Category: Dentist

A quiet dentist begins to suspect his expressive wife, also a dentist, is having an affair. Meanwhile, the three kids are picking up cues, and the persona of a crabby patient becomes his alternative inner voice.

The film is directed by Alan Rudolph (Breakfast of Champions, Choose Me) from a script by Craig Lucas (Reckless, Prelude to a Kiss), adapted from Jane Smiley’s novella, Age of Grief. One of the most immediate impressions from viewing the film, is that the dialogue and the performances feel like neither. For example, the husband, played by Campbell Scott (The Spanish Prisoner, Mrs. Parker and the Vicious Circle), will ask the wife, played by Hope Davis (About Schmidt, Next Stop Wonderland), a question, and she won’t even reply to it. She’ll just go on about something else. In this way, the writing seems less conceived, and more captured. However, the performances are just as critical to establishing this convincing illusion. Scott and Davis have a remarkable chemistry with each other, presumably developed over the course of their previous collaborations. They do seem like a married couple. The children, often the source of atrocious acting that annihilates the illusion of the story, in this case are also astounding in their realism.

As a character study, the film poses a fascinating question: if you suspect your wife of cheating, what do you do about it? The dentist’s inner voice, played in-scene by Denis Leary (Suicide Kings, The Ref), keeps pestering him to ask her, “Who is he?” The dentist replies that he would have to do something about it, which he is unwilling to provoke. Despite the sedate suburban milieu, the stakes are amazingly high. The dentist works with his wife at their dental practice, they have a family, a house, and a retreat in the woods. So much of his life and accomplishments are bound up with his wife, that he has to swallow his betrayal and anger. While trying to keep it all inside, it inevitably comes out. The dentist closes up even more, and plays his various roles with increased gusto. When they talk, they’re analyzing tangents of their relationship, and never the main issue. Furthermore, like animals before an earthquake, the children sense something is the matter. They react with tantrums and physical sickness to a surreal degree. In this way, the main characters communicate without talking to each other, delivering a refreshing perspective of our reality.

Whether or not one has been in this situation, the film does a subtly effective job of drawing the audience into it. Jealousy, paranoia, restraint, and obligation are all part of our lives at some point or another, whether we manifest them or are subject to them from others. Like most of Rudolph’s work, this attention to character gives the film an unusually powerful hold on the viewer, which is something that plot-driven Hollywood should take notes on.

This attention to realism in story is however a double-edged sword. The film spends several scenes charting how each of the family members passes along to the next a mystery fever, and then quixotically back again (what about antibodies?). Luckily, the film’s loyalty to realism ends there. The film’s departure from pure realism, the alternate voice provided by Denis Leary’s character, provides an entertaining and visually diverting counterbalance to the downbeat perspective and narration of the dentist.

Initially before any treatment held on, it is crucial to fully understand the patient’s chief complain and his/her desire from seeking a dental treatment in order to fulfill them. The success of treatment mainly relies on the patient’s satisfaction; therefore it is only possible through engaging the patient in decision-making process by visualizing the planned result in a 3D- wax-up and mock-up.

Wax-up is a diagnostic procedure done by a well-trained and skilled dental technician, were the potential treatment outcome is built in wax on the study cast before treatment. When this wax model be replicated intra-orally by the aid of silicone indexes and auto polymerizing resin over the unprepared teeth, this clinical duplication of lab work is called: “diagnostic mock-up” or “ diagnostic template”.

Diagnostic mock-up is an easy, rapid procedure that gives us an instant feedback prior to treatment. It is considered a productive way of communication between the patient, dentist and the lab technician (ceramist). Also, mock-up allows the patient to be involved in treatment planning which leads us to gain the patient’s confidence. Since the patient had the opportunity to express his/her own thoughts regarding the dentist’s treatment plan they will be highly cooperative in treatments that require long or multiple appointments and they’ll also feel responsible of the end result that they have chosen. Even mock-ups help in controlling the time and money by avoiding the repetition of steps especially the final result. In addition, seeing the desired changes clinically in a reversible manner allow the dentist to test the patient’s rest and smile position, occlusion, verify the contour, angulation, length, shade of teeth and phonetics.

Diagnostic wax-up can be used for diagnosing and planning the treatment of dentate patients, partially edentulous patients, and completely edentulous patients by setting the denture teeth or waxed teeth in a wax media. Wax-up can also be utilized as a treatment tool as forming radiographic and surgical implant placement guide in edentulous spaces, or forming a matrix to be used as a guide for amount of reduction during teeth preparation or for creating provisional restorations.

Techniques:

There are three ways of preparing the diagnostic mock-up:

A) “ Preliminary diagnostic mock-up” or “ free hand direct mock-up in composite”

B) “Secondary diagnostic mock-up” or “ mock-up according to the wax-up with self curing resin”

C) “CAD/CAM” or “ modern digital design mock-ups” or “ computer imaging simulation”.

“ Preliminary diagnostic mock-up” or “ free hand direct mock-up in composite”

This is a simple chair sided technique which is done at the initial appointments using an un-cured composite resin. It is totally reversible mock-up procedure were teeth are not etched nor bonded to the restoration.

Simply, composite resin, restorative material, with some degree of shade matching is contoured on the teeth intra-orally according to the planned shape and position of teeth. Then mock-up is evaluated while it’s still malleable in different lip position, phonetics, assessing the degree of integration with the face and lips. After adjustments are performed, composite is polymerized “ cured”. Next, photographs and impressions are taken to document the new smile design. Finally, composite mock-up is easily flacked off and sent to the lab along with the cast as a guide for the wax-up.

The main disadvantage of this mock-up technique is it’s high cost of composite specially if it’s used frequently. Also, some sort of difficulty is faced for quickly contouring the composite.

