There is a lot to fill you in on…

My wife and I had a son on April 7, 2015. We named him James Martin. He was 9lbs 4oz and 21.5 inches long. He is happy and healthy and getting to know him and learning how to be a father has been absolutely great.

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Here he is at 3 or 4 days old.

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And here he is almost 5 months old. Just chillin’ on a walk with mom.

I started endodontics two days after my son was born. I actually had to leave the hospital, go to class and then come back right after to bring my wife and son home. Endo was pretty intense and they didn’t really tolerate missing class. I’m sure in my situation I could have but missing the first day would have really put me behind. Overall, I think I learned more in endo and had a better practical knowledge of the information than most of the other classes I have taken so far. It was really tough and stressful at times. They gave us a manual with basically everything we need to know and they expected you to have the entire thing memorized. If they asked you a question and you didn’t know, they would make you look it up and come back to ask you later. And if you ask them a question that was in the textbook or the manual, they wouldn’t answer because we could find it ourselves. This was annoying at the time and added to the stress of the simulation clinic sessions but it made me really learn the material. We had weekly quizzes, sometimes more than one per week, so we were constantly studying for it. By the time the final came around, there wasn’t much studying that was needed.

We also had our intro to implants course at the end of the year. We learned about the different types of implants, we modified dentures that we had made the previous year to become implant-retained dentures. We also got some practice making a surgical guide for implant placement. The class didn’t take up too much of our time after hours really.

Another class worth mentioning was removable pros. In this class we learned all about designing removable partial dentures. I didn’t enjoy the class itself all that much but the material was interesting. It is like a puzzle when you’re trying to figure out what clasps to use, what major and minor connectors, and which teeth to use for support. We also learned the tooth modifications needed for removable partial dentures.

Now we can fast-forward to third year. Our third year is mostly clinic based. The year is split up into two halves. One half is called superblock and the other is clinical rotations. In superblock, you balance your time between endo, perio, and pros. This is a pretty intense time in your dental school career. Endo and perio, you are treating patients and scheduling out their treatment as it takes multiple appointments to finish one root canal or a scaling a root planning (which is all you do in perio except for the occasional assisting a graduate student or faculty in a surgery). In pros, you are scheduled patients to fill your requirements (a certain number of crowns, an implant patients, a certain number of full and partial dentures) and you are responsible for treatment planning and scheduling everything for this patient. It is a ton of paperwork and just as much clinical and lab work. If people fail superblock, it is usually because of pros. Half the class starts the year in superblock and the other half starts with the other clinical rotations. I have superblock second semester, and I’m starting in the oral surgery rotation. This rotation is 5 weeks and consists mostly of pulling teeth. We have to get 25 teeth pulled and two IV sedations but from what I’ve been told, people usually end up with 50-70 teeth. It could be one, two, or 32 teeth. If you do a full mouth extraction, there is also usually alveoloplasty involved (recontouring the alveolar ridge for dentures). We lay flaps for teeth that can’t be pulled easily and have the opportunity to use a handpiece to remove bone around teeth to remove them and place sutures after the surgery is done. It’s a lot of fun once you get past being scared since you have never done anything like this before.

My next rotation will be oral diagnosis and radiology for 5 weeks. Every new patient that comes to the school needs to be screened and treatment planned. That happens in oral diagnosis. Any radiographs that are needed are made and interpreted in radiology.

From there I will go to operative and pediatrics for 10 weeks. Operative is basically the same thing I did last year but with much more extensive restorations that are much closer to the pulp. I’m really looking forward to this rotation. The pediatrics rotation I’m not looking forward to all that much. I don’t have much experience dealing with little kids much less with other people’s kids. I have heard that patient management is tough. In this rotation, you are given professional pediatric assistants though, so that should help. Hopefully it will turn out to be fun. This rotation will take me into February and then I will start superblock.

It’s Been Awhile…

Sorry for the long absence. I got extremely busy and then the blog kind of got put on the back burner.

There is a lot to fill you in on. My wife and I are expecting a baby in mid April which is really exciting. My wife and the baby are doing great. There haven’t been any problems and overall the pregnancy has gone smoothly. Once the baby is here, my wife, who teaches fourth grade now, will stay home full time. Fortunately, the due date lines up perfectly for maternity leave to go through the end of the school year so she won’t have to go back to teach at the end of the year which works out well. (It’s almost like we planned it or something).

The reason it will work for us for my wife to stay home with the baby is mostly due to the Health Professions Scholarship. The scholarship comes to around $28,000 per year in addition to covering tuition, books and my health insurance. This plus what we have saved will get us through the next two and a half years.

