I study Dentistry - Ask me anything (AMA)

OP

Original post by ruby_1113

Thank you so much, that has helped alot. I have done two weeks work experience in dental practices, and volunteer in the hospital, as a young leader in scouts and am a peer mentor for younger students at school. I regularly volunteer at my local religious centre, on community projects and feeding the homeless. On NCS, I was unanimously voted by my team to lead a social-action project. Is this enough, because I didn't do any where near as much dentistry-related work as you. And the questions in the interview, by general, you do mean about yourself or about basic dentistry?

It really does depend on where you're being interviewed. Usually though they would expect a very minimal level of dental knowledge. That's what you're going there to learn after all. Having said that, it doesn't hurt to know the basics and obviously, anything mentioned in your personal statement you need to know much better as they're very likely to ask you about it.

In terms of work ex and volunteering, i wouldn't worry too much as long as you've done the minimum requirements.

At Barts we're much more interested in getting to know the applicant and their motivations, rather than throwing out curve balls and difficult technical questions. Communication skills are obviously very important and these will come across in your answers. Be direct, concise and answer the question you're asked not the one you wanted to be asked.Knowing the qualities of a good dentist and how you demonstrate these is obviously essential too. I would recommend going on some interview preparation courses, they're expensive but can be quite helpful. I've worked on a few and students seem to do pretty well.

Reply 182

OP

Original post by Another

Congratulations! What are the next steps for you now? Where's your DF1 at?
I graduate in 2019 and not feeling anywhere near ready lmao

Hey there, thank you very much it's been a long old road!

My DFT year is the Bristol City scheme which was my first choice and happens to be an absolutely amazing one with brilliant people running it. I don't know exactly which practice I'll be at yet as we haven't ranked them. That happens in the first week of July, by the second week of July we should then know our practices. It's decided based upon your national ranking.

After DFT, who knows...maybe I'll go on to do a year(s) as a DCT or maybe I will like it so much in general practice by then that I'll want to stay.

As for not feeling ready, I wouldn't worry too much, at the end of 3rd year I was nowhere near. I still feel like I'm not 100% ready now, but it's all about being safe and knowing your limits, and I'm confident with that. You learn a huge amount in the 3 clinical years of dental school and you will surprise yourself, I never thought I would be able to perform a whole surgical on a lower wisdom tooth myself but just the other day I did that very thing (it had dilacerated roots as well!) Realistically, DFT is where you really cement all of those skills though. Where are you training, out of interest?

Reply 183

OP

Original post by .A_C.

How would you deal with nervous patients?

This is potentially a very complex question with an even more complex answer. However, I'll try and cover the salient points.

1) Ascertain how nervous the patient is, this is either done through simple questions, observation or by the use of an anxiety questionnaire. In the case of children you can use the Child modified dental anxiety scale or their age. For example, children under the age of 3 are generally considered 'pre-cooperative' meaning that in general they aren't going to let you do much to them.

2) Identify what it is that is scaring or making the patient anxious, is it a previous bad experience, the fear of pain, the unknown, the sounds, the chair, the water in their mouth, the suction, the light. It could literally be caused by anything, especially when you take in to account children and also patients with additional needs such as autism that make them hypersensitive to stimuli.

3) Decide whether or not this patient is going to be suitable for treatment under Local anesthetic. At this stage you need to make a judgement call: 'can i treat this patient safely under local anaesthetic alone?' If the answer is 'yes' then we start looking at what we call non-pharmacological behavior management strategies. If however, the answer is 'no' then we need to look at pharmacological behavior management strategies.

4) Non pharmacological behavior management strategies:

One of the best resources out there if you want to look more in depth is the BSPD document.

http://bspd.co.uk/Portals/0/Public/Files/Guidelines/Non-pharmacological%20behaviour%20management%20.pdf

When working with nervous or anxious patients you need to make sure that you are considering both your verbal and non-verbal communication. For example, you need to make sure that you talk in an approachable tone and explain things in a non-threatening and jargon-free way so that the patient can easily understand you. You should maintain good eye contact (unless they're autistic) and have an open and welcoming body posture (no crossed arms or legs) you should also have the patient sitting up when talking and sat slightly higher than you. This makes for more effective and less intimidating interactions. You should always check understand as you explain things too, so that you can clarify anything that might be difficult to understand.

As for specific techniques, there are loads:

Tell, show, do: Tell the patient what you're going to do, show them what you are going to do and then do it.

