4th year

Student 1:

For all patients you will need: Consent form (include photographs on this), cost of treatment plan SIGNED, updated medical history (ask if any changes on EVERY visit).

Get 2 notebooks. Use 1 for appointments, and 1 as an actual diary. Take a sticker from the chart as a header and make notes on the procedures. Be specific, e.g. NOT “I took an impression” BUT “I used the wrong material, should have extended more posteriorly” etc. This will help you big time when you are doing the same procedure again on a different patient. It is also a good idea to write down step by step what you need to do for a given procedure e.g. 1st visit for an RPD, you do patient history, denture history, examination, denture exam, impressions, facebow, lab prescription, photographs, pour casts etc.

Make a list of your patients contact info, requirements you are getting out of the patient, tx plan, what you have completed, payment (how much paid and left to pay), etc. This will help you not only keep track of patient information but also if you have been given the right amount of requirements as you go along the year. This makes life a lot less stressful at the end of the year when requirements are due and you aren’t sure why they aren’t adding up to what you thought you had done. It also helps organize what you have left to do for each patient.

Student 2:

Basics: Order ALL your instruments and materials on the one day. If you have clinics on Monday morning, order them on Friday before 12pm or risk the wrath of the nurses and CSSD staff.
Book in your patients early, at least a week beforehand. Sometimes this may not be possible but as often as you can, book them in early. Send your patient’s a text reminder the day before or give them a ring if they don’t have a mobile phone. Even if they can’t come in the next day, you are better off knowing early so you can book someone else.
If a patient does not attend the appointment on the first visit or cancels at the last minute do not make another appointment for them unless they ring for one. If an existing patient cancels on you twice or does not show up, do not make new appointments for them. The best patient is the patient in the chair, not the one at home. Try to make it clear to patients that it is important that they tell you at least 2 days in advance if they cannot attend the clinic. Remember, your time in the clinic is precious.
If you get a no-show, you can go to the Oral Surgery Department when they are running the Emergency clinic, explain your situation and ask the demonstrator on duty if they have a patient for 4^th years.
 Stationery: Have a diary and keep all your patients’ phone numbers and CDS numbers in there. Use it to plan your weeks. Effective planning is essential. Make adjustments for cases that require 2 weeks in between when lab work is sent away. This takes some getting used to but once it’s done it will make life easier. Get a red, blue and black pen. Use only the black pen for writing up notes and charting. The red and blue are for perio charting. Buy your own lighter because you won’t find one on clinic when you need one, also have a selection of pens (black: one for sticky and one without; red; blue), and pencil…each demonstrator has different preferences on charting so its best to be prepared.

Photographs: Take them. You’ll need them for eportfolios and case presentations. As Steve Jobs said, “you can’t connect the dots looking forward; you can only connect them looking backwards.” Steve was definitely talking about case presentations here. You never know which patient will be used for a case presentation so treat each case like it would be and take plenty of photographs. Take the standard views with the cheek retractors and photo mirror on the day of history and examination. Take in between steps if you are making dentures, crowns and bridges, of articulated study casts, interesting impressions or you’re doing an interesting procedure eg. Using a putty matrix to make composite buildups.

Student 1:

– Master dentistry part 1 & 2

– Clinical problem solving ortho, peads

– OSCE for dentistry (can also get a photocopy for 14 euro at an scolaire)

– Summit operative dentistry (bought in 3rd year)

– Laura mitchell introduction to orthodontics book

– Wellbury paediatric dentistry

– Pedler Oral surgery

– Oxford handbook of clinical dentistry

– Cawson’s oral medicine

– Know the policies for each procedure – find these on blackboard

Student 2:

Attend the lectures! This might sound obvious but a lot of lectures start at 8.20 a.m and there will be one right after clinics, before lunch so it may be tempting to skip. However, attendance is taken and module coordinators are keeping close watch over who attends and who doesn’t. Also, it makes revising a bit easier when you understand what the lecture is about.
What to read:
The lecture slides (of course)
Summitt Operative Dentistry
Master Dentistry Oral MaxFax, Radiology, Pathology
Master Dentistry Oral Restorative, Paeds and Ortho
Removable Partial Denture –Jepson
Complete Denture –From Planning to Problem Solving
Introduction to orthodontics – Laura Mitchell
Essential Human Disease for Dentists– Sproat, Burke, McGurk
Paediatric Dentistry – Wellbury
OSCE for Dentistry PasTest

Do your logbooks continuously its a lot less stress if you add as you go along.

