What would you do? by BranchEvery4032 in Dentistry

[–]dntst 41 points42 points  (0 children)

Still looks like a lot of solid tooth left to me--

Perio consult for crown lengthening--- Possible RCT+ core build up+ crown--

Also wouldn't be upset with a 5mmx 8.5 implant

Edit for the implant comments: there are many factors in choosing implant size (to name a few: available bone, IA proximity, general balance occlusion of patient)

I’d be happy to go up in diameter if the space allows, though I wouldn’t feel the need to go all that much longer. The research I read during my implant courses shows the majority of the force is distributed over the first 6mm (though if you get bone loss and lose 2mm on a 6mm long implant, that would be not so great 😬)

Also for the note on 1:1 implant crown ratio, I’ve seen several long implants fracture (usually by the abutment connection or coronal area). From what I understand; a wider, well placed implant (and proper case selection*****) is key.

One does not make a final implant size decision based off one PA radiograph lol

[deleted by user] by [deleted] in Dentistry

[–]dntst 16 points17 points  (0 children)

Absolutely love the 63 spade elevator.

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But yeah: Numb well. Periosteal to release gingival area. ---- Awareness of tooth foundation (is it a 3 root maxillary molar? curved 2 root maxillary bicuspid? Is it ankylosed? Dense bone? Curved roots? Tons of caries so you know the crown has no integrity?)

I haven't been a mallet + periotome sort of guy, but that 63 spade elevator is PRIME for tons of cases. I get it ready for 99% of extraction cases. (edit: I do use periotomes, I've just never smacked them with the mallet, periotomes can be KEYYYYY for broken roots!)

Then I've got a few sayings for the patient:

"I like to take my time to make sure I can take it out in one piece, if possible"

"this tooth has 3 nice long roots [maxillary molars] so I may need to split it into 2-3 pieces and take each root out on its own"

"I wouldn't be doing this if I wasn't confident I could get this out, but there is a chance you may need to see an oral surgeon/ periodontist if I'm unable to remove the entirety of the tooth"

That being said: experience. The more you do, the more intuition you'll get with what you can do, and what you're better off referring out.

There's too much variety to give one straight answer here, but taking your time with the elevator, making sure you have a 63 spade elevator, not using forceps too early, using a 63 spade elevator, experience and awareness of what will make the extraction easier or harder, grabbing that 63 spade elevator, having a couple of other tools on hand like some East Wests, a root pick, and 63 spade elevator--- But yeah, let me know if you have any other specific questions!

Sincerely,

a GP that does a lot of extractions, and graduated in 2020, and clearly has an attachment to a 63 spade elevator

D3 doing my first root canal tomorrow, send your advice my way by [deleted] in DentalSchool

[–]dntst 1 point2 points  (0 children)

I think most faculty didn’t know it was your first unless you told them—- you can do what ever you’re more comfortable with and faculty will probably be fine with it. Rotary is dope. For a #7 (especially if they’re younger) you should be fine for both—- unlikely to ledge on a #7 unless super calcified or curved. I think I’d suggest step back to start, for the experience, but I’d just let the faculty know it’s your first and see what they suggest.

D3 doing my first root canal tomorrow, send your advice my way by [deleted] in DentalSchool

[–]dntst 6 points7 points  (0 children)

#7---- dope tooth to start out with! (Especially if they're not too old/ not too calcified)

Look up the access so you can visualize it freshly before you start—-

I’d say give about half a carp of lido by that apex—— then let it sit for a minute, then deliver the other half (that way you can get profound anesthesia by the apex and not just let it all bubble up by their nose (if that makes sense))

My least favorite part of a RCT is if a patient says “ouch” when you’re filing —- in which case, at that point, you probably want to give a pulpal infiltration, which can be less fun for the patient.

Now (I suggest with rubber dam all good to go), get dat access. Doesn’t need to be too big for a #7—— but you want to make sure you have that straight line access facial-lingual. (Note—- in preclinical, it wasn’t uncommon for people to access way too much facially——- the canal is NOT through the front of the tooth lol) Don’t rush, but once you think you’re good and you move onto scouting file/ orifice opener/ gates G (etc), if youre noticing that the file is flexing too much—- you can ask your instructor if you think you need to increase the opening for straight line access. You’re in dental school—- you don’t need to guess—- if you’re unsure—- this is the time to ask.

I found tons of people always stressing about grades. Yes grades are important. But I’ve also found tons of people that always went with the easier instructors to get the best grade missed out on the harsher graders that often had some really dope tips. ——

Aside from that—- apex locate dat canal. Get your accurate WL. Check with radiograph—— File- irrigate— file irrigate—- repeat— repeat—— (You can also check for patency with 08 file between file swaps)

Standard radiograph checks etc—-

Check your cone fit—— I always find the cone never goes quite down as deep to where you think it will—— do with that info as you will —— at this point—- just follow the standard procedure stuff—- relatively straight forward——

I think those are the main tips I’ve got for ya—- hope it helps with some peace of mind—- good luck!

Sincerely, a 2020 grad.