Structured time: using a countdown for certain procedures such as drilling so the patient knows how long they have until it stops.
Systematic desensitisation: Gradually exposing the patient to more and more incasive/complex procedures and moving on each time a patient is comfortable.

Modelling: showing a child a video or example of another child behaving well and being happy in the dental setting

CBT/NLP: these can be delivered by a trained practitioner and can be extremely effective at combating anxiety in certain cases.

Distraction: using stories and asking patients to imagine being elsewhere. Headphones with music and TVs/pictures on the ceiling can be very helpful for this.

Empathy: Speaks for itself

Enhancing control: You make the patient aware that they are fully in control of the situation and that they can stop at any time by raising their hand. You could also make use of a dental hand communication system such as Dentisign.

Positive reinforcement: Encouraging and rewarding patients for positive behaviors and ignoring negative ones.

Hypnosis/acupuncture: These can be use alone or in conjunction and can be very effective in certain circumstances for dealing with anxiety and in particular for helping patients with severe gag-reflexes.

The list goes on and on...

5) Pharmacological behavior management strategies exist on a sliding scale of intensity:

Oral sedation - these are drugs such as diazepam and temezepam (generally only suitable for adults) these are anxiolytics that can help mildly anxious patients accept care more comfortably.

Inhalation Sedation (N2O + O2) - This is what most patients refer to as 'the gas', it is delivered through a nose mask and the levels of N2O and O2 are adjusted until the desired level of sedation is achieved. Until (I believe) the 90s this could be used by dentists as a general anesthetic agent in general practice. However, following a number of deaths this was discontinued in the UK on safety grounds. However, today it can still be used at a lower and more controlled dose to provide sedation (Depression of the central nervous system without loss of consciousness). This is the sedation of choice in the UK for anxious children and mildly anxious adults. It has the advantage of being very safe, relative analgesia (kills pain) and also allows the patient to go home straight after.

Intravenous sedation (Midazolam, Propofol, Fentanyl) - These are much more powerful sedative agents that are delivered through a vein in the arm of hand. They produce a profound depression of the central nervous system but should not induce unconsciousness. This method is generally appropriate for children over the age of 16 and adults, including adults with special needs or significant health problems that contraindicate a General anaesthetic. Whilst IV sedation is often very effective it does mean that patients must bring an escort and wait in the clinic until they have fully recovered.

General Anaesthetic (Sevoflurane, Isoflurane, Enflurane, Propofol) - This is a procedure generally only carried out in a hospital setting where there are trained theater staff and a qualified anesthetist and accompanying anaesthetic machine. They are very expensive to perform and are generally reserved for children undergoing multiple extractions, extensive or invasive surgery such as removal of cysts or all four wisdom teeth or for plating mandibular/maxillary fractures etc. Whilst general anaesthetic is technically feasible for more or less all patients the risks often increase as patients are more unwell or older. There is the ever present risk of death associated with a general anaesthetic too generally quoted as around 1 in 400,000. However, this is for all operations and the real risk is much much lower for a health person undergoing short and simple surgery.

Hope that's helped to explain things a bit.

Reply 184

Mo3yman

12

What do you think about the singing dentist?

Reply 185

OP

Original post by Mo3yman

What do you think about the singing dentist?

I think what he's done for the image of dentistry is good and he's done a lot of good charity work too. I'm also aware that he's actually a pretty proficient dentist apparently. His lyrics are quite inventive and his eyebrows are incredible. Having said that I'm not convinced he's technically speaking the best singer in the world... We actually had him along to our Dental Dinner this year, which was an interesting surprise.

Reply 186

ReadilySalted

Is it fun and was it hard to get into dentistry?? I REALLY WANT TO BECOME A DENTIST!!!!

Reply 187

Another

21

Original post by Kartace

Hey there, thank you very much it's been a long old road!

My DFT year is the Bristol City scheme which was my first choice and happens to be an absolutely amazing one with brilliant people running it. I don't know exactly which practice I'll be at yet as we haven't ranked them. That happens in the first week of July, by the second week of July we should then know our practices. It's decided based upon your national ranking.

After DFT, who knows...maybe I'll go on to do a year(s) as a DCT or maybe I will like it so much in general practice by then that I'll want to stay.

