Work Experience 33: Dentist
Visiting the dentist has never rated particularly high on my list of favourite things to do in life. It’s nothing personal of course, my dentists have always been lovely people, I just don’t really like them poking around in my mouth with power tools. And not talking throughout an appointment is really hard for me to do! I was intrigued to learn about what it’s like to be on the other end of the dental drill, and was so grateful to Dr Karyn Nankivell for opening her Eileen St Dental Practice doors to me for a couple of days of work experience.
What did I do?
When I first arrived on day one I was shown around the dental practice, which had a lovely feel as it had been converted from an old home. Behind the reception area and waiting room were three dental surgery rooms, a kitchen/staff room and a steri room where all equipment is sterilised and stored, x-rays are processed and lab work is undertaken. Of all of the places I’ve worked throughout the year, this was by far the most spotlessly clean. I didn’t see a speck of dust, crumb or item out of place in the entire building. In an environment where excellent hygiene is imperative, that was of course great to see.
Each day at the dental practice begins with a team meeting at 7.45am. This is an opportunity for Karyn to run through her morning appointment list (which we all had a copy of) with her dental nurse Fiona. Karyn specified which equipment and products she may require for each appointment, read briefly through her patients’ records to re-familiarise herself with each and looked at any x-rays, medical history or other information that may be relevant for their appointments. Fiona jotted notes on her run sheet to reference.
After the meeting and a few minutes of preparation it was time to welcome the first patient of the day. Due to the nature of the appointments and in consideration of the patients, I sat in a chair in the corner of the room. I didn’t have a clear view of what went on inside each patient’s mouth, but that was ok with me!
I took detailed notes during each appointment I observed during my time at Eileen St Dental Clinic, and have chosen a few to share. It’s worth noting, Karyn introduced me to each of her patients before their appointment and asked their permission to allow me to observe their treatment. I happily took up my position on a chair in the corner of the room near the patient’s feet – not such a great spot to see directly into people’s mouths, but that was more than ok with me.
Over the two days a number of patients came in for a routine dental treatment and ‘check-up’, which involved an examination and cleaning of the teeth. Karyn first asked her patients if they have any problem areas, sensitivities or concerns with their teeth or gums. She then gently examined the teeth and gums using a metal probe and a small angled mirror to see behind and between the teeth. Karyn checked for any swelling, gum inflammation and cavities. She applied numbing gel to areas where patients had sensitivities in order to reduce discomfort while she was cleaning their teeth, and always calmly told her patients what she was doing as she went. She flossed between teeth and scraped off any build-up of plaque or tartar above and below the gum line on each tooth before polishing the teeth to clean off any residue. When she’d finished, the patient would rinse their mouth before Karyn painted fluoride onto the teeth. She explained to her patients that they needed to wait for half an hour before eating or brushing.
An elderly lady came in with a cracked tooth but no pain, and on inspection Karyn noted that an old filling had fallen out and needed replacing. Karyn put a metal band around the tooth as a wall for the filling, filled the space with composite (adhesive), set the filling, removed the band, polished it, flossed between the neighbouring teeth, asked the patient to chew down and move her teeth from side to side to check it was secure, then asked the patient to rinse her mouth and check for comfort.
After noticing a patient regularly missed three teeth when brushing, resulting in moderate plaque and some gingivitis, Karyn gave her patient a toothbrush and mirror and taught him how to clean his teeth effectively using big slow circles. She instructed him to always use a soft toothbrush, and to start with the top teeth when brushing.
A primary-school aged patient came in as she’d suspected one of her fillings had fallen out. After asking questions about whether it was causing her pain or sensitivity, or if she noticed food getting stuck in that spot, Karyn examined the patient’s teeth. What she found was that a new cavity had formed. Since it was only 6 months since her last check-up this indicated rapid decay. Karyn spoke with the patient and her mother about the importance of brushing twice a day for two minutes, as well as suggesting she limits her intake of sugary drinks and snacks (which the girl admitted to consuming quite a lot of). Karyn explained that having too much sugar during the day is bad news for teeth. They chatted about which foods and drinks the patient might enjoy snacking on that are lower in sugar and good for her teeth. Karyn then cleaned the tooth out and applied a filling. I really loved how gentle Karyn was with each of her patients, and how well she was at communicating with them what was going on with their teeth, what she needed to do, and what her patients could do to prevent further problems.
A man came in with an infected tooth that had previously been x-rayed and needed to be extracted. This involved putting numbing gel on the gums around the tooth and distracting the patient with a bit of chatter while Karyn brought out a big needle (out of the patient’s line of vision) to anaesthetise the gum, pressing the gum to check it was completely numb, then giving the tooth a wiggle with some big forceps. She yanked the tooth out with pliers that looked like a nut cracking tool, and gave the patient some gauze to bite down on. She provided the patient with some extra gauze to take home in case of continued bleeding, and instructed him when and how to use it. Karyn also explained that his mouth would stay numb for 3-4 hours, but that he could eat after an hour. She advised him to avoid exercise for the rest of the day, and to refrain from smoking and drinking for the rest of the day to reduce bleeding and infection.
After each appointment, all of the tools Karyn used were placed into a sterilisation box and taken through to the steri room, and the treatment room cleaned and prepared for the next patient.
What did I learn?
It’s interesting how much I learned from my position in the corner of the treatment room. I didn’t get a look into anyone’s mouth, I couldn’t see what Karyn was seeing when assessing teeth, or closely watch what she was doing while she was treating them. But I did have a fantastic lesson on what it takes to keep patients calm in what can often be a stressful situation for them. Karyn was so good at explaining the condition of her patients’ teeth, what treatments they’d require and when they may feel even the slightest discomfort, what they’d need to do following procedures, and preventative measures they may need to take to best look after their oral health. From where I was sitting I should see how hard she physically had to work at times (the second extraction I saw was a little more complicated than the first), but Karyn remained so calm and composed and her patients would’ve had little idea of what was going on. She ensured her patients felt as comfortable and relaxed as possible – something I know I definitely need when I visit the dentist myself. Karyn’s love for her work and genuine care for her patients is something I admired and am inspired by.
To read my interview with Dr Karyn Nankivell by click here.