I took the National Dental Boards Part 1 on December 29. Fortunately I passed on my first attempt. I was dreading having to continue studying to retake the test over spring break. In terms of studying, I started casually in early November going through the Dental Boards Mastery app. It was developed by students at the University of Iowa College of Dentistry and it is pretty great. It’s basically the Dental Decks in your pocket. The app keeps track of what you get right and wrong, which subjects to work on and different categories within the subjects that you are weakest. It also gives detailed explanations of the answers for each question. The app is really convenient because you can get through a handful on the bus or between classes without having to carry around a bunch of flashcards from the decks. It also has other great information like important terms and mnemonics which are really helpful. I went through the entire app. I liked that I could gauge my progress as I studied. Most of my class used it, some people only used this app. We all really liked it.

In addition to the app, I used a First Aid book from 2009. I think it was the second edition. This book is good to fill in the gaps that you don’t remember from the basic science classes and refresh what you did learn. I used First Aid for all of the subjects except anatomy. I did not like how this section was presented. It didn’t really fit with my learning style. For the anatomy section, I used the notes from the anatomy class we had as D1s. This worked for me because the professor for this class really geared it toward dental students. We had two units over general anatomy and the rest of the class was just head and neck. I skipped the first two units and then went through everything from the rest of the class. I focused most of my time on this section since the questions here can be very detailed. I’m glad I didn’t waste my time on general anatomy; I only had two or three questions from that material.

I also used released exams to gauge my progress. I bought a CD of released exams from an upperclassman and my school provided some as well.
I really buckled down to study after Thanksgiving. This was difficult while simultaneously studying for finals. I didn’t enjoy the second half of November or any of December too much. We finished up finals week on December 19 and then it was all day everyday devoted to boards. My wife and I went home for Christmas early on the 24th and then came back late on the 26th. I took two sets of released exams (I think they were from 2004 and 2009, each had 200 questions; the actual test is 400) and simulated a test for myself to see if I needed to study at home over Christmas. I got an 80% on this practice test. Part 1 boards are scored on an adjusted scale. So according to many sources, you need somewhere around a 65% to get a passing score of 75. I’m glad I tested myself so that I knew I could take some time off and relax over Christmas. According to the 1998 conversion chart an 80% is a score of around 92 or something like that. I’m not sure if that chart is still applicable but it definitely gave me confidence. Once we got back, I used the 27th and 28th to review everything and then took the test on the 29th. It was a long day (7 hours) and some of the questions were kind of obscure but for the most part, it seemed like a manageable test. The test is split up into two sections each with 200 questions. I went through each section and put answers for everything even if I wasn’t sure and then I went back through the section again to check my answers. I finished each section with about a half an hour to spare. Overall I felt somewhat confident when I was done. Then came the waiting game.

I think Part 1 boards are curved based on the group that takes the test during a certain time period. That means that you don’t get your score right away like the DAT even though you take the test on a computer. On Friday January 16th, my wife and I went home for a baby shower. This was the only time that worked for us since we both had Monday off for Martin Luther King day. The problem with this was the results from boards came on Saturday the 17th. We had an appointment in our home town Monday morning to have a family friend look at our car so I was stuck waiting all of Saturday, all of Sunday, and most of the morning on Monday and then we had a five hour drive back before I could get my results. It was torture to wait all weekend after so many people in my class were putting “Passed!” on Facebook. I considered driving back to our apartment Sunday morning and then returning Sunday night but that wouldn’t have changed whether I passed or not so I begrudgingly decided against it.

First semester went well. We started treating operative and preventive patients which is pretty awesome. (Preventive patients are just prophy recalls) A lot of schools don’t have D2s treat patients but we have the opportunity to with several checks along the way by faculty. We actually saw three patients last year a D1s for prophy appointments. Didactic courses also went well. We had fixed prosthodontics lab and lecture, operative lecture, growth and development, oral pathology, human pathology, microbiology, anesthesia and pain control, experiential learning, and periodontics (I think that’s everything). I ended up doing well in all the classes even with studying for boards over finals which I was pretty happy about.

As for second semester, we have fixed pros 2 that is ending soon and will be replaced by removable partial denture prosthodontics. We are also taking orthodontics lecture and lab, esthetic dentistry, basic pharmacology, pediatric dentistry, oral radiology, and we are continuing experiential learning, operative, and oral pathology, as well as seeing patients most Tuesdays in either operative or preventive clinics. We will be starting anesthesia and pain control 2 in March and Endodontics lab and lecture in April. They keep us pretty busy but it is going well. I will post some pictures below of some restorations I have done this year in the sim clinic.

I think that pretty much covers everything that has happened so far this year. I’m hoping to keep things up to date from now on.

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With this restoration, I took the picture before I put in the proximal boxes on the mesial and distal to take care of the unsupported enamel. These teeth have simulated caries in them. You normally would not leave that ML cusp unsupported like that but the tooth had more caries than it should have so I had to just follow the simulation. I also cleaned up the distal of that cusp before restoring with dispersalloy.

