Aamna’s Dental Digest

PADS is pleased to announce that the Spotlight Award* for the MYM 2023 goes to Mahum Sardar, Director Voluntary Committee- amongst the Standing Committees/ Executive Council.

Pakistan Association of Dental Students appreciates your immense hard work and consistent efforts and hopes that you will maintain this attitude and dedication in your upcoming projects too! ✨

*The Spotlight Award is awarded to directors for work done up-till half the term, decided by voting and Bimonthly Work Reports submitted.

Eid Mubarak Everyone! ❤️❤️
Sending so much love your way. 🌻

HOUSE OFFICERS BATCH E SIGNING OFF 🥹
And it finally comes to an end. We have officially left the nest and are now about to soar in skies unknown. We’re all berozgar lol. 😭😭😂😂
This year was a rollercoaster. I enjoyed the heck out of this year. I got to experience stuff I’d never thought I’d ever experience. I got to be a big girl and handle my finances (which I failed at miserably oof). I also microdosed on the real world, and I am not a fan. 🤡
Jokes aside, this year was amazing. I got to make so many memories, and as I type this, my ghum boi hours have resurfaced earlier this time hehe.
Housejob really is the best time. To my new houseofficers, this is truly the best time. Enjoy yourselves, refine your skills and learn new ones, and make memories that’ll last you a lifetime. Earn duas from your patients and teachers. 🌸

These two pictures are almost a year apart, the top one being taken at the start of our housejob, and the bottom pne being taken in the last week of it. 🩷

Alhumdulillah for this! 🌻

On the third floor of the Fauji Foundation Hospital, you make your way to the end of the hallway, the sign reads “Female Surgical Ward 1”. You enter the doors. Amidst the dull beige walls and warm lighting, you find a door to an office open. Blue color peeks through the office door. The sign on the door reads the name of a teacher who taught you in third year. Written in both the generic English font on the generic hospital issued nameplate, the door has a light golden plaque reading the name of the professor in Urdu. You find the professor in the middle of the hallway, surrounded by final year students “You have half an hour, go through these pages, discuss it amongst yourself, observe and examine the patients, and then we’ll go through it together, learn something new today, if you’re not in the mood, mark your attendance and go. But don’t waste this opportunity to learn something new.”
The professor looks up and smile. “AssalamuAlaikum sir! Kindly sign our clearance forms.”
He leads us into the blue room. For a place where you’re breaking bad news to patients, the room oozes calmness and tranquility. We compliment sir on his room decor. He smiles and talks about how he decorated this all himself. On a wall, there’s a poster that reads “I am, but a pen. And one day my ink will run out. I only hope I have created something beautiful in the meantime.” Funny enough, the word pen is made up from different pens given by different pharmacological companies. I find it so funny that I just have to take a picture. “Take a picture of me too.” Sir says, I blink once, twice. Maybe I heard wrong. But when I realise that sir actually said that, I drop my bag, whip out my phone and fiddle around with the camera. Sir smiles.

(Continued in the caption)

around this time last year i was preparing for my housejob, running around for my clearance and everything as someone who had just passed final year.
this time, i’m still running around for my clearance and everything but as a full fledged graduate who’s about to be done with her housejob in the next few days. 😩
nostalgia and sadness is really hitting me hard in the feels right now. 🥹✨

Last picture is from the final year clearance time.
How fast the time flies. SubhanAllah! 🌸

Eid Mubarak lovelies 🌙✨❤️
Alhumdulillah 🌸

🗓️: December 15th 2022

OT Day (1)

A young female patient fell face first from a bike where she was sitting behind her father. Her radiographs showed Right Parasymphyseal Fracture and Left Subcondylar Fracture (slide 2)

The patient was sedated and draped. Small bone screws in the maxilla and eyelets in the mandible for IMF and occlusal stabilisation was done. (slide 5)

Once the occlusion was stable, a Mandibular Vestibular Incision was given on the right side intraorally and the fracture line (demarcated in yellow) was exposed. The nerve bundle (demarcated in blue) was isolated so it would not be damaged during the procedure. (slide 6)

Then the fracture line fixed with 5 holes with 5 screws and 4 holes with 4 screws plates. Note how the plate passes under the nerve bundle. Incision was then closed with 3-0 vicryl. (slide 7)

Patient was seen the next day with great post operative results with minimal swelling.
The patient was then discharged after giving detailed instructions for maintenance of oral hygiene. 🦷🪥

A great procedure to observe.