“Secondary diagnostic mock-up” or “ mock-up according to the wax-up with self curing resin”

On the other hand, the second technique, which is used to form the mock-up, is by making an impression using an irreversible colloid impression then pouring it to get the positive replica of the teeth. By the aid of the articulator the casts are then mounted according to the face bow record. Next, the wax-up is built, taking into consideration all needed elements in a smile design, such as: gingival zenith, gingival architecture, teeth shape, proportion, axial inclination and embrasures.

Once the dentist and the patient are satisfied with the wax-up, then it’s time to review it intra-orally. From the wax-up we create a matrix using either Polyvinyl Siloxane putty material to form what is called “ silicone key” or fabricating “ vacuum –formed splint”.

On the patient’s teeth and surrounding gingiva we place a layer of petroleum jelly then it’s thinned with air, for the ease of removal afterwards. According to the period of time that the dentist wants the mock-up to stay in the patient’s mouth, the selection of the material relies. In case the mock-up is needed to be left home with then we fill it with a long standing material such as stained linked acrylic resin or if it’s made to be tried for a short period in the clinic as most cases, then we fill the matrix with “ flowable composite” or “auto-cure resin”.

The matrix is placed on the patient’s teeth until it’s fully polymerized. Excess material is trimmed form the gingival margins. Immediately the patient will able to see the proposed result and the clinician will have the opportunity to assess the contour of the restoration, along with length and inclination of teeth, occlusal plan, teeth relation with the upper and lower lips at rest and smile positions, phonetics, and the relation of the patient’s face with the teeth shape overall. At the end, simply a hand instrument detaches the mock-up.

“CAD/CAM” or “ modern digital design mock-ups” or “ computer imaging simulation”.

The classical way of providing a diagnostic wax-up and mock-up prior to the treatment in which wax-up is transferred to the patient’s mouth by the aid of silicone index and auto-polymerizing resin is time consuming and produces only one version of the treatment outcome. Therefore, digital smile design (DSD) has been provided to overcome the disadvantage and limitations of the classical method.

Recently many practitioners are shifting from the conventional method to the use of virtual technology, since what we all aim to regarding: providing the standard care for patient, reduction of operator’s errors are all achievable. Computer-aided design (CAD) and computer aided manufacturing (CAM); made it easier for both dentist and technician, reduced the time spent in the clinic and laboratory, improved the final mock-up accuracy and reproducibility and produces a very high terminal esthetic result. In addition, the software tools offer various tooth shapes according to the size, patient’s age, phenotype. Also, digital smile design (DSD) considers certain important facial reference plane for manipulating the design. A further benefit is the possibility to modify the initial design and to freedomly generate multiple future restorations in a skillful way.

On the other hand, there are some shortcomings of using DSD such as: the waste of considerable amount of material, being unable to establish a geometry which lies bellow the milling bur diameter and the difficulty of producing a mass component. Even, initially economic investment is needed to purchase the hardware also time and effort is needed to master the work with the design software.

Beside this, correct digital planning requires precise photographs, otherwise inadequate photos will distort the reference image and result in an incorrect diagnosis and planning. Despite these drawbacks of DSD, virtual technology is evolving and it is unstoppable phenomenon which continue to improve and will surely push the dental standards even higher.

Steps: The anatomical data of the patient’s jaws is either obtained by: inserting an intra-oral optical scanner to directly capture the data or by scanning digitally the patient’s cast using a laboratory optical scanner. In both ways, data collected is then transferred to software for designing dental restoration. By the aid of the software, the intra-oral scanned data can be added with the patient’s 3D-facial images; to produce “ Virtual Patient Model (VPM)”. Also, virtual articulators have also been developed in (CAD/CAM); to simulate jaw movements.

Once the VPM have been produced, face is analyzed after placing the reference lines in relation to the smile. Then, the frameworks of smile “ lips” are outlined in the software. Smile analysis relies on certain references as: incisal edge position, midline symmetry, gingival margins and contour. Eventually, teeth that will be restored are designed based on the size, shape and color. Also teeth alignment and inclination are adjusted to eliminate the dark corridors and to get an adequate embrasure space, contact points and areas. Finally, teeth color and translucency are established to finalize the smile.

Once the digital proposed plan has been approved by the clinician and the patient, mock-ups are immediately milled and tried in. Patient can evaluate the new design function and esthetic to inform his/her dentist of any modifications needed. Changes are done if required or if not then mock-ups are scanned and definitive restorations will be fabricated in very short time with great accuracy.

Comprehensive esthetic treatment requires careful assessment, planning, and multi-disciplinary approach. Therefore, when planning to change a patient’s smile, diagnostic wax-up and mock-up are the most important tools. As have been noted, the various benefits of mock-up when designing a smile includes: easy way of communication between the patient – dentist – lab technician, aid in fabrication of provisional restorations, allows the patient and dentist to evaluate the new smile design from more than one perspective and it saves money and time by avoiding the multiple repetition of the final restorations. These diagnostic mock-ups can be produced in three ways: free hand direct mock-up in composite, mock-up according to the wax-up and CAD/CAM. Each method has it’s own laboratory steps, materials, advantages and disadvantages, in which technique selection depend on the availability of modern equipment in the clinic as well the case difficulty. When planning a procedure we should look forward to achieve the greatest standard of care to the patient, aim to dramatically reduce the operator’s errors, since at the end the success of treatment relies on the patient’s satisfaction.

