How I Built My Own Career As A Dental Surgeon? After working hard for my ordinary examination I passed it with excellent passes for every subject. I continued my further education from bioscience subject and luckily could enter to the Faculty of dental science.
I am R.A Athugala, currently working as a Maxillofacial Surgeon in the teaching hospital Peradeniya, Sri Lanka. First of all let me tell the most important thing. The hundred percent self satisfaction which I feel today is a result of my correct decisions. If you can’t take correct decisions at the correct time that will be useless. So the first and most important thing that I have to say is you should take confident and straightforward decisions at the right time.
Being a dental surgeon is an ambition that came into my mind in my childhood. My pre school friend had a defect called “cleft lip”. Her upper lip has joined with the palate and as a result of that she was unable to speak. Seeing her pain made me stress and I tried to be a close friend to my bestie. After few years she admitted at the dental hospital. After an extra oral examination dentists decided to do a surgery. I was the person who treated her and relieved her pain. At that time I found an amazing person. She was her maxillofacial surgeon. I was amazed by her kindness. No words to explain her service in the dental hospital. As patients said she can eliminate their pain from her one single kind word. The most awesome thing that I experienced is she recorrected my friend’s physical appearance from a single surgery. It was unbelievable how she recorrected my friend’s lip to be visible as others mouths. Finally my friend was able to speak and that’s the day I took my turning point.
My journey – Career As A Dental Surgeon
Actually, it’s not easy to be a dentist. There are more practical things to do. Especially we have to use our hand skills more. Maybe for a girl, that can be a difficult thing. But as far as I’m concerned if there is determination anyone can reach this goal. After working hard for my ordinary examination I passed it with excellent passes for every subject. I continued my further education from bioscience subject and luckily could enter to the Faculty of dental science. During my advanced level period, I found more information about dentistry and watched videos of maxillofacial surgeries as a leisure time activity. Although I did them only satisfy my mind I got more advantages from the storehouse of knowledge that I maintained during my leisure time. Those were important during my clinical practices also.
You know what, we, as human beings have a main problem. Out of many problems there is one more. What is that? We always expect ease from life. We afraid to do challenges. But the challenges are the guiders who help us to achieve our goals. Absolutely the undergraduate period in the dental school also was a challenge to me. First two years had to learn about more things such as human body system, the parts of the body, muscles, nerves, arteries and so on. First two years were similar to the medical faculty curriculum. As you know, before starting study about abnormal conditions of the body parts we have to concern about the normal locations and conditions in the human body. In this case we as dental students studied more about the activity inside our body.
Yes, I agree it’s difficult to remember all the names of nerves, arteries, muscles and all that. But if you have a desire to learn, the thirsty will be automatically built. It was so interesting to learn with cadaver. We are separated to several groups which having eight members to one group. We started from cutting the skin and gradually went to inside the body. Day by day we were excited to see the parts of the bodies lively from the cadaver. Anatomy lab sessions are conducted to develop the knowledge about human anatomy. In addition to that there were two lab sessions as physiology lab and bio chemistry lab. In all lab sessions we developed our store house of knowledge. Not only the educational knowledge but also the good qualities are important to be a good future dental surgeon. With the help of senior students of our faculty we developed those things in an amazing manner.
After first four semesters which was having full set of assignments and examinations finally we could cover all the theory parts about human body and related diseases. The most sensitive part is we worshipped our cadavers for helping us to swim the depth of the human body and get to know about more things. Although it was just a dead body, we will save thousands of lives in the future with the help of the knowledge we learned from that dead body. Absolutely it is the day we started to develop our qualities.
If I compare my job with other jobs, the difference is we are dealing with human lives. In the true sense of the word we are the people who responsible to save lives and relieve human’s pain. So it’s important developing our qualities too.
The most unforgettable part came after the first four semesters. This was the period that we practically started to treat patients. Actually dental students start clinical practices before medical students. The reason is it’s difficult to practice the theory things we learnt without patients. If I asked a question from you as “What is the main thing we do in clinical years” you will answer me like “give treatments to the patients”. But it’s not that much narrow. First thing is the way you talk with the patient. As you know toothache is one of the worst pain people are facing. Therefore people who come to us can be with different mental conditions. A dentist should have an amazing ability to reduce their pain from just a smile. Even one word will be enough to eliminate someone’s pain.