🗓️: December 12th, 2022

A workshop on “NON-ODONTOGENIC PAIN;
DIAGNOSING THE UNSOLVED RIDDLE” by the Department of Oral Medicine 🦷

How many times have we come across patients that complain of pain that just won’t go away? After getting just about everything done from simple fillings and RCTs to multiple extractions, the pain still seems to stick around. To being told about “taking a softer diet” or “it’s all in your head”, at the end of the day all a patient wants is the validation that yes there is something wrong and yes your doctor believes you. 👩🏻‍⚕️👨🏻‍⚕️🤝🏻🙍🏻‍♀️🙍🏻‍♂️

This workshop told us about pain that doesn’t have much or even nothing to do with your teeth. Some pains severely limit simple daily tasks. Some of these are so severe that they may even push a patient into spiraling into mental health crisis. 🚩

As dentists, it is our job to listen to what our patients say. It is our job to reassure them and it is our job to help them find the answers they’re looking for, because once you know what’s wrong, it might get just a bit easier to live with it. 🌸

🗓️: December 12, 2022

A workshop on “NON-ODONTOGENIC PAIN;
DIAGNOSING THE UNSOLVED RIDDLE”

How many times have we come across patients that complain of pain that just won’t go away? After getting just about everything done from simple fillings and RCTs to multiple extractions, the pain still seems to stick around. To being told about “taking a softer diet” or “it’s all in your head”, at the end of the day all a patient wants is the validation that yes there is something wrong and yes your doctor believes you. 👩🏻‍⚕️👨🏻‍⚕️🤝🏻🙍🏻‍♀️🙍🏻‍♂️

This workshop told us about pain that doesn’t have much or even nothing to do with your teeth. Some pains severely limit simple daily tasks. Some of these are so severe that they may even push a patient into spiraling into mental health crisis. 🚩

As dentists, it is our job to listen to what our patients say. It is our job to reassure them and it is our job to help them find the answers they’re looking for, because once you know what’s wrong, it might get just a bit easier to live with it. 🌸

First Day of university and my Graduation Day.

We have come a long way!

Alhumdulillah 🌸✨

A series of pictures regarding one of the most interesting cases I’ve had the chance to experience and work on! 🤩

Patient presented to the Prosthodontics OPD for an Upper and Lower Complete Denture. She suffered from Bell’s Palsy, onset of which was during her childhood.
We knew from the start that the case would be a little different from other cases. 🤩

A talk with our Seniors and me and my PG Dr. A. were ready for action. 🫡😤✨

The steps for Primary and Secondary Impression was the same as those for simple CD cases. The real curve-ball was the Jaw Relation and Tooth Setup.

We inserted the rims in her mouth and recorded the Jaw Relation. The initial steps were the same as generic CD cases but we had to make some slight modifications in the tooth setup:

1️⃣ The occlusal plane will be tilted.
2️⃣ The tooth setup on the right side (which was affected) will follow the border of the rim.
3️⃣ The anterior tooth setup on the left side will follow the lower lip line and the posteriors will be set according to that.

Following these 3 modifications, we marked the midline, the lower lip line and the smile line (marked in the pictures shown). We recorded the tooth shade and off to the lab the case went until we worked on it later. 😄

The tooth setup didn’t look as different as we had anticipated. The slanted occlusal plane was balanced by the opposing arch and the occlusion looked pretty good.

The Trial went without a hitch. The Insertion gave us some trouble but our Lab Technician identified the problem and a slight trim later, the denture fit like a dream. (The problem was an undercut in the ridge where the denture would get stuck and would budge any further 😅).

The patient was satisfied with the denture. We made sure to tell the patient that we had to focus more on the functionality rather than the aesthetics when it came to her denture, which she did not mind at all.

Gave her the denture related instructions and sent her off. The happy patient couldn’t stop smiling. Alhumdulillah. 🥹✨

Meet my 6 1/2 year patient! 👦🏻

Little man presented with pain in his deciduous molars. A little conservative excavation with my favourite restorative instrument of all time i.e. a spoon excavator and a very cooperative patient, we managed to get the work done in record time! 🤩

The only hard part here was isolating the tooth so the GIC wouldn’t flow in between the contact areas and set as a single blob of filling haphazardly thrown in the cavities. The mylar strip kept on slipping between the contacts as the dimensions of deciduous teeth is smaller than those of the permanent teeth. But we somehow managed to make it work. 😮‍💨

A special shoutout to our DSA who helped me out so much. How good your dental assistants are heavily impacts how efficiently you can work. Don’t forget to appreciate you helping staff whenever you can. 🌸