Oral wellbeing and esthetics have become a major concern among the population for more systemic health and advancement. A standout amongst the most widely prevailing dental problems being malposition of teeth, a questionnaire survey was conducted to evaluate the awareness of orthodontic treatment among general dentist and non-orthodontic specialist. The questions asked in the questionnaire were 14 in number related to diagnosis and treatment planning in orthodontics. It was sent to 103 general dentist and non-orthodontic specialist. The scores where analyzed. The results were moderately satisfying and suggested more of clinical oriented teaching and training in terms of orthodontic principles and practices.

This study consisted of participants who were both general dentists and non-orthodontic specialties with a post graduate degree in any major of dentistry other than orthodontics. The study was conducted among the participants who were selected all over Chennai, to study the awareness towards the principle and practice of clinical orthodontic treatment. The concept of this study was made aware to all the participants through telephone and their consent was obtained. The questions were framed to assess the awareness in orthodontic therapy like diagnosis, malocclusions when patient visits the clinic, orthodontic treatment in periodontally compromised patients, retention following orthodontic treatment, functional appliance, opinion of orthodontist. The questions were circulated online to all the participants. Total number of response got was 103, all the obtained score were calculated based on the responses given by participants and thereby the total score was obtained. Data was analyzed and descriptive statistics were carried out.

The participants were 103 in number comprising both of general dentists and non-orthodontic specialists. According to the participants, the ideal age for treating malocclusion was 8-9years.

When the dentists were questioned about the knowledge on skeletal and dental malocclusion 96.1% answered positively. About 60.2% of them expect their patients to report for orthodontic treatment only after all the permanents erupt wherein 39.8% were against the same.Advising for functional appliance, 74.5% prefer before the eruption of second molars and 25.5 prefer after the eruption of second molars. 95.1% check for the molar relation for the patients before the treatment on a regular diagnosis manner and 4.9%denied the same. Extraction being more common to correct malocclusion, when asked to the participants 88.3% denied the fact that extraction was not compulsory and it purely depends on the type of case and patients chief complaint.

The general dentists and non-orthodontic specialist were questioned to find out if they thought that periodontally compromised patients cannot undergo orthodontic treatment but surprisingly 66%denied and only 34% felt that periodontally compromised patients cannot undergo orthodontic treatment.

When asked for whether patients who were missing their posteriors can undergo orthodontic treatment, 80.4% were affirmative and 19.6% were against.

In recent time, clear aligners have taken over and when asked for the awareness of clear aligners, 88.2% were aware and 11.8% was unaware.

92.2% believe that orthodontic treatment has influence on TMJ and 83..5% thinks that orthodontic treatment can solve previously present TMJ problems.

When asked about retention following fixed orthodontic treatment 99% were positive and preference of using the retainers were widely varied in duration from 3mnths to lifelong.

Finally, 96.1% general dentist and non-orthodontic specialist prefer a specialist (orthodontist) to treat the patients who have their chief complaint of malocclusion.

Malocclusion being the second most common problem following dental caries in young adults n kids, and also esthetics being of major concern amelioration of malocclusion is important. The basic component behind orthodontic treatment being diagnosis and treatment planning this questionnaire survey was conducted among general dentists and non-orthodontic specialists to assess the awareness and knowledge in the branch of orthodontics. The results at the end of the questionnaire survey was moderately satisfied.

Visiting Dentist: How I Have Chosen My Future Career

After I graduate high school, I plan on pursuing a career as a pediatric dentist. I chose this because I enjoy children and would love to get the opportunity to help them; this career can help me do that. I want to be a pediatric dentist because I know how important dental hygiene is, and I want to be the one who helps these children and makes them enjoy going to the dentist. I want every child to experience the dentist as I did, an exuberant place. Not a place that is frightening to them.

Ever since I was younger I always felt as though I would want to become a dentist and that I would be a good one. Visiting my dentist and seeing how he would help so many children for them to have a better life, fixing cavities, putting in fillings. I also think this would be an interesting and exciting career. When I look at someone one thing I’ll notice is their smile or teeth. I want to help children have healthier teeth and maintain healthy teeth in order to prevent them from getting cavities so they can feel confident about their smiles.

When I was younger, my visits to the dentist would always be enjoyable; I loved visiting the dentist. I can still remember sitting on the couch waiting to get my X-rays. I always had to wait a little while because we would do our X-rays from oldest to youngest ( I was the second youngest out of my five siblings). Then when it’s finally my turn for an X-ray, which they just called it pictures not to scare us, they would put the seat down and help me up. Then they would slowly crank it back up and put the vest on me. After taking my “pictures” I would then sit on the couch again and wait my turn to get my teeth cleaned. Finally, when it was my turn I’d sit in that seat waiting for my dentist to come to look at my teeth. I’d answer the same questions every time “Are you brushing at night?”, “Yes Sir”. “Are you flossing?”, “Sometimes”. Then they’d proceed to tell me to make sure I floss at least twice a week. After getting my teeth checked and polished I would get to pick out my toothpaste. There were so many choices, yet I got the same one each time, bubblegum. After they were finished brushing my teeth I got to pick out a toy. This was probably why I liked going to the dentist so much because I knew every time I’d go I would get to pick out a toy I wanted. There were so many options to choose from: bracelets, bouncy balls, little rubber ducks, cars, etc. You name it they had it. I also enjoyed going there because they were very nice to me, and always made my time there fun. These were life-changing experiences for me that made me want to become a dentist. My dentist inspired me by the way he was able to help so many children.

