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Blogs

THE NEXTDDS Student Ambassador Blogs

It Takes More Than Studying: Volunteering as a Dental Student

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          The role of the dentist is often misinterpreted. Most people believe that the dentist just deals with toothaches, cleanings, and the occasional cavity. It may be true in function, but our role really expands to fit the needs of the communities we serve. There is a level of respect that comes with being a dental practitioner, and this is commanded in the way we fill our part as those who serve. For these reasons, it is absolutely imperative for the dental student to become involved with the surrounding community via outreach and volunteer opportunities.

 

Dental school offers much to learn regarding hand skills and the proper way to handle challenges presented daily by our patients. What is lacking, however, is how to engage and encourage people to be invested in their mouths. At Rutgers School of Dental Medicine, we are required to volunteer five hours per year in a variety of settings. I taught kindergarteners the importance of oral hygiene and assisted at the local food bank. When members of the society you serve see you helping out and showing a true investment in them, an environment of trust becomes established. Showing the real person behind the dental mask creates a bond that will ultimately encourage the patient to trust and work with the dentist. This is especially true when working with young children.

As dental professionals, we strive to provide optimal care for our patients. At times, this goal may be compromised due to requirements necessary for graduating dental school. By incorporating a habit of volunteerism, these seemingly opposing ideas can be approached in harmony. Because I am a D2, I have yet to start working with patients, but that does not mean I have been inactive. Through my volunteer activities, I have found many patients looking for dental care. This has benefited me because I am being proactive, and hopefully avoiding the lack of patients I might experience in my third year. I am also benefiting the patients because they know me and have experienced my dedication to volunteering, recognizing that I truly care about their well-being.

Volunteering does not always sound like the most ideal opportunity in dental school. Waking up early on a Saturday to dedicate time that is already precious seems counterintuitive. Ultimately, it is a true benefit to both the dental student and patient. The benefits become even more obvious when you become a practice owner or associate. My father is practicing pediatric dentistry and has spent one day every week for the past 25 years devoting his services to underserved populations. When I speak to him about his career, he always mentions that the most satisfying part is giving back. It may cost him money out of his own pocket in the short term, but by seeing to the needs of even the most disadvantaged patients, people recognize the kind of person my father is. Establishing a habit of volunteerism early in our careers as dentists benefits those around us, but ultimately it is an investment worth pursuing.

Happy Employees = A Successful Practice

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    I’m sure everyone has heard the saying, “Happy wife, happy life.” The same sort of saying could be applied to your practice. Although it may not have that catchy rhyme to it, “Happy employees, successful practice,” could be just as important and true. Without the happiness and contentment of your employees, running and maintaining a successful practice could be a challenge.

 

I worked in a pediatric practice for four years and was involved in almost all aspects of the office including assisting, scheduling, office work, sterilization, and billing. Each day was a constant whirlwind of crabby kids, unexpected treatment, and leaning on each person in the office to pick up extra duties and tasks. Being involved in an office from the employee side helped bring this concept to light. If my fellow coworkers and I hadn’t been happy, the foundation of the office would have crumbled. Through my experience, I have come up with three very simple steps to help you reach employee happiness.

 

1: Support and be confident in your employee’s decisions and performance

There is a reason we have interviews and trial periods for employees. It’s to make sure they are competent, hardworking, and worthy of a position in your practice. Once your employee has proven that they can complete the task at hand to your expectations, it is best not to constantly look over their shoulder and second guess them. This, of course, has its limitations and should not be followed when an employee hasn’t met these criteria. However, the constant pressure and doubting may make your employees feel inferior and incompetent, which is not an ingredient for a happy worker. Your employees will feel more important if they are able to perform their job without constant pressures from their boss. They will gain self-confidence and worth by knowing that their boss believes in them and supports the work they produce.

 

2: Be open to suggestions your employees may have regarding the office

Although you may own the office, and all decisions ultimately go through you, it is still important that your employees feel like they have a voice in the workplace. Open discussions between employees and owners may help everyone feel more fulfilled in their workplace. This also may open the door to more effective communication. Employees want to feel like they can voice concerns to their boss, and if you are constantly making decisions without any input from them, they may not feel comfortable communicating with you.