As for not feeling ready, I wouldn't worry too much, at the end of 3rd year I was nowhere near. I still feel like I'm not 100% ready now, but it's all about being safe and knowing your limits, and I'm confident with that. You learn a huge amount in the 3 clinical years of dental school and you will surprise yourself, I never thought I would be able to perform a whole surgical on a lower wisdom tooth myself but just the other day I did that very thing (it had dilacerated roots as well!) Realistically, DFT is where you really cement all of those skills though. Where are you training, out of interest?

I'm at KCL. I enter 4th year this August, but I took an intercalated degree for this year. I've forgotten a lot, so I practically have to relearn all my science and theory in 2 months.

The intercalation was worth it though. I was heavily burnt out by the end of third year. Even though I hardly got any practice last year - still haven't touched a metal denture, crown or endo. Here's hoping next year blossoms into a miracle lol

Congratulations on your dilacerated roots surgery :congrats:

Reply 188

OP

Original post by happydimples

Is it fun and was it hard to get into dentistry?? I REALLY WANT TO BECOME A DENTIST!!!!

People have a mixture of experience, some i know really don't enjoy it but they often tend to be what I would consider the people who did dentistry for the wrong reasons. I.e. family pressure, money, prestige, to find a partner...

Personally, I absolutely love dentistry and i think it's a fantastic degree and career. I couldn't recommend it more (to the right person). Of course there are times when I don't enjoy it and sometimes I have even questioned whether this is the right choice for me. However, the good days where I love what I'm doing vastly outnumber the days where i don't

As for getting in to dental school, I can only vouch for my own experiences all the way back in 2011/12. I have to be honest and say that I think getting into dentistry was possible one of the single hardest but most rewarding things I've done in my life, second only to my BDS. Having said that, a large degree of difficulty can be attributed to my personal circumstances: I come from a family where I was the first person to go to uni and I didn't really have any healthcare professionals to talk to, my school was pretty poor and no one in living memory had ever applied for dentistry, so I got no help from those two sources. (In fact I actually got rejected on my first attempt at applying because my school didn't realise what the entry requirements for dentistry were and I was predicted AAB instead of AAA!) The only real source of information I had was hear-say on TSR. Naturally some of this information was less than accurate. (this is one of the reasons I m so keen to give back now, I wish that I had been able to access this sort of advice/knowledge when I was applying)

It's great that you're keen to join the profession, the key is to prepare early and read lots!

Reply 189

ReadilySalted

Original post by Kartace

People have a mixture of experience, some i know really don't enjoy it but they often tend to be what I would consider the people who did dentistry for the wrong reasons. I.e. family pressure, money, prestige, to find a partner...

Personally, I absolutely love dentistry and i think it's a fantastic degree and career. I couldn't recommend it more (to the right person). Of course there are times when I don't enjoy it and sometimes I have even questioned whether this is the right choice for me. However, the good days where I love what I'm doing vastly outnumber the days where i don't

As for getting in to dental school, I can only vouch for my own experiences all the way back in 2011/12. I have to be honest and say that I think getting into dentistry was possible one of the single hardest but most rewarding things I've done in my life, second only to my BDS. Having said that, a large degree of difficulty can be attributed to my personal circumstances: I come from a family where I was the first person to go to uni and I didn't really have any healthcare professionals to talk to, my school was pretty poor and no one in living memory had ever applied for dentistry, so I got no help from those two sources. (In fact I actually got rejected on my first attempt at applying because my school didn't realise what the entry requirements for dentistry were and I was predicted AAB instead of AAA!) The only real source of information I had was hear-say on TSR. Naturally some of this information was less than accurate. (this is one of the reasons I m so keen to give back now, I wish that I had been able to access this sort of advice/knowledge when I was applying)

It's great that you're keen to join the profession, the key is to prepare early and read lots!

This is soo inspirational! I will prepare hard, you will be a great dentist and hope you pass your exams! :smile:

Reply 190

Original post by Kartace

As the title says - ask anything you like!

Are you screamish?

Reply 191

OP

Original post by honour

Are you screamish?

Presumably you mean squeamish?

To answer your question: No, not really.

There's not really much that freaks me out these days. I really REALLY don't like vomit, but unfortunately I've been vomited on twice at university and I think I'm probably getting desensitised to it at this stage.

The one thing I watched which made me feel a bit uncomfortable (a lot of people find this too) Is a lefort 1 osteotomy. This is used in orthognathic surgery to manually reposition the maxilla (upper jaw) it looks really freaky. Skip to about 5:20 and you'll see exactly what I mean...

