IV sedation can be fun – for the oral surgeon

September 13, 2013 By Trish Walraven 1 Comment

Haven’t you wondered what your patients experience when you send them to your most trusted oral surgeons? Here’s an in-depth video that explains the process of taking out their third molars:

I have to give the Awkward Spaceship sketch comedy group a HUGE thank-you for making this a top-notch, truly hilarious, dental-wanna-see video. I wish I could say I’ve seen a funnier skit or parody about dentistry but no one else even throws a paper ball anywhere close to where you guys throw ’em. So for now I’ll say congratulations and suggest a new challenge for Dentally Challenged:

Offering a smile makeover to someone whose teeth are the LEAST of their problems.

Serious tongue action

August 28, 2013 By Trish Walraven 3 Comments

Are you in a state of media overshock after this gratuitous display of tongue-adge on a certain video awards show? No? But it may give you pause to think about all the naughtiness that tongues present to you as a dental clinician on a daily basis.

Most tongues behave themselves very well when you’re working in their realm. It IS the tongue’s kingdom after all; the mouth is where this majestic muscle rules supremely, preventing any dangerous objects from being inhaled or swallowed. However, there are some tongues that simply won’t cooperate, no matter how much you comfort and reassure them. See if you recognize any of these personalities in the tongues you have worked with.

The Stalker

This is a tongue that hangs back, ominously, but sort of follows you a tiny bit, like it’s planning to MURDER you while you’re simply blowing an occlusal surface dry. It is the godfather of tongues, so you had better not refuse its offer of allowing you to LIVE.

The Fist

If you encounter The Fist, you will be lucky to gain power over it. Usually appears when you’re working on an upper posterior tooth. The tongue will ball up and tighten so hard that you cannot wedge anything, not even oxygen itself, between the tooth and the tongue.

The Dive Bomber

You know you’re working with a Dive Bomber tongue when the tip of it continuously pounds you from every direction. It wouldn’t be surprising at all if the patient were actually whistling downward and making the CRRR crash sound with every hit. Your dentistry may feel like the crumbled buildings in Space Invaders by the time this appointment is over.

The Wave

A tongue doing The Wave is bad. Not that it’s doing anything to get in your way, but when the ripple of peristaltic action starts quivering along the rim of the tongue, that usually means that the patient is about a half-second away from a gag and a wretch. Have your high-speed suction available for…um…incidentals.

The Bulldozer

Everyone has had experience with this tongue. It’s one big bully, pushing you around, scooping up the rubber dam clamp and pelting it against the wall before you even consider straightjacketing it with your square of latex. The Bulldozer will warp impression vinyl into a freakshow of “was that a human or an octopus?” when questioned by your lab, and is generally violent towards anything you try to put in the attached patient’s mouth.

The Lover

This tongue is so embarrassing! You’re working along, minding your manners, when it just sort-of slinks up the handle of your mouth mirror and begins pole dancing. Worst of all is seeing this happen to a straight male dentist by an apparently straight male patient who has no idea that his tongue is lovingly caressing the tools. You just. Can’t. Say. Anything. But your assistant will, after the appointment, behind your back. Or worse, to your face.

The Exorcist

I’ve only seen The Exorcist once. Okay, twice, but it was the same patient, and I would have never believed that a tongue could move like that unless I’d seen it with my own eyes. The Exorcist stands up, perfectly straight in the center of the mouth and slowly and continuously rotates in a clockwise direction while you’re cleaning the left side of the mouth, and then stops and begins rotating in the opposite direction when cleaning the other side. The only reason I didn’t call a priest was because the patient’s health history showed she was taking some major antidepressants and schizophrenia medications.

The Puppy Dog

Like a real puppy dog, this tongue is actually kind of cute. It bounces, following you around while you’re touring a patient’s mouth, stopping to sniff while you check the edge of an old amalgam, wagging its tail when you give it a little attention. It’ll even pee on itself if it gets nervous. Yeah, you’ve seen that submandibular salivary gland gleek squirt piddle.

The Cobra

The Cobra should be heeded, but it is more of a display than an actual threat. When a patient’s tongue slowly raises up and looks like a curved shield about to strike, get out your clarinet. It’s time for a little snake charming.

The Victim

This tongue acts like it’s been maimed and waterboarded, cowering in the back of the throat like it’s trying to make itself as small as possible. You actually feel sorry for The Victim, and find yourself trying to convince the patient that you’re not the dentist from The Marathon Man, which can cause some funny looks from the oblivious. One problem with The Victim is that it may end up consoling itself by acting out its former abuse and become The Lover. NOOOOOOOOOO!

And if this is the best tongue-in-cheek humor you’ve EVER READ you need to share it now. Oh that was bad. But share, because the world needs more tongue humor, at least.