A dentist examines and treats disease or injury to teeth and gums. There is always going to be a need for a dentist because everybody has teeth, who do you go see if you have a bad toothache that doesn’t go away or if you chipped a tooth? A dentist. “There will always be a demand for primary care physicians, nurses, and dentists, but one distinguishing factor about dentistry is that generally speaking, fifty percent of the population does not have a dentist in three years. That means fifty percent of the population is underserved by a dentist; that figure presents a huge opportunity for professional dental growth.” This was said by Gregory Cumberford, DDS, GPR. Dentists make a high salary, so if all of the people who weren’t visiting the dentist would make appointments, this would raise the amount of money they make, and in return, there would be a larger need for dentists. They are also expecting the demand for dentists to grow about sixteen percent by the year 2022 because many dentists are expected to retire in the next decade.

The salary of a dentist is relatively large compared to other occupations. The salary of a dentist in Louisiana ranges from $125,300 to $164,090, with the average being about $140,324. Salaries can also vary depending on the city you work in, your education, certifications, other skills, and the number of years you’ve spent in that profession. A Pediatric Dentist’s median salary is about the same as a regular dentist’s, it’s $142,350, while the high is $241,995. Being a dentist has many benefits, one of them is that once you become a dentist you can specialize in whatever area of dentistry you want to. You also have a bit of freedom and flexibility most dentists are their own bosses and make up their own schedules.

Most people say that they would never want to be a dentist, much less a pediatric dentist. Having to examine and clean teeth when they may not be clean, or their breath may stink. Also dealing with children, they may get scared, cry, or they may even bite. However, I was never one of these people, we don’t ever really think about how much we need our teeth. We use our teeth to eat our food, and also we use them to speak. If you try saying thirty-three thieves thundered through thick thorns, without your tongue touching your top teeth; it’s hard. This is why we need to take care of our teeth.

When I was younger I never had any cavities thanks to my doctor. That really helped my self-esteem knowing that I had healthy teeth. I must admit being a pediatric dentist may be hard at times though. When your patients are adults you can ask them questions and they can respond and let you know what’s wrong. When working with children it may sometimes be harder because they can’t always tell you what the problem is. Being a pediatric dentist you have to deal with the parents, and sometimes the parents think they know what’s best for the child. Even though you may think a certain treatment might be better for the child, you have to respect the parent’s decision.

Pediatric dentists provide services such as teeth cleaning and polishing. They administer dental sealants and fluoride treatments that prevent tooth decay; also they diagnose future problems the patient may be at risk. A full-time pediatric dentist spends around thirty-six hours a week at work and thirty-three of those hours are spent with patients. Most people who are going to be a pediatric dentist first get a bachelor’s degree which is four years, then attend a dental school which is four years, and then go for an additional two years to specialize as a pediatric dentist. Admission to dental school is very competitive and there are only sixty-six dental schools in the United States. “The two to three extra years of training focuses on the treatment of developing teeth, child behavior, and psychology, making children feel comfortable, child’s physical growth, and special requirements of children’s dentistry.” They also receive training for special needs children.

As part of our senior project, we were required to job shadow a person in the particular profession we would like to go into. I had the opportunity to shadow some of the dentists/ dental hygienists at the very own dentist’s office I have been visiting since I was younger, in Opelousas. I observed several different people while they worked with patients, one of them was Toni Torres, a dental hygienist. She had to help take x-rays on the children, first, she explained to them what they were going to be doing. She then proceeded to fix the machine so she could get a clear picture of their teeth. They had trouble with one child, it was her first time taking x-rays and she was nervous. She would move her tongue and bite down too hard causing the picture to not be visible. After a couple of tries, they eventually got a clear x-ray. She had to be patient with the little girl while trying to take the x-rays; she also had to make sure the little girl wouldn’t get scared because that would cause her to cry, causing a larger problem. Most of what Dr. Torres did was polish teeth and administer fluoride to children’s teeth.

I also had the opportunity to shadow Dr. Whitney, a recent graduate of dental school, who went two extra years to specialize as a pediatric dentist. I looked at x-rays, while she explained to me what I was looking at. She showed me x-rays of a patient from that day and then from six months ago; you could see where the cavity was now and how it wasn’t there six months ago. While I was there a child came in who needed a filling and two silver caps. She started off by numbing his mouth, she told him she was about to squirt her water and he needed to close his eyes so she didn’t get it in them. She then proceeded to give him a numbing shot, they tell them it was water not to scare them. After about eight minutes his mouth was numb and she started working on the filling. Once she put the filling in I handed her the LED curing light I was holding, and she turned it on and put it over the filling. The curing light makes the filling hard so it doesn’t fall out.

After doing the filling it was time to work on the silver caps, she had to try several different caps to find the ones that fit perfectly. Once she found the right ones, they put the glue on them and pushed on the teeth. While doing these the little boy moved a lot and would try to close his mouth so it took Dr. Whitney a little longer than usual. After she was finished she talked to me about schooling. She said how she had to go the two extra years to get special training for children and the two extra years allowed her to be able to put the children to sleep while she was working on them if she needs to.

Some of the pros of being a pediatric dentist are that you have a good income, and you get to be your own boss. Also, you get respect, dentist are generally highly trusted and respected. If you like to work with people, being a dentist is a great job for you because you have a lot of patients to work with. Being a dentist you do a variety of different jobs that may be challenging and interesting; no two days are the same. There is always excitement, while working with children there is never a dull moment. Being your own boss you are able to make your own hours, so you will be able to work the hours you want. Pediatric dentists get the chance to offer solutions that can fix problems with their patients. Creativity is often used while trying to solve problems, most pediatric dentists are creative. Being a dentist there will always be a demand for dental services.

Some of the cons of being a pediatric dentist are that the education you need to become a pediatric dentist takes ten years. The schooling is long and getting into dental school is very competitive. The costs of the ten years of school are fairly expensive; you have to pay tuition at college for the four years it takes to get a bachelor’s degree, and also the four years of dental school plus the two years to specialize in pediatrics. Being a pediatric dentist comes with high responsibility, you are in charge of a child’s health; this can also lead to stress. Having the keep the patients happy, and having pressure on you to do your best can be very stressful and overwhelming at times. Opening up your practice can be expensive, this is part of the reason why it costs so much to go to the dentist. Being a pediatric dentist you have to deal with some patients with bad breath or gross mouths. After you have been working a while you will get used to it, but at first, it can be challenging.

