Dr Pulp

How to Improve your Practical Hand or Dexterity In Dentistry.The Secret of that Perfect Hand.

2011-10-17T15:25:00.003+05:30

This article have been written for dental students but beginner dentists can also find it helpful.

Being a Dentist we are bit different from other health professionals.We treat our patients by working actively
inside there mouth and we have to develop superior manual dexterity to achieve best results.Consider average mouth opening of a person,it is not more then four fingers wide and what about the visibility and accessibility of our operating field? It’s weird!!! We work in a field in which people struggle to put a ‘Burger’ and we are expected to do miracle and yes we are doing miracles. We perform detailed, meticulous procedures on a minute scale and margin of errors are in micro fractions, our instruments are sharp and invasive, loss of concentration will result in damage to vital tissue which is unacceptable.

Hmmm... I think its enough of self praising!!

Q.So what is this so called Good practical hand ?
A.It is called as Clinical dexterity in proper terms and it is skill in performing task especially with hands.

Clinical dexterity or abilities to perform task with hands develop over time,starting with primitive gestures such as grabbing at objects to more precise activities that involve precise eye–hand coordination.Improving your clinical dexterity involves practice of same procedure multiple time in controlled way, In this way small muscles of your hand will be conditioned for the procedure. This is called as developing Fine motor skills and these are the skills that involve a refined use of the small muscles which control the hand, fingers, and thumb. The development of these skills allows one to be able to complete tasks such as writing, drawing, buttoning and finally doing dental procedures.

How motor skills are developed?

You must know that there are two types of motor skill,

Gross motor skills include lifting one's head,turning,moving head etc.Generally large muscles develop before smaller ones, thus, gross motor development is the foundation for developing skills.

Fine motor skills include the ability to manipulate small objects,and various eye–hand coordination tasks. Some examples of fine motor skills are using the pincer grasp (thumb and forefinger) to pick up small objects,like holding endodontic files.

Two Essential Things that affects your motor skill:

1.Hand-eye coordination:

One more important factor for a dentist is good hand-eye coordination. Hand–eye coordination is the coordinated control of eye movement with hand movement, and the processing of visual input to guide reaching and grasping along with the use of proprioception of the hands to guide the eyes.

2.Correct Positioning :

Positioning is very important for engagement in fine motor tasks. A dentists seat should allow him to sit comfortably with his feet placed firmly on the floor. His hips, knees, and ankles should be at 90 degree angles, with his torso slightly forward. His operating field should be approximately at the level of his elbows when his arms are at rest at his side.Keep in mind that trunk stability is necessary for good mobility of the arms, hands, and fingers.

Interesting Fact: Ambidexterity is a specialized skill in which right and left both hands are equally dexterous and dentist can use any one of his hands as dominant one while working.

How can you build your skill by the time you proceed in your dental school :

1.Start with simple manipulation of dental materials: how to hold spatula and bowl. What is the correct technique of mixing? Don’t dare to underestimate it. it will build foundation of your dexterity as well as your confidence and in bonus you will learn about properties of dental materials. If a dentist cant manipulate plaster or alginate it’s hopeless.

2.Wax block carving: Enjoy your carvings. Carve the anatomy of ALL teeth not for completing quota but for fun. Never ask anybody to carve for you. Dedicate as much time as you can in understanding and reproducing the anatomy of tooth. Not only teeth but you can do your imaginary carvings .Get an idea from your surroundings try to carve it on wax block and if you make something good don’t keep it to yourself Show it to your classmates, teachers and seniors get appreciated, this is the secret of building positive attitude, every time you get appreciated your confidence is improved your hand is improved.

3.Making miniature models/ sculptures: out of dental materials like plaster and modeling wax is one of the favorite things I did in my college time. I used to make something out of any dental material which can be manipulated. Fortunately I got Best crafts award in “Colors 2009” annual function. Try doing!! its real fun. Beside it will improve your dexterity and confidence.

