Entries in the Category "Dental"
our code of ethics
In the April 2 edition of the ADA news, Dr. Maitland discusses issues of ethics in and out of dental school. The ethics issues present within dental schools is very evident, but difficult to address. The one problem that I can relate to is the concern of clinical competence.
How is this a question of ethics? Consider a third year dental students first patient. If the amount of preclinical time is insufficient, the student will be unprepared to perform at an acceptable level, putting his/her patient [and the general population] at risk. If this student is allowed to continue in the clinic at this level, without mention, they may not be aware of the degree of clinical deficiency. Then, at the end of four years, they are surprised when they don't pass their boards.
Part of the problem is that we have many instructors, and each may only see a small piece of each students work. If a student has done poorly on a daily project or competency, it may be passed off as a bad day, and no single instructor may see just how many "bad days" this student has had. Not wanting to come down too hard, faculty allow this performance to continue by giving passing grades. I understand that operative procedures [crown preps/composite preps/provisionals] are graded subjectively, but students have a right to honest criticism. When it is time for the student to enter clinic they face an even steeper learning curve, and if their abilities aren't at an acceptable level then something needs to be done.
Quality assurance is why we have an independent party administer board exams, and also why it will be near impossible to realize a curriculum integrated format for our clinical boards [but that is another entry]. What can be done [in my most humble opinion] is to establish a pre-clinic preceptor program that mirrors what is in the clinic. One or two faculty assigned to 10-15 students, who are responisble for all pre-clinic grading for those students during the first and second years of dental school. The consistancy of grading the same students' work allows the preceptor to monitor the growth of the students, and address problems as they arise. It also makes one or two people responsible for the clinical competence [or lack thereof] of those students.
No system is perfect. I am thankful that my education has been very clinically oriented, and I am proud of the level my classmates and I have achieved. I am also pretty confident that we are all ready to begin seeing patients. However, if a student is clearly not ready, is it ethical for a school to advance him/her to enter the clinic?
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A Dime a Dozen? Not Dental Blogs.
If you are one of the two people who visit this site on a regular basis [just kidding...I hope], then you have read the reviews that I posted on the subject of the dental blog. I made a recent discovery of DMDStudent.com, and wrote a bit about the site. Ben, of DMDStudent.com, also recently wrote of his experience searching for dental blogs which echoed my feelings... There aren't many out there.
Why? For one, the babyboomers, just aren't on par with the technology available [minus Dr. Lavine and a few others]. Gen-Xer's are either just getting comfortable in their practice, or just graduating from dental school. Frankly, there just isn't a whole lot of free time to spend getting a site working, or to maintain one either. Also, and I think this rings true with the Gen-Yer's as well, it takes time to see the benefits of such an endeavor, and most in our generations are looking for instant feedback or gratification [which doesn't happen with things like this].
Another reason, I feel, that there just aren't many dental blogs is the doubt that it will serve any purpose. "What makes me an expert? Why would anyone read what I write? I'm not that good of a writer. I don't have anything to say." But, I have learned that it does a great service, and I look forward to seeing how successful it may be as a tool for my patients.
The challenge, that I've found, is deciding on topics to write about. Dr. Levine's [The Digital Dentist] focus on tech products and advances, and their relevance to dentistry is amazing to me. The ability to write consistently and to stay up-to-date is a quality I admire. As I maintain this blog, I gain more and more respect for those like Dr. Levine who are able to continually produce good material.
The Dental Blog. They might become less hard to find, but good ones will never be a dime a dozen.
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A Fellow Student
DMDStudent.com, is a blog posted by a fellow dental student. Ben is a D1 at Temple, and actively posts about all things related to dental school. From excellent study tips, to showing off his amalgam restorations, his writing is clean and concise, and his pictures are very well taken. I'm glad to see that I'm not the only dental student committed to using blogs to help and educate others. Keep it up, Ben.
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Oral Hygiene Instructions
This is a piece written for our ASDA Newsletter, "The Occlusal Record". I was asked to write about how oral hygiene intructions should be given. Instead of a directive, or how-to, it ended up as a narative describing the challenges I've faced in giving OH instructions successfully.
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Continue reading "Oral Hygiene Instructions"
What will dentistry do?
I'm deeply saddened by the story of Deamonte Driver. This poor child, suffered from an abscess, didn't get treatment, and died from it. The finger is being pointed [squarely] at the dental profession, and I have serious doubts that we can solve this on our own. The ADA has issued a response, which addresses the major problem..."We need state and federal public officials to stop shortchanging dental programs, which costs all of us heavily in the long run"... aka - insurance and access to care. The Driver family didn't have any. That is the reason they waited to get treatment. Had they been covered, it wasn't easy to get to a dentist that would accept medicaid. It was one hurdle after another for this family.
We have all seen what has happened to medicine thanks to insurance companies. Preferred Provider Plans, and HMO's have all but destroyed private medical care. I am thankful that the ADA is so strong, and I have confidence that we as dentists will have the ability to guide our state and national leaders to a solution. This tragedy is all too common, and the access to care needs to be improved in our country. If everyone makes a small effort, we can solve this big problem, together.
I am not planning on accepting insurance when I start practicing. Why? Because I don't want to be told how much my services are worth. We have spent a lot of money on our education, we have worked hard to develop our talents, and we deserve to be paid a fee reflective of that. I don't want to be regulated, and I don't want my patients care to be compromised because their insurance company won't pay.
