recent measles outbreak is one of those things that was not really at the forefront of my mind until I started wondering what to do if someone came to our school clinic with symptoms of measles.  For that reason, I decided to do a short overview of measles targeted towards the dental student for this blog. 


First, what is measles?  

Measles is a highly contagious respiratory virus associated with a moderate to high fever and eventually a generalized itchy rash. Approximately 90% of susceptible individuals who come into contact with the virus will become infected. Other symptoms of measles can include nasal congestion, runny nose, cough, and conjunctivitis. Of particular interest to oral healthcare providers are the pathognomonic Koplik’s spots. These are clustered white lesions that often present on the buccal mucosa opposite the molars approximately 2-3 days before the measles rash appears.  

How is measles transmitted? 

The measles virus is transmitted via airborne transmission or direct contact with infectious droplets, which can remain infectious for up to 2 hours after the infected individual leaves the area.  The incubation period for measles is about 7-21 days. People are considered to be contagious from 4 days before to 4 days after the measles rash appears.  


Who is susceptible? 

All healthcare workers should be immunized against measles and have documented proof of immunity. There is no defined treatment of measles other than supportive care, therefore the best way to prevent transmission of the virus is vaccination. Two doses of the vaccine are 97% effective at preventing measles. Anyone without the vaccine, immunocompromised individuals, individuals with chronic underlying disease, and small children, especially under age 1, are most susceptible.  


What should I do if someone presents in my clinic with symptoms of measles? 

The best way to discern if the patient is not fit for elective dental care due to the measles virus is a thorough medical history and good observation skills. Specifically, ask about common symptoms of measles virus, whether or not the patient has been exposed to someone with the measles virus, whether or not the patient has been immunized against measles, and whether or not the patient has traveled internationally to areas where the measles virus is more common.   


If you suspect a patient of having the measles virus, you should present the patient with mask and gown to prevent further contamination of your operatory and refer the patient to emergency care so that they may be placed in airborne isolation.  Your school may have different guidelines for control of infectious disease, so be sure to familiarize yourself with them in order to protect yourself and others.  


Finally, I hope this update has been helpful, especially for those of you in areas where there is a current outbreak of measles or a high population of people who do not vaccinate for various reasons.  



Outside the School

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 Being in dental school is hard work. Anyone who has gone through the process can tell you that. There are exams, both practical and clinical, as well as the pressure to enhance your hand skills while juggling stressful didactic courses. It is a wonder that most of us make it through all four years. As a fourth year dental student, I am allowed the luxury to look back on it all and dissect the entire experience. And I can honestly say there was a reason I was able to do as well as I did: I was involved in a variety of extracurricular events.  


These extracurricular events ranged from participating in student government to becoming a fraternity member. They also included organizing events for our school Student Awareness and Multicultural Enhancement group. It is through these interactions that I was able to get to know the student body. Dental students I have not been able to interact with in the classroom would introduce themselves during these events and I was able to form many friendships and strengthen older relationships as well.

My particular favorite event that I have been involved in is one thrown by the Student Aware. This event is called Multicultural Night and it is certainly one that is always looked forward to by the entire school. We set up booths that are run by different students who represent the large variety of culture in the dental school. There is food, music and beautiful traditional outfits on display. It is an evening that embraces the diversity our school has to offer and encourages everyone to learn more about this wonderful aspect of their institution.

Many of these organizations fostered a strong sense of comradery that I believe is essential to dental school life. Although the profession of a dentist can seem to be a solitary one, it is in fact one deeply rooted in teamwork. A dentist is only as good as his or her clinic, staff and coworkers. Although we use our two hands to help our community, we cannot succeed without the hard work and organization of those who work with us. I believe this ideal is first introduced to us as dental students. We are taught how to practice dentistry but we enhance these abilities by learning from our fellow students, interacting with faculty and staff, and participating in extracurricular events which encourage us to develop social and personal skills. 

The Value in "Going the Extra Mile"

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Each one of us has made remarkable accomplishments. Were it not so, we would have never made the cut to begin our dental education. The application process required years of preparation. Many of us juggled academics, shadowing, service hours, jobs, and anything else on the side to set ourselves apart. It was a long and grueling road. There were times that I was stretched so thin and I would stop and wonder, “Why am I doing all of this?” 


I will argue that the point of prerequisites was not just to jump through hoops, but rather to establish habits of dedication to lifelong learning. It is easy to enter dental school and think, “Alright, I did all the hard work and I’m here. Now I can relax and just get by. Afterall, C’s get degrees.” Do not be so quick to forget the road you travelled to get here. Make the most out of your opportunity.


Any sports fan or athlete can relate to the influence of going the extra mile. For example, basketball games are often won or lost based off of second-chance points. Every last effort can give you the edge. Perhaps your team isn’t shooting too well and they are getting outplayed. There comes a crossroad when they either give up or make a run for the win. Things can turn around in a hurry as players dig deep and fight for every rebound just for the opportunity to outscore their opponents.


This principle applies more to your dental education than you might think. Often things don’t go as planned. Due to my inexperience as a student, I frequently have to repeat steps or correct my work. This is not a failure, but rather an opportunity to make it better the next time. I find that my progress is hindered when I either settle for mediocrity or throw in the towel altogether. Don’t allow things like this to get you down. Put in the extra time and you will eventually become a master of your craft.


Look beyond your school resources for Continuing Education opportunities either online or in person. These courses are often free to students and allow you to pursue specific areas that you are passionate about. Additionally, by showing your interest in Continuing Education, you will become better trained and more marketable as an employee. A good place to start for such resources begins at your local state dental association.


Have you become complacent in your journey? Look around you and I’m sure you will find a fellow classmate that has lost sight of the big picture. In dentistry, you have a remarkable opportunity to make a difference in your patients’ lives. Don’t deny them access to quality care by putting in the bare minimum. Make each day count by going the extra mile.

Florida's Dental Day on the Hill

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 Dental Day on the Hill is rapidly approaching for the state of Florida. Dental Day on the Hill take place in the state’s capital of Tallahassee each March and serves as the state of Florida's lobby day for dentists. 


