A tip for dentists

my choice!

• Invest on a lovely fruity lip balm. When your patient does not smell too pleasant, apply some onto the inside of your mask before you enter the room. Make sure the lip balm does not have any dark colours or else it'll show through...

Floss floss!

Today at work, one of my patients made an interesting comment. When asked her about how often she flosses, she answered me back saying oh I have to do it every night. It's funny 'cuz now that I'm flossing everyday I feel dirty when I don't floss. And also I can see things getting stuck more if I skip a day.

...I totally agreed with her. I feel the same now but it never came to me like how she stated it. I used to be so horrible with flossing..especially with my lower retainers.. but now I'm getting better. My teeth feel different if I haven't flossed. Also I feel stinky. Probably it's me being a bit too self conscientious but hey, the result isn't so bad. It makes me floss regularly. I'd better not end up with periodontitis when I'm in fifties nagging my patients to floss. Self note, I will be more diligent! I recently bought a pressie for myself, Waterpik. But I haven't even opened it yet and used it... Hmmm better do it soon.

my work life

Today at work, I got a new hairdo. I don't think you can tell much difference in the photos actually... but this is what my boss texted me tonight:

Hi Janie I didn't get a chance to really tell you how absolutely fantastically gorgeous you looked today with your new hairstyle! In fact, since you came back from NZ this week it is as if you have become more beautiful than before... just like a new bride should be! Q is a very very lucky guy! I am sure he knows it! Have a nice day tomorrow. Rest before your busy Easter weekend! Cheers

Awwwww despite his age he's still a very sweet guy hahah. this is one of the reasons why I have no intention of leaving my practice any time in the future, if it is within my will. Gosh he is such a good business man. Obviously he knows how important it is to keep me here.... :p

Extractions of wisdom teeth

Extraction of 37, 38 and 48

As you can see, there's extensive bone loss between 37 & 38. I offered root resection of 37 and extraction of 38, but the patient said he'd just take them out both. Fine with me, simpler and faster. The mesial root tip of 38 was ankylosed and was retained  during the extraction procedure, along with the curved distal root tip... so I had to dig into the sockets with the root tip. It was alright... total time spent, 11minutes.

This was a bit more challenging. Can you see that the root tips of this wisdom tooth is joined with the "tunnel like" interproximal bone in between? Because of that I could not section the roots too easily. I did raise my question on the joint roots initially, but I couldn't believe it till I actually tried luxating the tooth. The tooth became quite mobile with the stripping of the crown to provide a bit more space with the tooth in front. However it wasn't going to be so easy because there was a channel of bone in between the roots that was holding the tooth. I sectioned the tooth, removed the interproximal bone, then twisted the root tips out. Quite nerve breaking using the handpiece so close to the nerve!! Total time spent, 23minutes.

 

My aim is making the incision on the gum as neatly as possible, putting sutures in as neatly as possible, and making the extraction wound as small and minor as possible for better and faster healing. I have so many third molar extraction cases coming up next week... very looking forward to them all!! ......who knew... a girl who was so scared of extraction would become a tooth buster..... that's why people say, you've got to live to see how things turn out! You never know when pigs will fly...... so watch this space.

Captures from work

Hello...

I was quite free at work...

So I played with my camera. People at my work don't like posing for nice portraits so it's either an instant capture with luck or a sneaky shot while they are not paying any attention to me. If none of these... then I end up taking a photo of their hands covering their faces.

My boss and Shay working on implants

Nick and Barbara. I made a noise and he turned around... hence the look

This is his third patient of the day... and I'm still here taking photos

But I wasn't all that free after all.. I had an extraction of 38 ie lower right wisdom tooth under oral sedation. It was pretty simple. Heard that you can apply for fellows for oral surgery after doing some study. Might look into that further.... Yay. Jyoti is going to take some implant courses for dental assistants soon. I will be able to do more cases now. Can't wait... 

Study time!

To boost up my confidence in doing implants, I attended the course on Minimal Invasive Dental Implant course, sponsored by 3M. Perfect timing, I have patients lined up for it......