4.Preclinical Work: Take your preclinical very seriously. This is the step before handling real patients. This is to prepare and train you for your clinical work. If you try to skip it or take it lightly. You are going to do blunders in your patient’s mouth. Become through with the basic theories try to do work as ideal as possible. Complete your quotas and work hard to do so.

5.Clinical Work: A sound practical knowledge is necessary for doing clinical work it’s the humans on which we are working on. we have to read lots of literature to understand and build good practical knowledge. It’s important to note that I am not asking you to mug-up the theories, I am asking you to understand it, analyses it and be able to Execute it when needed.While working on patients be calm and controlled try to execute the ideal work style ( I know it not 100% possible but try to be close to it) if you know you will have particular patient in particular days ex- extractions in oral surgery posting then do your preparations. Find books on local anesthesia read the technique for blocks arrange a skull and mandible find some one good in that to demonstrate you the landmarks and technique. Try making mental map and imagine it in patients. Believe me if you are prepared you will be less anxious and more confident. Try to apply this in every department, if you know you have to treat patients be prepared for it. Never go empty head you will not get anything accept your frustration and scolding from your teachers.

Pattern of learning for Dentists- [ The Read, See and Do] formula

READ- your text before any Demonstration, don’t go blank for any demonstration.

SEE – Observe carefully with full concentration what your Teacher or Guide is demonstrating. Humans have amazing photographic memory use it.

DO- Try to execute it as soon as possible our memory is very volatile try not to rely on it. Doing soon means you retain most of the part of demonstration.

So now we know how it works and how it can be developed. First and foremost thing is your interest in dentistry. The person aspiring to become dentist should be self motivated and ready to accept this challenging field. This field require long period of Training, Patience, Hard work, Endurance and Dedications. (It’s important to note I have not written the word intelligence because I don’t think it’s need in starting because you will develop it by time if you have above mentioned qualities).

Its not important where you start its important where you end.

This article is not for those who want to achieve there goals by hook and crook or just want a degree.I am writing this article for those who want self improvement and want to achieve there goals by there work and prove themselves.This field is for tough people and hard workers don’t opt it if u don’t think you are one of them otherwise you will end up in frustration and failure and if you are dedicated then don’t worry because one day you will develop these qualities and achieve success.

photo credit: Symic via photopin cc

6 Tips to Improve Your Tooth Carving.

2011-05-28T12:32:00.012+05:30

STEP 1. Read and understand the tooth anatomy
1.Before your guide gives you the demonstration- first thing you must do is read the anatomy of that tooth. If you will go empty mind its difficult to absorb anything from demo.
2.While reading the anatomy make point wise notes of the each surface of tooth. Facial, lingual, Mesial etc.
3.My favorite book for dental anatomy is Wheeler's Dental Anatomy, Physiology and Occlusion use it. it's a must and best standard text book.
4.Don't rely on memory keep this notes and Wheeler's book beside you while you are carving the tooth.

STEP 2. Get proper instruments
1.Get a good quality Lecron carver for yourself. While buying the carver check for the sharpness of carver, don't take blunt carvers.
2.A Metal scale ruler is best for measuring dimensions, vernier caliper can also be used for perfection.

3.Take good quality of carving wax it should neither be too soft or too hard. too soft will be distorted and too hard will be difficult to carve.

STEP 3. Keep an ideally carved tooth in front of you
Ask some one like your Teacher or fellow classmate or Senior Who are good at carving to do an Ideal tooth carving for you, This have two benefits- 1. You have an Ideal carving to look and learn,2.You get a extra Demo when you see your friend or senior carving the tooth. If no body is there to carve for you then get an Extracted tooth.
Step 4. Start Carving
1.At the time when you start carving you should have good understanding of the anatomy of the tooth.
2.Start with gross carving of different surfaces - starting with facial then lingual, then mesial and distal, occlusal being the last.
3.While doing the gross carving keep measurements 1mm greater then what is needed this 1mm will be used in fine carving and finishing.
4.After doing the gross carving, go for the fine carving for producing the details
5.Wipe the finished tooth with a piece of gauze. be careful not to apply pressure.
Step 5. Remove Distraction & Concentrate
1.Find a comfortable place where there is least distraction.Carving needs lots of concentration,observation and learning don't take it casually.