This is a unique opportunity to meet with representatives and state senators who cast deciding votes on legislation that will directly affect everything from student loan debt burden to mid-level providers in Florida. It’s important that our state sees that their decisions impact us as students, since we are the future dental providers of Florida. 


There will also likely be a networking social with leaders of the Florida Dental Association (FDA), other dental school students from LECOM and Nova, and practicing dentists that are attending lobby day. As a major dental school in Florida, the University of Florida College of Dentistry will be excusing students to attend this event in order to demonstrate a profound student presence. Furthermore, the college will be preparing students for this political event by having a lunch and learn the week before to go over all the legislation being discussed during Dental Day on the Hill. 


There is also a briefing the night before where students will learn how to present their case or concerns before representatives. This is going to be a great opportunity to introduce students to the political side of dentistry. With the state and federal healthcare laws constantly in debate,politics are becoming an increasingly integral part of dentistry. Therefore it is important that, when given the opportunity, dental professionals show the governing bodies that we care about the decisions that are being made about our profession by showing up in large numbers and voicing our opinions.

Can I share my personal life with patients? A literature review of self-disclosures.

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A revolutionary change that has come about in dental and medical education is the focus on the patient-doctor relationship. A newfound interest in training health professionals to become caring and respectful human beings in addition to knowledgeable and competent doctors has changed medical education for the better. Even medical school interview formats and medical student acceptance rates are associated with personality traits, such as agreeableness and extraversion, that promote positive patient-doctor relationships.

In some institutions, the same focus on the doctor-patient relationship has made its way into the dental profession. Dentistry, like primary care, is a profession in which the patient-doctor relationship is of utmost importance. Motivating patients to improve their oral hygiene is an important step in maintaining the health of the dentition and periodontal tissues, and has much in common with lifestyle modifications that primary care physicians encourage in their patients. The success of the physician and dentist are both arguably rooted in the strength of their patient-doctor relationships. Additionally, dentists often administer treatment that requires substantial patient trust, as 80% of the adult population in the United States admits to some level of dental anxiety. This demonstrates that providing optimal dental care is dependent on good rapport between the patient and dentist.

Given the growing interest in the patient-doctor relationship, strategies to properly develop this relationship must be delineated. One well-documented method of developing trust and forming a relationship is “self-disclosure.” Some literature suggests that this may actually be one of the best ways to develop a relationship in which a health professional can deliver optimal care and begin to help his or her patient effect positive life changes.

A recent article in the New York Times documented one doctor’s experience with the struggle to determine whether or not to self-disclose with her patients. In this article, Dr. Danielle Ofri recounts an experience in which self-disclosure resulted in a patient feeling unsatisfied with her own life in comparison to the doctor’s. While the desire to share details of one’s own life with patients can be almost reflexive, Dr. Ofri considers whether this “reflex” can do more harm than good.

An article published in Annals of Internal Medicine entitled “Enough about Me, Let’s Get Back to You”: Physician Self-disclosure during Primary Care Encounters“Enough about Me, Let’s Get Back to You”: Physician Self-disclosure during Primary Care Encounters reviews the literature on self-disclosure and makes recommendations to physicians on how to approach this concept in practice. It relates that self-disclosure is often unhelpful and possibly risky in clinical practice. It can distract the patient and overstep boundaries. The article relates a disturbing set of statistics. “…40% of physician self-disclosures were unrelated to patients’ preceding remarks. Most self-disclosures (85%) did not seem to address patients’ medical concerns or promote relationship-building, and 11% seemed disruptive, in that they interrupted patient histories, were competitive, or raised potentially troubling emotional issues. The article goes on to suggest that physicians consider the relevance of their self-disclosures prior to sharing them with patients.

            On the other hand, the same article indicates that self-disclosures by the physician can help patients adhere to physician recommendations, given that the disclosures are relevant to the recommendation being provided. Additionally, patients and doctors alike believe that self-disclosures can increase intimacy, decrease a sense of hierarchy, and improve the overall doctor-patient relationship. Thus, authors of the article suggest that physicians engage in self-disclosures that emphasize empathy and understanding of the patient’s concerns without shifting the attention to the physician.

            In light of all this, dental professionals should take care to provide adequate empathy and support for their patients without sharing details of their personal lives that distract from patient care. They should consistently question their reflexive desire to self-disclose, yet share personal sentiment when it will bolster the patient-doctor relationship in a way that is relevant and appropriate. Hopefully, as dental institutions continue to stress positive communication between the patient and dental provider, and as literature on the topic expands, dentists and dental students will be better informed on how best to establish a constructive relationship with their patients.


Jerant AGriffin ERainwater J, et al. Does applicant personality influence multiple mini-interview performance and medical school acceptance offers? Acad Med. 2012 Sep;87(9):1250-9.

Getka, E., & Glass, C. Behavioral and cognitive-behavioral approaches to the reduction of dental anxiety. Behavior Therapy. 1992; 23(3): 433-448.


Collins NLMiller LC. Self-disclosure and liking: a meta-analytic review. Psychol Bull. 1994 Nov;116(3):457-75.


The New York Times Company. When Doctors Share With Their Patients. http://well.blogs.nytimes.com/2013/11/12/when-doctors-share-with-their-patients/. Accessed November 24, 2013.

Morse D, McDaniel S, Candib L, Beach MC. “Enough About Me, Let’s Get Back to You”: Physician Self-disclosure during Primary Care Encounters. Ann Intern Med. 2008 December 2; 149(11): 835–837.


Morse D, McDaniel S, Candib L, Beach MC. “Enough About Me, Let’s Get Back to You”: Physician Self-disclosure during Primary Care Encounters. Ann Intern Med. 2008 December 2; 149(11): 835–837.

