Category Archives: Dental

Three strikes and you’re out.  Isn’t that the way it is supposed to go?  That is how it had gone by 1:40 this pm.  And I was feeling like an ogre.  I suggested that since the first three attempts to work had ended up pretty much as failures that I should go home.  My office manager said I don’t think so!”

The first child was autistic.  His aunt brought him because his mother “knew” he wouldn’t behave for her.  He was not doing too badly but his patience with us only lasted about 15 minutes.  I guess we’ll have to do him in the OR under GA.   Just too much auditory and tactile stimulus associated with dental work.  It just seems such a lot of risk to put a kid through for a simple one surface filling and a couple of sealants.  I wish that I could get him in on a few more occasions and work with him till we could at least get his teeth cleaned in the office.  And I wish his mom wasn’t so negative – she is fairly terrified herself and so sure that it will all be a horrible experience for him.

The next child was 11.  He was just bad, but I suspect some other things may be going on in his mind.  Or maybe very little is going on in there. His poor mother – she had to bring him in by herself since the kid’s dad did not show up to bring him.  So, in comes mom with an infant, a couple of toddlers and this unruly 11 year old.  She clearly has her hands full.  So, expecting a lot of help from her is out of the question.  The boy won’t even get in our chair.  He actually only has a loose baby tooth but of course he won’t try to wiggle it out himself.  In fact, I try to make some kind of eye contact with him to explain what he can do for himself and he turns away and walks off as I am speaking. 

The third child is so little.  He doesn’t want to be in my chair either but he is small enough to hold.  So, lying him back, head in the crook of mom’s elbow, we check out the 19 month old child’s teeth. He’s not in as bad shape as some – only needs a couple small fillings and, if the fluoride varnish fails to arrest the decay in the front teeth, the top four teeth extracted.  I’ll be seeing him again on a sedation morning, maybe in June since that is how far in advance we are booking these appointments. At least he is not in pain and his young mom is weaning him to a cup.  For him there may be hope.

And now it seems to be getting better.  The little girl now waiting to get numb, will have all of her work done after today’s appointment.

Friday was just another of our days in the operating room.  But that day it all began to get to me.

Sometimes being a dentist and caring is an absurdity.  Bizarre that if I don’t cause some pain there is no way to help things get better.  Cynicism is hard to avoid.  Last week, I think I either cared too much and started to despair or I was extremely cynical I’m not sure which.

By the end of the day on Friday I was feeling absolutely drained, pessimistic and was kind of losing hope that I could make any difference in kids lives.  The morning in the OR really got to me.  Usually, I feel fairly good about getting a lot of work done on a child that really needs it.  But Friday, I just felt tired and a lot like my efforts to accomplish something were futile.  The whole week was filled with little hurting kids and they just seem to keep on coming!

First case: sixteen teeth…..too many to need out at three years old.    She really was a little sweetie.  Cleft lip and palate, tiny little thing. 

Second case:  nine permanent teeth …still way too many and three of them front teeth.  And he was not cute or nice.  Probably never will be.  He awoke from the anesthetic screaming, kicking and fighting to keep his head off the pillow.  Refused to lie down and spit blood over everyone.  Of course, there was no one there that he knew and he didn’t know a lot of English.  That would be pretty scary by itself but to wake up with a mouth sore and not really comprehending all that had to be done don’t really blame him. 

And the other kids I’d done under sedation earlier in the week , plus several new consultations for kids just too much like these two OR cases … Seems there will never be an end to it.

I am sick of taking out teeth on little kids and bigger kids that should never have gotten into such a state of disease.  Sick of taking out all the teeth on a child that should be smiling and happy and beautiful.  Sick of trying to help when the child’s own parents hardly seem to care.  I am tired of seeing children who have been hurt by the neglect of their parents.  Tired of seeing parents give a child a bottle of cola in order to keep the child quiet.  I’m tired of seeing a child who at eleven can’t manage to sit in the chair and have treatment done because he is the victim of poor parenting(or none) or his brain has been damaged by a mother who could not abstain from alcohol while pregnant. 

Life just seems so unfair to some kids!

I guess if God has put me in a position to do even a small thing to help these little guys I’d better give it my best effort.

Maybe it is better to be a domineering boss.  That way if I dictated stuff no one would dare question or complain – at least in front of me.  But I’m afraid that just isn’t me.  And because I care but sometimes can’t accomodate everyone – well it wears me down.  So tonight I am tired.  I’m tired because although my staff have known for months about my trip to the Congo, today when I told them that I needed them to take most of their holiday time while I was away I got very negative reactions.  Somehow the thought must not have dawned on them before, although it has always been the rule that they would take their vacations when I did.  So it means that some of their time off may not coincide with school vacations – although 2 and a half weeks of it will.  And no one up till now has informed me of any important dates that they will need to have off. 

