Category Archives: Dental

This has been almost a write off as far as patients showing up.  I am glad I can access the internet otherwise,I would be really bored. 

There are no weather related excuses.

Maybe the flu?

And since my CRV is in the shop getting serviced, I am condemned to just sit and wait.

Might as well go and write cheques for payroll.  I am not making any income but the staff must be paid!

To miss a day of work, I have to be really sick.  I don’t suppose there is any great merit in that except that if I don’t work then a couple other people are left jobless and incomeless for the day.  Being the boss means not that I can do whatever I want as my kids would sometimes like to believe but rather that I have to take all the people who work for me into consideration.  The business has to keep going and I am an essential cog in the wheel.

Today, however, I did something I have never ever done before.  I had to quit before my last patient was done.  I was in the middle of the procedure, the filling preparations were done, liners in place, matrix bands on.  At that point I said to my assistant, “You’ll have to excuse me for a few minutes.  Could you get this ready for the filling.”  And out I went quickly to the back door where I thought I would recover by getting a bit of fresh air.  Instead, I had to head down to our staff biffy where I sat on the floor in that state of just before puking till it did indeed pass.  Then I looked at my face in the mirror.  I was about the colour of white bread.

I made my way upstairs again planning to finish off those fillings.  My partner, Roger, took a look at me and suggested he finish them for me. 

My patient was very nervous.  I hope I didn’t freak her out by almost passing out.

I am now home in bed, feeling somewhat better but still too close to regurgitating for my liking.

I feel a bit like I was blindsided by a ninety year old grandma.  She came in needing teeth.  Had some old, old dentures that needed replacing.  Had tried several places and each time the teeth made were a “terrible fit”.  So she came to me.  And I tried my darndest.  I really did.  I was prepared today to start over again but she had had enough.  And that is fair in a way.  Someone her age should be expected to adjust to new stuff with difficulty and I think she just has too much stuff going on in her life right now medically.

I guess I was done in by her need, her seeming feistiness and maybe by my own pride at being able to make pretty good dentures.

One refund cheque must go in the mail.

Days like this I think I should stop making dentures.  They are the only dental work for which I have ever had to issue refunds.  And I do honestly try my very best to satisfy the needs of the patient so it is a real let down to have a patient give up on me, refusing to let me rectify the problem.  Makes for a crappy day.

There are moments when the work I do seems worthwhile; moments when God shows up and makes me aware of his goodness and of how much he has blessed me.  There are those moments when I realize that he has let me be his hands for him.  That is when I am thankful for the hard work and often messy stuff I do every day; thankful that he called me to do this dental stuff.

I had such a moment a day or so ago.  A little over two years ago, I was called to the hospital to take impressions for a feeding plate for a little girl with a cleft lip and palate.

This is one of the sort of additional dental things I have taken on in this city so these newborns and their moms don’t have to be sent down to Saskatoon in those first days of life. It is not a difficult procedure, just taking an impression in a tiny little mouth and then going back to spend a few moments with the mom as we insert the feeding plate and the mom learns how to take it in and out and use it.  

Anyway, this little one was one of my patients two years ago.  Yesterday she came in with her mother for her first dental check-up.  Lip and palate have been repaired – at least the first step is done.  She is obviously a much loved child.  Her teeth are cared for impeccably.  She was so polite, it was cute and a great reward for me to see her and hear her say, “Thank you Doctor.” 

Funny, the same day, I got another call from the nursery.  A new little boy needs to be seen.  I wonder if I will see him again in two years.  I think I will still be doing this then.  This will be one of the things I will miss most when I retire from practice.  Maybe I will hang on to this as long as I can.

Today seemed long.

On the plus side the sky was lightening in the east on my way to work and as I write this, the sun is still imparting a glow to the sky. 

But at work, the day seemed long.  It was busy enough , so didn’t drag.  In fact, I decdided to do a couple of fillings for a guy from out of town so he would have to make fewer trips down from La Ronge, and completely missed my lunch hour.  Maybe I am just too old to be missing my lunch – I don’t have the energy I used to have.  Or maybe it was the difficult filling I ended the day with.  That one bordered on what we term “herodontics”.  the last tooth in the arch and the filling went way down on the back side of it (distal) below the line where the enamel of the tooth joins the root.  Did what we call a sandwich restoration – using two different materials, one which can be flowed down into the far depths onto the root area and the other a regular bonded sivler filling.  A challenge. 

The course I went down to Saskatoon for today was one of the best I’ve done in a  long time – Using French in Medical Practice.  The day went considerably faster than the usual draggy lecture.  We reviewed the terms for the major systems and then had fun.  There were three actors who were our patients for the day.  What a job they did!  The guy who played the 82 year old Mme LaFleur beginning to become forgetful was simply hilarious! 

And my French is not half bad.  In fact on of the young Francophone physicians told me it was very good.  So that made me feel good.  I usually feel fairly self conscious speaking it to a real Francophone.  I know my verbs rarely agree and I am TU/toi ing rather than using the more formal vous when I should, etc, etc.

Visited the kids too and had a quick supper with Rachelle too.

And the drive – I find it goes fast if I take a good chuck of the time to talk to God about stuff.  And I can listen to whatever music I like on the way. 

This week I received two special gifts.

Not the conventional gifts of chocolates, cookies or cards that are commonly given by patients.

These gifts came totally unexpectedly, unannounced and unaccompanied by a card.  In fact the givers don’t even know they gave them.  But they were among the best I have received this year so far.  Real live success stories.

The first came from a young woman.  She is 20 now and has a small baby.  She carried herself with a confidence that in some ways surprised me. 

