Fourth Week: Removable

        During our fourth week we had the opportunity to attend the clinic of Removable where we were able to observe the students from third and fourth year deliver removables and complete dentures.  The procedure they use is similar to ours and to the techniques we have learned here I will describe the appointments they use.

1) They use the first appointment to take impressions in order fabricate the custom tray. We were able to observe how they make the custom tray. They use aluminum foil so that the wax doesn’t melt on the model and a resin material to cover it for the custom tray. They have a lab equipped with all the instruments to do these steps.

 

This is the lab where every student has
their models, equipment to work and materials.

Here is the making of the custom tray: which consists of
three layers: aluminum foil, wax and resin for the tray

This is the TRIAD is a machine used to photocure
the costum tray evenly

2) Here they are trying the custom tray in the patient, they have to add modeling clay in the borders of the custom tray so that they are able to copy the delimitation of the area in order to get a precise impression.

3) After having the jaw relations you are able to develop the wax up of where the patient is going have their teeth, so you are able to try the wax in their mouth in order to evaluate the vertical dimension, the support of the lip, the patient’s smile, where the facial midline is, the nasal wing to determine the canine’s cusp,  the patients occlusion, facial bow, the parallelism of the Camper line and the occlusal line, choose the color of the teeth and its shape.

Here we have the materiales needed to check the occlusal line,
 the color of the teeth and the patients occlusion

4)Then comes the appointment where you try the anterior teeth and see how the patient reacts to them  and how they suit the their face. Then you can try the posterior in order to get them to the optimum occlusion for the patient (centric occlusion). They have articulate paper that is shaped like the patient’s arch in order to detect any areas that occlude prematurely.

5) When everything seems to be fitting correctly the denture is sent to the lab in order to have the acrylic poured in.  Here in Baylor they have their own lab in the General Dentistry floor, which is really convenient because they assure that the things get there on time because they deliver them themselves and it makes the waiting time shorter.

6) When the denture is completed, there is an appointment to try it on, adjust occlusion or any high spots.  The patient receives a 24 hour appointment and a one week follow up in order to check how the denture is suiting them.  They receive a packet of adhesive and a set of instructions to help them get used to the dentures.

This experience has helped us reinforce all of the theory we have learned in our classes of removable and to prepare us for our clinical work in January 2014. This will helped me get a visual idea of how to explain the steps to the patients and how to approach the psychological part of complete dentures, because some patients are really hesistant and do not want to use them, and its our goal to make them feel at ease and positive with their treatment. 

Third Week: Surgery

        As the third week began, we were transferred to the Surgery Clinic. This clinic was fully equipped with:  automatic sphygmomanometers to take the patient's pressure before their surgery or extraction, electronic thermometers, nitrous oxide tanks, a center to properly wash your hands and an area to put your clinical gowns on. Here in Baylor dental students are allowed to do more than extractions, we were able to see them do  tori removal, buccal exostosis, alveoloplasties and frenectomies.

     Their extraction techniques are pretty similar to ours, the only thing is that they work standing up the whole time, which after a while gets to be pretty tiresome. The only variations I was able to observe is that they are more lenient when it comes to high blood pressure in a patients, because they still consider 150/100 in medicated hypertense patient acceptable for surgery.

   It was interesting to watch the administration of nitrous gas to the patients and the way they regulate it. When the patient asked for that kind of anesthesia there had to be a control of their blood pressure every 30 minutes to ensure the patient's wellbeing.

Implant Lab

Second Week

Throughout our second week we still attended General Dentistry and helped students with crown preps, fillings, cleanings, etc. But there were four new highlights of the week:

1) We were able to take our CPR lesson in order to be approved by the American Heart Association as a Healthcare Provider. In this course we were able to apply what we learned online to an emergency scenario where we had to give CPR to both and adult and a baby. Giving me the opportunity to see how to react in real life and to see how everything is managed. It was a very enriching experience.

2) We were able to assist to a Veneer conference with Dr. Mohsen Taleghani. This was such a wonderful conference, we were able to carefully assess different techniques of placing a veneer, the materials used, the latest technology involving their manufacture and their applications. Being able to witness how lives have been changed after undergoing such processes and how impressive veneers are nowadays. You can't even tell the difference between the real tooth and the veneer next to it! This allowed me to appreciate my career even more and realize how we are able to change lives one smile at a time if we really dedicate ourselves to do our best in every work we do. Dr. Taleghani is a clear example of a passionate dentist that considers himself a teacher but a student as well, because he says he will never stop learning in order to give his patient the best treatment possible. He has been very clear that dentistry is his vocation through this quote: “How many people get to say they love their job? I am uncertain how many feel this way, but if someone were to create a list, I would be at the top.”  He is a true inspiration. 

Dr, Taleghani

3) I was able to observe the process of infection control the students have when dealing with patients that have contagious diseases such as Hepatitis C, AIDS, etc.  This allowed me to get a different approach of the protocol that Baylor developed for these scenarios.

4) We were able to observe how the students prepare their models for a patient that is going to receive an implant and the protocol it involves, as well as all the equipment they use. The protocol is similar to the one used in our clinic but the difference is that after the surgical part is done; the student is able to finish the implant by placing the crown; and they have verify that every little detail is perfect. In order to accomplish a successful osseointegration and function of the implant.

The whole experience has really been wonderful!

First Week: General Dentistry

Rotation: General Dentistry 

When we arrived at Baylor we were given a brief tour of the Dental Department composed of 7 main floors: oral surgery, perio, general dentistry, pediatrics, ortho, endo and prostho. We were given our badges to be identified as student observers and continued to learn about the protocol that Baylor withholds. Starting out with the HIPPA: which is the patient confidentiality and that we shall not discuss any cases outside the clinic, continuing with online tutorial of the American Heart Association in order to be able to give CPR and last but not least we received a lecture on infection control.

Baylor 

 We start at 8 am everyday and attend lectures for two hours, the classes include: Orthodontics, Oral & Maxillofacial Surgery, Applied Pharmacology, Practice Administration, Pediatric Dentistry, Professional Ethics & Dental Jurisprudence, Advanced Principles of Patient Evaluation and Advanced Techniques & Materials. From 10-5 pm we attend the General Dentistry Clinic, where we are able to assist in procedures involving: crowns, fillings, root canal treatments, postes, bridges, cleanings, sealants, veneers, etc.

It has been an incredible experience because we have been able to learn new techniques from the fourth year students  and show them our way of doing the same procedure, making every appointment a collaboration between the techniques from Baylor College and Tec of Monterrey.

We were able to assist a practical exam they had, in which they had to perform a root canal treatment on the 1.6, it was very interesting because we do not perform root canal treatment in molars so being able to see how they made it was amazing. I was able to learn how to use GUTTACORE which is a machine that melts the guttapercha and then they apply it to fill the root canal, I was also able observe them clean the root canal with rotary instruments instead of manually like we were taught.

GUTTACORE equipment 

The guttapercha inside the canal 

The Dental Clinic is huge, composed of over 100 units in which they use a similar device as we do, they have a computer in which they have their patients information and evaluations.

They also have a section called Advanced Technology which consists of 6 units fully equipped with the latest technology  from the best chairs, to  X-Rays, scanning devices for crown prep, CAD CAM, Vita Easy Shade Compact which is a device that scans the color of the patient's crown in order to replicate a similar color for the new porcelain crown. So the students are able to be assigned to these units in order to be introduced to the latest technology in Dentistry.