Tuesday, February 24, 2015

Welcome to ENDO.

I haven't been able to post anything about dentistry - mainly because lately dentistry has been consuming my life (as if there are times when that's not the case..)

More specifically - endo has been draining my life away.

This is our first quarter taking an endodontics lab - and unlike other lab classes, we don't even have weekly lab quizzes or additional projects outside of the work we are expected to complete in class. Regardless, the world of endo has been quite an undertaking.

In case you're not familiar, endodontics is the specialty of dentistry involving the removal of infected/inflamed pulp in teeth. All teeth have a crown (the visible part that you traditionally associate with a tooth) as well as a root that keeps the tooth anchored into your upper and lower jaw. Inside the tooth is a small tunnel - or root canal - which contains the nerves and vasculature that innervate and nourish the tooth structure - keeping it vital. When you have any trauma, deep cavities, or infections that reach this root canal where the dental pulp is contained, you have to remove it!

And that's where this endo lab class comes in, as well as my latest bouts of suffering.

First, I'll explain the steps that are involved in an endo procedure, and then I'll mention why they make my life so difficult. Oh, and remember all those human teeth dental students are supposed to collect? Well this class is the reason why! We need real human teeth that contain canals, etc. unlike plastic teeth which are just little blocks of pure plastic.

1. Initial access preparation & coronal flare
In this step, you're essentially creating a deep preparation that allows you to reach the roof of the pulp chamber. The idea is to create an access (aka preparation) that is as conservative as possible.
HOW IT CAN RUIN YOUR LIFE: However, you run into problems when you're using calcified teeth and you can't find the canal. Sometimes, people will "perf" or perforate through the tooth - which is when you don't realize that your bur is not going in the direction of the location of the canal and you drill a little tunnel straight through the crown of the tooth.

2. Cleaning and shaping
This is the classic aspect of endo that has to do with all of the colorful files in little yellow sponges. If you've shadowed in a dental office, or had a root canal therapy performed, maybe you know what I'm talking about. The purpose of these files is to take something that is small enough to fit into the canal and start cleaning all of the necrotic/infected pulp out. The files increase in size - so you're basically increasing the diameter of the canal with a slight taper through filing with a series of endo files!
HOW IT CAN RUIN YOUR LIFE: Sounds easy enough, but depending on how curved the canals are, your little metal files can do something called "transportation" - where you perforate through the root in a NEW direction, SEPARATE from the actual canal, or something called "ledging" - where your file creates little ditches along the inside of the canal. Ideally, you want the root canal to have smooth walls and follow the natural pattern of the canal, so both of these things are bad news (aka, you'll fail your project and you have to go find a new tooth to start all over again)

3. Obturation
So once you've emptied that root canal out, you need to fill it up with something that is biocompatible and can prevent the tooth from harboring new bacteria. You basically start filling up the tooth with these little points called gutta percha, which is a rubbery material that can be heated and reshaped to seal off the canal. In our lab class, we use this method called "lateral condensation"  - which is when you basically stuff your tooth with these thin, cone-shaped gutta percha points, and take a pointy instrument that you can push the GP points to the walls and condense them together so you make space for more cones. More cones means a more dense fill, which means less chances for voids.
HOW IT CAN RUIN YOUR LIFE: Voids. Every step of the way, we have to manually take radiographs (UCLA is pretty oldschool, so we do the whole - take a radiograph, dip it in developer, water, fixer, water in a little darkbox) - and if you see voids in your canal, you gotta take all that stuff out and do it over again. Your gutta percha can also extend out of your canal (so can your files) and shoot out the apex. Which is bad. Even though our instructor likes to say "Gutta percha, never hurtcha!!" I don't know if he truly believes that since significant gutta percha extrusion can mean you have to redo your project.

Sad life :(

_______

Here's the latest project that I completed - a #30 (right mandibular 1st molar). There were so many disasters. SO MANY DISASTERS!! I was in lab for about 15 hours working on this.. But in the end everything worked out. Thank goodness!!!

Hopefully this can give you a small glimpse into the world of endo! Obviously some people really enjoy it.. I don't know if I'm one of those people :p




Wednesday, February 4, 2015

The Little Things

Today was an exceptionally good day - but it didn't initially seem that way.

