Penobscot Community Health Center

This is where we live:

Hamlin House - nice historic house that used to be occupied by Hannibal Hamlin, vice president to Abraham Lincoln.  It's about a 5 minute drive to the clinic, which is very convenient.

Kitchen.

TV room.

Somehow I got stuck in the smallest room in the house.  Most rooms have two beds.  We share the house with other dental and medical students.

This is where we work: 

Gabe in his operatory.  We get assigned an operatory and we get our own assistant as well.  It's incredibly nice not having to set up for each patient or clean up after yourself or suction for your own MOD #14 amalgam preps.

Break room - a place to chill during down time.  Free coffee, tea, and hot chocolate makes it nicer.  Clinic runs from 7:30am to 6pm, which would seem like long hours, but it goes by pretty quickly for the most part.

And this is where we play:

Beehive hike at Acadia National Park.  That's my roommate - a 3rd year dental student from Tufts.

Lobster at a lobster shack near Bar Harbor.

Baxter State Park, climbing Mt. Katahdin, the highest point of Maine.

At the top of Mt. Katahdin - also the northernmost point of the Appalachian Trail.

Chimney Pond in Baxter State Park.

Gabe enjoying the weather and ice cream at Bar Harbor.

Life is good in Maine - weather is perfect, people are nice, scenery is beautiful, seafood is delicious.  Clinic has been nice as well - we're given a lot more freedom and it feels more like "real-life" dentistry.  We see about 5-6 patients a day with mostly fillings, extractions, and some endo.  It's made me appreciate how well UNC has prepared us up to this point - particularly after talking to some of the other externs here from Tufts and Boston University.  They get into clinic a lot later than we do and it just seems as if they're a little less confident seeing and treating patients at this point than we are.  Well, except for endo - I feel like we're taught a lot of endo "knowledge" but I feel very limited in my ability to do much endo.  It seems like having most everything referred to grad endo has sheltered us from knowing how to deal with harder cases (which I had to do here.. ended up breaking a file in a patient's tooth, but that's another story.. at least I diagnosed her correctly, right?).  Also, dealing with the pedo patients here have humbled Gabe and I.  Gabe has had some rough bouts with pedo, an example being today when he had to restore two teeth in a patient who refused to sit still.  He ended up having to do a pulpotomy and place an amalgam (after multiple tries) in this patient while restraining himself from choking her - I think she was close to biting his fingers off and eating up the rubber dam.  I have had some tough pedo patients that I didn't really know how to deal with as well.  But maybe that's just because of our personalities, not due to our lack of training.  The attendings are pretty good to work with - pretty hands-off (sometimes to our detriment) - and the clinic is usually pretty busy.  Gabe and I have enjoyed it.  It makes it hard to want to go back to school to do dentistry.

With much <3 <3 <3 from Maine to our wonderful class of 2012ers,

-Tim and Gabe

Hello from Lincolnton!

Hey everyone! It has been fun to read all the post on here. I've been at Lincoln Dental Services the past 2 weeks and I wish we did a whole year of rotations instead of at school!! It feels so nice to not worry about patients and just sit down and do dentistry. The dentist here is a general dentist who only sees children under 18 with Medicaid or HealthChoice (I think that's the name of the insurance).

The first week here was pretty slow bc it was the last week of school for the little kiddies so there were alot of broken or cancelled appts. But I've learned a couple cool tricks here so far. For instance, he does palatal anesthesia by going through the distal papilla of a tooth and waiting for the lingual side to blanch - it looks ALOT more atraumatic, the kids don't even flinch-compared to the regular palatal blocks that I have put some adult patients through =/. Also, he likes to talk about dentistry. Alot. Which I didn't mind one bit bc every free moment we had (which we had lots of it last week) he basically was going through his mind and vomiting years of knowledge into my brain. haha, maybe that wasn't the best choice of words.

It's picked up alot this past week though and Ive been doing a mix of SSC,fillings,ext, and loads and loads of sealants, which he sandblasts first before using the all in one bonding system. I've made a couple of kiddies cry already - but they deserved it! jk Last week this girl started crying when I was flossing the canine in order to put on the rubber dam, so mom didn't like it and made us stop the procedure. Then she started lieing (?) to the dentist that we didn't tell her we were flossing and that if she had known we were 'just flossing' she would have let us continue. Well dang lady, you were standing right beside me holding her hand and you couldn't see the white stringy thing in my hand?? Maybe I shouldn't be too hard on her bc she probably doesn't recognize what floss looks like :). But that was my mini drama of the week.