When I first saw her she was frightened and in pain; sent down to see me by the dental therapist in her home community.  She was pretty enough even with the obvious lack of development of the mid-face till she opened her mouth.  Her teeth had never been cared for and were so decayed and covered by debris that she did not smile.  Her teeth were not only badly decayed but were a jumble; a malocclusion that was so severe from poor jaw development that we wouldn’t even be able to make her decent looking false teeth if we went that route. 

This week I received two special gifts.

Not the conventional gifts of chocolates, cookies or cards that are commonly given by patients.

These gifts came totally unexpectedly, unannounced and unaccompanied by a card.  In fact the givers don’t even know they gave them.  But they were among the best I have received this year so far.  Real live success stories.

The first came from a young woman.  She is 20 now and has a small baby.  She carried herself with a confidence that in some ways surprised me. 

When I first saw her she was frightened and in pain; sent down to see me by the dental therapist in her home community.  She was pretty enough even with the obvious lack of development of the mid-face till she opened her mouth.  Her teeth had never been cared for and were so decayed and covered by debris that she did not smile.  Her teeth were not only badly decayed but were a jumble; a malocclusion that was so severe from poor jaw development that we wouldn’t even be able to make her decent looking false teeth if we went that route. 

In a case such as this, successful treatment depends on attitude, determination and a willingness to change some ingrained habits of hygiene(or lack thereof).  I didn’t know if she could do it but everything depended on it.  We would do our best to get her treated if she kept up her end.  She needed more than what her insurance normally paid in a year.  She needed to see the Orthodontist within the year and she didn’t meet the criteria because of the extent of her decay and her poor hygiene.  We would have to plead her case with the authorities and get the rules bent. 

She understood the extensiveness of the treatment she needed enough to leave our office in tears.  She knew that she would have to meet some pretty rigid standards if we were going to advocate for the treatment she needed. 

The changes didn’t happen overnight but she came back to be treated.  Little by little we made progress.  We requested special considerations for her from the regional dental officer and got them.  She overcame her fear and had fillings, root canals, more fillings and oral hygiene instruction till we knew that she knew what to do.  She began the long process of getting ready for braces and maxillofacial surgery.

This week she came back for her regular check-up.  She came in with a smile, showing off her braces.  She is cavity free this year.  She is flossing, brushing and keeping those braces shiny, even investing some of her own funds for the preventive products we could offer her to help strengthen her enamel.   

We didn’t get to see her small baby – the band would spare no funds to send her nursing baby down with her.  As she left we asked if she would like an infant toothbrush to take home for her baby.  “No thanks,” she replied. “Don’t worry though.  I have about five of them.”

The second gift also walked out of the office smiling.  He is a big guy; not so old, only seventeen I guess, but he has thick black hair down to the middle of his back and a full beard.  He is the kind of guy you might be afraid to pass walking down the street if you judge by his looks.  In reality, he is one of the most polite gentle young men I know. 

A few years ago he came in with his father, his teeth pretty much a jumble in his mouth too.  His dad wanted his son to have better teeth than he did.  So we started work on getting things straightened out.  But kids from homes where the parents have split up can have a real hard time complying with the consistent wear that a retainer type of appliance requires.  So it went with him – missed appointments, poor brushing and instructions not followed very well; walking in late because he had to get himself to our office. 

Finally we suggested to him that he come in with his parents and we would discuss discontinuing his orthodontics.  This time mom came in with him.  She promised that she would take control of getting him to the appointments seeing that he brushed and of making the payments.   So we gave him one last chance.

The chance we took with him paid off.  Today we removed the braces from his beautiful teeth; straight with no cavities.  It was good to see him leave smiling.

That kind of satisfaction, seeing good things come about in kid’s lives and having a part in it, makes me love the work I do. 

I have treated most of my family members at one time or another.  Most are regular patients – if my family can be classed as regular.  And I have no problem inflicting pain on them if it is needed – as in wisdom teeth extractions, etc.  And I am sure they would do the same for me, if they could think of someway to repay me!

But today I experienced why there is wisdom in the advice not to take on the medical/dental treatment of people who are close.  There are times when it is just too emotionally hard.  It is no problem if the receiving person is in basically good shape and the treatment is simple and routine.  But there are times when it is just not great. 

My dad lost his last two teeth today.  Last week one broke off and so it was inevitable. But today was at least as traumatic to me as it was to him.  Sort of like the end of an era – the last of his teeth.

Maybe it was just the stark reality of his physical condition.  Maybe it was that I am his little girl and for the first time I had to do something to him that he did not want to have done, really.  So I did it.  I soothed his fears as best I could and he still trusted me enough.

I like to learn new stuff.  The course I am attending today and tomorrow will be good.  Attendance is really small – about 15 of us, so the hands on aspect will be great.  We can actually try some stuff and the two instructors will have time to answer our questions and show us stuff one on one.  Couldn’t ask for much better than that.

Sounds like this is something I will start implementing right away too since I have been trying some of this on my own just because it seemed to make sense.  I guess it does – there is a whole system well thought out.  Now I should be able to do what I like to do just a whole lot better and with more predictable results.

I should not be here.  I am posting this from my office computer after finishing an emergency.  The poor girl broke off about one third of her front tooth .  And of course she is in a wedding party today.  Used to hang around my house with my oldest daughter.  When she called this morning I thought – I’m not sure if that bit of information is the way to talk me into going into my office on the second day of my vacation.  But anyway, I did – get talked into it. 

I guess I remember – the morning of dental school grad – I had an inlay in progress and out it came.  A call to my dentist and I became his number one priority that morning.  Got glued back together and to convocation in time.

Compassion.  I seem to have inherited a healthy dose of it from my ancestors.  Oh well, I could have gotten worse.