 

3: Make your employees feel appreciated

Finally, but most importantly, appreciate your employees and voice this appreciation whenever you can. We live in a society where people need to feel appreciated, and this can’t happen if they aren’t told once in awhile. Something as simple as a “thank you” can make a world of difference in an employee’s eyes, especially when they have gone above and beyond the call of duty. I think in most cases you will be amazed at how much harder employees will want to work if they see that someone has taken notice. Employee appreciation, I believe, is truly the golden key to success.

 

You cannot operate a practice without the hard work and dedication of your employees. And in order to keep your employees at your office, they must feel fulfilled and happy. I believe that if you start with these three key points, you will be well on your way to running a successful and happy workplace for all.  

Special Smiles

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Throughout my childhood, I had always heard so much about the Special Olympics program, which allows athletes of all ages with special needs to participate in competitions and win prizes for their abilities. As I grew older, I had the honor of being invited to help staff the program and learn more about what this amazing event has to offer. Very few people know how much the Special Olympics program means for participants, not only for children with special needs, but also for their families. I was pleasantly surprised to learn that not only was it a sports collaboration, but also a health screening service in addition to the exciting events that families enjoyed.

 

            When I was in college, I was invited to join the Special Olympics Special Smiles team in the field of dentistry to help screen children with special needs for oral care and other services. It was there that I learned about the misconceptions about children with special needs, and how to effectively demonstrate oral health care and hygiene practices to prevent future discomfort or their need for future dental work.

            Many of the children exhibited fluorosis, caries, and had fractured teeth from sports injuries or congenital abnormalities. Parents explained their journeys to finding the right dentist, and the hardships they encountered as a family trying to find care for their children.

            When I volunteered at the Special Olympics Special Smiles event in New Jersey, I had the pleasure of working alongside a dentist who taught me the basics of clinical screenings before I began dental school. This was an excellent preliminary experience to learn all about dental terminology and various conditions associated with congenitally acquired disorders. Not only did I have the opportunity to learn about these conditions, but also how to manage and identify them in a clinical setting. Many of the Special Olympics Special Smiles program participants required mouth guards for their regular sporting activities, so we were able to provide them along with other preventive services, such as fluoridated toothpaste, floss, and toothbrushes. They could then prevent dental caries while enjoying their daily activities at a minimal risk.

            Another Special Olympics Special Smiles program was recently held in Miami, which similarly provided dental and oral healthcare aid for children with special needs. There, special needs children were also provided with non-intrusive dental exams to encourage oral hygiene and to ameliorate issues in the dentition. Although many participants were known to be regularly noncompliant with dental professionals, they were more relaxed in a friendly and inviting setting, which helped decondition them from previous fears of the dentist.

This is critical to help provide care for children and adults with special needs, as they will be more likely to become compliant in the future if dental phobias are eradicated. Using the “tell-show-do” method, many of the participants learned proper oral hygiene techniques, learned about prevention, and reduced their dental anxiety for a brighter and healthier future.

Treating Cracked Teeth

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As a third year in dental school, one of the most difficult tasks in clinic is gauging the longevity of certain teeth. This past week in our Endodontics class we learned about cracked teeth and the various prognoses for each type of crack that may result.

The first type of crack is the fractured cusp. Patients with this type of crack in a tooth generally present with pain upon release and this can be gauged with a tooth sleuth to determine which cusp is the one in question. To treat this type of crack, remove the cusp and restore the tooth. Root canal therapy is only necessary if the crack has affected the pulp but otherwise the overall prognosis of the tooth is good once it has been restored. The next type of crack is one that starts in the crown and cracks the tooth mesiodistally. To treat, the crack must be prepared until it is gone and a crown is likely to keep the tooth healthy. Again, root canal therapy may be indicated based on the extent of the crack. If a cracked tooth is untreated, it can lead to a split tooth in which the crack extends down to the root and can separate the tooth in segments. If the crack extends on to the root surface beyond a restorable area, extraction will then be necessary. A third type of crack is the vertical root fracture. This starts in the root as opposed to the crown and usually begins in a buccolingual direction. These teeth almost always have had a root canal treatment prior. The only way to treat these teeth is by extraction or removal of the fractured root (a root amputation or hemisection may also be indicated).