Art and flossophy

June 5, 2013 By Trish Walraven 3 Comments

Hal Mayforth must really like dental floss. Therefore I like Hal Mayforth, and as much as I used to be an evangelical hygienist who preached that there was only ONE WAY to dental health, and that was through flossing, I have since become a little more ecumenical in my approach: there are many paths to righteousness. WaterPiks, Stimudents, Superfloss, Sonicares, Soft-Picks, angled flossing gizmos, they’re all okay in my book of holiness as long as patients aren’t looking all stagnant between their teeth when they visit our office.

In your office, you should still promote flossing as well, since it’s the gold standard of interdental cleaning, patients understand its necessity, and they’re expecting the lecture from you, but they still won’t do it, maybe.

Or maybe if you let something else do the talking, they might floss? That’s where Hal Mayforth comes in. He’s an illustrator whose style may already feel familiar to you. It should; he’s been doing this sort of thing for over 35 years. His keen humor might look really good in your operatories, in your reception area, along the walls, and it just so happens that he’s got a few prints for sale about dental health if you’re looking for a way to lift up the level of levity in your practice.

When he’s not tending to his teeth, Hal Mayforth is busy getting his work published in national magazines like Rolling Stone, The New York Times, The Wall Street Journal, Newsweek, Forbes and many others. You know, the ones who still actually print on paper. And his sketchbook is fun, too. I borrowed a couple of sketches from it to display below for you to enjoy, and mostly, for you to get a sense of his focus.

It would make me happy for you to Visit Hal’s website and take a look at his creativity. If for nothing else, you need a smile today.

And isn’t that what dentistry is really about?

Poetry for the dental soul

May 6, 2013 By Trish Walraven 3 Comments

You know how they say whatever you give to the universe, it will come back to you double? I shoulda been more careful….

This all started about a month ago, and it wasn’t even supposed to be a poem; more like silly prose set to music, but one thing led to another and the darn thing practically wrote itself. Not that it’s art in the sense of revealing the true nature of the human condition, but I thought it was pretty funny and so I shared my little ditty, “The Ballet of the Stray Hair” with a friend, who posted it over here at DentalEggs. You should go there, read it, and then continue on with this story.

Back already? Well, then.

A few weeks later, unsolicited, a little limerick popped up in my inbox from a professor at the college where I took my STATE BOARD EXAM! What do I do? I HAVE to publish it, right? Because if I don’t I’ll keep having those nightmares where my instructors find about a bajillion clicks of subgingival calculus and make me repeat my senior year over and over until finally I get to take my board exam and lo and behold the patient’s teeth are caked with green marijuana stain…. Wait, no, actually, that last part really did happen.

In the middle of all this, I was invited to the Townie Meeting, and something that didn’t happen in Vegas didn’t stay in Vegas. It came home as a bug in the back of my brain (it could have been in a worse place, admit it, you thought it!). One of DentalTown’s original masters of meter told me that there were thousands! yes thousands of dental haiku written years ago, almost forgotten behind the cobwebbed threads of the message boards. And I received permission to repost a few of them here.

Hey Universe… thank you?

On to the poetry now.

(be sure to click the link to see why this limerick’s subject is appropriate)

There practiced a dentist in Maine,
Who worked hard, hard as a train,
Esthetics was his love,
But he forgot to glove,
The Boards took his license again.

Dr. Raghu Puttaiah

These haiku are posted in the order of their original appearance. Think movie credits, but with only one actor. It’s kind of a soliloquy, actually.

OSHA training tape
must review for staff to watch
thrice I fall asleep

patient excited
will fix rotten teeth tuesday
oops forgot check book

open wide I say
the assistant turns to retch
oh god it’s anug

brown nubs, baked bean teeth
patient rinses with pepsi
between cigarettes

Lortab seven please
Ultracet is what you’ll get
no? then there’s the door

a long day for me
tears, red-faced child wants father
refer to pedo

“just so you know Doc,
I don’t like things in my mouth!”
Not even your brush?

your teeth are rotting
hurting, stinking, and all loose
“Can I get them bleached?”

two rough sedations
why did he eat that breakfast?
vomit in the sink

other doc’s patient
MFLI composite
should I steal him? No.

I hate most endo
boring snoring tedious
oh crap! broke a file.

started root canal
paid in full but won’t come back
on mom’s credit card

can you get it out?
well, there’s nothing left but root…
do I need a shot?

why do I do them?
the tooth is buried in bone
sadomasochist

zoom day white excel
left it in my trays too long
teeth are white, but ouch!

silver point canal
retreatment necessary
ultrasonic? yes.

perio abcess
white purulent exudate
debride and Trimox

smoke? get dry socket
I pack some gelfoam in there
maybe it helps some

appointments not kept
what is wrong with these people?
next time I’ll not show

what’s that dark shadow?
it’s peri-implantitis
periodontist

DENTURE PATIENT

This plate doesn’t fit!
he looks at the wall photo
I want ’em like that!