Does it not occur to them that if I have no assistants to work with when I get back from the Congo, that I will also have no money to pay them with!!!  But then again, I need them as badly as they need me.  And they could get another job a whole lot easier than I could.  They just wouldn’t have as easy going a boss as either Roger or myself.:-)

Work tomorrow should be fun because…! Tomorrow we are in the Operating Room again.  Two pretty big cases. 

The saddest one is an eleven year old who refuses to get work done “in the chair”.  As a result, he will have 8 to 10 permenant teeth out including three of his four top front teeth.  For some reason mother couldn’t (wouldn’t) come with him and we even had to get a telephone consent.  This involves two people explaining things to the parent over the phone – extra work in a way.  Trying to make sure that the parent understands that her son will be going home with no front teeth and that he will not grow another set.  Hoping she maybe cares enough to get him to brush his teeth from now on.  Realizing that the boy probably thought we would be putting in some dentures at the same time as we were taking out his rotten teeth.  Having to tell him that “no” he would be going home without teeth in the front. 

Pretty hard to make a denture for a growing boy that will last the required 8 years under the guidlines of the authority that pays for his work.

I wonder what chance this kid has in life?

Today I have eaten too many good things.  Chocolates, nibblings of cheese, sausage and crackers, veggies and fruit, and still some leftovers from our staff party on Saturday.  We only have two more days to work before we take a bit of a holiday for Christmas and we have lots of gifts that have shown up at the office tempting us to eat it all before the end of the week. 

Work has been slow over the past week and will likely stay that way till January.  Our schedules are filled but at this time of the year people tend to forget that they had dental appointments, so there are a lot of missed appointments.  And people would rather spend their money on things that are more fun – at least in the short term.

So I am looking forward to the break and am needing it too.  Just wish our bills would stop coming in for the holiday.  Oh the joys of being a buisness owner and employer!

The nice side is that our employees are so nice.  I am wearing a new pair of ear rings and have a new plant – a beautiful tiny evergreen as well as a canister of coffee and a new mug.  These gifts always catch me a little off guard and sort of humbled by the generosity they show.  I really do think that we have one of the best staffs of all the dental offices in Saskatchewan! 

Yesterday, I got a call midmorning while I was out running around doing my usual Saturday am groceries and stuff.  This time it was from my office manager.  My partner has been on call this past week and fighting this bad cold/bronchitis thing that has been going around.  He was in to one of our minor emergency facilities getting checked out and while he was unavailable an emergency call had come in.  L. was fielding his calls for him and this one seemed an emergency that I needed to be in on. 

A mother had called for her son(mothers tend to do this for sons long after they should be able to call on their own).  The evening before, in a hockey game, her son had been cross checked right in the mouth!  And he was just about to get his braces off in about a month.  Two of his teeth were still attached to the braces but were not anywhere near their required “straight” positions any longer.  And his lip was pretty badly cut up as well.  HELP!!

I do a fair amount of orthodontics so fortunatly for him, the right office was on call.  We got him in, determined that the teeth were not broken, froze him and pushed the teeth back into position(almost straight).  I think I’ve just gained a new patient that needs at least two root canals now.

And this guy was sent away with a mouthguard.  Please, please, please – if you play hockey or fool around on the ice or the road in front of your house with a stick, is it too much trouble to save yourself about a thousand dollars by buying and wearing at the very least a simple $40 mouthguard.

So ends my dentist’s rant!

Yesterday I had a neat experience.  One I haven’t had for a long time.  I went to work as usual. I had prayed in my morning time with God that I would be helpful to someone today, that somehow my work would bless someone. 

Instead, it worked the other way around.  One of my patients came in and before I had a chance to do anything he said, “Thank-you”.  I think I must have looked a bit taken aback when he said that.  It was totally out of nowhere. And that is all he said at first.  Then looking at my sort of surprised face, he said, “I mean thank- you for looking after my teeth and helping me get them back in order. I had let them get pretty bad”

This one thank-you makes up for a lot of the unthankful, even critical, people we see every day.  He blessed me in a way he may not even realize.

This was quite a day.  I got to the office to pick up our tubs of stuff for the OR and to pick up my two staff people going along to assist.  I really didn’t expect to see Judy since I knew she was pretty sick.  But in she came and off we headed to the hospital.  We had a good anaesthetist today – this guy has a good sense of humor and he listens to the radio and drinks coffee while we work.  I guess he is working too but our hands are busy and so drinking coffee is out except for the breaks between cases. 