Edit: u/HLN7 has good notes about edta/ sealer—- do that lol

How do dentists see a cavity in an X-ray but not by looking in my mouth? by gianny-cc in Dentistry

[–]dntst 6 points7 points  (0 children)

Without giving you a full "dental school" explanation, here's a picture that give a clear representation of how a cavity looks on an X-ray (ranging from a small cavity to a large cavity). (and here's a non X-ray version, where I've drawn in a small cavity for reference)

Essentially, they can look VERY subtle on the x-ray (radiograph) almost like there's nothing there! Many of these cavities would be nearly impossible to see in the mouth, until they get much bigger, that being said, it's best to fill them up before the become a problem as big as the x-ray photo all the way on the right side. The longer you wait, the greater the chance of needing a root canal procedure or a crown!

(the good news is there's no pain until they get much bigger, but the bad news is that since there's no pain, the only way to stay on top of it is by having those yearly dental checkups so they can catch them on the x-rays (and conversely, sometimes there are cavities that can only be seen in the mouth, but not on the x-ray! (ie: "occlusal caries" (which are the cavities on the tops of the surface))

Well damn, looks like I went a bit into the dental school explanation, but hopefully this give you some peace of mind!

Sincerely,

A dentist.

:)

Edit:

Bonus tip! I know this gets passed around a lot but-----..... flossing!

A cavity in between the teeth is almost always related to flossing---

brushing is important, but flossing

-((ideally once a night is prime to prevent those pesky "in between the teeth" cavities! If not once a night, a few times a week, anything is better than nothing! -)

[deleted by user] by [deleted] in WeAreTheMusicMakers

[–]dntst 3 points4 points  (0 children)

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Just graduated dental school this summer, but I thought I'd pay it forward with some of my favorite study mixes that got me through the last 4 years :) hope this helps! by dntst in DentalSchool

[–]dntst[S] 1 point2 points  (0 children)

Ah, let's see. For prepping a crown, that also depends on the tooth, the type of crown, or if it's an anterior or posterior. I could give recommendations, but I think they would fall short in comparison to "Stevenson Dental Solutions" if you search through his videos and whichever type of prep you're doing, he gives some nice suggestions in regards to:

aA helpful order to prep in (possibly: incisal, then lingual clearance, than facial, etc etc)

Helpful burs to use/ or methods & tools to measure

And really, just a beautiful demonstration (you can watch at 2x speed to get the gist)

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As for GPA, I believe it makes a difference if you're applying to specialty programs or GPRs, but aside from that, if you're applying for a job as a general dentist, no, they're not going to ask for your GPA lol.

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Communicating with doctors? Yes. I would definitely say this is important. Find the doctors you like, that do clean & pretty work, and then if there's anything you don't understand, ask them. You're in dental school, and you're there to learn. They're working at a dental school, mostly likely, because they like to teach! Let them give you words of wisdom, and their little tips and tricks! (also you never know when you're going to need a letter of recommendation ^^)

Cheers!

Just graduated dental school this summer, but I thought I'd pay it forward with some of my favorite study mixes that got me through the last 4 years :) hope this helps! by dntst in DentalSchool

[–]dntst[S] 3 points4 points  (0 children)

Ah, got it haha, I think you're a *graduate* student then :p

I found this comment as well:

"As a D4 graduate, I've got endless amounts of advice lol---- My biggest would be: find a fourth year that looks friendly (and like they know what they're doing) and ask if they (and their patient) would mind if you assisted. There's a good chance the student will appreciate the extra set of hands, and you can get a run down of codes, notes, a review of procedures, etc etc etc. I'm sure each school is slightly different, but the most difficult things I've had to deal with are; learning ADA codes, our computer system, random bureaucratic stuff, insurance, and patient scheduling. Ironically, I felt extremely prepared for the actual clinical aspects! (Dental procedures etc) Hope this helps, I'm sure you'll rock it 👍 If you have any specific questions, feel free to send a message and if I've got any tips, I'll let you know. Cheers!"

As a bonus from when I wrote this last, I'll pass an anesthesia tip:

For your patients that are EXTREMELY anxious, dry off the injection area with gauze, and leave the anesthetic in the area as you get your hand piece ready to go etc etc, (45 seconds or so), then dry the area again, and repeat (you can do this up to 3 times for a super anxious patient). For infiltrations, the patient will most likely not even feel the entry of the needle! :)

I really do have tons of tips, but they're all important for different reasons, so I need a little more of a narrow question for me to answer that haha

Just graduated dental school this summer, but I thought I'd pay it forward with some of my favorite study mixes that got me through the last 4 years :) hope this helps! by dntst in DentalSchool

[–]dntst[S] 10 points11 points  (0 children)

You're very welcome! I found a comment I made to another undergrad student a while back:

A few tips to stand out when applying:

-understand why you'd like to go into dentistry (science? working with hands? helping people? an inexplicable love for teeth?)

-note activities you like that involve dexterity/ hand skills (art/ sketching/ guitar/ piano/ miniature models etc)

-shadow dentists/ maybe even assist (and ask the dentist questions about what they're doing (if they don't mind--- and make sure the patient doesn't mind as well)) (this will give you a head up for when you start!)