Benefits of Attending a Dental Conference as a Pre-doctoral Student

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When my classmate first alerted me of an upcoming dental conference in our area, I pushed the idea aside. Sitting in class from 8 to 5 everyday in school, I was not interested in listening to more lectures over the weekend. Even so, I agreed to join her at the Michigan Dental Association’s Annual Session in May. Needless to say, I am so grateful that I did. As students, we so often focus on the science and clinical skills it takes to become a dentist, and we can sometime forget that there will be lives to live and practices to run once we get that diploma. At the MDA Annual Session, I was exposed to a new world of dentistry, filled with networking and  professional development. Since then, I’ve also attended ASDA’s National Leadership Conference and plan to attend the ASDA Annual Session. I’ve taken classes ranging from “Developing Your Practice on a Budget” to “Finding Your Why” and have had the opportunity to meet so many new people, practicing dentists, national leaders, and students alike. I would urge any dental student to step outside their box and find a conference where they could work on becoming the dentist they want to be outside the classroom and clinic. The first step is committing to a weekend and putting on your best business professional attire, then the rest is up to you. Here are some tips to getting the most out of your 3-day professional development retreat: 

  • Find a new friend  
    These events are the perfect place to develop new friendships with people that will be your colleagues for the rest of your career. Dental students from across the country attend various conferences and it can be so beneficial to connect with someone that might be your future specialty resident or practice partner. Collect names, numbers, and emails in a specific location and keep in touch. Perhaps you can meet up again at the next conference you both attend.   
  •  Take advantage of the Vendor Fair  
These fairs can be overwhelming. They generally consist of a long line of 50+ tables set up with every dental product you can imagine. Don’t just go for the free samples. Many of the vendors are so excited to meet interested dental students, and they are more than happy to explain their product. Ask questions and you will quickly develop a sense for what to look for in these products when you enter practice.   
  •  Categorize your classes  
Most conferences offer a wide range of classes from professional development to practice management to clinical skills. It is important to categorize your classes and ensure that you attend lectures from each category. This way, you receive a well-rounded education and don’t get stuck listening to the same lesson each hour. Once you’ve attended a few conferences, then you can target the classes that you feel you need more training in.   
  •  Have fun  
While sitting in lectures doesn’t sound like optimal weekend plans, these conferences can make for a great time. They’re often held in cool cities and most nights are open for exploring. Take some friends and take some time to reward yourself for the hard work you put in towards becoming a better future dentist!   


Value of Community Service

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WesternU strives to train compassionate, humanistic healthcare providers, and throughout the last several years of my education, I’ve been able to participate in many community service opportunities. Recently, I spent seven weeks at two AIDS Project Los Angeles (APLA) dental clinics providing low-cost dental care to members of the HIV and AIDS community. One afternoon, a woman walked in wanting to become a new patient. When the receptionist explained to her that the clinic was for patients with HIV, the woman responded with wide eyes, loud hysterics, and rushed out the door. Though no dentist could ever react similarly (ethically or legally, at least) when faced with HIV patients, many would still unfortunately prefer to not treat them. APLA provides a safe, judgment-free place for the HIV community to receive much needed dental care. While there, I learned that these patients can be some of the most in need of regular dental care and management due to the destructive nature of the disease and medications associated with it. I’ve become less apprehensive about treating this particular population and have learned how to better serve them. 


Meet Each Need with Dignity (MEND) in Pacoima, CA, is an organization powered by volunteers whose mission is “to break the bonds of poverty by providing basic human needs and a pathway to self-reliance.” I have volunteered on multiple occasions on weekdays and Saturdays in their dental clinic. We help members of the community living in poverty by relieving their pain, improving their hygiene, and restoring their aesthetics and function. By eliminating dental infections, performing fillings, and fabricating dentures for those missing teeth, we improve quality of life for the patients. Some experience improved self-esteem and some are more able to eat and enjoy more balanced nutritious meals. After all, it’s easier to choose vegetables over French fries and ice cream when you’re not in pain and you have teeth to chew with. 


Sometimes with our busy schedules studying for exams, trying to finish graduation requirements, and attempting to maintain some semblance of a social life, it’s hard to find time to volunteer and give back to the community. However, one of the most valuable things I’ve learned from my experiences helping others is that it can be very nourishing for the body, mind, and spirit – for the volunteers, that is. Focusing on someone else’s problems gives you a break from your own issues and can help you put things in perspective. This reduces stress, which has far-reaching health and social benefits. Making a positive impact on someone else helps me feel good at the end of the day. Smiles are contagious – when patients are happy, smiling, and expressing their gratitude, I can’t help but genuinely smile back. Hopefully the next time an opportunity for community service comes up, you can think about how giving back to others can also mean giving back to yourself.

Digital/3D Dentistry

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Recently, in several of my classes, I have been shown the realm of “digital dentistry”, a term which I am simply using to describe digital impressions, CEREC machines, and other computer aided design/processing units. I had of course heard of the many uses of 3D digital imaging and processing, but have only just recently begun to ponder the change that seems to be taking place in the dental profession. They say change is the only constant, and that definitely holds true in dentistry. My professors have a wide array of experience with these types of computer aided dental technologies, and although they each have their own opinions about them, they all agree that these machines are the future of dentistry.


As the popularity of digital imaging technology grows, it makes me wonder how the dynamic of the traditional dental practice will change along with it. Although there will always be a need for dental labs, will they decrease in number as an increased number of CAD/CAM units are put into practice? Growing up, many of my aged aunts and uncles were slow to learn how to use computers as they seemed to be more trouble than they were worth. I think their opinions have changed as we have surrounded ourselves with computers and smartphones in every home. I have to assume a similar situation will arise with 3D digital imaging and processing in the classic dental office. It is quite an expense for a practitioner to take on, however, one has to wonder how long it will be before the average patient would be surprised to hear that a dentist does not use this available technology.


As a dental student, I am in my infancy as a practitioner and have already had some training on this equipment as a part of my curriculum (which is great), so perhaps I am a little biased when I say that I believe every dentist should make use of this technology. Patients want to go to a dentist that works quickly and does a great job. Most patients would also prefer to make as few trips to the dentist as possible for a given procedure, and most dentists would likewise prefer to have the flexibility to see more patients. Both of these are possible when an office can process and place a crown in one visit as opposed to two or three, while performing a root canal in the mean time. There will always be situations that will require a more traditional approach with alginate impressions and the use of a dental lab, but I believe that will come to be the exception as opposed to the rule.