In the clinical sessions we are rotated from department to department and could identify different types of diseases. At the periodontal department mostly cared about the periodontal diseases, gingivitis, tooth calculus and discolorations. Some people are afraid to face the society because of their conditions such as teeth discolorations. They hide their beautiful smile. Luckily we can give their innocent smile back. At the prosthodontic department we met hundred of patients specially elders who were having difficulty in biting and eating. Some were worrying about the missing teeth of front of the mouth. After step wise procedure we could replace their missing teeth in a proper manner. In here it’s important to keep a strong connection with the technician.
At the oral surgery department we extract decayed and painful teeth of patients. Actually, the first anesthetic moment will be an unforgettable day for all dental students.
Although I was able to be a dentist my main ambition was to act my future role as a maxillofacial surgeon. For that I had to study more. That was the period I met many people who were suffering life time. Luckily I could turn their sad life into a happy life. I met lots of patients who were having cleft lip, cleft palate, temperomandibular joint problems, cancers and bone problems. They have been lived in silent mode in their past years of life time. But I could change their path. In addition to recorrect their defects we also take every possible efforts to train speaking for them. Small children who are suffering their whole life even without education, are examined and treated by OMF surgeons. Actually we can change their faith.
While I was doing my intern period in the Kegalle base hospital I met lots of elderly patients. They have come from remote areas and financially they were in a poor situation. Some patients came their since last day midnight because of transport problems. Those days I realized the value of on time working. If we got late to come to the clinic even 5 minutes, that may long the suffering time of the patients. Some time that little five minutes can cause to patient’s death. In the true sense of the word we should be very responsible about our services. We all have to consider their suffering as our sufferings.
Lucky to say that, in some cases I was the first patient who recognized their serious diseases. Once I met one person who came to visit me complaining about his toothache. Although the patient complaint is on a toothache I examined all intra oral and extra oral structures as usual. When I was examining he asked me to extract his tooth as soon as possible. The patient was having a serious pain. I gave him painkillers and examined intra oral structures. I could recognize the pre oral cancer symptoms on his soft tissues. There was an inflammation and gingival erythematous. But my thorough examination was not wasting of time. Because his cancer condition was at the pre stage and luckily we could save patient’s life after few treatments. There were so many cases like hypertension, diabetes that I could recognize and send the patient for further treatments.
Behavior management of children
Another interesting experiences that I got are when I transfer to the paediatric department. There I had to provide dental care to children from birth to 16 years. At the paediatric department we have to manage three dentitions as primary dentition, mixed dentition and permanent dentition. There are children like cooperative, uncooperative, healthy, children with special health care needs, with a simple dental problem or with complex dental problems. In here actually we have to specially focus on children’s behaviours. Behaviour is the activity and mannerism made by individuals, in conjunction with themselves or their environment, which includes the other systems or person around as well as the physical environment.
The children behaviours change according to their chronological age, their mental age, their own values and expectations, cultural background, social background and particular situation and time. There are favourable behaviours and unfavourable behaviours among them. Children may need treatments under general anaesthesia. This dental fear and anxiety in childhood may persist to adulthood and is a significant predictor for avoidance of dental visits in adulthood.
I could train my mind to focus on very fine things during paediatric intern period. Among phobiae, dental phobia was the most common followed by height phobia and spider phobia. During my intern period I saw some children cried when they see me. I used to bring some toys to be friendly with them. Happy to say, it worked. Finally they came to visit me to my house also after the end of their treatments. As dentists we should have a clear knowledge about patients’ fear and how we can manage it. I’ll keep a brief introduction about the types of fear according to their age.
Preschool child ( 2-6 years )
- Is more effective in interpersonal communications
- Is influenced by immediate environment
- Aggression and sympathy co- exist
- Fear related with pain and blood
Middle year child ( 6 – 12 years )
- Peaceful period of time
- Time for joining others of own sex
- Time for sexual growth latency
- Understand what is seen
- Child possesses pre logical reasoning
- Anxiety could be deal reasonably
Adolescents ( Above 13 years )
- Individual is no longer a child but not yet an adult too
- Adolescents have a different connotation, they may prefer for the adult world.