My very productive day started off with the cruisy ride to the course, on Audi A3!!! :D thanks to my colleague. Man I've got to get Q7 soon too... Can't do A3, TT or X5 anymore due to very valid reasons.....

The lecturer for the day is a prosthodontist from the states. He has been involved with the Mini Dental Implants since the develpment in Oklahoma about a decade ago. He was such a good lecturer and I think I've managed to digest quite a bit... It's just too sad that within 6 months I probably will not be able to remember much unless I refer back to my own notes. Hahaha. Being too honest here.. people say man is a creature of oblivion don't they?

But luckily, I won't be able to forget much, because... I've got a case coming up on this Friday!! :D

For the edentulous lower arch, four minimally invasive implants with the the tissue-supported denture works perfectly well.. Success rate of 90%+  over the last decade. Mind you, I've grown to realise the difference between the implant failure and case failure. Of course, the success rate for the cases is over 99%... and you know what I mean. 90% or 99%, they are both very high success rate, but still, there's a big difference between those two figures compared to that of 80% & 90%. So, we all must aim high. As high as we could! And we much reach it!!!

One of the green o-rings have been left on the implant to demonstrate how the denture is "picked up".

A great model to demonstrate the soft tissues, cortical and trabecular bone structure of the resorbed mandible. Four implants placed anteriorly to avoid the parasthesia. Somehow my model's trabecular bone was rock solid compared to others... The guy sitting next to me said that I have to go to the gym more often! Then he realised that mine was a bit of the odd one... manufacture defect! Hmph. How fortunate...

Denture sitting on the implants. Fine trimming is needed once I go back to the clinic on Friday.

The thought of studying after leaving university has always daunted me but I'm slowly finding it quite exciting. More info seems to be registering into my brain as I have background knowledge to begin with. Plus it's not all about studying in the library, half of the time it's hands on learning. And the beauty of dentistry is that it's always very practical to what we do. We can always relate it back to our cases. Perhaps I should study more once I have a bit more time... maybe after a few decades :p Hope my brain cells stay intact till then!

Okie I think I've exercised my brain enough for the day. Now time to exercise the rest of me... Off to the gym now. Who knows I might be able to apply more power with my thumb and index finger when I come back from the gym so I can compress the bone more easily. Woot woot to the implants.

Yay pressies!!

Small pressies like this make my day :)
Awww he was such a nice patient... though I feel pretty bad because at the end we had to extract the tooth.. :( But oh well. That solved the problem instantly so I think he's very grateful about it! I'm happy as long as they are not in pain... Sometimes when I'm under extreme stress I dream about having a toothache and it's horrible. It's the worst nightmare you can have. Would people laugh at me if I say that's how I know what a toothache feels like? It's like... a tooth is having it's own migraine kinda feeling.. but when I say that to patients, they tend to agree......

Mmmm now, I'm in trouble.  Gonna have difficulty resisting those chocolates. Only a few dairy milk chocolates in the box though. I think there are only two. TWO!! Only two I'm addicted to..... :( :(

....
resisting....
resisting.......
Arghhh so tempted.....
......
........
.....


Ok. No diet for the day. There you go. I've eaten two within a blink of an eye.  OOOO so yummy! But must tell Mini that carrot sticks do not taste so nice so he can stay away from it...

Wisdoms

29yo male

Demanded that he wanted both the lower wisdoms out today as he cannot take too much time off at work.

I strongly recommended oral sedation for his own comfort but he said he should be ok.

Alright fine with me...

 I started surgical exos of the 38 & 48. One of my colleagues wanted to see how I do it so he tagged along as well, which was quite enjoyable.

I don't like sectioning the roots.. I get scared of lingual nerve damage. But this one I kinda had to or else it would've taken ages for them to come out. I sectioned in the teeth, then lifted up the distal roots then the mesial portion followed. Poor patient he must've been traumatised with all that noise, water sprays and the suction.. did I mention the cranky sounds from the metal instruments against the teeth and bone??? >0<;; But amazingly, he didn't even flinch. He was fine all the way through. He kept on saying he has to get them all out so he can go back to work asap.  If it was me.. I would've passed out within a few minutes.... .. really... I'm being serious.