There are several physical stresses and risks that come with being a pediatric dentist. It takes a toll on your body, you’re either on your feet or sitting in an uncomfortable chair. Pediatric dentists are trying to work and see in small places and they are often contorted for long periods of time. Hearing the constant high-pitched buzzing sound of a drill can lead to hearing loss in some dentists. However, there are stretches and daily exercises to help with the muscle pain, and massages help heal the muscles. Also to prevent hearing loss dentists can wear earplugs, although several of them do not.

Surprisingly dentists have one of the highest suicide rates, up there with farmers. This might be due to the fact that a study in 2015 by the American Dental Association showed that “eleven percent of dentists responding were diagnosed with depression, while the rate for the general population was 6.7 percent. Six percent of dentists surveyed had an anxiety disorder while only 3.1 percent of the general population did. Four percent of dentists reported panic disorder, while only 2.7 percent of the general population reported the same.” Several dentists suffer from stress, this stress can lead to depression, anxiety, panicking, and other emotional problems.

Before deciding to be a dentist many people don’t consider all the pros and cons. Many people only get to see the good side of it; maybe because that’s all the dentist wants you to see or maybe not. It’s not always happy and stress-free, being a pediatric dentist you have to love your job. You can’t just be in it for the money, you have to be in it to help people. Working with children they can tell if you don’t want to be working with them, so you have to always be cheerful and interact with them and make them feel comfortable.

After graduating high school, I plan to attend Louisiana State University in Baton Rouge. In my freshman year, I will live in a dorm because incoming freshmen have to. After I plan on renting an apartment with a friend or friends. While attending LSU, as of right now I am planning on getting a bachelor’s degree in biology, but there are other majors I may consider. If I get a biology degree it will take me four years to achieve that degree. After graduating from Louisiana State University in Baton Rouge, I will be going to dental school in New Orleans at the School of Dentistry at LSU Health. I will move out to New Orleans while attending dental school, which is four years plus two extra years to specialize as a pediatric dentist.

The medical field has always interested me ever since my mother became a nurse and took me to bring your kid to work day. Since then I always imagine myself as a nurse; helping people feel better. It wasn’t until I started college and taking my prerequisites that reality settled in. I discovered that I couldn’t handle the sight of blood and the inner workings of the human body without feeling nausea. After rethinking my career path I found my passion for dental hygiene while doing an internship in a dental office.

I always wanted to make a lasting difference in people’s lives. In the dental field, you’re educating the public about the importance of oral health and easing their minds on both serious and non-serious procedures. Not to mention it’s a field that is high in demand. Most dental careers have a high job growth rate for the next ten years. You can specialize in your field of work according to what your interests are. There are many career avenues like orthodontist or hygienist. Not many career fields have set hours like in the dental field. Most offices are open Monday through Friday with the hours of 8 am to 5 pm. Giving you the time to raise a family, which is very important to me. Also making lasting connections with the patients is another reason why I’m attracted to the dental field. Successful offices make their patients feel like family. Lastly, in this field, every day isn’t like the last. You’re constantly having new experiences and meeting new people so, it’s never boring.

The reasons why I believe my personality will be a great fit for working at a dental office are my high work ethic, my love of learning new skills, I’m well organized, pay attention to details and my people skills. I’m constantly getting high praise from my supervisors and boss on my work ethic. I make sure my work is done on time and done accurately. I also help out where I’m needed the most without being asked to. Make sure to get clarification on tasks I’m not too sure on. Exceedingly open to learning new skills that I may not necessarily need to know for my job title, but will help the company run better. For any medical office to be successful the employees have to be well organized with all the paperwork and records in-trusted to be filled correctly. My attention to details will come in handy when verifying patient’s records and procedures. Most importantly, my people, skill are essential to a dental office because many people don’t have dental insurance or have the money to spend on dental care. It’s all about making people feeling welcomed and important so they keep on coming back.

The steps that I have taken in order to be ready to work in a dental office are first, shadowing at a dental office, second bring my experience of running the front desk at Smile Wide dental office with my ten plus years customer service experience, and lastly is applying to this course. I shadowed at a local dental office in Durham for a month. The office manager Pam allowed me to shadow the hygienist and dental assistant. I even got to shadow the dentist for a few days and ask him questions found it very informative. I plan on shadowing another office in the summer and one more when I get into the program. I feel the more offices I can shadow at the better equipped I’ll be because each office is run slightly different. I have training in medical administrative assisting in which I have worked in a dental office for two years till the dentist relocated to Florida. I feel this experience helps me stand out and better understand the material covered in this course. This program has high reviews from alumni students. They stated they retain all the trained, they revived and felt more than prepared for the workforce. Most of them found jobs after graduating. So if I get into this program I feel it will be the best step towards getting ready to work at a dental office.

I understand that this is an accelerated course in which it isn’t like a typical college course. We will be learning many different skills in a shorter amount of time. Therefore, attendance and studying are key to being successful. We won’t be readdressing materials as we progress or have the time to build on what was already addressed. It is up to us, the students if we succeed or fail by putting in the time both in class and outside of class.