The best way to diagnose any of these types of cracks is first to use transillumination. This technique uses a light and shines it directly onto the tooth from the lingual in order to see if a crack exists in the coronal portion of the tooth. Taking a periapical radiograph is also very useful in diagnosis of cracked teeth. Another valuable tool is the periodontal probe. With cracked teeth, there will almost always be a deep pocket where the crack arises; thus, probe around the tooth in question and if you feel a deep pocket and the tooth was otherwise periodontally healthy, a crack may have resulted. As with any type of dental pain, the earlier you can treat it the better. Be sure to get these patients in as soon as possible before their problems progress because once a tooth is extracted, a patient’s dentition will never be the same again.

Social Media Sensation: Activated Charcoal

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The newest buzz in social media regarding dental care has been the use of activated charcoal for tooth whitening. Initially, I deemed it another “do-it-yourself” whitening sensation that would lose its hype, but I was wrong. There is still a continued conversation on this trend, and even toothpaste brands that now contain charcoal. It is definitely now worth further exploring, particularly so you have an informed perspective. There have been YouTube videos and social media posts of celebrities using activated charcoal, which brings more attention to the topic. Dental professionals need to be aware of what’s going on in social media, as these are questions that patients will ask.

It is stated in Drug Store News that activated charcoal reportedly “removes stains without abrading the enamel or using chemical bleaching agents” by absorbing stain particles and eliminating them. Additionally, the activated charcoal “balances the PH of the mouth while protecting against the growth of pathogens and cavities.” These seem like great benefits, but the harm that may be caused and the long-term effects on one’s dentition are not known. Medical professionals have urged against the use of activated charcoal in the oral cavity because of its actual use in medicine. It is used to absorb poison in the stomach from overdoses. So, regular use in the oral cavity is not recommended. The ADA spokesperson Dr. Kim Harms has commented on the unclear effectiveness of the use of activated charcoal.

My initial thoughts are that due to the abrasiveness of activated charcoal, its use can lead to enamel deterioration and erosion. There is no evidence stating that it is more effective than whitening toothpaste, and it does not have the ADA Seal of Approval. When it comes to toothpastes that contain activated charcoal, which supposedly has the benefits but not the abrasiveness, studies still need to be conducted to determine the effectiveness and side effects. I would also suggest that patients with crowns or veneers do not use these toothpastes because it may cause staining. The dental community continues to recommend peroxide based whitening products at home and in a dental office as well as fluoride based toothpaste to strengthen teeth.

We will see what occurs in the next few months or even years if the use continues. The dental community will have to take a really good look at this current craze.

 

http://www.drugstorenews.com/article/curaprox-introduces-toothpaste-made-charcoal

 

http://www.smilesny.com/blog/ada-spokesperson-no-evidence-charcoal-teeth-whitening-method-is-effective/

Hypertension and the Dental Patient

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    Hypertension is one of the most common diseases encountered in a dental practice. Nowadays hypertension affects almost one third of the population in the United States.  The biggest issue with this disease is the fact that many people are not aware of having it since it doesn’t always show symptoms. In a dental practice management includes recognizing the disease, correctly measuring the blood pressure, knowing about the treatment options and the adverse effects for the mouth. Hypertension is divided into primary and secondary hypertension.  Primary hypertension, also known as essential hypertension is recognized as a chronic medium to high blood pressure. Secondary hypertension is due to an organic cause.

