Day 3: Wednesday
The third day involved visiting a lot of patients with fillings (involving both cracks in the teeth and cavities). Additionally, I learned more about the sanitation process and its involvement with different kits (i.e., types of kits, the different tools needed in each kit, etc.)
I got to shadow a different doctor, Dr. Van Scoyoc – he is a periodontist that works intermittently with Cary Family Dental. Today’s patient was an individual with starting signs of gum disease and tooth loss. There was a deep cleaning involved, and I got to talk with Dr. Van Scoyoc’s dental assistant about her journey in specialized dentistry.
Fun fact: a periodontist is different from a dentist in that they are specialists in gums, not teeth!
I also was laughing for thirty minutes because I saw a box labelled “bagette” and it reminded me of bread “baguette” – for the life of me, I couldn’t imagine why Dr. Acton would need bread for surgery, but I was afraid to know the answer
Day 4: Thursday
Since Dr. Acton doesn’t work on Thursdays and Fridays, I instead followed Dr. Madden around for the day. I spent most of the day learning from her dental assistant about the more social side of dentistry, which I found to be really fascinating as it aligns with my interest in public health. We talked a lot about the estrangement between public health and general medicine and the importance of education within patients and in general, and I learned a lot about the difference in education between dental assistants, hygienists, and dentists.
Fun fact: dental assistants need an associates degree + training, hygienists only need an associates degree, and dentist need bachelors + dental school + residency!
We met a lot of patients, who I really enjoyed talking to – one of which was getting his teeth cleaned before his wedding on Monday!
I also got to take another look at Itero, and I saw an example of how Invisalign fixed a malocclusion (when teeth overlap).
I also thought the face model on the mask box looked like the Walmart version of Zac Efron, but no one in the office seemed to agree. :/
Day 5: Friday
The office was closed on Friday due to Memorial Day weekend (which worked well for me since I had a debate tournament), so I took some time to do an independent study on fillings, which I had seen a lot about. Here are my notes!
Fillings:
Composite fillings help the structure and integrity of the tooth after cavities, hold, grinding, and other activities break down the enamel.
- The teeth are polished and cleaned.
- The tooth is numbed with anesthetic.
- Micro etch is applied to the tooth, and a waiting period follows.
- The micro etch is rinsed off.
- Bond is applied to the tooth.
- The bond is cured with the LED light.
- Composite is applied that is tooth colored.
- The composite is cured with the LED light.
- The composite is polished and shaped.
- Floss is used to remove excess composite out from between the teeth.
Etch: an acidic substance that helps prepare the tooth for an adhesive by oepning up the enamel microscopically
Bond: a bonding agent that hardens and bonds with the etched surface of the tooth to prepare for the composite
Composite: a resin that is made to restore cracks and holes in the tooth
No dental pictures, but here is a photo of me and Maria headed to debate! 😀
Day 6: Monday
The office was still closed for Memorial Day, so I continued my independent study – this time on Invisalign/Itero and crowns. Here are my notes!
Crowns:
A crown is a type of covering placed on top of damaged and/or reshapened teeth. The crowns can be made of metal, resin, ceramic, and/or porcelain (?).
- The teeth is injured or damaged.
- The tooth is filed down to be made smaller.
- An impression is made of the tooth with impression putty.
- The impression is sent to a lab to make the permanent crown.
- In the meantime, a temporary crown is placed on the reshapen tooth.
- The temporary crown is removed when preparing for the permanent crown.
- Anesthetic is administered to the area.
- The permanent crown is affixed to the tooth and sealed permanently.
Invisalign and Itero
The Itero machine uses NIRI technology and CAD/CAM software to take 3d imaging of the teeth. The machine uses hundreds of pictures per second to capture a model of the teeth from all possible angles. The scan is then sent to Invisalign to print retainers, dentures, crowns, etc.
Still no more dental pictures, so here is a photo of me, Maria, and Ivy touring DC after the tournament!