Step 6. Do Imaginary carving
1.Just take a wax block and carve what ever comes in your mind, keep a model in front of you or just imagine and carve a sculpture.
2.This need not to be perfect or amazing, I ask you to do this because it have following benefits.-You don't have to be perfect or follow any measurement so you carve with more relaxed mood. It will keep up the interest of carving.-Yo start to learn the properties of wax- how much pressure to apply and how to remove and cut wax. what to do what not to do. its a basic process of learning.
Practice, Practice, Practice
Keep on trying and practicing to carve, It can not be mastered in one day,
More you carve better you get.When you practiced enough with certain tooth, help your friends if they ask for it, Don't carve to complete their quota but give them demo and share your learning.

"Hand of Hope!" A Medical miracle

2011-05-02T19:42:00.019+05:30

On Aug. 19, 1999, photographer Michael Clancy shot the "Fetal Hand Grasp" — his picture of a 21-week-old fetus grasping a doctor's finger during innovative surgery to correct spina bifida. Nearly four months later, on Dec. 2, Samuel Armas was "born famous."

The photo, which first appeared in USA Today on Sept. 7, 1999, quickly spread across the globe as proof of development in the womb and was later cited during congressional debates on the Partial-Birth Abortion Ban Act, which passed in 2000.

No wonder they say the world still holds wonderful
miracles ...
A picture began circulating in November. It should be "The Picture of
the Year," ...or perhaps, "Picture of the Decade." It won't be. In fact,
unless you obtained a copy of the U.S. paper which published it, you
probably would never have seen it.
The picture is that of a 21-week-old unborn baby named Samuel Alexander Armas, who is being operated on by surgeon named Joseph Bruner. The baby was diagnosed with

spina bifida and would not survive if removed from his mother's womb.
Little Samuel's mother, Julie Armas, is an obstetrics nurse in Atlanta.
She knew of Dr. Bruner's remarkable surgical procedure. Practicing at
Vanderbilt University Medical Center in Nashville, he performs these
special operations while the baby is still in the womb.

Duringthe procedure, the doctor removes the uterus via C-section and makes a
small incision to operate on the baby. As Dr. Bruner completed the
surgery on Samuel, the little guy reached his tiny, but fully developed
hand through the incision and firmly grasped the surgeon's finger. Dr.
Bruner was reported as saying that when his finger was grasped, it was
the most emotional moment of his life, and that for an instant during
the procedure he was just frozen, totally immobile.

The photograph captures this amazing event with perfect clarity. The editors
titled the picture, "Hand of Hope." The text explaining the picture
begins, "The tiny hand of 21-week-old fetus Samuel Alexander Armas
emerges from the mother's uterus to grasp the finger of Dr. Joseph
Bruner as if thanking the doctor for the gift of life."

Little Samuel's mother said they "wept for days" when they saw the picture. She
said, "The photo reminds us pregnancy isn't about disability or an
illness, it's about a little person" Samuel was born in perfect health,
the operation 100 percent successful. Now see the actual picture, and it
is awesome...incredible....and hey, pass it on! The world needs to see this one !

After reading this touchy Article it came in my mind that where is this Little Samuel nowadays.So i researched little bit and found some recent pictures of him and some more facts about the story behind the picture.& some one even made a (facebook page of hand of hope) Here is more to satisfy your curiosity.