In my humble opinion, this technology is similar in potential to that of the internet in the 1990’s and those who make the effort to learn how to use it sooner rather than later will be at a serious advantage. The use this technology when it is appropriate and indicated will certainly add to any dentist’s ability to provide the best possible treatment for their patients. 

Dentistry and Disabilities

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Dentistry and Disabilities


Disability insurance is something most dental students, including myself, are not overly concerned about. We have been told that our profession relies on a healthy neck, back, hands, and eyes. But, those horror stories of dentists injuring their backs and being forced into early retirement would never happen to you, right? Personally, I have had my fair share of close calls, but that does not mean I will opt to sit out on the next winter ski trip or fall softball league just to avoid a potential accident. I enjoy seeking life’s thrills, and minor accidents hadn’t ever stopped me, until two weeks ago.


A minor car accident left me with a broken right wrist, surgery to place pins in my scaphoid, and eight to ten weeks in a cast. In many ways, the accident was lucky.  No one was further injured, the break was on my non-dominant hand, and I am only a dental student, meaning there is no major financial loss that practicing dentists would experience.


I could steer this conversation towards the difficulties of life and dental school as a one handed student, but I will save you the pity party. Instead, I want to sincerely stress to you the importance of researching and purchasing disability insurance that is right for your lifestyle.  While in dental school, all members of the American Student Dental Association (ASDA) have disability coverage available to them at no cost. The following is taken directly from asdanet.org:


As a dental student, the ADA offers no-cost ADA-sponsored Student Members Disability Insurance to you during school and residency as a benefit of ADA student membership. This important coverage includes:

$2,000/month disability income insurance for up to seven years to help pay living expenses during a period of disability due to injury or illness

Up to $150,000 to help repay student loans

Coverage renews automatically each academic year for ADA student members

Eligible ADA student members can create a login at www.insurance.ada.org/RegisterNow and follow the prompts to request activation of this disability insurance.


After you complete your dental education, the coverage remains at no cost through December 31st of the year of graduation. You then have the option to convert your student member disability coverage to two types of ADA-sponsored disability insurance for practicing ADA member dentists:

$2,000/month of ADA Members Disability Income Protection Plan: This plan helps replace lost income and members can apply for additional insurance, up to $15,000/month.

$2,000/month of ADA Members Office Overhead Expense Plan: This plan helps repay student loans and members can apply for up to $25,000/month.

To convert, simply pay the premiums when you receive your invoice via mail in December following your graduation, and maintain active ADA membership.


Visit www.insurance.ada.org/, call 855-411-5197, or e-mail planspecialist@greatwest.com for more information and to learn about coverage provisions, limitations, terms for keeping coverage in force and the option to convert to member coverage after graduation at ADA member-only premiums.


So, for all of the procrastinators like me that have read this far, you can continue sleeping well.  Just make sure you have activated your free student disability insurance. While we are students, we can continue living fearless, courageous lives. However, what are we to do once we begin practicing in the real world? Here in the state of Texas, the Texas Dental Association (TDA) does a great job of meeting with third and fourth year students to address the issue of purchasing disability insurance after graduation. The TDA partners with their own insurance company to cater a disability package to dentists in Texas. For those not in Texas, the ADA provides members with two options of disability insurance, as provided in the indent above. However, as with all insurance plans, there are benefits and limitations.


The ADA does have your best interests in mind, but their plans are not tailored to your specific needs and income. Some of you may plan on living and practicing in an area of the United States that has a significantly higher cost of living than other areas. For you, it would be wise to investigate disability plans with private insurance companies that will consider your practice income and overhead and offer are more affordable monthly stipend if you lose the ability to practice. Another determinant is the consistency of your plan. Will your insurance company be able to raise your premiums or lower your disability coverage after initial contracts are agreed upon? Renegotiation of your insurance plan can be good or bad, but it is important you are involved in the decision.


I am no expert in this field, and even I plan to do more researching before graduation. I simply urge you to be proactive. Attend lunch and learns when this topic is presented. Ask questions to any insurance or financial representative that crosses your path. Accidents can happen to the best of us. Having a back up plan for you and your family can save a lot of headache in your future.

Courting the right NMATCH

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We all are trained in the DO’s and DON’TS of Dental school interviews. For example what to wear, what to bring, and how to act, but the real question is whether the Residency that you’re putting all this work in for right for YOU! This blog will give pointers on not only how to be successful during residency interviews, but as a soon to be doctor, what you should demand out of this relationship.


A journey of a thousand miles begins with a single step:  Start to investigate programs before you even apply for them on the ADEA PASS. Get to know the program based on their website and look for posted FAQ’s. I recommend doing a site visit before applying. This is a great way to eliminate applying to any unnecessary programs, and only applying to programs which are a perfect match for you! Investigating which programs you want to apply to can be the biggest step in deciding to do a GPR, Oral Surgery, Endodontic, Prosthodontic, Pedodontic, Anesthesiology or Periodontic Residency. Applying to too many can be a waste of time and money on both the director and your part, thus I highly recommend doing your investigation early. While at these site visits and evaluating the program remain courteous…


You catch more flies than with honey than vinegar: Be courteous and personal to those on site of interview day, and not just the interviewer but your competition, the entire faculty, front desk, and Residents. Your ability to be personal sends a message to the program on whether you would be a good fit or not.


He who asks a question is a fool for five minutes; he who does not ask a question remains a fool forever:  Asking questions shows your interest in the programs and demonstrates that you’re involved in the conversation with the person interviewing you. No one likes to be in a conversation with someone who is not active. Be prepared to ask a wide range of questions while on your interview. Ask current resident on how to prepare for the interview. Some great questions are:


-What are plans for this program?

-Tell me about the frequency of complex cases that Residents are able to accomplish once becoming established in this program?

-How many Residents go on the further residency programs after this one? And where did they go? (This last clause may seem pretentious, so use judiciously)

-What CE/didactic courses or clinical training do you offer that set you apart from most other programs? (Great question for a site visit)



As I stated earlier, we are trained in general how to behave during residency, but making that perfect match is like finding the right person. It takes inquisition, consideration, and most importantly time!