These are on blackboard and you will have a template that you copy from the main page and paste into your patient’s page when you create it. It’s important not to change the actual template otherwise your info will be on the template everyone is using. You need to find at least one multidisciplinary case in 4th year (usually the one you end up doing your case presentation on). It’s not hard to do but that means they need cons & perio or pros & perio, etc. The earlier you start on this the better because rarely does treatment go as planned and its nice to have options (change treatment plan, find new patient, use another multidiscilplinary case if you have one) if a case doesn’t happen to go as expected.

Student 1:

Start about a month before hand and give yourself enough time to do the reading, that takes up the bulk of the time. Make sure your grammer and referencing is pristine as you can lose marks for that.

Student 2:

Do some basic reading as soon as the topics are released. Having a basic understanding of the terms used in the area of review is really handy before you get into the meat of the subject and begin writing. Ask a friend to proof read it once you’re done writing it. Chances are, once you’ve read it more than 50 times, you are not going to spot grammar errors and spelling mistakes.

Student 1:

Other competency exams besides the filling include prosthetics and perio. For the prosthetics you can either do secondary impressions for a full denture (one arch) i.e. trim tray, green stick, and take the impression OR design and explain a Co/Cr partial denture design (radiographs of abutments, survey, design, prescription, long term prognosis). As for the perio, it is diagnosis and hand scaling of a quadrant. Make sure you have all the appropriate radiographs for all your competency exams.

Student 2:

There are three competency exams: a class 2 restoration, periodontal diagnosis and hand scaling of a quadrant, prosthetics, either a secondary impression for a full denture or design and explain a cobalt-chrome partial denture design. Prepare before exams because the supervisors will ask you questions on your choice of denture design, your diagnosis etc. Make sure you have the radiographs necessary for the exam. Try to do the competencies early after Christmas, once you’ve gotten some clinical experience. If you come across a patient that needs a class 2 restoration early in the year, keep it for your competency and do it for the exam!

Don’t text your patients from the computer because if they respond to that number it will never get to you. You should be contacting them from the phone in the restorative clinic. Check the memo book there frequently to see if someone has left you a message.

Always call or send your patients a reminder because at the end of the day its your own time you are wasting if they don’t turn up. Try to ring between 9 and 5:30, anything earlier or later can be considered unprofessional unless you know the patient or have okay-ed it with them.

Be on time…especially for ortho, surgery, and morning lectures and speak up during surgery and tutorials when questions are asked.

Don’t book too many patients, as they will build up and after seeing them once you’ll end up not being able to see them again for another 2 months which is not good.

If you find someone with an easy class 2 filling i.e. a lower 4 or 5 hold on to it until February because you can use them for your clinical competency exam.

Some supervisors will ask you to leave a lecture if you come in wearing scrubs so check the timetable if you are on a morning clinic and make sure you change before heading in.

1st term is pretty light because clinic is a shock to most people so they go easy enough on you (i.e. no exams) so if you are planning any trips that is the best time.

Ortho is overwhelming depending on who you have…just keep up with the material remember its foreign for most of us.

Oral medicine has a lot of overlap with path so keep reviewing. Review your head and neck anatomy and pharmacology for surgery. Especially know the most common prescriptions (analgesics and anti-biotics).

Student 1:

Get started on your requirements straight away. Make a plan from week 1. Think about cases which you need several sessions for as early on in the year as possible. You can do a filling on the very last session in June, but you can’t start a denture Px or a RCT Px then. Also try to get your cobalt chrome denture patient and your full/full denture patient out of the way asap, they are difficult to come by and are time consuming. Try to start root canals straight after Christmas to get your confidence up.
Try to get a patient who needs composite buildups so that you don’t need to worry about your filing requirements…not to mention its great practice with aesthetic dentistry.

Student 2:

Start root canal, denture and crown/bridge patients early. These cases will require time and might be tricky to do once exams are close. Although it’s daunting because you are doing them for the first time, you need to bite the bullet and get it done. Know the options available for each case so you are able to offer them to your patient. This is ethical patient care and your patients will respect and appreciate you making this effort.
Know what the codes for the yellow sheet mean and write them yourself or risk losing out. Know the different classes of fillings and how many surfaces you can get for each. If you have a patient requiring composite buildups, that’s great because then you won’t have to worry as much for filling requirements.

Requirements:

Perio: 4 maintenances

Fillings: 90 surfaces in total, 25 amalgams and 50 composites; other can be either.

Endo: 4 canals

Crown/Bridge: 1 unit

Denture: 1 full/full, 2 partial {one has to be cobalt chromium}