Several studies have determined that hypertension is due to a complex interaction between genetic and environmental factors. Several of the predisposing factors are age, family history of cardiovascular disease, smoking, excessive alcohol consumption, sedentariness, cholesterol rich diets and co-occurrence with other diseases.  The treatment of hypertension includes more than just antihypertensive medication. One of the critical aspects of controlling blood pressure is to adopt a healthy lifestyle. A healthy lifestyle includes smoking cessation, moderate alcohol consumption, exercise, low sodium diet and losing weight for the overweight patients. Some of the antihypertensive medications to treat hypertension are thiazide diuretics, beta blockers, ACE inhibitors, calcium channel blockers, etc.  All these medications influence the oral environment.  The most common side effects are xerostomia, gingival hyperplasia, and lichenoid reactions.

            Xerostomia results in decay, difficulty chewing, swallowing and speaking, candidiasis and burning mouth syndrome. This side effect sometimes forces the physician to switch the medication and it is imperative of the dentist to find ways to alleviate this symptom. The dentist can advise the patient in different ways to stimulate salivary flow and to sip water frequently, to reduce the caffeine intake, to avoid alcohol and alcohol containing mouthwashes. In addition, the dentist can apply fluoride topically to protect the teeth surfaces from caries. Gingival hyperplasia is caused by calcium channel blockers and it is manifested by pain, gingival bleeding, and difficulty while chewing.  This can be reversed by switching to a different antihypertensive medication. Other side effects of antihypertensive medications are ageusia and dysgeusia.

            When a patient presents in the dental office with hypertension it is essential to obtain a detailed medical history that includes a family history of cardiovascular disease, hypertension, medications, duration of treatment and severity of the disease. It is important to always remember that patients with hypertension are at an increased risk of developing adverse effects in the dental office.  Blood pressure measurements should be done for every new patient for each visit.  Measuring the blood pressure routinely may reduce the event of complications during dental treatment.  It also important to take into consideration the “white coat hypertension”.  This results in a higher blood pressure reading in the office than if it were taken outside the office. This can either give the impression that the patient has high blood pressure when they don’t or can mask the underlying disease.

Licensing in a Nutshell

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There are several ways dentists can become licensed in the United States depending on where they want to practice. The different pathways to achieve licensure can be somewhat overwhelming, and taking a live patient examination can make licensure even more stressful. Did you know that dentistry and cosmetology are the only two career fields that still use live patient examinations? Medical doctors, surprisingly, do not have live patient examinations. Licensing exams include the WREB, CDCA (formerly the NERB), CITA, SRTA and CRDTS. In addition, dentists can also be licensed by portfolio in California and by residency in Minnesota, California, Colorado, and Ohio. So, which pathway should you take?

 

Ultimately, the decision on how you want to achieve licensure depends on the state in which you intend to practice. As a first step, I would highly recommend visiting the website of each state’s dental board. Figure out what exactly their licensure requirements are and if there are any caveats associated with them.

What do I mean by caveats? Let me give you an example. I am currently a fourth-year dental student and will be completing a one-year, PGY1 AEGD program in California. Since I would like to stay in California to eventually practice, I have decided to achieve licensure through my residency program instead of taking the WREBs. Now, why wouldn’t I go ahead and take the WREBS, knowing that it would open me up to practice in more states? After doing some research on the California State Dental Board website, I discovered that if you have failed the WREBs within the last five years and are trying to fulfill licensure by residency, you would not be able to get your license this way. More so, some GPR and AEGD programs will not let you start their program if you have failed the WREBs. Instead of putting myself through all that stress, I decided not to take the WREBs and get my license through residency. This is what I mean by reading into requirements and seeing if there are any minor details to be aware of before taking an exam.

A quick note on licensure by residency: In applicable states, it can be achieved by completing a one-year, post-graduate (PGY1) CODA-approved GPR or AEGD program. Licensure by residency does not include specialty residencies.

Keep in mind, depending on the state, dentists can also achieve licensure by credential if they have already been a licensed dentist in one state and would like to practice in another. Usually the dentist needs to have practiced in their licensed state for about five years and have accumulated many working hours to be licensed in another state. Again, this really depends on the individual state and what their exact requirements are.