Maryland's Mission of Mercy Dental Program

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There isn’t a more rewarding experience than witnessing first-hand the impact of Maryland’s Mission of Mercy Dental Program. For the first time since starting dental school, I was reminded of the qualities that initially drew me to the field of dentistry. Not only was I able to witness this, but my hands were helping bridge the gap for so many people without access to dental care. 


Mission of Mercy’s Dental Program is a fully mobile dental clinic. The clinic travels with portable dental treatment chairs, x-ray machines, autoclaves, instruments, electric generators, and hand tools. Several hundred volunteer dental professionals along with volunteer staff hold two day long dental clinics at different locations around the country. The first Mission of Mercy (MOM) Project launched in July of 2000. Since then, the program has expanded across the country. Maryland is home to four MOM events that are hosted in Western Maryland, Mid-Maryland, Eastern Shore, and Southern Maryland. Two MOM events occur in Maryland each year. The hundreds of patients that are treated at MOM lack access to dental care, lack financial ability to afford dental care, or simply have no dental home. There is no cost to the patients; everything is free for them. MOM does not use any government funding; therefore, patients do not have to show any documentation proving their poverty. You might be thinking, who pays for everything at this fully mobile dental clinic? The dental organizations of the state where the event is held raise private donations to cover the entire cost of the event.


I volunteered at my first MOM Project this past fall in College Park, Maryland. When I first arrived, I saw several hundreds of patients lined up outside of the building. Many of them had pillows and blankets and had spent the entire night in line for the 7 AM opening. All services at MOM are provided on a first-come first-serve basis. Once the doors opened at 7 AM, they were closed just a few hours later as the facility quickly filled up with patients in need of dental care. Services provided at MOM vary from one event to another, but typically MOM offers cleanings, extractions, root canals, fillings, oral surgery, and oral hygiene education. The event was unlike anything I have ever experienced, and I really felt a sense of love and community among everyone there. I assisted alongside dental professionals who cared for the patients like they were family, and it was rewarding to see the impact we made in people’s lives.


I am planning to volunteer at the upcoming MOM next month in Maryland, and I am really excited to help MOM continue to build relationships within the community for years to come. As dental students, an experience at MOM will remind you why you are enduring exam after exam, long nights of studying, and endless hours in the simulation lab.

Stress Management in Dental School

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It is no secret that dental school is not easy.  Between numerous exams, lab projects, and/or clinical responsibilities, the life of a dental student can become quite stressful at times. It is essential that dental students find outlets to manage their stress appropriately to reduce anxiety.  There are many options that provide stress relief for dental students; you just have to find an option(s) that works for you. 

At the Indiana University School of Dentistry (IUSD), we are fortunate to have a large gym near the dental school which caters to undergraduate and graduate students.  It is not rare to see many of my colleagues and even professors at the gym before or after classes and clinics.  Joining a gym near your dental school not only makes it convenient since time is limited, but also gives you the opportunity to reduce stress with your colleagues.  I often find my classmates working out together, which makes stress management fun and enjoyable. Many gyms provide student rates and offer a variety of programs/classes to cater to your unique interests.  You can’t go wrong with a gym that offers diverse options! 

Yoga has become a very popular option for stress reduction among dental students.  As a matter of fact, many ASDA chapters are incorporating yoga classes into their wellness initiatives at their schools.  Ross Brenner, a third year dental student at IUSD first experienced yoga during IU ASDA’s complimentary yoga class this past December. He now practices hot yoga and says, “There's nothing like hot yoga that takes stress away. Every time I finish a session, I feel clear and ready to tackle what's ahead of me.” Practicing yoga offers many benefits such as meditation and relaxation, which can help release the day-to-day stressors of dental school.  Many yoga studios provide student discounts, which can make memberships affordable. Personally, yoga is one of my favorite ways to reduce stress and anxiety from dental school. It has been a great option for me ever since I started dental school. 

After big exams and hours of studying, my classmates and I plan fun events for everyone to enjoy, which provides a chance for everyone to hang out outside of school.  I highly recommend this option to you and your colleagues.  You can attend professional sports games or catch the latest movie out in theaters.  Regardless, checking out new experiences with your colleagues outside of dental school and without scrubs can be an exciting occasion to reduce anxiety.  In addition, it will give you the opportunity to know your classmates better!  

Stress is inevitable during dental school.  The key is managing the stressors appropriately to maintain a positive outlook during your dental school career.  There are many outlets to choose from like working out or trying new activities with your colleagues.  Either way, it is essential to discover methods in managing your stress to make dental school enjoyable and exciting.  Take a break from the books and go find what helps you reduce stress! 

Informed consent in Dental School

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 Finding the perfect balance of informed consent can be a challenge, even to the most qualified of dentists. As a D3 student, I have found many obstacles in balancing: education of patients with appointment time and the patient’s personal preference. And in the end all of these efforts can be unhinged if a professor does not agree with your treatment plan. Informed consent is a process I take very seriously and will always present the possible options to a patient before the patient makes a final decision. I want to run though a stressful scenario I have encountered during my time in dental school and hopefully prevent this from happening to you.   


Scenario #1: 23 year old patient with poor oral hygiene, poorly controlled type 1 diabetes, rampant decay (every tooth in the mouth has caries with many hopeless teeth). The series of treatment plans we came up with included: 1. Extraction of hopeless teeth, implants to replace teeth, crowns on remaining teeth, 2. Extraction of hopeless teeth, partial denture to replace teeth and crowns on remaining teeth or 3. Extraction of all maxillary teeth, full maxillary denture, extraction of hopeless mandibular teeth, crown remaining mandibular teeth and mandibular partial denture.

