Tag: DENTIST

One of the things I enjoy about the Army is the necessity to stay fit.  I think if I did not have someone checking up on me and making sure I was maintaining a certain fitness standard - it would be easy to let things slip.

This year in particular I was pretty happy with things.  I have lost 30 lbs to date.  I have never had a problem with the PT test - always passed without any problems - but I have always had to get taped - the only time I hadn't was when I was enlisted and in basic training.

What helped me to lose the weight?  When I hit 200 lb I was shocked - never been there before.  I also wanted to pass the EFMB.  The 2 of those combined to provide the motivation I needed.  I began by portion control on foods, and preparing for the EFMB ruck march along with my regular fitness program did the rest.  I'm proud to say the last 6 months I have maintained and even lost a little more.  Now I'm running faster then I have at any other time (with the exception of basic training), and feeling great.

Here's some pictures from our PT test last friday.

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Great day as always in the clinic.  In the morning Dr. Ross and I had made arrangements to work on a case together.  He had a patient that he was going to deliver immediate dentures to after I pulled the remaining back teeth.  Prior to me seeing the patient he took the canines down to the gum and sealed them.  I removed the teeth, and he inserted the dentures.

Lower teeth.  The back theeth had pretty significant bone loss around them and had a poor long-term outlook.

Upper jaw.  Note the canines that were reduced and sealed for future use.

The black dots under the nose and chin were made by the Prosthodontist before the surgery as a reference of how the patient came together with his teeth.

This next patient (a marine) came in on sick call and was seen by another dentist - I was called to assist.  The patient had been to the hospital and cleared already.  He was hit in the mouth by a flashlight that came through a window.  I grabbed one of our other new dentists - and we made it a teaching case. 

After he was numb I manipulated the tooth back into position.  Etched and bonded a ligature wire from canine to canine.  Made an appointment for him to come back in a week to do the endo.

In total for the day: delivered 1 crown, 1 tooth re-impantation, took out 17 teeth on 5 patients, and remade a temporary bridge for a patient that had broke.

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Had a great day in the clinic yesterday.  Another example of why the group practice aspect is great.  One of the other dentists had a paitent that had had bone loss all the way down one of the roots of his molar.  This left a huge defect - one that if left untreated has the possibility have healing in such a way that an implant in the future may be difficult.  So he grabbed me and I placed a membrane and a bone graft.  Things should work out, and this will provide an area that will be amenable to an implant in the future.

Other than that procedure I did: 12 extractions on 4 patients, 1 crown delivery, 1 crown prep, 1 post operative visit, 4 amalgams on 3 patients, and 1 composite on 1 patient.

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Yesterday I took the day off and we went down to Busch Gardens Williamsburg.  Anheiser Busch owns many amusement parks as well as Sea World, and each year allows military to attend for free with their families.  They call the program Hero Salute.  The program has been on-going for at least the last 4-5 years.  It is great that companies such as Anheiser Busch make this effort.

Didn't get back until late, but we had a great time.

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Yesterday in the clinic was great as always.  1 pulpectemy, 1 molar endo, 3 amalgams and 2 composites on 3 patients, 9 extractions on 3 patients.

Have you ever wondered what an abcess looks like?  I took the wisdom tooth out on the lower left (the viewers right) corner (black all around the tooth).  The following shots will show you what it looked like.

The pink/red tissue is the sack that forms around the tooth.  The pus can accumulate in/around.

I pulled the tissue away from the tooth

The back tooth of this bridge had decayed.  There was puss coming out from areas around the tooth.  The bridge also moved because it was now only anchored on by the front tooth.

That is the underside of the bridge.  All the "stuff" you see is food debris, plaque, and tooth remnants.  The bridge was cut so that the front tooth still had the crown kept on it.  Then the tooth was removed.

This is another tooth with an abcess that LTC dela Cruz that I work with had taken out several years ago.  Just another reason to take care of your teeth!!

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Thursday brought back to me one of the many things that I enjoy about Army dentistry.  That is the group practice setting that is found at most Army dental clinics.  Almost all Army dental clinics have at least 2 dentists.  This produces a "safety net" for new dentists, and a "sounding board" for more experienced dentists.  This is something that is not as readily seen in private practice.  It would be very difficult for a partner or associate out of school to get help from a more experienced dentist in the practice.  In private practice "time is money", patients are stacked on top of each other, it does not create an environment that encourages constant teaching and mentoring.  In the military that opportunity exists.  Dentists can block off time to work, mentor, or learn new proceedures with one another.

Thursday while delivering an upper and lower partial on a patient, the lower partial rocked - despite my best efforts.  I finally got Major Ross our prosthodontist to come and take a look.  After trying himself to get it to fit - he taught me about a procedure I was unaware of.  He recommended taking the lower partial and sectioning it.  Each side was then seated and a pick up impression was done.  This was sent in to the Army lab to have it laser welded.  This is one of the things that I enjoy about Army dentistry!

In addition to the partial, I was on sick call in the morning.  That day I did: 1 crown prep, delivered a crown, removed sutures, extracted 4 teeth on 2 patients, 2 composites, 3 sick call patients.

This was a patient I was able to help MAJ Ross with on Thursday.  This patient had had most of their dental work done in the Phillipines.  The bridges were made out of base metal, ill-fitting with large overhangs in many areas, defied several of the basics of sound prosthetic work - antes law and 2 cantelevered posterior teeth.  #21 had to be extracted due to non-restorable caries that were present under a very large overhang of the bridge.  This patient will be able to get the quality of care that she has lacked in the past.

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In the Army a hail and farewell is a chance to say goodbye to those that are leaving, and to introduce those that are coming in.  Yesterday in the clinic we said goodbye to CPT Maddox who is moving to Ft. Knox, and SPC Williams who is moving to Ft. Hood.  They had a pizza party for them at lunch, and they had done things a little more formal for them at Commander's Call prior to this.  Best of luck guys!

Because I had the training last week, we had to shift some of my paitents around.  Many of them we put on this weeks schedule.  It was a  very busy day, and it went by very quickly.  Yesterday we: did 2 consults, prepped 2 crowns, delivered an onlay, delivered 2 crowns, did 3 resins (2 and 3 surfaces), 1 amalgam (3 surface), and took out 8 teeth (combination of full bony, part bony, and regular ext).

This is what happens when you don't floss.  Huge chunks of calculus (tarter) hanging off the teeth on either side.  These led to the bone dissolving and gum tissue growing all down and around the tooth.  I don't think I have ever had to scrape and dig so much tissue out of a tooth socket in my life.

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