Hopefully, in the near future dentistry will start to pull away from the live patient based examinations and opt for more licensure by portfolio or residency. Until then, it is important to do your research and make sure to understand all the details associated with your state and choice of licensure.

 

Presenting a Treatment Plan(1)

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Switching over from simulation clinic to clinic has been a whirlwind of change. I was quick to learn that I could not use my patient’s head and upper torso as a place to rest my instruments and hands as I once did with my manikin. I also learned that ideal preparations are hard to come by. My patients don’t have the same ability as my manikin to open wide and keep their tongue out of the way of my hand piece. I also learned that I could not just begin any procedure without receiving proper consent from the patient. Switching over from simulation clinic to clinic has added the entire aspect of patient interaction, a component of care that cannot be learned from a text book and differs from patient to patient. It adds an entire new dimension to dentistry and is what makes the field so great.

One of the most rewarding and enjoyable parts of this transition has been presenting a treatment plan. When composing a treatment plan, it is done with the patient’s needs and wants in mind. However, I never thought that I’d have difficulty presenting a treatment plan to a patient. Although most treatment plans are accepted without question or concern, there are some that require a little extra effort to get the patient on board. Recently, I have realized that every treatment plan needs two components before the patient accepts the plan. It must address the patients concerns and chief complaints, and it must show urgency.

Before getting into specifics of which type of cleaning a patient needs, or fillings and crowns, I have always made it a point to address the patient’s chief concerns first. If they are seeing us for a specific reason, they want their concerns addressed. In some cases, it is a lot easier than others. If a patient is in pain, we address to relieve them of their pain before doing any other work. In cases where patients address an elective procedure, such as teeth whitening, to be their chief complaint, it is important to preface the plan with addressing that problem, but showing them the benefits of going through with whitening when we find it appropriate.

The next most important thing while presenting a treatment plan is to show its urgency. It is important to add value to our work. If a patient does not feel pain, they are less apt to get a small restoration they need. Explaining the prognosis of the specific treatment with the use of visuals helps the patient understand and see the importance of specific treatment.

In the future, we may have other staff presenting treatment plans, but while in school, it’s in our hands. If we address patient concerns and add value to what we wish to do, we are more inclined to get patients that are more involved and willing to go forward with treatment.

 

Presenting a Treatment Plan

 Permanent link

Switching over from simulation clinic to clinic has been a whirlwind of change. I was quick to learn that I could not use my patient’s head and upper torso as a place to rest my instruments and hands as I once did with my manikin. I also learned that ideal preparations are hard to come by. My patients don’t have the same ability as my manikin to open wide and keep their tongue out of the way of my hand piece. I also learned that I could not just begin any procedure without receiving proper consent from the patient. Switching over from simulation clinic to clinic has added the entire aspect of patient interaction, a component of care that cannot be learned from a text book and differs from patient to patient. It adds an entire new dimension to dentistry and is what makes the field so great.

One of the most rewarding and enjoyable parts of this transition has been presenting a treatment plan. When composing a treatment plan, it is done with the patient’s needs and wants in mind. However, I never thought that I’d have difficulty presenting a treatment plan to a patient. Although most treatment plans are accepted without question or concern, there are some that require a little extra effort to get the patient on board. Recently, I have realized that every treatment plan needs two components before the patient accepts the plan. It must address the patients concerns and chief complaints, and it must show urgency.

Before getting into specifics of which type of cleaning a patient needs, or fillings and crowns, I have always made it a point to address the patient’s chief concerns first. If they are seeing us for a specific reason, they want their concerns addressed. In some cases, it is a lot easier than others. If a patient is in pain, we address to relieve them of their pain before doing any other work. In cases where patients address an elective procedure, such as teeth whitening, to be their chief complaint, it is important to preface the plan with addressing that problem, but showing them the benefits of going through with whitening when we find it appropriate.

The next most important thing while presenting a treatment plan is to show its urgency. It is important to add value to our work. If a patient does not feel pain, they are less apt to get a small restoration they need. Explaining the prognosis of the specific treatment with the use of visuals helps the patient understand and see the importance of specific treatment.