The patient choose treatment plan #2, but this was the treatment plan that the faculty was in favor of and so the patient was inclined to choose it. This treatment plan is a good option, but the patient was supposed to make the decision not the faculty. As we progressed to operative to excavate and sedate caries on multiple teeth the faculty that day did not agree with our treatment plan and believed that a full denture would be a better fit for the patient. This upset the patient and no work was completed that day. The following operative appointment with a different faculty member, the patient now told me that she wants to go with the option of a full denture after discussing it with a relative that has been through a similar experience. But the faculty that we worked with that day did not agree that she should get a full denture. The patient and myself are frustrated and confused by this back and forth treatment plan.

This scenario is a major problem in dental school and many students have had a similar experience. As students we do not make the final decision and this can be frustrating to both the student and the patient. We spend the time explaining the cost and benefits of each treatment plan then in the end if the faculty we are working with takes a glance at the patient and does not agree with what the patient and the student have come up with then the entire process gets halted. The patient should make the final decision, but many times they do not feel they are in a position of power so they will yield to the faculty’s decision. The best advice I can give is to stick with the same faculty (especially in complex cases) and empower our patients to let them know they have the final say. The patient’s decision trumps all, in the end it is their mouth and their choice. 


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     After 21,521 steps or 10.29 miles, my feet hurt and body ached, but spirits were high because we had treated over 500 children in one day. The annual Give Kids a Smile event had come to an end, but the memories will be cherished by all for a long time to come. For the last two years, I’ve had the opportunity to work on the student-run Give Kids a Smile committee at Arizona School of Dentistry and Oral Health (ASDOH). Once a month all year long we meet to collaborate with administration, alumni, local universities, dental professionals, clinics, and businesses. Each meeting grows with importance and anticipation for the day we get to forget ourselves and work hard for underserved children.   


     With such a large operation, each class has different responsibilities on the day of the event. Whether they’re treating patients, assisting local volunteering dentists, leading operations and preparation, setting up supplies and entertainment tents, coordinating pre-dental volunteer efforts, escorting children from check-in to check-out, screening hundreds of children throughout the year, comforting anxious or nervous children, guiding busses/transportation, or even translating, every single student has a very specific and important role.   


      It’s incredible how much good can be accomplished when so many people are dedicated to work together for the same common goal: to give kids a smile. The Give Kids a Smile day means more than giving over $250,000 of dental services to underserved children. The event is more than a public health intervention or opportunity for students to treat hundreds of kids. That day is a culmination of an entire year’s worth of planning, preparation, and fundraising that ends with a reward far greater than the cost. Give Kids a Smile is the essence of dentistry; to use our gifts to change others’ lives and in turn change our own.   


     For most ASDOH students, administration, and local volunteers the Give Kids a Smile day started before 5:30 am. Entertainment tents needed to be set-up, supplies dispersed, breakfast provided, and operations ready to function at a high rate. Some of the games for postoperative children to play included: bowling, basketball, fishing, cooking, face-painting, dancing, and photos with Pixar legends and Disney princesses.  Operations within the dental school were intricate and well-organized enough to treat over 500 underserved children in just six hours.

      The energy of volunteers and children alike was tangible. Laughter from both parties could be heard throughout the day.  Healthy smiles were given to the kids, but lasting smiles were given to the volunteers. Anyone who helped even just one child smile has a memory worth more than any currency. While many volunteers dressed up as Superheroes, the real heroes were those that gave their time, their hands, and their hearts all year long to lift those children up for at least one very special day, and who helped flip their fear and pain into confidence and comfort.  Give Kids a Smile all started with one idea and Dr. Jeff Dalin’s desire to make a difference. What’s the next great idea?   


 What legacy will you leave behind in dentistry?  


 Tyler Hanks  

 DMD, MPH Candidate  

 ASDOH 2017  

 Social Entrepreneurship President   

The Road to Specializing

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When asked on the first day of school who had an intent to specialize, I bet at least half of your class raised their hands.  If you are one of the many individuals beginning their dental school journey with your hand in the air, these tips may help you along the way as you contemplate a career in a dental specialty.

1. Explore.  Start off by getting to know the specialties.  From prosthodontics to pediatrics and endodontics, there is a wide range of options.  If you are fortunate enough to go to a school that has specialty programs, go check them out.  On your virtually nonexistent spare time, pop up to the clinic and shadow or assist.  This will not only give you a better idea of what goes on in that specialty but it will give you a chance to pick the brains of the residents.  Also, see if your school has a mentor program to connect with dentists of varying specialties in the community to get a better view of what life is like in the particular field.  Shadowing or doing an externship is very important and required for some programs like oral surgery.  Shadowing will also expose you to the practice and business aspects of the specialty which are not commonly taught in depth throughout dental school. This is your time to figure things out.  Discover what you like, what kind of grades you need and whether or not you think after four years of dental school, you will be okay with more school.

2. Study. Study.  Study.  Study.  That’s the number one thing you can do early on in your dental school career.  Find out how you study best, whether it’s rewriting notes, camping out at the library, quizzing with a friend or even cramming.  Dental school is a whole new game, one which may take awhile to figure out, but in the end, you need to do what works for you.  Whatever it is, get good grades to be competitive for specialty programs, especially if you’re looking into programs like orthodontics.

3. Network.  Knowing people is everything.  Make connections in all settings, from your  classmates to your upperclassmen, faculty, administration, and residents.  You will interact with these individuals every step of the process so you might as well develop a good relationship early.  Most importantly, do not treat your peers going into the same program as competitors.  It will consume you.  Work together, build each other up and use each other’s strengths to improve yourselves as individual candidates.  Making friends with people with similar goals will be extremely beneficial for you as they can be your study buddies, research partners, and emotional support when you are stressed.  These relationships will also help in the long run because residencies want cool people that are team players, not individuals that are first in class but gunners and keep to themselves.  Also, make sure to get to know residents— they were in your shoes only a few years ago and have some great advice!  Don’t brown nose but don’t forget they are people too.  Most of them are probably new to the city and would love to make new connections just like you.

4. Research. Check out specific programs’ websites and statistics, ask faculty or friends in the field, or scroll through Student Doctor Network.  Do whatever you need to find out what the requirements are for the specialty.  This includes deadlines, required grades and even specific tests.  Both oral surgery and orthodontics require special exams so make sure you prepare for this and put it on your to-do list well in advance.  At this point, you should also re-evaluate if you’re ready for more school.  Some students are a little more ambitious their first year of dental school than their third when it comes time to apply.