Day 7: Tuesday
I was so happy to get back to the office on Tuesday! I reunited with Dr. Acton and the team and we continued to see more patients. Tuesday was probably my favorite day because I got to see two extractions and a bone graft for one of them! Extractions are simply what the sound like (the removal of a tooth that has dying nerves or is severely damaged in some other way), but bone grafts help the extracted are to develop bone structure again so that an implant can fit where the hole was. I loved the science behind the graft (the new bone cells from the graft and the old bone cells from the mouth fuse together and grow new bone), and it was really cool to see the whole process come together!
Fun fact: the bone graft material is usually made from the bones of cadavers! (it’s sanitized, of course, but that fact almost made me gag)
I think I definitely got more of a chance to bond with some of the patients, and I even got to talk with a gentleman who worked somewhere in medicine/public health about how dentistry is one of the most important medically informative fields out there.
Here’s a photo of me in my jacket after seeing the bone graft procedure!
I got the soul scared out of me when I ran upstairs to look for my water bottle – apparently it wasn’t important to mention that there was a legitimate life sized cut out of Dr. Acton just vibing in the corner, so I turned the corner and screeched, rightfully assuming he was a wizard and had come for my soul. Great day 😀
Day 8: Wednesday
Wednesday was another day, but unfortunately the last day, of following Dr. Acton around the office (since he wouldn’t be here on Thursday.) Today was probably my favorite day beyond the terms of dentistry, as there were a lot of rather apprehensive patients in the practice today. However, I got to witness Dr. Acton using education and science to explain to people why they shouldn’t be afraid to take care of their teeth, but also why dental health is important overall and what steps they could take to make the patient as comfortable as possible during the visit (extra topical anesthetic, neck pillow, TV as a distraction, and a blanket) (I was high-key kind of jealous of the blanket because my dentist would have never). I feel that all those interactions and more were definitely the reason why so many people like Dr. Acton – not only is he knowledgeable, but he’s understanding and willing to go the extra mile for every patient. It was super heartwarming to see, and I’m so glad I ended our internship on such an uplifting note.
On another heartwarming note, there was a staff meeting at the office and Dr. Acton brought his dog! Her name is Mazie, she is the light of my life, I would die for her, and I probably got caught around 30 times sneaking up to give her a quick hello before the next patient came into the office.
Itero machine after examining a patient with crowns who needed a partial denture
Mazie appreciation posts <3
Day 9: Thursday
Dr. Acton was gone for the week, so I continued to shadow Dr. Madden for the day! There was a lot of work with dentures today, along with partial dentures and bridges (a false tooth that is supported in the place of the missing tooth by crowns on the neighboring teeth). I got to talk with Dr. Madden’s dental assistant again today, and I also got to learn about the temping program within dental assistants and how the dental system works for traveling dental assistants.
We also took a lot of impressions, where I got to learn more about the different types of impressions and why it’s necessary to do impressions despite the presence of the Itero (the Itero has a very wide base to take pictures and some people have very small mouths – so, it’s easier to jus take an impression with smaller instruments, especially if you only need part of the mouth and not the whole mouth). Here are my notes for impressions!
Impressions:
Impressions are moldable solutions that are used to make accurate models of teeth and their structure. They are used for crowns, bridges, dentures, implants and probably teeth aligner trays (invisalign).
Light body: lower viscosity impression material – placed directly on the tooth to capture fine details
Heavy body: higher viscosity impression material – placed directly in the impression tray to support light body and capture impressions from the outer sides of the teeth
Retraction cords: pieces of string that are used when making an impression – inserted high in the margin between the tooth and the gums to create a clearer view of the teeth before the impression.
Thursday was definitely a very sentimental day – so many different people besides Dr. Acton helped me feel at home at Cary Family Dental, and I am so appreciative to have had the opportunity to exist and learn amongst all these important people.
To Dr. Acton and Cary Family Dental, thank you again for the amazing opportunity!
