Tuesday, September 16, 2014

A Day in the Life of a Dental Student

Welcome to the Day in a Life of A Dental Student Series.
 My schedule changes dramatically throughout the course of a year and I want to highlight that. As I move from a second to third year dental student, I will be transitioning from learning pre-clinical procedures to working with actual patients. Some pretty big changes are coming my way and I really want to share and document all of it so each month I will be sharing a new aspect of dental school. Initially, dental school started out with full days of lecture. Now, we are doing preclinical exercises like learning how to numb a patient (by practicing on each other..eeck!) and how to make denturesEven weekends are crazy around here. 

For today, I will be talking about learning how to do a root canal. 
Here's my exact schedule last Tuesday. 

5:00AM Wake-up/Shower/Get Dressed
 I have dental lab today, meaning that I have to wear scrubs. Just made getting dressed that much easier.

5:30AM Time for Breakfast & Studying
I'm definitely a morning person. Before class I either study or go into lab early. Today I'm going to study for my upcoming exam in 2 days. I decide to study endodontic procedures (root canals), since this is also today's lab assignment.

7:30AM Headed to School 
Finally wake-up the world's laziest dog and take him out before heading off to school

Yea I have no idea how that position is comfortable

8AM-10AM Endodontics Lecture

Time to shift gears and spend the rest of the day in dental lab doing some root canals! 

10AM-12PM Endodontics Dental Lab
We ended up having a pop quiz, definitely glad I spent the morning reviewing. After the quiz, I continued to work on my endo projects....root canals on extracted teeth. We started with incisors, moved onto premolars, and are now working on molars. Lab is self-paced with faculty circulating to answer questions and grade completed assignments. It's my job to make sure that I get through all of the projects by the due date (eck it's approaching fast).

My Lab Set-up for the Day 

12PM Lunch 
I like to use my lunch break wisely. I run home, take out the pup and fold a load of laundry.

1PM-5PM Endodontics Dental Lab
I'm ready to start my mandibular (lower) molar. I'll run through a quick summary of the root canal procedure.

Eric Herbranson, images derived from the Tooth Atlas produced by eHuman 

I start out by taking x-rays of my extracted tooth. This allows me to see an outline of the canals and measure how far down I need to drill to access them. 

Dental Manikin Head 

I put my typodont into the manikin mouth and drill to open up my tooth and access the canals within the tooth's roots. Basically, I need to cut through the enamel and dentin completely to reach the pulp of the tooth. 

Each tooth is unique. However, research gives us an idea of what we can expect to find when opening up a given tooth. In a mandibular molar, there are typically 2 roots with 3-4 canals. For this particular tooth, we know that there are 3 canals 65-70% of the time and 4 canals 30-35% of the time. I found the first 2 canals easily, but then spent a long time looking for that third and possibly fourth canal. But I couldn't find them! 

A professor confirmed that I had an anomaly in my tooth and there were only 2 canals. Go figure. I'm not complaining though because each canal has to be cleaned, sterilized, and obturated (filled) separately. So less canals equals less work :)

Have to keep those canals lubricated!

Next, I determined the length of the canals via the x-ray. It's important not to go past the apex of the tooth when cleaning and filling the canals. 

Cohen S, Hargreaves K, Keiser K: Pathways of the pulp, ed 9, St Louis, 2006, Mosby

I won't go into too much detail, but I spent the rest of the afternoon widening the canals and clearing them of debris and bacteria. 

             In Progress        Void in Distal (Right) Canal       Correct             

I love doing root canals, but the very last step is a pain in the butt for me. The first time that I filled the distal canal I ended up with a void. In the middle picture above, you can see the specs of gray within the white. This is a big no no. Failing to completely fill the canal will allow the bacteria to reattach and thrive. Then the whole procedure would fail. Two more attempts and I finally filled the canal properly.  

5PM-6:30PM Break
Time for a much needed break. I head home and spend it walking PJ and eating dinner.

6:30PM-10:30PM Study Time! 
I spend the rest of the evening studying for my upcoming exam. Thankfully, it's all dental science so at least studying is interesting.

10:30PM Time for Bed
I'm such a grandma and I normally have a cup of hot tea and watch an episode of Frasier (best show ever) before heading to bed.  

Photo Source: Torabinejad, Mahmoud,  Ashraf Fouad,  Richard Walton . Endodontics: Principles and Practice, 5th Edition. Saunders, 040114.