Let’s hope this little dude completes his summer vacation homework in time for when his school opens. 🤭

🗓: July 22nd, 2022

My very first bridge removal! 🤩
The patient had a 4-unit bridge that had to be removed because one of the abutments (46) was compromised and had to be extracted.
The 4-unit bridge had 2 abutments (34,36) and 2 pontics. The patient was informed about the limitations of an x-ray as it doesn’t show the status of the crowns and the extent of caries, it only shows the roots and the the surrounding bone.
We had to be extra careful as the patient had another 7-unit bridge adjacent to the bridge we had to remove. 😮‍💨
After 30 minutes of intense instrument swapping (both manual and automatic bridge remover) and me almost punching myself in the face while using the manual removal, the bridge popped out of the mouth and flew over our heads. 😂
My PG Dr. A was the real champ here, who took over the case when she saw me struggling. She managed to dislodge the bridge almost completely, while I had the honour of delivering the final blow. The credit still goes to Dr. A though. 😆
Sadly, we weren’t able to save 34 as the crown was severely damaged due to caries, both the crowns of 34 and 36 were removed with the crown. 😅
The patient was sent to OMFS to get the remaining tooth structure extracted. 😌
The patient was very kind, and he was extremely patient with us while we worked. I hope uncle has a safe flight tonight. 🌸

Also thank you Dr. Kaynaat for the pictures. 💕

Aamna’s Dental Digest updated their business hours.

🗓: February 19th, 2022

*APDSA Snack 1: How To Handle Paediatric Patients!*

As my house-job rotation for Paediatric Dentistry draws near, I feel it’s time I reorient myself from dealing with geriatric patients in Prosthodontics to dealing with paediatric patients in Paediatrics.🚸
In some way, dealing with both extremes of age is somewhat similar. Both have a hard time understanding commands, both have a hard time communicating, and when both age groups get agitated you surely won’t get any work done.😅

The theme of this webinar was learning how to deal with paediatric patients. There are 3 major considerations that you must keep in mind while treating kids:
1️⃣: Mental Health of a child.
2️⃣: Psychological Trauma.
3️⃣: Their Perception of Dental Treatment Now versus in the Future.

Since we’re setting a basic foundation of dentistry in a child’s life, how they experience dentistry in this age group will largely impact how they’ll perceive it in the future. Dental Anxiety and Dental Phobias burrow their roots deeper and deeper if a person has a traumatic dental experience in their childhood.
There’s a relationship between us, the child patient and the parents/family/guardian that is termed as the “PEDODONTIC TRIANGLE”. It is a delicate balance between the three groups, where tipping off one side results in the destructive impact on the other.

As the dental world progresses by leaps and bounds, there has been a shift from “BEHAVIOUR MANAGEMENT” to “BEHAVIOUR GUIDANCE”. How are these any different you may ask. Well:
🟢BM stigmatises an individual, while BG supports and guides the patient/family.
🟢BM makes the dentist look a bit bossy and entitled that instills negative emotions in the patient/family and makes them feel like their losing control, while BG gives them the control that makes them less apprehensive.

While dealing with paediatric patients, one must know about “ADVERSE CHILDHOOD EXPERIENCES (ACE)”
These become apparent in the first 18 years of life (from ages 3-18 to be exact), and include:
♦️Psychological Trauma.
♦️Abuse/Neglect.
♦️Living Conditions and their impact.
♦️Parent/Carer problems.

Knowing how to identify these experiences are very important for child safety. Sadly in Pakistan where we do have active CPS organisations, so many of these abuses go undocumented simply because “They aren’t in our domain.”

Finally, one must know how to schedule a paediatric appointment, for optimal working conditions for us and positive dental experiences for the child.

➡️1st Visit:
The first appointment should NEVER be the one where you drill and fill. The first visit should be all about prevention and information for the patients and their families. In this appointment, all you need to do is try to gain the trust of your tiny patient. Make the child watch a video, show them around the clinic, apply the principle of modelling to show them there’s nothing to be scared of. 😁

➡️2nd Visit:
The second visit is about you setting the field for work. Explain them the procedures. Apply the “TELL-SHOW-DO” technique. Encourage questions and answer them accordingly. This is where you strengthen your bond with the patient.

➡️3rd Visit:
This is where you work. Be prepared for minor hiccups along the way. Don’t forget to positively reinforce good behaviour and ignore the bad ones. At the end of the day, praise the child for their cooperation.

Now you might just have earned yourself a new friend and a new patient! 🤩🌸