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I don’t have a before picture but this was a simulated class IV. We were practicing with different opacities of material to match a real tooth. It looks a little too translucent because the adjacent teeth are solid plastic but it was actually correct.

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This restoration was a 3 surface composite. The picture of the prep is after I built up the mesial and distal contacts and then removed the matrices to finish.

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This is from fixed pros II. We did a prep for an all ceramic crown in fixed pros I, scanned it with Cerec and had the crowns milled in the lab at school. We just got them back today to do the external characterization. The instructors showed us a finished crown to mimic since we couldn’t copy the adjacent teeth. I also added in a few craze lines for fun.

One Year Down

Well, I’m back. Sorry it has been so incredibly long since my last post. Second semester was extremely busy.

So it’s official. I’ve finished my first year of dental school. We took our last final on June 20th and we are on summer break until August 25th. I guess I should insert the obligatory “1/4th a dentist” comment here. A lot happened over the last several months. I’ll give the sparknote version here.

We had anatomy and histology classes that were kind of combined into one super class we called Gristo (Gross anatomy + histo). The tests were taken at the same time but the grades were split up at the end. Anatomy was tough. It was definitely more detail oriented than I was used to. Luckily the professors for these classes were fantastic. They really engaged us in the material and were really willing to adjust the class as we went when something didn’t work or if something really worked well. We finished these classes up in May making for a very intense week. We had a lecture test in operative the Friday before and then Monday we had cumulative lab tests in anatomy and histology and then cumulative lecture tests in both on Wednesday. That week is a blur. We capped it off with our white coat ceremony Friday night of that week. This ceremony is basically a symbolic rite of passage where we gain clinical privileges. After that week, we felt that we really earned those white coats.

Another class we had was occlusion. In the lab portion of this class, we made a set of complete dentures to fit our mannequins in the sim clinic. This class was challenging but once we got the hang of the procedures and techniques, it could be fun sometimes depending on the day and whether or not someone accidentally walked off with your mixing bowl and spatula in the bench lab. Below is a picture in the middle of setting the denture teeth and another of the final dentures I turned in. We finished them up and polished them after they came back from the lab.

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We finished up Operative in June. This class was one of my favorites. I love working with my hands. I’ve carved and used small rotary instruments for years so the lab aspect was just fun for me. The lab practicals went really well and my skills improved substantially throughout the class. Here is a picture of an amalgam restoration of a simulated buccal cusp fracture of a mandibular second premolar, before final polishing. I was pretty happy with how it turned out. The picture quality isn’t that great here but you get the idea.

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I can’t forget about Anesthesia. This was just a short 1 credit course that we didn’t start until around April. It went over the general techniques of the injections, the types of anesthetics, anatomy, and things like that. This class also had the dreaded “stab lab” where we took turns injecting each other with anesthetic. Everyone got nine shots on one side of their mouth. It wasn’t as bad as it sounds but it also wasn’t pleasant. We had a resident as an instructor for our group. He really walked us through everything so there wasn’t anything to worry about. We all had to have our BP taken before we could be injected to make sure we were all healthy. There were some very high BPs that morning. Everyone was a little nervous. Of course right after that was a lunch and learn that served Chick-fil-a. It was almost hard to enjoy the chicken sandwich with half of my face and tongue numb but I managed without too much cheek and tongue biting.

We had preventive dentistry where we have our first patient experiences. We start by working on one another doing cleanings and charting. Then in May we had our first two patient experiences. We could either have random recall patients from the patient pool or we could bring in family members. I had a random patient and a family member. Both appointments went well. Working with patients really solidified in my mind that I’m joining the right profession.

At the beginning of May we started oral radiology 1. It was just a general overview of anatomy landmarks and procedures. We did get to have patient contact at the end of the class in June. We were split into groups and assigned a certain morning where we would make all of the radiographs needed for that morning. It was pretty fun. Before that we had to practice placing the digital receptor on each other so we could remember how uncomfortable it is when we place them in patients. We also practiced making radiographs of skulls to make sure we were getting the placement right.

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Well, that is about all I have to talk about for classes at the moment. I’m waiting for my last two grades to be posted online. The deadline is July 9th but all but two are up there now. I’m pretty confident that I know my grades in these two courses so I can say that I’m happy with how the semester went. Lets hope I don’t forget it all before this fall. My wife and I are taking the summer off for some much needed relaxation. There are several beaches near by where we have already spent several days canoeing, reading, and fishing. I have the fairly painful sunburn to prove it. Other than that, I’m doing some work for my grandpa cleaning and recovering antique binoculars that he collects and restores for some extra money. (This is actually good practice for improving dexterity I’ve found). I’m also casually reviewing some things from the school year like dental anatomy and things like that so it stays fresh.

That’s all for now. I hope everyone is enjoying the summer!