Oh yeah, it's also super awkward that the parents (90%) of them stay in the room while I'm working. Sometimes it's helpful bc they'll tell their kid to shut up and stop whining but most of the time it's not.

Overall, it's been pretty fun here. I enjoy being close to home and hanging out with my 2 nieces which are a handful to care for! I've gotten comfortable with the staff there, we sit around and eat lunch together and they've been catching me up on the office gossip, haha.

See everyone back in 2 weeks! :)

~Lana

Back to school...

It's more exhausting to see two patients at the SOD than it is to see ten in the real world.

-Kev

Bernstein Dental Center

Hi guys,

I first wanted to just say how awesome all of you are!  It has been so great reading all of your posts.  It sounds like everyone is getting a lot of great experience! 

I don't have a lot to report from my rotation yet.  I am at Bernstein Dental Clinic in Greenville, NC part of Greene Dental Services.  Everyone is super nice and helpful!  Last week was tough for me... I guess just getting acquainted with everyone and being comfortable enough to just dive into a procedure.  I am a lot more comfortable this week.   I am working with six doctors that rotate in and out of the clinic and it is interesting to see all of their takes on dentistry.  They have had a lot of great advice to offer.  And, they all call me "Dr. Bowen", which sounds pretty good to me! 

Today was a pretty productive day.  I saw three patients for extractions, did an operative appointment, took impressions for maxillary and mandibular dentures and poured them up, and did two comprehensive exams.  Pretty good I would say!



I am staying with my brother and his wife which is great, because I have not spent much time with him since I left for college.  I have also gotten to visit with my mom who lives about 30 minutes from here.

I hope everyone enjoys the rest of your rotation.  See you in July!  Take care!

Shenan and Anna Do America!!

We made it! After around 32 hours of cross country driving (and listening to about every CD we have ever owned) we made it all the way to Flagstaff, Arizona.  We started early in the morning on 6/2 and made it to Little Rock, AR by that evening after a brief lunch stop in Nashville. Day two after a quick off road to Muskogee, OK ( http://www.youtube.com/watch?v=-iYY2FQHFwE ) we reached Oklahoma City for lunch and a stop at the Oklahoma City Bombing Memorial.  If you've never had a chance to see that memorial, I totally recommend it.  We spent the night on day two in Amarillo, TX...not much there except the Big Texan Steak Ranch (http://www.bigtexan.com/) which we decided to pass on. There's always the way back to take the 72 oz steak challenge. On day 3, we stopped in Albequerque, NM's Old Town area which is really nice and finally drove into Flagstaff around 3 in the afternoon. 

Things I learned on the trip: 1. Crossing times zones going west is awesome; driving back losing hours is going to be terrible  2. There is a Sonic at every other exit from Arkansas to Arizona 3. There is literally nothing in Arkansas

Flagstaff is a great place to live.  It's kind of like a big Chapel Hill/Carboro.  Lots of hippies, natural foods, and live music. The first day here, we happened upon the Flagstaff Hullabaloo which was a downtown festival chock-full of chainmail, wings, and other extravagant costuming.  We have also been very impressed with all of the hiking/outdoor sports to be had and have tried to do at least one thing a day after work. We have seen the Meteor Crater, Sunset Crater, Wupatki National Monument, Elden Mountain, and the Grand Canyon so far. Today we plan to go to Sedona.



Our Clinic experience so far has been really great. We have been jumping around from the Winslow (base) Clinic to two other clinics located far into the Navajo Reservation at Leupp and Dilkon.  Everything on the reservation is subject to Indian Law, so as I was told on one of the trips out there, "If you want to speed you better have $50 or a case of beer ready."  Generally the clinics are set up in a double wide trailer, but have CCD receptors, new ADEC chairs, and one site even has continental delivery system.  Most are associated with other medial clinics also for people living on or near the reservation.  Specialists come in on a  weekly basis to take care of some of the more specific professional needs such as implant placement, oral surgery, and orthodontics.  Basically, there is a lot going on all the time at this very small clinic and I know that we are both excited about what we may get to see in the coming weeks.