I woke up this morning at 7AM to a stream of texts and missed calls  - I thought the spin class I take with one of my friends was supposed to start at 8AM.. Turns out it was actually 7AM.. so I texted her back immediately being like - "OMG IM SO SORRY!!!" and things like that. Esp since it was my turn to drive this morning :p

So anyway, I decide I'm gonna go to KREC instead, and just do some random stuff - row, squat, jumprope - things like that. But lately, I've been trying to do more pushups, and GUESS WHAT PEOPLE!! I did FIFTY PUSH-UPS (not all at one time but still)!! Okay I can see how that may sound really silly - but I used to not be able to do more than 20 in a workout!! So I'm really proud of myself for that.

That was little thing #1. 

On to little thing #2.

I've been kind of frazzled the past two days in an epic hunt for a maxillary premolar. For our endodontics lab class, we need to have extracted teeth with closed apices (so they're fully developed teeth), and straight-ish canals to use on our midterm/practical. My original tooth didn't fit the criteria exactly (even though it passed the initial inspection.. sigh) so I was on this mad search for a premolar. That same friend I accidentally flaked on for spin happened to have an extra jar of teeth, and gave me a premolar that MIRACULOUSLY was great for the case that I needed!! When I developed my x-ray of the tooth and held it under the light to inspect - I was literally like


Many tears of joy. That was little thing #2. Though it was actually a rather big deal so we'll call it little-ish thing #2. 


Little thing #3. 
I had a prophy scheduled for today with a patient that was supposed to be known for being rather grumpy. I managed to take his blood pressure on the first shot which was EXCELLENT (this is the first time I did this people, lol) - but long story short, my patient left the appointment all smiles, talking about his/her dog, and asking if I would be able to do their next cleaning :) So that was an great little thing.

So many little things to discuss, so little time! 
For little thing #4 - this is actually about one of my favorite spots in Westwood.

It's not a bar..
and it's not the gym..

It's the corner stand with coffee samples over at the Trader Joe's in Westwood. 
This is literally one of my top 5 favorite places to be after a long day. I don't know what it is about the ritual of just hanging out in Trader Joe's, perusing the food labels and walking around that makes me feel so comfortable. I usually have to hide my excitement and try to act like a normal human being whenever I walk into Trader Joe's. But yeah. Coffee samples after a long day. It's such a beautiful thing. Which leads me to little thing #5 - who's actually not a thing but a human - this little girl sitting in a stroller caught my eye and started waving and smiling at me!! I was about to die from cuteness overload, but I remained strong, and am alive to tell the tale :)

Then I went to whole foods and bought my favorite chips in the whole world!! Little thing #6!!

But the thing to top it all off was when I got home to check whether or not my garbage disposal was fixed. It's been broken the past 2 days and started to smell gross and I was really annoyed by it because the people hadn't come to fix it. When I walked through the door, here's what I found:


:)

He rescued our small spoon and the garbage disposal works. Makes me want to find this guy and let him know he brightened my day :)

Long story short, it's really nice to be happy again :)

Monday, February 2, 2015

My Sunday Recharge


I love Sundays because I get to attend my favorite spin instructor's class and start the day off right. She only teaches Tuesday and Thursday mornings (when we have school), so I only get to take her class once a week. 

If you've never tried a spin class before, I highly recommend going to one! When I trained for my first half marathon, taking spin classes helped me boost my distance from 5 miles to 10 miles after a couple of classes. I think the main reason is that with endurance running, it's 95% mental - so if you learn how to beat the "I can't do it" mentality during spin classes, it's a lot easier to push yourself harder with distance running. I'm sure you can see how strengthening your mind in that aspect is really helpful for all areas of life. Spin is about making your way through discomfort and learning your limits. And then taking those limits and destroying them!! haha. 

Plus, spin classes are known to burn a ton of calories, and they're a very meditative/introspective form of exercise. Every time I go, I get that runner's high feeling that you get around mile 3 of running - except with spin, you get it within the first 15 minutes of class. I always leave feeling like I sweat out all the negative emotions and frozen Trader Joes tamales that had accumulated in my body over the week in that one 45 minute class :p

And after spin, I head over to church to really start the week off right. One of the things I am most grateful for this quarter is having a car and being able to get to church on my own schedule. As someone who's been a rather fickle christian, something I've consistently noticed is that people who love God have happiness and a sense of peace that is grounded - it just doesn't seem to go away. 

My 24 years and 5 months of living tells me that from a practical viewpoint, this is something that is really hard to come by. 

What do you do to recharge?