- Looking forward independence
- Working with adolescent is a pleasant experience – maybe bit sensitive and moody.
As dentists we have to treat for all this kind of patients. PersonalIy I prefer to meet various type of patients and educate them. Patient education is also a wide topic. As health care professionals we need to give a good knowledge about their conditions in addition to treat their presenting complaint. Because they come to visit us due to lack of knowledge.
When talking about children’s treatments the main thing we have to consider is their anxiety. Anxiety is a sympathetic hyper- arousal. Personal factors such as age, level of anxiety and the medical status of the child, dental factors like pain, type of the treatment need, complexity of surgical procedures and the dental team, external factors such as parental dental fear, social background of the family, ethic group, child rearing and temperature cause to dental anxiety.
According to my experiences in dental field there are more differences between adult patients and child patients. Although a child attends the dental services as a result of he/she is forced to do it, when we consider about an adult patient he/she is not satisfied with the treatments he will seek a new place/ doctor. In addition to that a child patient will have to return even he/she doesn’t like. But in case of an adult patient even if an adult put up in an unavoidable discomfort, he/she has freedom to do what he/she likes. Of course a child is in dynamic status of growth and the adult is in static state. Therefore we have to make our treatment plan accordingly.
Diagnosis and treatment planning
When we diagnose a patient we have to do it step wisely. The diagnosis means a concise description of presenting disease in a particular mouth at a particular time.
At the diagnosis procedures..
- Determine the category
- How severe / How susceptible is the patient
- How extensive ( distribution )
- Is there active disease now? Or is the condition a result of past diseases ?
- What is the risk profile
So, considering above facts you have to realize the condition. There should have an analytical knowledge about the subject. That’s why people consider our degrees as first class degrees. Sharp and clear theoretical knowledge is important to future works.
Caries are the main problems among children, young and adult people. If we focus only about their current situation and treat only for presenting complaint, our service has not completed. Not only treatments but also we have to educate patients to stop bad habits and educate about the final results of their bad habits. For dental caries we can promote not to get sugary foods, give a basic knowledge about tooth pastes ( fluoridated tooth paste), teach them brushing methods, give idea about how we should select a tooth brush and promote brushing after meals etc.
Apart from that there are lots of patients who are having oral cancers. As we know the main reason for oral cancers are betel chewing, smoking and alcohol consumption. Sometimes people use them because of lack of knowledge. They haven’t any idea about the final results of that. We can motivate patients to give up those habits in a friendly manner. The key principal of the minimum intervention care includes recognition, reduction, regeneration and repair. As dentists we have to be neat and do all the procedures in order.
At the restorative department also there are thousands of patients who are waiting for fillings. First we have to clean the cavity in a proper manner and then after making undercuts we can fill the tooth. Remaining period of the filling will depend on the hand skill of the dental surgeon. So we should take every possible efforts to complete patient’s needs in a proper manner. The cost of dental instruments and dental materials are high. Managing them is one of a big responsibility.
Screening for diseases
Out of the individual treatments, we have to consider about the population oral health also. I have personally visited more than 100 clinics in remote areas. Screening and research making is one of my favourable thing in my carrier. Screening is searching for unrecognized disease or defect. Although patients come to visit us and get treatments we have a responsibility to visit healthy people and save their lives from getting into a disease condition. Screening is directed at people who are yet asymptomatic. Our aim of the screening is reducing mobility and mortality by early detection and treatment of disease for those screened positive.
Ask questions, clinical examination, laboratory tests, x rays and genetic tests are the types of screening. Within my intern period I have screened for oral potentially malignant disorders using clinical examination at the clinic, dental caries from bitewing x rays, breast cancers using mammogram, cervical cancer conditions using pap smear, prostate cancer from prostate specific antigen test, tuberculosis from manteaux test and diabetes using random blood sugar test.
In my point of view, being a dental surgeon is a blessing for the rest of my life. Today I thank you for the incidents that I faced in my childhood. Now I have achieved my goal and enjoying my life by healing patients. Honestly, I appreciate all the people who are having a desire to join my field. Health care professionals are the protectors of human beings.
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