It is really incredible how much difference it makes working with someone who has a good sense of humor.  Everyone works more efficiently and the day has a lightness to it.  It is fun to work with someone like this.

Then we went back to the office and sent Judy home.  She probably shouldn’t have come in the morning, but she is such a conscientious person and she knew that I needed her help.  She went home, Trina was there today so she helped me get my afternoon patients done and Michelle who is about 7 months pregnant became exhausted – she has been working alone for most of the week with my partner since Trina’s kids were sick.  At the point where Michelle was about losing it from exhaustion, our hygienist pitched in and helped the others clean up operatories and even assisted me for a few minutes.  At the point where we all could have lost it, everyone there came through and pitched in.  We made it to the end of the day in one piece and all of our patients got the treatment they needed.  A couple of extra special sick and tired people got flowers today and they deserved them!

The one thing that struck me was that I have several staff members that I know are “evangelical” Christians.  Sometimes they are not there when they could really help out.  I know there is a fine line that is hard to walk when it comes to how one spends their off time – family or helping out a co-worker who is really too sick to work.  I don’t feel that I as the employer can insist that they give up a day off but I think that the other worker would have given up her day off if the other assistant had been too sick for something as important as a morning in the OR. She actually has done some changing of plans in the past tto do just that.  Going the extra mile for a co-worker can be a tangible example of love and friendship.  Self interest put first sure can destroy a relationship.  I think the assistant that came in today giving so much both to me and to the kids that we were able to treat is showing more of Christ’s type of love than the “evangelical “one. 

Not much unusual going on today for me.  Work was work – except that I got a call from a sick assistant this morning early.  She sounded awful.  There seems to be a flu like illness going around.  One of my partner’s assistants was also home because one of her kids was ill, so we were really short staffed.  I think this flu must also be affecting patients because there werer sure a lot that did not show up in the last few days. 

Tomorrow morning bright and early I will go to spend another half day in the operating room.  And I will be without my assistant unless she makes a very speedy recovery.  That will be interesting.  Dental assistants are soooo much help and I am used to working with one.  And time is always at a premium in the OR.  My dental therapist is going with me tomorrow but she has never been in the OR before so I will have to show her what is the correct procedure for setting up and such and that is the part of the whole procedure that I am not used to having to do.  As I say it may be an “interesting” morning.  Three kids to do and I don’t want to end up not being able to start my final and biggest case because I have run out of time.  Those OR nurses can be real bears when it comes to keeping a tight schedule!

Why is it that some people are just grouchy.  It seems to be that there are one or two especially grouchy people that come to see me.  They are always negative and no one enjoys having them come in to the office.  They doubt and question everything that you propose to them as being in need of treatment.  So it makes me very conservative in what I suggest.  I am reluctant to tell them the treatment they should have because I know they will question everything I say in such a manner as if to imply that I am suggesting it just to make money off them.  They end up hurting themselves because it is so difficult to propose a treatment plan that is in their best interest – that looks at a long term plan.

I have one especially grumpy old man and another especially grumpy old lady.  Today it was the turn of the grumpy old lady.  She should have been in for a cleaning a year ago.  We would like to work with her to get her gums into a healthy state.  But it is pretty hard when she refuses to follow our suggested treatment.  And then she acts as if it is our fault that her mouth is sore.  So every time we see her we have gotten to anticipate a complaint and a lot of whining – not just about the teeth and our work but about the world in general.  Makes you wonder what goes into these people to make them so negative.

Sometimes kids amaze me.  All of the kids we saw today were just great.  Usually there is at least one screamer – but not today.  And that made the day almost blissful.

We would expect a child of 7 or 8 to be able to handle having a filling or two.  But todays winner of patient of the day had to be the three year old who sat in my big chair.  She was so tiny.  It is hard to believe that such a small little thing could have such big holes in her teeth. 

If a dental visit still lingers in your recent memory, do you remember having your lower jaw frozen?  Did you feel just a little pinch and maybe wince or jump just a little?  Not this kid!  She was still as a mouse.  She sat there and let us fix her up and there was not a peep out of her the whole time – for two big fillings. 

She was referred to me as a management problem!  Someone was frightened off by her age I suspect.

She now has two new pink “Twinky Star” fillings and a mother who must be very proud of her. 

So Randall next time you are trying to whip up your courage to come see me, try and follow the example of this little 3 year old  —  OK?