Today was a change of pace in my daily dental adventures, as I worked in the city office today and observed a variety of oral surgery cases. When I first arrived, a women had walked in on her lunch hour with pain in her back tooth. The Dentist asked the woman's age-something I was taught never to do in America-and he knew without looking in her mouth that the problem was her upper wisdom tooth. Apparently in spite of her lower tooth pain, the problem was actually cause by the upper tooth sharply rubbing against her inner cheek and lower wisdom tooth. Her upper wisdom tooth was impacted and pushing against her other teeth, and the problem could easily be solved by removing the tooth. The youg woman was already shaking just having the dentist looking in her mouth, and the thought of him yanking out her tooth was horrifying. The Dentist must have spent over fifteen minutes convincing the frightened patient that it would be in her best interest to remove the tooth now. I was impressed by his calm demeanor and delicate approach to coax the nervous woman. I often find that so many of my peers are too caught up in the science of medicine that they forget that so much of the field is about patient care- which requires relating to the patient, and understanding their fears to the extent that they will be comfortable enough to accept the treatment. Just the other day I was on the phone with a woman who wanted to schedule a simple hygiene appointment, but she was so horrified by a traumatic experience she had where a hygienist 'ripped her gums apart (as she claimed)', and I had to ease her into even scheduling an appointment- convincing her that the dentists were very gentle, etc...After finally convincing the woman to have her wisdom tooth removed on the spot, still shaking, the woman accepted her treatment plan and bit the bullet. Within three minutes, she was numb, and the tooth was out. She exclaimed that it didn't even hurt at all! The doctor had actually spent more time talking her into treatment than treating her. I suppose that's just part of the job- and oddly enough, it's the people aspect that I actually admire most. Really, lots of people can learn how to take out a tooth, but it takes a special dentist to make a patient feel at ease and accept a course of treatment.
The next patient was the opposite of nervous. Rather, she was ecstatic to get her new implants. As an NHS patient, she was overjoyed that the Dentist was even treating her with implants. She wanted to see everything, know all of the details of the procedure, etc... After completely sterilizing the room and draping it in surgical drapes, the team was ready to go. The Dentist numbed the patient, and after ensuring she was numb, he lifted her lip and made a small incision in her upper gum, exposing the bone. He was first removing a cist that had formed on the tip of the root of one of her canine teeth, and he would then begin the implants. He drilled a small hole in her bone under the gum, exposing the cist. The next few steps blended together a bit, but he ultimately pulled out the tooth, which had the cist attached to the root tip. Next he began the implants; and first removed two teeth from the woman's bridge, exposing space in the gumline for the implants. He drilled a hole into the gumline through the bone, and made a place for the implant. He explaind that it is important that the holes are paralell so when the implants are inserted they are perfetly in line in case down the road she wants to have a bridge put on, or something like that. After drilling the hole for the second implant, he screwed in each implant into the fresh holes, and used special tools to remove the excess bits of metal while leaving the implant flush to the bone (as they were bone level implants). After capping the implants, the final step would be to sew the gum flap back over the bone and over the new implants. Though the patient would have a couple of toothless spaces in her mouth sans teeth for a couple of weeks, it would be worth it down the road when she could have a variety of appliances attached to the implants. In a couple weeks she could have a bridge placed in the space, and in six months time, she could have the implants completed once the bone grows over the new implants. The patient was so overjoyed with her treatment that she gave the Dentist a big hug after the bloody procedure. I'm quickly learning that here, perhaps in London, or perhaps just in this practice, patients often walk in off the streets expecting their problems to be solved, and more often than not, they are! I can't say that would always happen in the states, there is usually a lot more formality in medicine, but at least for now, in my minimal experience, proper care is being given to those in need.
Cheers.
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