Wednesday, 19 December 2012
Tuesday, 18 December 2012
What a treat!
So at the Mercy Ships dental clinic in Guinea, I have been exposed to so many lovely things that I had never seen in Canada. My lack of dental gore in Canada had less to do with what country I was in, and more the fact that I worked in a general family dentistry practice who referred the majority of extractions to an oral surgeon, whereas in our Guinea clinic, exo's are the main procedure.
It is surprising to me how many root tips we remove without finding abscesses present. In plain English, that means that someone has a tooth that has rotted so badly that the whole crown (visible tooth above the gum-line) had been destroyed, and only a remnant of root of left in the gums. When there had been that much decay, you would think that there would have been more infection present in the tooth sockets after they have been taken out. Well today, I got to see a number of lovely, squishy flesh balloons (abscess) emerge from the sockets, attached to the end of the roots. I personally find this fascinating to actually see in real life. For years at my dental clinic we would take x-rays of sore teeth and be able to see evidence of infection, but the bone that it destroys at the apex of the root, but back then, if we didn't root canal the tooth, then we referred the patient to have the extraction, so I never got to see what these severely infected teeth looked like when they came out.
Very often we will do 'clearances' in a specific area of the mouth (which means removing all of the teeth in an area) or extractions of many neighboring teeth, and these prodedures will get quite surgical with bone removal and scalpel use and sutures. So interesting! (I know none of you readers agree)
Some of the molars that we take out have crazy curved roots, or the roots are splayed out at a 90 degree (or more) angle. The dentist will think that he is about to do a routine extraction, and he struggles and struggles to remove this tooth, and when it finally comes out, roots intact, we can see the reason for all the difficulty, it looks like the tooth was in the middle of doing 'jumping jacks.' I have heard from the dentists a number of times "I would never have taken that tooth out if I had seen the x-ray." That's right dental folk, we really don't use x-rays. We have a portable digital machine that doesn't work half of the time when you do want to use it. We are doing humanitarian work and do not legally need x-rays, so we just don't. I have never taken out a tooth, but from watching these guys and gals pop teeth out in a matter of seconds, I don't see why we should need them. (So Erin B, I guess that I won't have extensive opportunity to improve my paralleling technique...)
Today, the dentist working at the chair next to mine was grasping the crown of a molar with his forceps, and the tooth exploded and pieces went flying, one piece bounced off my scrub top!
It is surprising to me how many root tips we remove without finding abscesses present. In plain English, that means that someone has a tooth that has rotted so badly that the whole crown (visible tooth above the gum-line) had been destroyed, and only a remnant of root of left in the gums. When there had been that much decay, you would think that there would have been more infection present in the tooth sockets after they have been taken out. Well today, I got to see a number of lovely, squishy flesh balloons (abscess) emerge from the sockets, attached to the end of the roots. I personally find this fascinating to actually see in real life. For years at my dental clinic we would take x-rays of sore teeth and be able to see evidence of infection, but the bone that it destroys at the apex of the root, but back then, if we didn't root canal the tooth, then we referred the patient to have the extraction, so I never got to see what these severely infected teeth looked like when they came out.
Very often we will do 'clearances' in a specific area of the mouth (which means removing all of the teeth in an area) or extractions of many neighboring teeth, and these prodedures will get quite surgical with bone removal and scalpel use and sutures. So interesting! (I know none of you readers agree)
Some of the molars that we take out have crazy curved roots, or the roots are splayed out at a 90 degree (or more) angle. The dentist will think that he is about to do a routine extraction, and he struggles and struggles to remove this tooth, and when it finally comes out, roots intact, we can see the reason for all the difficulty, it looks like the tooth was in the middle of doing 'jumping jacks.' I have heard from the dentists a number of times "I would never have taken that tooth out if I had seen the x-ray." That's right dental folk, we really don't use x-rays. We have a portable digital machine that doesn't work half of the time when you do want to use it. We are doing humanitarian work and do not legally need x-rays, so we just don't. I have never taken out a tooth, but from watching these guys and gals pop teeth out in a matter of seconds, I don't see why we should need them. (So Erin B, I guess that I won't have extensive opportunity to improve my paralleling technique...)
Today, the dentist working at the chair next to mine was grasping the crown of a molar with his forceps, and the tooth exploded and pieces went flying, one piece bounced off my scrub top!
Tuesday, 4 December 2012
If saliva were red... well in Africa it is!
So we were pulling this guy's teeth today - and they were solidly embedded in his bone. Elevators and forceps were not enough, had to get out the surgical hand-piece. The HVE tips here are different looking - exactly like hammer-head sharks. It is difficult to angle these sharks to properly catch all of the water. After luxating the root tips for so long, there is a lot of blood flowing, which gets caught up in the spray. The result is a literal 'splatter zone' of red, landing on the patient's white shirt. My skin crawls as I can almost feel this bloodbath. Extractions are so fascinating!
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