2009

new year feels the same for me. it doesn't make any changes at all. it's just another flip to a new calendar, a new diary to be filled and a new organizer to fill in with patient's appointment. last night was celebrated with dear TV and Angah. nothing much. i never appreciate new year. i never even celebrate it. but during previous new years, it's a MUST for me to make new year resolutions., but for this new year i only had one, hm... probably two. first of all I WANNA GRADUATE! i have enough of life here. i wanna finish my study and work and have my own money. i envy my friends who's already leaving their title as students.


however, 2009 did make a lots of impact in my life. my wedding!!! ngeee~ it's gonna hit one year soon. i'm married at 22 which i never ever imagine. well. u can only plan your life, and God is the one who fix everything. Sayang. i love u till the end!


some of my close friends changed their status too. Yattea & Paly, Ain Roslan, Kema & Khai, Watai, Izyan, Ceah Fasihah.


also i went to Singapore, to visit my grandfather who i haven't seen for almost 10 years with Sayang and Tok. it was our honeymoon plus meeting relatives trip. well, who on earth brought their grandma on their honeymoon's trip aite?!


i enter my final year, in 2009, which seems forever when i was in first year. i need to manage my own patient, answering all the questions by supervisors alone, without a partner to help me. i even need to clean all the instruments used on my own, which makes me leave the clinic at 6 pm almost everyday. it sucks ok! can't wait to move my butt off this school soon! everyone, please pray that my journey will be safe!!!


goodbye 2009. i'm hoping for a better 2010. insyaAllah.

RACIST

 i studied in a Convent school for 11 years. my friends came from different ethnic groups Malay, Chinese, Indian, Siamese and etc. i'd been used to mingle with friends that didn't share the same custom with me. but who cares. as long as we can get along, we never actually make race as a barrier between us. we share stories, laughs, foods and drinks without even care.

and today i met a patient who refuse to be treat by me cause I'm a Malay. it did breaks my heart. cause previously i never 'double standard' my patients. i treat them equally. whether there are Malay or Chinese (i haven't had Indian patient here in Kelantan). even i myself went to dental clinics run by Chineses.

and this woman is a teacher. who's supposed to show some examples to others. 

CASE STUDY 1- IMMEDIATE DENTURE

this is my patient a 22 years old lady. she had mobile front tooth due to an accident she. she went for splinting of the tooth and some treatment with the periodontal specialist. both of the treatment fail. and the tooth had to be extracted. i made a denture for her before extracting the tooth. so that when it was extracted, she won't walk around woth no front teeth. this denture is known as immediate denture.

can u guess which one is the 'fake' teeth??
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the answer is the right one

LOCKED JAW!

last Thursday i did my first conservative treatment (or better known as filling) on my patient who is also my friend here. i plan to do only one filling on one tooth because that was my first time doing. after doing the x-ray of all thet teeth, my supervisor asked me to do 2 filling on 2 different tooth instead. because the x-ray shows that the tooth next to the indicated tooth was also infected.

so i drilled of the infected area or better known as caries area. showed it to my supervisor. i need to correct the cavity preparation for a few times before i can finally restore it with amalgam ( the black thing u use for filling).

when i was about to show the well prepared cavity, suddenly my patient complained that she cannot closed her mouth completely. i panicked. i don't know what to do. my supervisor was busy listening to my friend's case presentation. i could not disturb her. for about 15 minutes, my patient was unable to close her mouth completely. can u imagine how it feels when u are unable to close your mouth. for 15 minutes????

when  my supervisor came to see my patient, her jaw can already be closed completely. but when she checked the movement of her jaw, it was slightly deviated. so my supervisor asked everybody in the group what will u do if somehow our patient experienced that problem or better known as locked jaw during the treatment?? all of us were quiet. so she gives me assignment  that ought to be presented to her this Sunday. 

so this is what i found.

    There are different causes of lock jaw and the cause determines treatment. Tetanus is an acute infection caused by a bacillus and characterized by spasmodic contractions of the jaw muscles. With a tetanus infection, incorrect diagnosis leads to death. The most common cause is spasm and shortening of the jaw muscles. Muscle spasm is treated with moist heat and TMJ exercises to loosen the muscles. With muscle spasm, the lower jaw can slide laterally but not open.

          Sometimes lock jaw happens after a dental injection, when an anaesthetic is accidentally injected into the jaw muscle. If the spasm is from dental infection, it should be treated aggressively. An abscessed tooth makes pus which may extend into the jaw muscles causing muscle spasm and inflammation.

          If a jaw opens and won't close, it's due to a forward dislocation of the jaw joint. The joint pops forward and out of place and won't go back. It's treated by firmly gripping the lower jaw and rocking it downward and backward until it pops in place. This problem can occur after yawning or remaining open for a long dental appointment. A closed lock jaw can be from anterior dislocation of the TMJ disc.        

         Locking can occur after an overdose of phenothiazines or in some neurological disorders especially in the basal ganglia. Patients who experience lock jaw often have regular headaches and neck aches. There is often a history of head and neck trauma and these patients often grind their teeth. Massage therapy and TMD treatment can help.

so about my patient, my supervisor adviced her to compress her TMJ with warmed towel and practise opening her mouth at certain limit. she must control her mouth opening during laughing or yawning so that she won't experienced the problem again. 

actually before i started treatment I'd checked on my patient TMJ (that's a routine to us) and both side were clicking on opening. i thought that it may be my fault as she had to open her mouth for a long period but during the treatment i noticed that she didn't open her mouth too big. and i didn't forced her to open it bigger. so maybe it was my fault or may be the problem was already there, i just make it worse. hoho.

luckily that patient is someone that i know. so she didn't sue me. haha. for me who knows the patient before the treatment, i know that she had the habit to yawn as wide as she can. memang dah tak senonoh dah dia nie. haha. no offenced  girl!