What will my part be in the solution? I'm not sure yet. I see myself taking one day every other week, and spending it at a "free clinic". I could also see myself doing some work pro-bono, or taking "mission trips" to underserved areas. I do think it is important to do something, anything, to help those who don't have access to care. If we don't find a solution as dentists, then someone else will, and we might not like it.
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Lexi-Comp Lunch and Learn
Lexi-Comp gave a great lunch and learn today. They passed around all of their reference library, giving us dental students a chance to see what they were about.
I am already familiar with the PDA version of the drug data-base that Lexi-Comp produces specificaly for the dental profession. It has come in handy so many times already [and I'm not even in the clinic full time yet]. So, I didn't come wanting to purchase anything...
I did anyway, though, because I was impressed with their "Illustrated Handbook of Clinical Dentistry". Designed for dental students, and written by Dr. Richard Lehman, a former perio resident at Harvard [who passed away before the book was published]. Some of the money made from the sales of this book are donated to his foundation, so it's a good cause as well. The pricetag is a bit hefty on a dental student's budget at $45. However, they are pretty good about discounts when you buy more than one title, or if they visit your school [they gave a copy of "Your Roadmap to Financial Interity in Dental Practice" if you purchased any title today].
I posted a picture of the cover, as well as a sample page. The print is easy to read, and all of the information is nice and condensed. I think it will serve me well even before I enter the dental clinic...
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ortho impressions 2
We took alginate impressions in ortho today. Enough said.
...and the bass player asks, "Are there any good dental blogs?"
Since I've committed to writing a blog, I thought I would look at what else is out there. I wanted to find out who else was writing, and what topics they were writing about. So I did a simple search, and grabbed the top 10 pages or so. Based on the relevance of recent entries, the design, and the quality of writing, here are some of the best, and worst dental blogs on the net.
OK. Here's what I found [these are in no particular order].
Dental Blogs.com
Edited by Tom Hedge, this site is, " a real-time, interactive web site about the world of dentistry made possible by a calloborative effort by the greatest minds in dentistry today."
With over 15 different authors, this blog touches [on the first page] on topics from HDTVs, soft tissue lasers, the economics of a digi-pan, new milling machines, and the mid-winter meeting. Articles are short and to the point, well written, and designed for you to "take it or leave it" depending on your interests. I look forward to checking out the rest of their archives.
The Digital Dentist
Written by Dr. Lorne Lavine, the Digital Dentist offers opinions, advice, and information about the latest trends/gadgets/technology in dentistry. Very easy to read, and embedded links make it quick to see what Dr. Lavine is talking about. Excellent resource.
Dr. Chris Kammer's blog
This is what happens when good intentions go so, so, wrong. The articles are not bad [there's only 2 that I could find]. Geared more for the general population, [from what I can tell. only 2 articles, remember] this blog hasn't been updated since 12/05. Thumbs way down, Dr. Kammer.
Dr. Thomas O'Neil
This is a great example of what a blog can be when associated with your practice's website. Directed to patients, and regarding topics relevant to patient education and services offered. The information is relevant, but it is also used as a sales-pitch. Dr. O'Neil very clearly states the negatives of amalgam, and the positives of composite [in school, we were taught positives and negatives of both]. Also, there are no links to any research articles, or references. Overall, the bolg/website is well written and the layout is good. I'm not a big fan of the website design, but I'm less of a fan of not citing where you found your information.
Brookside Dental
This blog is also linked to a dental practice website. Dr Patricia Pauley DDS, Dr Cynthia Pauley DDS and Dr Carrie Magnuson DDS provide information regarding their practice and, like Dr. O'Neil, services offered as well as general topics in dentistry and patient education. I prefer the layout of this site to the one listed above. It is easy to read, and I feel the opinions/information offered are balanced and reflect current trends in dentistry. Nice site.
Tooth Booth Dental blog
Canadian alert. I like this site. Easy to read from a patients perspective, relevant to professionals, and concise enough to read quickly or skim to find topics that interest you. Dr. Hans Skariah posts [based on the first page] regarding current topics in dentistry and dental health websites. Most of these posts are, "Hey, check this out," types, which save me time looking for these things myself. He also has a habit of citing the articles he gets his information from.
My Dental Complaint
Not a dentist. Not an expert. Though, he does cite faculty at dental schools, and the ADA, Mr. Kowalsky runs a business helping people find dental insurance. Insurance companies have not solved our health care problems, or improved the quality of care recieved, and I don't expect them to do the same for dentistry.
Blue Harmony
This blog is written by another dental student, Ping, at NSU. The layout is hard to read, and the topics are along the daily diary vein. She is consistanty posting, and I can relate to many of her dental school stories [minus the car wrecks and manicures].
Dr. Bob's blog
Dr. Bob has posted an article. It's well done though, I like the writing and the site design. But, he's only posted once.
Dr. Kenneth Mogell's blog
Dr. Mogell has a blog linked to his practice website. Just in case you forgot what blog you were reading, he places his banner at the begining of every entry. Every single post. I think that the blog is well written, like the other dentists above [with the blog linked to the practice] it's designed for patients. He provides information regarding how he can improve your headaches, how periodontal disease might be linked to pancreatic cancer as well as the move into his new office. All in all, a nice site.
If there are any others that I should have mentioned, let me know.
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