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Tuesday, September 8, 2009

"Oraqix" ~SLOW!!!!

My morning patient today was actually kind of difficult, he was a pretty difficult class II with super sensitive gums and tons of bleeding! I had to probe quad by quad after anesthesia because he had so much inflammation and therefore sensitivity in his gums. My patient doesn't like the N2O and had a really hard time getting numb from the lidocaine. He told my instructor (who was REALLY SLOW) that he usually doesn't get numb easily but she still only used 3/4 carp of lidocaine for his LL quad! I'd have used at least one whole carpule, but I can't do anesthesia yet... Just as I expected, I went to scale with my ultrasonic and my patient who wasn't numb even though my instructor claimed he was, lit up like a christmas tree. I felt so bad, but I was hoping that I wouldn't have to wait for her to come back and give more LA. Instead we had to wait while Instructor Snow went and found the Oraqix that is "so great for numbing the gingiva!" When she found it, she didn't know how to assemble the applicator so after playing with it for about 5 minutes, she decided to start looking for someong to help her. AAAGGGHHHH!!!! Oh my gosh I got so tired of waiting and I could tell my patient and his daughter were getting impatient as well.
Then on the UL it was the same story only she decided to just use the remaining 1/4 carp of lidocaine for the entire quad! And then to use the oraqix to numb the rest. That would be a fine idea on a patient for whom the LA worked but instead my patient was wincing with every move of my scaler. (I promise I'm not that bad at instrumentation!) I missed some spots on the top because I was too shy to dig in with my patient in so much pain. Then... on the pt. encounter form she noted that I need to be brave enough to dig for all the calculus and she actually had the nerve to write "maybe some more anesthesia?" What the heck??? I probably could have finished the patient in one appointment had my instructor not been so skimpy and slow with the numbing... and exams, and checks, and x-rays, and signatures, ets... Also, when I was trying to walk my patients out, she was just starting a scale check so I asked if I could get another instructor to sign it instead (usually the other instructors would then tell me to just put their initials on the paper for them) but instructor Snow was trying to tell me that I had to wait and make my patients wait for her to finish her "very thorough" scale check so that I could get her signature before they left. I just had Professor Bossenburger sign it instead... Thank you!
The afternoon went much smoother, Dr. Naylor was my instructor and she helped me out so much! I had a class V patient that actually had a good amount of calculus, and I was able to finish her in one appointment. Dr. Naylor showed me some nice tips and tricks and helped me get the few spots that I missed. It went very quickly and we got it all done, 4BWX and all.

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