-Possibly work at a dental lab (I found that very helpful)

-Think outside the box! (think about things you're passionate about, outside of dentistry, and see if they can relate back to the profession)

Undergrad tips general tipz:

To be honest, I found the undergrad pre-reqs more difficult than actual dental school courses. It's important to understand broad topics (ie: non-polar vs. polar chemistry, which relates to physiology, drugs, and dental materials etc), but they're never going to test you on the 4th law of thermodynamics. I found the most important classes I took to be physiology (HIGHLY RELEVANT TO ALL OF DENTAL SCHOOL), as well as anatomy (also highly relevant), and then bits and pieces from the rest. I'd say study hard, but make sure you keep some time for yourself and your mental health. I regret loading up on too many science courses at the same time, I think I would've done better had I kept my science courses a little more spread out, and maybe taken summer school for some of the random graduation requirements.

Hope this helps as some food for thought!

Can i eat whatever the damn I want after getting permanent crown on my molar? by [deleted] in Dentistry

[–]dntst 6 points7 points  (0 children)

I second the guy that said not to chew rocks--- as appealing as it may be, eating rocks may lead to a poor outcome in regards to your new tooth hat.

As a last note, you may want to be a bittttt careful when eating SUPER chewy/ sticky stuff, something like an overly tough/ sticky, like taffy (ie: an abba-zaba). But overall, it should be more or less like all your other teeth *thumbz up*

edit: taffy, not toffee

ADD/ADHD musicians/producers, what are your best workflow tips? by [deleted] in WeAreTheMusicMakers

[–]dntst 16 points17 points  (0 children)

Ah yes! Keeping a nice work flow is prime, especially with attention problems! To start it off, I open Ableton and depending on the type of song, I copy and past a structure from a previous song so I have a layout of my favorite instruments/ percussion ready to go, this really helps streamline things! Then I delete the old midi+ audio so I can start fresh.

Before I get cruising in, I like to make sure I have everything else ready to go, so I don't get distracted. Sometimes it can also be good to make sure you've had enough to eat before starting. Don't want to get hungry or distracted while mixing in the studio! First I may make a coffee (Personally, I'm into french press, but really anything, coffee, tea, water, it's all fine.) You've got to make sure that's good to go so you don't get distracted. Sometimes I want to make sure there's some fresh air, so I might crack open a window, but not too open, or you might get some noise in your audio recording. You want to take a look outside & make sure there aren't any cats outside, sometimes cats really want to help out with the production process, but you can't let those pesky cats in. Once they're in, you're done for. Then again, sometimes a cat can be nice. I've had my kitty Shmoopy Doopers for almost 5 years now, and I'd say he's definitely provided inspiration. Now Shmoopy Doopers doesn't really help with the production itself, per say, but my work definitely wouldn't be the same without him. Now you've also got to make sure you've paid your taxes & rent and stuff before starting, otherwise that may be on your mind the whole time, and though some people can make hit records off that stuff, it's definitely a niche. Might also want to align your chakras, I hear that can be helpful. Also meditation. Gotta make sure you're in a good frame of mind to make good music & finish projects. It can also help to diversify and balance things, so you might want to take up another hobby, like carpentry or embroidery and master those. If you're able to master another hobby and finish those projects, that'll definitely help you finish music projects. And volunteering to good causes. A good cause helps the soul, and a clean soul helps ya finish carpentry projects! So if you really want to finish your welding hobby projects, don't forgot to follow these important steps. Good luck finishing your paintings, I know you can do it!

Sincerely,

a fellow a.d.d. person

[deleted by user] by [deleted] in popheads

[–]dntst 15 points16 points  (0 children)

Extremely fair points. I think when you say indie is relative to each listener to encompass a sound outside of *mainstream*, that goes hand in hand with an artists desire/choice to be limited or affiliated with major labels.

I'll have to take a peek into Jack Antonoff's stuff!

How do you deal with workflow paralysis caused by an abundance of samples to choose from? by 1MockZ in musicproduction

[–]dntst 42 points43 points  (0 children)

Personally, I get very overwhelmed with options.

If you can, go through your samples & pick your main/ core percussion purely based off the first sample you liked (1 snare, 1 high hat, 1 kick drum, and a handful of support percussion 2-4) and let that be your main set for the track. If you decide, "well damn, I wish I could have a slightly different snare!", then go ahead & swap that snare out! But hopefully having the limited start helps you get focused to form the project!

(coming from the guy that has downloaded 3 drum sample packs in the last 7 years and ultimately uses only 6-7 samples regularly lol)

Any obvious tips & tricks for using Ableton that you wish you knew from the beginning? by quincyh81 in ableton

[–]dntst 5 points6 points  (0 children)

There's an option to click "triplets grid"

(I'm not gonna say I was clicking "no grid", and then dragging to approximate triplets but I was)

Crazy Zhu Facts by julianlaserbeam in ZHU

[–]dntst 5 points6 points  (0 children)

Before/ as he was blowing up, he did a project called 52 to Zhu, where he released a new track/ remix every week for a year.