The purpose of this essay is to provide basic knowledge for dental students and dental practitioners regarding management of pregnant patients in a dental clinic. A pregnant female require substantial care, medical monitoring and emotional assistance and it is strongly recommended that a thorough oral health assessment is to be carried out for pregnant females. It is also important for a dentist to know and take measures according to patient’s condition such as alteration in the medication and deference of certain elective treatments that may coincide with the organogenesis phase of the fetus and it is recommended that the practitioner consults with the patient’s obstetrician.

Human gestation is a period of dynamic physiologic changes designed to support the developing fetus. Systems affected are respiratory, gastrointestinal system, circulatory system, and musculoskeletal. These alterations influence the patient’s general health and make her prone to develop complications unique to pregnancy. The alterations that occur during pregnancy are due to an increase in maternal and fetal requirements for the growth of the fetus and the preparation of the mother for delivery. Both systemic, as well as local physiologic changes occur at the time of pregnancy. A noticeable increase in secretion of estrogen and progesterone is seen by up-to 10 and 30 times respectively.45% of pregnant females have gestational diabetes because pregnant women are unable to produce sufficient amounts of insulin to overcome the antagonistic action of estrogen and progesterone. These changes in hormonal levels affect most of the organ systems including oral cavity. Bacterial flora of the oral cavity changes with the change in hormone levels and these changes support the occurrence of pyogenic granulomas and disease process in periodontium.

A Pregnant woman requires various levels of dental support throughout this time and the dentists therefore must understand the requirement of the pregnant patient and improvise the treatment plan and should not perform those procedures which could require multiple dental radiographs and medications which could be harmful to the fetus unless it is an acute infection and cannot be deferred. For the protection of both the mother and unborn child, dental professional may need to incorporate maternal counseling, changes in treatment modalities, or changes to their customary medication repertoire.

Gingivitis and pregnancy associated hyperplasia are the common mucosal changes reported. Pyogenic granulomas and alterations in the saliva have been reported and are related to the elevated levels of estrogen causing an increase in the permeability of blood capillaries. This increased permeability results in accumulation of inflammatory factors. Pregnancy actually exaggerates pre-existing diseases rather than causing it. A typical lesion of periodontium that appears is pregnancy is epulis, it is a type of pyogenic granuloma which is characterized by a dark red, swollen and smooth gingival tissue which bleeds easily. The increased level of salivary estrogen, the proliferation and desquamation of the oral mucosal cells provide a suitable environment for bacterial growth which also predisposes the pregnant woman to dental caries.

It has been theorized that the endotoxins from periodontal inflammation are risk factors and cause a stimulation of the production of cytokines and prostaglandins. Such pro-inflammatory mediators could cross the placenta barrier and may induce fetal toxicity that can result in preterm delivery and low-birth-weight. Chemical mediators involved in maternal periodontitis have also been reported as a strong risk factor of preterm low birth weight and improving periodontal health before or during pregnancy may prevent or reduce the occurrences of adverse pregnancy outcomes and leads to reduction of the maternal and perinatal morbidity and mortality but such cause to effect is yet to be proven as no such relationship has been established between periodontal disease and preterm low birth weight.

It is advisable that during the first trimester, oral health status is assessed and the patient is informed about the changes which they might encounter during the pregnancy. Knowledge about the regulation of these changes should also be outlined, if they occur. Patients also must be educated and the dental treatment should be done if possible, should be restricted to prophylaxis and emergency treatment where possible. Dental radiography for pregnant females is considered safe during pregnancy if protective measures have been provided which include thyroid collar, Lead apron and use of high speed E films. No fetal abnormalities have been reported to x-ray radiation values of 5-10 cGy and a complete set of full mouth radiographs results in radiation exposure of value 8 × 10–4 cGy. The highest risk to the fetus from teratogenicities is during the first 10 days after the conception. Spontaneous abortions have been reported in various studies during first trimester when dental treatment were received by the patient15,16. Organogenesis phase is completed by the end of first trimester and the second trimester is reported to be the safest time to carry out minor elective dental treatment, but some unavoidable dental emergencies such as acute pain and infections should be addressed at any stage of pregnancy to avoid patient discomfort. Treatments that take longer time to complete the procedure and require any elective surgical intervention must be postponed until delivery has taken place.

Dental chair position should be controlled and monitored while working because when uterus expands it lies right over dorsal aorta and vena cava. These may get compressed when patient is in supine position resulting in reduction of cardiac output, venous return and uteroplacental blood flow. An Aortrocaval compression leads to supine hypotensive syndrome and this syndrome is characterized by weakness, restlessness, sweating, pallor and tinnitus. This situation is managed turning the patient on her left side and placing a pillow to elevate her right hip and buttock by about. Strict precautions should be taken during the second month of the third trimester, procedures should be avoided where possible. The rest of the period of the third trimester is safe for elective dental procedures that do not require surgical intervention. Protocols followed for dental radiography are the same as for the first trimester and peri-apical and bitewing radiographs can be taken with protection protocols.

During pregnancy the serum plasma concentration is reduced, lipid solubility increased and low plasma half-life, therefore the prescribed drugs are easily absorbed, distributed and cleared from the system as compared to a non-pregnant female. All these factors leads to increased transfer of drugs from mother to fetus via placenta which can culminate and cause potential miscarriage, low birth weight, neonatal toxicity and teratogenicity which raises the chances of morbidity and mortality of the unborn child19-22. Food and Drug Administration (FDA) has classified drugs on basis of their risk to mother and developing fetus during pregnancy into various categories.

When prescribing antibiotics to a pregnant woman, amoxicillin and penicillin V are the safest drugs and the most common drugs and these are classified as class B. Tetracycline and Doxycycline are categorized in class D because these affect teeth and bone development. Arthopathy and congenital cartilage defects are reported in animals with use of Ciprofloxacin but there are not sufficient evidence among human studies thus categorized in class C23.