5. Apply. Decide on how many schools to which you want to apply and make a list based on your preferences.  Start asking professors and dentists for your letters of recommendation early so you give them ample time to write a well-constructed essay to reflect your qualities.  Also, set aside enough time to write your personal statement and make several drafts before you submit.  Check to see if your classmates, relatives, professors or one of the faculty in the specialty program will read your essay and give you feedback. 

Whatever you decide as your final destination, specialty or general dentistry, work hard, stay ahead of the game and enjoy your dental school journey. 

Drinking Your Teeth Yellow

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We are all familiar with the classic science experiment of leaving a tooth in cola overnight. Not only will that tooth look discolored the next morning, but in many cases, the tooth will also exhibit some level of dissolution.



There are many ways that the chemicals and dyes in a drink can affect the aesthetic quality of your teeth. What most people see when you smile is the enamel of the tooth. Enamel is a hard substance that is made of 97% inorganic material and 3% organic material. The inorganic content is mainly composed of hydroxyapatite, which contains calcium and makes your teeth look white. Drinks other than water often have chemicals that are able to breakdown the major components of enamel resulting in discoloration and yellowing of teeth. So who are the culprits?



Coffee – That rich, warm aroma comes at a price, and I’m not just talking about the $2.00 you’re shelling out for tall cup of Starbucks. Coffee contains chemicals such as tannins, which are very acidic in nature. The acid in coffee naturally breaks down the bonds in enamel resulting in thinner and more translucent enamel. Not to mention, coffee is darkly pigmented. This combination of factors greatly increases its staining power on your teeth.


Tea – Yes, even that lighted pigmented white tea you love has the ability to stain your teeth. Much like coffee, tea is also high in tannin content, which means your teeth are subject to an acid attack. In fact, tea is known to have greater tannic acid content than coffee! The same principles of staining apply here. As we drink tea and other beverages with acidic content, the acid attacks our enamel, degrading the inorganic material that keeps our teeth looking white and pearly. One of the reasons our teeth look more yellow is the fact that the dentin lying beneath our enamel becomes yellow tinted.


Wine – We all know how great wine is when paired with food. Despite its great taste and antioxidant power, wine is also one of the top teeth staining drinks. In addition to tannins that both tea and coffee have, wine contains chromogens. Chromogens are colored compounds that have a penchant for enamel. Paired with the acidity of tannins, your favorite Cabernet could be a leading contributor to darker teeth.



Rinse your mouth – Following a meal or beverage intake with heavy pigmentation and/or sugar, rinse your mouth with a swish of water to loosen up the particles from sticking to enamel.

Use a straw – Using a straw will help decrease the exposure of the facial surfaces of teeth from the damaging components of beverages.  

Eat cheese – The protein content in cheese acts as a barrier for your teeth and prevents heavy acid attack on enamel.

Dental Student Debt

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We all know going to dental school is by no means cheap! Many of us will graduate with around $200,000-$500,000 in student loans to pay back. While this may seem like a gray cloud looming overhead, there are some repayment programs which can help those large sums seem slightly less daunting.  Below are two of the payment plans which maybe most beneficial to dental students:


Income-Based Repayment Plan (IBR): Your maximum monthly payments will be 15 percent of discretionary income. Your payments change as your income changes. This plan is up to 25 years, and any outstanding balance after 25 years will be forgiven. Keep in mind you may have to pay income tax on any amount that is forgiven. Eligible loans include direct subsidized and unsubsidized, subsidized and unsubsidized federal Stafford loans, all PLUS loans made to students.


Pay As You Earn Repayment Plan: Your maximum monthly payments will be 10 percent of discretionary income. Your payments change as your income changes. This plan is up to 20 years, and any outstanding balance after 20 years will be forgiven. Keep in mind you may have to pay income tax on any amount that is forgiven. Eligible loans include direct subsidized and unsubsidized and direct PLUS loans made to students.


For more detailed information on these types of repayment plans you can visit: https://studentaid.ed.gov/repay-loans/understand/plans


While the payment plans listed above are two options there are also many other ways to help alleviate student debt. Some of these options include military scholarships while attending dental school as well as military repayment programs after graduation. There are also different types of public health scholarships which may repay up to a portion of your student loans.


Ultimatley, there are many different options to explore and before deciding to choose one make sure you explore all your options. So what is my best advice as a current dental student? Do as much as you can to educate yourself about your loans and interest rates. Also make sure you find out all the details about any type of repayment plan before signing an agreement. While in school live frugally and maintain that lifestyle once you graduate until you have your finances under control. Also if your thinking of buying your own practice after graduation try to set money aside and don’t put it all towards student loans, this will help you when trying to take out a loan to purchase your practice. Also if you have any credit card debt try to pay it off prior to graduation. I know dental school is expensive, but in the long run it will all be worth it as long as you manage your finances wisely!

Tips for your Voyage into Drilling

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This semester I have started a clinical teaching class at Pitt Dental in which upper classmen get to interact with first year students as they begin their journey in dentistry.  I have the pleasure of working in our operative dentistry class, which is the first time first years pick up a drill.  From my interaction so far I have noticed many “nuggets of wisdom” from those teaching the class and those students realizing it on their own.  I wanted to share some of them with you today.



Do not be afraid to try new things. When you are learning how to drill, get advice from as many different clinicians as possible, young and old.  This is your time to try new things with no possibility of causing harm to your patient.  So try a different bur or a hand instrument.  Remember that as you grow in your drilling that your preferences may change so remember to keep adapting your technique.


Practice makes perfect.  Although your homework assignment may only be two preps, do more than two preps that week.  Every prep you will learn something new from and prefect your drilling technique.  Your hands will get stronger and steadier.  This is an exam that you cannot cram for.