And you'd be wondering how I do all those surgicals??

At times, I wonder too....

Group photos

Had a great time with the team as an honorary member haha. Though I don't have mantu lens, I think these have turned up quite nice :)

Dr Lee, Dr Hong, Miriam, Kala, Crystal

We wanted to take some nice group photos with the green background. Ladies first, Dr Hong was the "bag keeper". He was so shy to show the little bag on his shoulder I had to turn him around. I wasn't supposed to be in the photo but we got captured at the wrong time.

with four gorgeous ladies' bags!! (Mine's the brown one)

Then comes the stoned look (I don't think he enjoyed it too much..)

So, while Dr Hong was keeping all the bags together, us girls'smiles were captured by Dr Lee...

Me, Miriam, Crystal, Kala

My bokeh isn't so bad

Three girls working across the road

The two twin doctors

Smile!!

Fun team!!

Smile smile!!

All together we give you a good smile :) 

We help you to have healthy gum

We replace your missing gap

We get rid of your wisdoms

We whiten your teeth

So come and see us

...

so lame -_-

On my day off at work

After two of my colleagues have been fighting against 38 for more than an hour, I got called in... oh ya... on my off day! Aiyoo... but I'm happy to help out as always. I love extractions....

By the time I got to the surgery the crown portion of the tooth was long gone. Only the stubborn roots left with nothing to hold onto.

Just to explain how I targeted this tooth:
By the time I saw the tooth there was no crown... (hence the red line). I removed buccal, distal and mesial bone, while staying away from lingual at all times (the green line). Though it's hard to tell from this OPG the roots were lingually tilted...... -_-'' so when I tried using the luxator it kept on jabbing against the lingual wall. So the last resort was separating the roots (red dotted line). *split* Then within seconds the distal root came out, then the curved mesial root. I made sure that there's no other fragments of tooth or the loose pieces of bone left in situ, then closed neatly. All is done within 15 minutes. Woot woot! I was so contented....

Maybe I really should study oral surgery..... very tempted! Maybe when BBB and Mini become independent enough. Hahaha...

Pubic Holidays

Hul...

No wonder we were having difficulty looking for the staff...

We all had a good laugh ^0^

Lovely evening with everyone...

09.11.10

The so called "weekend" staff were invited to Tej & Anil's house for the lovely Indian curry evening. Woot woot Indian curry~!!! Sadly, I totally forgot to take photos of curries...... how silly of me. The only food photo I have is the entree. It was yummy yummy!! Yum~~~~!!!!!

Thanks to Tej & Anil, we had wonderful time together :) and here are the captured memories. I decided not to put them up on fb so this is the only way to enjoy them!

fyi that is my beer :p

Arhan with funny pose I

Arhan with funny pose II. He is all ready to be an actor :p

Dr & Drs Madan

:) 

As you requestd :)

Arhan = Anil's top half + Tej's bottom half (of the face...)

Sherin - she said she wanted to hide her tummy... what tummy?? I can't see anythin'?

Sherin & Rizwan

The girls I

The girls II & Anil

All the girls - Aayu is too shy...

Looking somewhere else

Sorry Rizwan you've been blurred but I think I look nice.... 

 Pretty Jyoti

And her beautiful daughter Abby I

Abby II

 Abby III with amazing concentration

We had to call her quite a few times to get this shot

Aayu. She's gorgeous :)

So I made her a Cover Girl 

Hehe :)

 Jyoti - looking too young to be a mum

 Jyoti and Abby

 Jyoti, Aayu and Abby

 The Gurung family

A bit too plain?

This is better?!???!?!? :p

Anil & Tej. So sweet together... ^^

As you requested :) :)

Marcel & Rizwan. So sweet together too ^^

I was trying to help Tej to do some dishes but I end up being the model for Marcel's photography exp

Cozy livingroom

Sharp Abby and blurred Me

*The End*

but our fun is to be continued...