Professional Development Reflection Q10
At the start of my third year, I was in the process of removing a crown with recurrent decay on a patient for the first time. I was using the crown splitter and I lost my fulcrum and the crown splitter slipped off the tooth and sliced a two-inch cut on the patient’s palate. The patient was anesthetized so he did not feel pain, however, the cut was deep and bleeding heavily. I calmly excused myself and told faculty about the incident and they came to check that the patient was okay. Luckily, no major nerves or vessels were severed, and the bleeding eventually stopped. After the procedure concluded, I awkwardly told the patient there was a cut on the roof of his mouth due to an instrument slipping and he seemed unbothered and left. After the incident I felt terrible that I hurt my patient and I regretted not fully disclosing how severe the cut was and not mentioning the incident to him until the end of the procedure. At the time, I was trying to avoid panic, but I felt that downplaying the situation wasn’t appropriate or fair to the patient. I also should have told the patient that he would likely be in pain. Not fully disclosing the extent of the injury was irresponsible and could have caused the patient to worry about what had really happened and not trust me.
This incident taught me a lot about what to do during emergency situations and highlighted how important it is to be truthful with my patients. I commend myself on keeping my cool in front of the patient, but moving forward, I will make sure I tell patients about any incidences that happen during the procedure right when they happen. Patients have a right to know about the details of their dental care and any injuries that happen to their body. In the future, I will do my best to maintain stable fulcrum and work carefully to keep my patients safe. It’s important to remember that we are working with sharp instruments that can permanently injure people and we should never get too comfortable or become careless when working in the mouth. However, accidents happen and if they do, I will make sure that I disclose the details of the incident and fully explain the complications, expected pain, or potential issues that can result from treatment or injuries due to dental procedures performed.
Professional Development Reflection Q12
After finishing my two most recent removable prosthodontic cases, I learned how important it is to set realistic expectations at the start of treatment. My first case was a full upper and lower denture and the patient presented to the clinic with a set of dentures made at Western Dental that were loose and didn’t fit. The patient was excited about her new dentures hopefully fitting better and although they did, the mandibular denture I delivered to her at the end of treatment was only mildly retentive and required adhesive to stay in place. Similarly, my other case was an immediate upper and lower denture recommended due to the patient having missing teeth with the remaining teeth all periodontally compromised and mobile. This patient was excited to finally have back teeth to chew on and she was disappointed when the final immediate mandibular denture didn’t fit well a week after extractions. In both cases the dentures were made to the best of my ability and with extensive faculty guidance, however, the patients felt uneasy because I hadn’t warned them from the get-go about how unstable mandibular full dentures usually are for patients. From the very first appointment I should have emphasized that mandibular full dentures are rarely retentive, unless the patient opts to have implants placed and an implant overdenture is fabricated. I should have made sure the patient’s expectations were appropriately set before they had agreed to treatment.
These experiences highlighted how important it is to fully outline the risks, benefits, and complications associated with treatments and procedures. It’s critical that dentists set realistic expectations about the outcome of final treatments so the patients aren’t surprised if and when things don’t turn out ideal. As a licensed dentist after graduation, I plan to give my patients worst case scenario and best-case scenario before any treatments I deliver because it is the patient’s right to be made fully aware of what they are getting themselves into when they sign the consents and agree to a treatment plan. I believe that the best way to make a patient happy and trusting is to set expectations low and deliver high quality ideal dental care to the best of my ability.