Dental Reflections 002

got to review a case today after a pulpect, thought this one was worth writing up.

pt walk-in c/o lingering sensitivity on #12

o/e: #12 barrel morphology, AR (o) intact (and yes the barrel was that big), nttp/pp and perio normal but lingering to cold, EPT positive

dx: #12 irreversible pulpitis, normal periapex

so there i was with a pulpect of a #12 in a tooth with an old AR which i suspected to be a dens invaginatus. hacking out the AR yielded.... no pulp chamber or canal. gentle exploration at the base of the invagination yielded nothing either. and so, one consult later, my answer appeared in front of me... the canal, by very very careful staring at the PA, was in fact mesial to the dens invaggie chamber, and had i gone on a quixotic dig-to-china spree on the base of the chamber i may well have done a mid-root perf. heng ah!

lesson learned... in the dens invaginatus the pulp chamber proper may not lie in the middle of the tooth!

Dental Reflections 001

what i learned this week:

1) fear is a very powerful motivator and must be managed well. or else patients will go and do stupid things and make stupid choices.

2) the people who have dental anxiety tend to have heightened gag reflexes and strong circumoral and tongue muscle tone. truly trouble never comes singly.

3) never underestimate the trouble in matrix banding a lone-standing tooth and trying to get good contour from the outset. it's not going to happen.

4) the person who smokes a pack a day is smoking just over $10 bucks of noxious chemicals every day. this means that the SAP visit he claims is too expensive could be afforded by, oh, say, stopping smoking for 5 or 6 days. the single unit chrome partial by not smoking for, oh, 2 months. and then imagine the patient who smokes 2 packs a day...

4a) truly, smoking is a great social evil that keeps the poor poorer. and yet it is a self-inflicted poverty that strikes in 2 phases; the first when the person spends his hard-earned Yusof Ishaks on smokes, and second when he lands his posterior on the NCC treatment list...

Luminosity Is Levity/ And Levity, Luminosity

its been a very long time since i put finger to keyboard for this blog. far too long. but i guess after recent turns of events one should take the time to put ones mind to the written word as an exercise in focus. sorry boss; there ain't not patients present on worklist or in-tray...

it finally happened on sunday. ibu myra decided to postpone the orthognathics for PJ because of a persistent, nasty, phlegmy URTI. in a dispassionate way, one could well reflect that it was for the best. who wants to do elective ops on a patient who isn't ASA 1? and in a way that allows one to be gripped in emotion, this has been something that she's quite literally been waiting for; and end point to her ortho tx. and this has taken four whole years, probably twice the duration of your average pt. but all in, long term management of a disappointment situation must be one whereby disappointment gives way to acceptance and a willingness to move forward. failure to recognise a closed door and an acceptance of a new path will only need to unhappiness and depression.

so what's my take on the whole thing?

- the good Lord closes doors according to his will and timing, and it is definitely not in the christian's best interests to either whine at the door which he closes, or to try to breach the door.

- at the same time, the door which he will surely open instead of the closed door will be a door that will prove beneficial compared to the closed door.

- true peace comes from acceptance of guidance when one's will is subordinate to, and guided by, the divine hand.

so yeah... time to apply leave for the 12th of may!

a second thing ive been wanting to do is start a series of blog entries on what i've learnt at work so far. i'd hate to forget any of the lessons that i've learnt while i've been here, and there are so many of them...

as a closing note, watch Bamboo Blade. a recent work of anime, this short series focusses on a high school kendo club and its members. and thats probably all i can say without blowing the plot, after all its classic slice-of-life genre stuff. the brilliance lies in how this series has fun, advances plot and yet doesn't take itself too seriously. there's emotional development, yet not too treacly and emo, great shinai-work, and they even created a whole faux Super Sentai show for the lead character to idolise! enough blurb! get thee to Veoh!

Star Rise - Bamboo Blade Seiyuu