Story of the "Fetal Hand Grasp" Photograph
As a veteran photojournalist in Nashville, Tennessee, I was hired by USA Today newspaper to photograph a spina bifida corrective surgical procedure. It was to be performed on a twenty-one week old fetus in utero at Vanderbilt University Medical Center. At that time, in 1999, twenty-one weeks in utero was the earliest that the surgical team would consider for surgery. The worst possible outcome would be that the surgery would cause premature delivery, and no child born earlier than twenty-three weeks had survived.
The tension could be felt in the operating room as the surgery began. A typical C-section incision was made to access the uterus, which was then lifted out and laid at the junction of the mother's thighs. The entire procedure would take place within the uterus, and no part of the child was to breach the surgical opening. During the procedure, the position of the fetus was adjusted by gently manipulating the outside of the uterus. The entire surgical procedure on the child was completed in 1 hour and thirteen minutes. When it was over, the surgical team breathed a sigh of relief, as did I.
As a doctor asked me what speed of film I was using, out of the corner of my eye I saw the uterus shake, but no one's hands were near it. It was shaking from within. Suddenly, an entire arm thrust out of the opening, then pulled back until just a little hand was showing. The doctor reached over and lifted the hand, which reacted and squeezed the doctor's finger. As if testing for strength, the doctor shook the tiny fist. Samuel held firm. I took the picture! Wow! It happened so fast that the nurse standing next to me asked, "What happened?" "The child reached out," I said. "Oh. They do that all the time," she responded.
The surgical opening to the uterus was closed and the uterus was then put back into the mother and the C-section opening was closed.
It was ten days before I knew if the picture was even in focus. To ensure no digital manipulation of images before they see them, USA Today requires that film be submitted unprocessed. When the photo editor finally phoned me he said, "It's the most incredible picture I've ever seen."
- Michael Clancy (photographer of the hand of hope)
check his website

Picture of Samuel Armas

Credits:

[Image:Michael Clancy ]

10 Free Apple iPad iPhone Applications for Dentists and Dental patients.

2011-04-26T17:09:00.029+05:30

So my dear friends ! Apple iPad is here and being a dentist we all are thinking how to use it to improve our practice.iPad can be used in all aspect of dentistry it can simplify filling of patients forms and record keeping,It enables you to educate your patients through various pictures and video applications and it can also help technicians refer to digital images and create perfect prosthesis.if you

Here are Top iPad application hand picked by me, Hope you find it useful. Note-Most of the applications can also be used on iPhone

1.Dental Expert- By Cosmetic Innovations,Inc

This application is an excellent patient guide it nicely explains all the aspects and procedures of dentistry,and it have proof read by Dr.MarcLazore of NYC Dentist.Its the best thing.Its Free! Check here for details & download

2.Dentistry ProConsult- By Georgia Health science University-

This is a must have application for every dental students.It includes procedures for all kind of dental treatment in quick and easy way.Its one of the authentic manuals you can use.And guess what?? Its Free! Check here for details and download

3.Dental Manager- By Team Mozzi

This application is for Dentists It can be used for treatment plan construction,for calculating dental costs,For patient consultation and sending results,customer management through photos, emails,SMS etc. to create patient database on your mobile.And the best thing is that its Free!.Check here for details & download

4.Dental Aid Lite -By Digibunny Tech

This application tells about main procedures of common dental treatments,This application provides plenty of figures.The content is divided in categories.Overall best for patients.It will cost you Free! Check here for details & download

5.Dental Plan- By Brayant Clark

This is very useful as For patients They can learn and apply for various dental plans by this application, It also support medical plan,Its Free! of cost.Check here for details & download

6.Dental tree- By Twigger LLC

Its an interactive communication device which covers whole range of dental treatment options.It is very nice educational tool.Its Free! of cost.Check here for details and download

7.Dentalappointments.com- By Dentisoft Technologies

This application makes managing your practice easy.You can research dental tearms,establish online relation with current dentist.set appointments,billing records and much more,and all this is Free! Check here for details & download.

8.Dental Removable Partial Denture Design- By Renata Janson

This application can be used to design RPD on the pictures of the patient cast.I personally don't know the effectiveness,you can download and try, trial is free.You have to buy if you want full features but for now it's Free! Check here for details and download

9.Pediatric Dental Expert- By Cosmetic Innovations,Inc

This application is a parents guide to understand all aspects of your childes dental care & it have been proof read by Dr Marc Lazare of NYC Dentist.its Free! to download so go for it if your care for our child.Check here for details & download

10.DentalXChange Activity Snapshot- By DetnalXChange

If you use DentalXChange for maintaining your bills this application will be very handy for you.It maintains your -Claim connect,Bill connect,Payconnect And its Free! Check here for details & download.

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