Immediate teeth
he wanted them yesterday
expects perfection

I don’t understand!
why is this taking so long?
this stuff makes me gag!

my old teeth were fine!
except that they were rotten…
“You should have brushed them”

EXTRACTIONS

cold steel and sunshine
former captive relinquished
clink clank shiny bowl

cotton gauze poultice
damming the flow of red life
platelets, activate

By no means is this collection complete! These were my favorite dental-themed haiku, and even though I didn’t check them carefully they all seem to follow the traditional 5-7-5 syllable rule. If you adored these like I do and want more from those who haven’t given me permission to share, go on over to this DentalTown thread, become a member if you haven’t already, enjoy the sometimes poignant ramblings of a bygone time, maybe even hold a revival and start a new poetry post if you’re inspired thusly.

And I promise, no more poems about hair from me!

UPDATE:

Darn! She made it private! what? The poem that I wrote. So I guess that means I’ll have to host it my own dang self here.

The ballet of the stray hair.

Watch my fingertips: nimbly they fly
along the lip line, touching on cusps
to steady their course
while their grasp guides a mirror and a probe.

Their orchestration is captured in full spectrum detail
Thanks to a pair of magnification loupes
And a headlight emanating from my third eye area.

Previously unnoticed, a black line of evil
begins to uncoil away from the mirror handle
and adheres itself to the tacky vermillion border.
The spectre of horror becomes threefold alarming
When I realize that the patient is a blonde.

At this point I’m not wondering of its origins
as much as trying to get rid of the hair
before the patient becomes aware.

My ring finger attacks
in its pale latex slicker.
Success! I have liftoff
And a wipe to the napkin
Surely means that the hair is gone.

Worky-work, cleanie-clean.
WTF? It’s back! This time on the tongue!
Damn that static cling.
The hair is mocking me.

Time to go all Wile E. Coyote on its ass.
Quick glance to the patient’s eyes.
Total obliviousness. Good.
The snare is laid
between my suction tip and modified pen grasp.

Crap. The hair went halfway IN the saliva ejector
and now it’s acting like a telephone cord
that doesn’t want to wind straight.
OMG. Hair s t r e t c h e s before it breaks.

Two big black hairs in my patient’s mouth.
Two big. Black. Alien hairs.
It’s time for a gauzy intervention.
“I got a little messy, here, let me clean you up!”
With the force of a primary tooth extraction
times two
the hairs are gone.
They are gone for sure
because I took the two pieces of gauze
over to the wastebasket
and personally dumped them
and checked my static latex fingers afterwards.

We both sigh.
Worky-work, cleanie-clean.
Really? A booger?
Hanging halfway out of the patient’s nose?

I sure hope that’s not someone else’s, too.

Patients: Floss Your $%#*^@# Teeth!

October 17, 2012 By Eva Watson 10 Comments

Now… don’t let the title of this piece make you cower into your stinky underpants drawer.

My intention is to simply explain the importance of why you lovely patients must floss your teeth. After seven years of clinical experience and seeing the outcome of a non-flossing lifestyle, my hope is that those reading this highly important dental topic will gain the vital understanding of flossing and how gum disease will affect your life.

Let’s start by me asking for your full attention by you getting your crusty, Starbucks-stained teeth out of your $8.00 latte you really can’t afford but feel the urge to economically consume every, single morning before you go to your soon-to-be outsourced job that just increased your dental insurance premium for a minute because here’s what I have to tell you.

Are you ready? Good.

If you don’t floss your gums will become a festering, disease-ridden, smorgasbord of unrelenting bacteria that will ultimately make your gingivae bleed in buckets every, single day of your life. If you don’t floss your gums you will spend thousands (I’m not kidding) of dollars to simply control the incurable disease (and it is a disease) that you have let build up over years and years of utter neglect.

Exudate will ooze out from underneath your gums and after questioning by the clinical professional (How YOU doin’?) the finding(s) will be defined as ‘asymptomatic’. That is, you will feel no pain. What you will feel is the false sense of dental health with the perpetual lie you keep telling yourself when you think, “It doesn’t hurt,” while the blood-filled pus continues to bubble and percolate underneath your gums.

Allow me to continue.

Your social life will remain that of the lonely-lived bachelor/bachelorette whose breath completely, I mean, completely reeks so intensely, you will have no realistic chance of any dating prospects. You will continue to waste money on the premium whitening kits at your local store to give off the illusion of a healthy mouth in the hopes of attracting a mate. Your highly offensive, (Not joking. It’s awful.) metallic-smelling breath from your lack of flossing is so oppressive no one will want to kiss you nor come within five feet of you. (Yes. The odor is that strong.) And we can still smell it through the masks we wear. Sorry.

Once your teeth become mobile, or loose, from the lack of flossing and the prolific bacteria eating away at your bone that supports your teeth, then, and only then, will you notice and mention the finding to your dentist and/or dental hygienist. (Hey, that’s me!) You will hear the word ‘unsalvageable’. You may even hear the word ‘hopeless’. That means your loose tooth/teeth will have to be pulled out from your rotting mouth because you were lazy and didn’t floss.

You’ve just lost your tooth… which could have been prevented if you only had used that little piece of string.

Sleep tight.

IV sedation can be fun – for the oral surgeon