[video="youtube;GqofMdofZKE"]https://www.youtube.com/watch?v=GqofMdofZKE[/video]

(edited 6 years ago)

Reply 192

Original post by Kartace

Presumably you mean squeamish?

To answer your question: No, not really.

There's not really much that freaks me out these days. I really REALLY don't like vomit, but unfortunately I've been vomited on twice at university and I think I'm probably getting desensitised to it at this stage.

The one thing I watched which made me feel a bit uncomfortable (a lot of people find this too) Is a lefort 1 osteotomy. This is used in orthognathic surgery to manually reposition the maxilla (upper jaw) it looks really freaky. Skip to about 5:20 and you'll see exactly what I mean...

[video="youtube;GqofMdofZKE"]https://www.youtube.com/watch?v=GqofMdofZKE[/video]

I'm so squeamish I can't even spell that word. Why did you chose Dentistry over Medicine? Are teeth really that interesting? :rolleyes:

Reply 193

OP

Original post by honour

Are you screamish?

Or watch from 2:30 onwards in this one...

[video="youtube;ZpWb1G3qlFM"]https://www.youtube.com/watch?v=ZpWb1G3qlFM[/video]

Reply 194

Original post by Kartace

Or watch from 2:30 onwards in this one...

[video="youtube;ZpWb1G3qlFM"]https://www.youtube.com/watch?v=ZpWb1G3qlFM[/video]

STOP >:C

Reply 195

OP

Original post by honour

I'm so squeamish I can't even spell that word. Why did you chose Dentistry over Medicine? Are teeth really that interesting? :rolleyes:

This is a pretty complex question to be honest and one that I've previously answered at great length a number of times.

Really it doesn't come down to just 'Teeth'. In the same way that being a a colorectal surgeon isn't just about bumh0les, or being a vascular surgeon is just about blood vessels. It's much more about what the work you do represents as well as the process and the working envirnoment. For example, I gain great satisfaction from relieving patients who are in pain. Or, from helping people who are self conscious about their smile, some people come to me with teeth that are so worn down they can't eat properly. Being able to do something for them is likely to give them a significant increase in their quality of life - THAT is hugely satisfying.

Also, dentistry isn't just teeth of course, it's also the gums, the periodontal tissues and the hard and soft tissues of the head and neck. For example, when I was in third year I had a patient come into the emergency dental clinic complaining of a swelling and dull pain coming from the left hand side, around the area of the wisdom tooth with a radiating pain into his ear. Now, I had a look, expecting this to be a case of pericoronitis or decay only to find that the patient had a large cancerous tumour on his retromolar pad (just behind the wisdom tooth), the swelling was the cancer invading the bone and he also had a metastatic lymph node in the neck. Had I not been taught how to recognise these sorts of lesions then it may have gone undiagnosed for much longer...

There are also a large number of medical problems which are detectable in the mouth long before general symptoms are evident. Such as Diabetes, HIV, Leukaemia, Anaemia ...the list goes on and on.

Having said all of that. There are also a few real-world reasons why I chose dentistry over medicine. I wanted to work 9-5, I wanted a social life, I didn't want to be working on-call hours, I wanted the ability to run my own business and have some independence, I wanted continuity of care with my patients, I wanted to be able to diagnose, treat and continue caring for my patients from start to finish, I wanted a hands-on career with a creative and artistic element to it. I wanted the flexibility to be able to move away from the NHS before the tory government manages to squeeze every last penny out of it.

With all of this in mind, i still haven't ruled out medicine. Many people before have in fact expressed particular interest in why I personally didn't choose medicine (given my deep, and somewhat out of character for a dentist, interest in the subject) There are two other options: Maxillofacial surgery (or oral medicine, but I'm not interested in that) Maxfax is a dual qualified degree medicine/dentistry and consists mainly of dealing with serious head and neck trauma/cancer/deformity. However, it's an incredibly demanding career, not to mention competitive and arduous in training.

I hope that has gone some way to explaining my thoughts and feelings on the matter :smile:

(edited 6 years ago)

Reply 196

OP

Original post by happydimples

This is soo inspirational! I will prepare hard, you will be a great dentist and hope you pass your exams! :smile:

Good man, I've actually already passed them all, and qualified, but thank you anyway!

Reply 197

ReadilySalted

Original post by Kartace

Good man, I've actually already passed them all, and qualified, but thank you anyway!

WOW!! CONGATULATIONS!! :yay:

Who did you vote for today? :smile:

Reply 198