Paracetamol (Acetaminophen) is a relative safer drug for pain management of a pregnant patient as compared to Aspirin and has no negative effects reported so far but prolong use of acetaminophen with narcotics have shown neonatal respiratory depression24.Use of acetaminophen in adults may cause livers toxicity and dosage should not exceed more than 4gm/day. Most of the analgesics which are prescribed to normal adults are categorized as class C for pregnant patients however there use is not absolutely contraindicated as there are no studies reflecting that they affect fetus but use of Class C drugs should be of short duration. Use of Ibuprofen has been associated with fetal ductus arteriosus and inhibition of labor in third trimester thus categorized as class D but for first and second trimester it is categorized as class B25 (Table 2).

Local anesthetic agents can be used during pregnancy. Lidocane 2%, Prilocane and Etidocane are classified by FDA as safe anesthetic agents but there use should be monitored and should not exceed maximum recommended dose. Mepivicane 3%, Procaine and Articane can also be used but with caution and consent of obstetrician and should be avoided if any their alternate is available. Epinephrine is a class C drug, theoretically if injected intravenously it might obstruct uteroplacental blood flow, which can be prevented by slowly injecting local anesthesia using aspirating needle and limiting to a minimum dose required.

American Dental Association (ADA), FDA and WHO have classified amalgam restorations to be safe for pregnant patients requiring cavity restorations even though the dental community is uncertain about the use of dental amalgam. It has mercury metal alloy, consisting of 50% of organic mercury. Dental amalgam restorations release mercury vapors (a form of inorganic mercury) in the oral cavity especially during chewing. This released mercury could cross the placental barrier through blood circulation. Although no such evidence has been found or is yet to be reported that it is harmful during the pregnancy and many concerns can be effectively managed with the application of dental rubber dam during restorative procedures. Composite resins and glass ionomer cements can also be used for restorations however, it was observed that bisphenol-A, a component present in composite resins, results in endocrine disruptions in animals.

Procedures which require gingivectomy should be done with caution and could raise a concern for a dentist while treating the patient as it may lead to bacteremia. Literature does not provide sufficient evidence to support the concern but pregnant patients may be given prophylactic antibiotic coverage if there is risk of developing infective endocarditis. In a controlled clinical trial, 1806 women were randomized to get scaling and root planning. Patients who were assigned to get delayed periodontal treatment until after birth showed a worsening of their periodontal status over the course of pregnancy. No significant correlation could be found between groups who had birth complications in relation to periodontal infection and the treatment provided for the disease. Nevertheless periodontal therapy should be provided either antenatal or during a safe pregnancy period and should be restricted to supra gingival scaling and polishing where possible.

First trimester (conception to 14th week): The most critical period of rapid cell division and active organogenesis occur between the second and the eighth week of post conception. Therefore, the higher risk of susceptibility to stress and teratogens occurs during this time and 50% to 75% of all spontaneous abortions occur during this period.

Organogenesis is completed and therefore the risk to the fetus is low. Some elective and emergency dental procedures are more safely accomplished during the second trimester.

Although there is no risk to the fetus during this trimester, but pregnant female may experience higher level of discomfort. Short dental appointments for treatment should be scheduled with appropriate positioning while in the chair to prevent supine hypotension. The safe time to perform routine dental treatment is the early part of the third trimester, but from the middle of the third trimester routine dental procedures should be avoided.

It is important that a Dentist-Obstetrician-Patient interface is well established while formulating a treatment plan for pregnant patients so that the chances of complications to occur can be significantly reduced for a better results. It is necessary that health professionals collaborate to ensure that such patients receive thorough oral health assessment, intervention as well as oral health education. The dentist must gain basic understanding of the physiological changes and influences that may occur during pregnancy with the use of certain medications and dental procedures and with use of dental radiography. Oral and maxillofacial surgeons should be consulted if there is an emergency involving trauma and severe dental infections. Active treatment in pregnant females should be focused towards improving the maternal oral and general health with minimum fetal risk.

Dentistry is about working diligently and amicably, whilst keeping the patient’s best interest at heart. It was after receiving orthodontic treatment and being able to personally experience the power that excellent dental work can have, both aesthetically and emotionally, that fuelled my desire to become a dentist. In addition to this, becoming a dentist would allow me to explore human oral biology further and combine my intricate manual dexterity whilst also actively improve our society’s welfare.

Reading an article from The Times about the rising cleft palate abortion rates has stimulated my interest in oral maxillofacial surgery; I enrolled in a one-week placement at Huddersfield Royal Infirmary. I was amazed at how epileptic pregnant women using topiramate or valproic acid medication have an increased risk of having a baby with a cleft lip as well as other birth defects. Subsequently, I enrolled in a FutureLearn Online Course regarding paediatric dentistry to consolidate my knowledge of oral birth defects. I delved into a range of oral abnormalities such as problems affecting the oral mucosa and major oral traumas. This reiterated that dentistry is an ongoing learning process, requiring consistent reading on research to ensure best patient practice.

On a placement at Smile Orchard, I appreciated the crucial value of teamwork between dental nurses and senior dentists; the significance of communication between senior dentists was emphasised when an agitated patient who was confused about treatment for his decaying tooth came in. I learnt that comforting patients can improve adherence to recommended treatment. Patients are more likely to disclose information if they trust their dentist and the quality of interaction improves, resulting in shared decision-making. Aside from treatments, I valued the importance of oral healthcare advice given to patients from their dentist as preventative care is significant in ensuring healthy teeth. After I identified the decayed tooth in the patient’s lower first molar it fuelled me to broaden my oral scientific knowledge further. I read “Crawson’s essentials of oral pathology and oral medicine” to strengthen my understanding of common gum diseases. Intrigued by how gastroesophageal reflux disease can cause tooth loss over time to vulnerable groups such as smokers, I gave a presentation to my community about the dangers of continuing to smoke, especially around their children.