Know why.  Why do you not want to cross the marginal ridge on this tooth? Why are you learning a prep there?   Why do you want a flat floor on an amalgam prep?  These are all questions that you should be able to answer at the end of your first operative class.  Real teeth do not look or act like the ones you practice on. They come with their own specific problems.  Any dentist should be able to take their basic knowledge and create preps from non-ideal situations.


Know when to stop.  There will be days where you will look at a prep and think if I could just get that one enamel rod out of there….and poof!  Your prep is ruined.  Know when to say that this is as good as I am going to get it.   Learn when you are going to do more harm than good. A lot of this comes with practice.  This is not as easy as it sounds, especially on practical day.


Hang in there! Just like the cat poster says, this is a journey that has no shortcuts.  There are times when you will feel discouraged (example: indirect vision) but still keep at it.  The admissions committee at your dental school accepted you because they saw your drive. They know you can do this, just keep at it.



1st Patient? No Problem !

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Emma J Guzmán, Next DDS Ambassador, University at Buffalo School of Dental Medicine 


Are you stressed about having your first patient? Are you not confident in your abilities to conduct the procedure? No worries! Remember a few key things-> you learned all the procedures and practiced them so whether or not you feel like it, YOU ARE READY!

Be confident in your abilities and make sure you don’t show your patient when you are not sure about something. Stop, take a breath and ask your instructor if you need help.

Preparation is key in every patient visit and once you complete these steps you will have no troubles during your first patient visit.

Call you patient and schedule the appointment. 

During this first interaction besides asking them to come in, you can get a feel for what your patient’s personality is like. How did they answer the phone? Did they seem indifferent or excited about coming in? Did they want to get off the phone quickly or did they want to speak to you for a while?

The answers to these questions can help you determine the type of person you will be dealing with.

Evaluate patient charts and radiographs.  

Look at the previous procedures your patient had done, check their periodontal status, restorations and caries risk assessment.

This information gives you a general feel for what your patient’s oral health is like and will give you a baseline at the beginning of the appointment to know whether or not the patient’s oral health has improved or worsened.

Looking at the radiographs will also give you a clue of the patients health and knowing when the last radiographs were taken will prepare you in anticipating whether or not you will have to take radiographs during your appointment.

Prepare yourself for the appointment. 

Now that you have information on your patient, you must make sure you know the sequence of the exam and how each procedure is done.

The anatomy and findings will be different in each patient but knowing the general sequence of the exam will help it run more smoothly.

Read a lecture or watch a refresher video of the head and neck, extraoral, intraoral and cranial nerve exam.

Make sure you know what instruments to use for each surface, etc.

Day before appointment. 

Have you clinic bag ready with all the materials you may need

Blood pressure cuff, mirror, pen, pencil, patient goggles, etc

Day of appointment. 

Get to clinic early and set up you station with ALL of your supplies

You DO NOT want to interrupt the appointment to go get supplies.


Get your patient from the waiting room, have a short conversation to get a feel for their mood and explain to them what you will be doing during the appointment.

Follow the order of the appointment that you previously prepared for and ENJOY performing Dentistry!

After the appointment. 

Thank patient for coming in and personally bring them to the business office if that is not done before the appointment. Make sure that they have their parking pass.

Ensure all findings and next appointment are included in paperwork.

Treat yourself for surviving your first patient

Note: Certain details are specific to UBSDM but you can alter anything to work you the clinic at your school  

Humor in the Dental Clinic

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             “Establishing rapport” has become one of those phrases that you hear over and over in dental school. The patient provider relationship is built on trust and communication, and the first step is to build a rapport with your patient to make them feel comfortable. So many patients have anxiety coming to the dentist. At this point who wouldn’t? Despite dentistry ranking as one of the best careers year after year, it is portrayed negatively in the media time and time again. Little Shop of Horrors, Horrible Bosses, The Whole Nine Yards, even kids movies like Finding Nemo do not show the dentist in a positive light. This is part of the reason why establishing rapport with your patient from the initial visit is so crucial. So how do you do it? How do you break down barriers between yourself and your patient? 

            For me, the answer is humor. Making jokes with patients is one way (but not the only way) to make the patient feel at ease. It has been claimed for centuries that laughter has health benefits, however only recently have scientific studies been done to try to prove this. In an article by Dr. Mora-Ripoll, four potential mechanisms of action were used to describe the effects of laughter. First, laughter can lead to direct physiological changes to the muscular, cardiovascular, immune, and neuroendocrine systems which can have short term or long term benefits.  Second, laughter can lead to a more positive emotional state and this may lead to a direct improvement of health or lead to a better perception of health. Third, laughter can optimize one’s strategies for coping with stressful situations. Finally, laughter can increase one’s social abilities which can lead to better stress management and health benefits. Furthermore, Dr. Mora-Ripoll described laughter as having numerous direct effects including: exercises and relaxes muscles, improves respiration, stimulates circulation, decreases stress hormones, increases the immune system’s defenses, elevates pain threshold and tolerance and finally, enhances mental function.

            While the benefits of laughter and humor are vast, in the dental office, a simple joke can ease the tension and make the patient feel more comfortable. That is why for this blog, I asked some of my classmates to see the best jokes and one-liners they use with patients to try to get a giggle, or maybe an eyeroll (we’ll take what we can get…) Here is what I got:


Mike, resident pun maker of Stony Brook D3 class had a few to add:  


After finishing an arch of perio probing, I ask the patient if they like Bon Jovi and then say “Because we’re half way there….”


When I finish their prophy, I say their teeth are clean enough eat off of


When treatment planning, I ask if they want an amalgam, composite or crème filling.

Andrew had one to add as well:

Sorry that lidocaine tastes so bad, but if it tasted good it would be candy cane


Or you can stick with some regular dental jokes:


Q: What did to the tooth say to the dentist?

A: Fill me in when you get back


Q: What do you call a bear with no teeth?

A: A gummy bear


Q: What did the dentist get for an award?

A: A little plaque


Please let me know any jokes you use with your patients that get a laugh! And for more funny dental jokes, check out some of the dental humor boards on pinterest!



Mora-Ripoll, R. (2009). The therapeutic value of laughter in medicine. Alternative therapies in health and medicine, 16(6), 56-64.