In the future, we may have other staff presenting treatment plans, but while in school, it’s in our hands. If we address patient concerns and add value to what we wish to do, we are more inclined to get patients that are more involved and willing to go forward with treatment.

 

There’s No “Right” Answer to Interview Questions

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I asked the students I was interviewing for the class of 2021, “Why do you want to go into dentistry?” Being on the other side of the interview table was relieving, but also enlightening.

But now, as I talk to potential dental students who have upcoming interviews, they always ask me what the “right” answer is to certain questions. Well here it is: there isn’t one. Yes, we listen to your answers. Yes, we like to hear certain thoughts and we do pull from what you say to see if you are a fit for the school, but that’s not all we look for. In fact, that’s not even half of what we look for. Sitting through interviews these last couple of years, I have realized the main requirement for a good interview: be yourself and be confident. Being able to carry out a full conversation with your interviewer is key, whether it be about dentistry or last night’s football game. Interviewers want to feel like they connect with their interviewee, and they want to be able to feel like they can see this person in the hall a year from now and strike up a conversation.

 

Having now interviewed a number of dental school candidates, I can offer several tips:

Be yourself and know yourself: Talk about what makes you unique as a person and as a student. Share stories and how they made you who you are today. Share your hobbies and interests and how they made an impact on your life.

Know the interview type: Contact the school and find out the format of the interviews. Know if you are walking into a one-on-one interview or a group interview. Practice with a mock interview.

Know the common questions: No matter what school you interview at, there are still common questions that you should be prepared for. Be ready to clearly share why you want to attend the school and why you want to pursue dentistry. Make sure to be compassionate and thoughtful.

Ask questions: Have a few questions to follow up after the interview. Ask about certain programs within the school that interest you.

Follow up: Ask for a business card or contact email afterwards. Send a thank you card or email to your interviewers. Let them know you appreciated taking the time out to interview you.

So go in there, be yourself, be confident, and rock the next interview that comes your way!

Traveling on a Dental Student Budget

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You only get to experience your 20's once in your life -- a time of learning and exploration. As many of you know, I moved to Columbus on my own about two and a half years ago and it has been the best decision of my life. Throwing myself in to a new environment solo forced me to step outside of my comfort zone and to meet new people. Now that I am approaching the end of my third year in dental school, I have been constantly asked, "Where do you see yourself after graduation?". This is such a hard question for me to answer because not only do I fear commitment, I also have not seen enough of the country to pick a concrete place to develop my future practice. However, in 2016 I made it a goal to travel the country and explore many new destinations. Here are a few tips on how to travel while on a dental student budget.

#1: Make friends across the nation. By becoming heavily involved with ASDA and having attended many national conferences, I have been blessed to meet countless dental students from the West to the East. Learning about each dental school from my colleagues has been a delight, but actually traveling to these destinations has helped me learn that not all dental schools are the same. Making connections has helped me save hundreds in hotel costs by crashing on couches.

#2: Apply for an airline credit card. Many airline credit cards, like Southwest and Frontier, offer bonuses if you spend X amount of dollars within the first few months of having that card. Although we all try our best to budget within dental school, many of us have to pay rent and groceries and can therefore expense these onto the credit card. From there, you can use your bonus miles to save on future flights, a luxury I have already taken advantage of.

#3: Get involved with ASDA. Many local chapters make valiant fundraising efforts in order to fund members to attend the national meetings. As I found out what this organization has to offer, from advocacy efforts to professional engagements, I became involved and was able to attend many of the trips to attend national conferences. With ASDA, I have been to Boston, Chicago, Dallas, Milwaukee, Orlando, Ann Arbor, and Washington D.C. – all of which would not have been possible had I not put in the effort to become a leader within my local chapter.

Although traveling can be quite expensive, I feel that these tips can help alleviate travel costs and help open our eyes to the beautiful country. You never know when a career opportunity may just be a quick trip away.