A clear line of communication between a dentist and their patient is essential to capture patient’s medical history and ensure accurate diagnosis. During my placement at Manningham Lane Dental Practice, a patient was unable to express her pain in her temporomandibular joint two days after her extraction and denture placement. I felt the situation might have been better handled using a verified translator application that doesn’t save or share data with any parties to ensure patient confidentiality.

Participating in NCS allowed me to employ teamwork skills whilst supporting a charity. As Project Manager, I evaluated team decisions critically whilst delivering my ideas, maximising my leadership skills – which I continue to do as Community Prefect at my school. I have a 3-year commitment to Henna design which requires long concentration, good manual dexterity and an eye for detail. Achieving Gold in the Senior Maths Challenge has driven my ability to deconstruct unfamiliar problems and by completing Access to Bristol, it has affirmed my desire to study dentistry in higher education.

Supporting minority groups against discrimination is an act I take pride in. I am able and willing to relate to many different people by educating others about the importance of Black History as well as speak out against discrimination of LGBT youths to school pupils. Likewise, through volunteering at an elderly care home I was able to well inform a dementia sufferer about the dangers of refusing to take prescribed medication. Through researching thoroughly and explaining why the rumours he’d heard were false and why he is encouraged to adhere to his medication, led to him eventually becoming fitter and more active. Being able to present the options and its side effects to the man highlighted the significance of autonomy – allowing a patient to make a well-informed choice.

Throughout my experiences, the ethnic mix of dentists I have met has failed to reflect the diverse community that dentistry offers. I aspire to use my academic capacity and strong community ethos to challenge this, by fulfilling the stimulating role of a dentist and giving my patients the confidence to smile. I intend on delivering exceptional healthcare for the benefit of social welfare and being involved in pioneering research that could shape the future of the dental field.

The sacrifices begin at the instant when those two pink lines show up, and many times ever sooner. As a saying goes ‘pregnancy is a beautiful time in a woman’s life, but it can also be one of the most stressful and tough one, despite how much she may love it.’ Pregnancy causes many changes in the physiology of the female patient. These alterations are sometimes subtle but can lead to disastrous complications if proper precautions are not taken during dental treatment. Hence, as a dental student, the first question that invades our minds would be how pregnancy conditions could affect the management of a dental patient?

First and foremost, the most visible changes in the oral cavity of a pregnant woman will be the changes in gum. For instances, the level of progesterone, a female hormone, projects drastically to 10 times higher than the normal level. This may enhance growth of certain bacteria that cause gingivitis. Because progesterone is a sex steroid hormone which plays a key role in the modulation of bacterial-host interactions. Besides, the immune system may work differently during pregnancy. This could change the way that the body reacts to the bacteria that cause gingivitis, causing their gums to be redder and bleed, particularly during brushing or flossing between teeth. All these changes are referred to as ‘pregnancy gingivitis’. Being a dentist, one should identify the cause, in this case, gum problems encountered by pregnant women are not due to the development of plaque, in fact, it is due to the increase in hormonal level during gestation. To minimize the effect of pregnancy gingivitis, a dentist should know that the clean their oral cavity and use antimicrobial mouth rinse to reduce inflammation of the gums effectively.

Subsequently, the other problem related to the gums during gestation is pregnancy granuloma. The changes occur at the later stage of pregnancy which is at the second trisemester. They are red nodules, typically found near the upper gum line, but can also be found elsewhere in the mouth. These growths bleed easily and can form an ulcer or crust over. Women with these growths usually have widespread pregnancy gingivitis. Although pregnancy granuloma often interferes when speaking and eating, it will disappear after labor. If a pregnant woman removes it about half the time, it will grow back afterwards. A dentist should privode professional teeth cleaning. However, if periodontal surgery needs to be done, it will be advised to postpone until after giving birth.

In some severe cases, the oral problems that develop in gums may certainly leads to tooth problems. When a pregnant woman leaves their periodontal disease untreated and undiagnosed, pregnancy may gradually worsen and as a result causing chronic gum infection. Gum is a layer of tissue that seal tightly around the tooth to support the bones and at the same time provide protection to the tooth. Gum gives protection by forming a barrier to prevent the invasion of bacteria into the root of the tooth. However, when the gum is infected seriously due to untreated pregnancy gingivitis, it can lead to tooth loss.

It is a known fact that not all pregnant women will experience morning sickness. For some women, morning sickness is a major symptom of pregnancy. Along with the nausea comes, the vomit will content large amount of hydrochloric acid which came from the stomach. The acidity of hydrochloric acid is very low ( pH1-2). If the acid is left in the mouth, it will probably cause enamel erosion especially at the back of the front tooth. A dentist should advise a pregnant woman to rinse her mouth after vomiting. Rinse with a mixture of water and baking soda, which is an alkaline solution, in order to reduce the acidity of her mouth. It is indispensably significant to not brush right away after vomiting, since the acid in your mouth will only help erode the teeth as you brush.

When a dental patient is pregnant, a dentist ought to advise her to not crave for sugary foods. Because most women may have unusual food cravings during gestation. A regular desire for sugary foods may increase the risk of tooth decay. If nothing but sweetness will satisfy your craving, try to sometimes choose healthier options such as fresh fruits.

These collective changes may pose various challenges in providing dental care for the pregnant patient. Treatment of the pregnant patient has the potential to affect the lives of two individuals (the mother and the unborn fetus). Certain principles must be considered in the treatment of the pregnant patients so that, it benefits to the mother while minimizing the risk to the fetus.