There are two Tufts students with us and they are both nice.  Interestingly, one is a guy that I worked with at UNC before starting dental school.  We saw them the first two days and haven't seen much since due to travel to different clinics.  Tufts students can get credit for endo on rotations! Wouldn't that be nice...  Like many of you have commented, I feel and have been told by our attendings that students from NC are very prepared for these rotations.  I haven't noticed it, but apparently even the other students who are here with us are not as comfortable jumping right in as we are.  Go UNC!!

Vegas next weekend if anyone wants to meet us!!

Made it to Kenya!

Chris and I made it to Kenya at 3:30am local time (we're 7 hours ahead of NC) and got to spend the day with Josiah before putting him on a plane back to Chapel Hill this evening. We rode pikis (Kenyan dirt bikes) and chased zebras, antelope and giraffes across the Great Rift Valley for the majority of the day. 

Riding the pikis

Checking out the HUGE spikes on the acacia bushes

Giraffes!

So that Chris and I don't inundate this blog with all our Africa pictures, we've set up another site at: Kenya Blog. 

Good luck to all of you all returning to group practice and safe travels to everyone getting to their sites!

-Elise and Chris 

Assitants Make the World Go Round...

A critical point about assistants:

Make sure they have more than one CD in their operatory stereo.  Otherwise, you could find yourself stuck with four solid weeks of mid-90's Keith Sweat.  I'm not saying that I don't appreciate working on a four year old to the sound of "Your body, all over my body, your body, all over my body..." but it certainly adds a hilarious degree of surrealness to an already insane process.  The assistant is spectacular, and receives my near-constant teasing very well, but a man can only take so much. 

Hope everybody's ending their rotations well.  Good luck to the a-d'ers, and God help those of us returning to school.

-Kev

Maine

Greetings from Maine! It has been fun reading about everyone’s experiences. Courtney and I are in Bangor, ME, staying at a house built in 1851 which used to be the home of Lincoln’s vice president, Hannibal Hamlin. We have had housemates from the dental schools at University of Iowa – no, they have not heard of Dr. Eric Rivera, and Tufts, and medical students from the University of New England. There are also dental students from Boston University at the clinic. It has been interesting to find out about the different dentistry programs. It seems that New England schools provide somewhat more limited clinical experience while Iowa’s program is very similar to UNC.

The dental clinic is a huge facility currently being expanded to about 40 chairs. The construction was completed earlier this year and they are putting together and stocking the operatories in the new wing. There are six full-time dentists, four GPR residents and four other externs. There are eight hygienists and they just added six new dental assistants. It is a large operation and they serve a lot of patients. They are starting a new pedo residency program this summer and are also expanding the existing GPR program. In addition to the federal programs, there is MaineCare which covers everything for children through age 21 and provides free care or discounted fees on a sliding scale for adults who qualify based on income. For example, endo and post/core are covered under MaineCare and the crown is around $200-300.

We have an assigned operatory and an assistant who works with us. It has been really nice not to have to schedule patients, to set up and break down operatories, and to balance mirror, handpiece and suction. The work is mainly restorative, extractions and endo on both adults and children. We get to use the rotary ProTaper for instrumentation and Touch ‘N Heat for vertical condensation and backfill for endo, which has been a great learning experience. They also use gutta percha which requires only a main cone instead of a million little accessory cones.

We have tried to make the most out of our Maine experience, despite the rainy weather and temperatures in the 60s for the first two-three weeks. We visited Acadia National Park and Cadillac Mountain which are about an hour from here. We also went to Bar Harbor, a small waterfront town and a popular vacation spot. A few of us hiked on Dorr Mountain which is in Acadia.

Boston is less than four hours away and a great weekend trip, although it wasn’t a good ideaR to drive there because it was difficult to pahk the cah in the city without going broke. Anyway, the weather was warm and I had a wicked good time walking along the Charles River, sightseeing and trying some great food on Newbury Street, which is a mix of historic houses, shops and restaurants. Mike’s Pastry is a popular place in Boston’s Little Italy for cannoli and other Italian desserts so we made a stop there to overdose on sugar. Boston is a very nice, walkable city with a lot of history.

Georgi

Cadillac Mountain

Acadia National Park

Making our way

It was a hike :)

We are almost there

1270 ft

On top of Dorr Mountain

Chocolate-covered cannolo from Mike's Pastry in Boston...

View from across the Charles River

Pooh Bear's La Rez in Cambridge

Clinic