Restorative

The perfect prep.

Written by Dr. Lincoln Harris | Jan 19, 2018 6:34:44 AM

Helicopters are very different to cars. In your car, as you push the pedal, the dial goes higher telling you that you are going faster and the RPM is climbing.

In a helicopter, there is gauge telling you how much of the total power you are using. Once you go over 100% of total power used, then you risk crashing and dying.

Our brains are the same

If you reach 100% of mental capacity, you crash. So the key to doing good work is to reduce the amount of unnecessary thought going on so that you can devote the entire brain to the procedure at hand.

Surgeons in medicine have long understood this and that is why they now do most operations under general anaesthetic, rather than with a rum swilling patient screaming and thrashing about while they try to do delicate surgery.

Oh no, the prep you do with your drill is only the end of a long line of preparations. Ones that are important.

Yesterday I did six crown preps on one patient

What was the preparation?

1. Manage anxiety. With drugs. (for the patient, not you).

The patient was identified at the initial appointment as being anxious. Anxiety is infectious. Your patient will generously share their anxiety with you. You will divert 30% of your mental capacity to managing anxiety. You will also feel stressed. Patient was given 2mg of Lorazepam preop.

2. Too much local anaesthetic.

You want the patient to be profoundly numb. You do not want to be worried they will feel something. You do no want it wearing off too soon. You do not want the patient jumping when you are really intensely focussed on something causing your own heart rate to gallop away like the wind.

For a single molar, I will use 4mls of anesthetic with andrenalin on the buccal, and a small amount of the palatal. I do not want the clamp hurting. I don't want the wedge hurting. I don't want the gingivectomy hurting. Or teflon.

Any time something hurts, it reduces your ability do perfect work

3. Four or six-handed dentistry.

You should not look up from the patient. Staff are trained to have what you need ready to put in your hand as you need it.

4. Risks, problems, money.

All these should be carefully discussed beforehand so that you do not have stressful things to suddenly discuss during the treatment if things do not go as planned. And of course, you don't want to finish and not be paid. No signed treatment plan. No treatment. Prepayment of a booking fee for long appointments.

And the list goes on.

Only when all these are prepared, can you well prepare the tooth.

Don't try to do dentistry with half your brain. 🙂