The worst profession

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Accumulated bit of material to create a theme. Hopefully, in the "corner" does not fit. Too sensitive beg to move away from the screen, some pictures a little harsh.

Will 16 ph.






I must say that several aims. First - try to create a representation of how the doctor at a reception at the state clinic, with what face. II - Educational) Maybe someone reading this post, make for yourself any conclusions, he learns something new, useful, and some never want to kiss strangers guys (girls) in the clubs, or buy for a new toothbrush). And the third - just to pass the time, see pictures, among them will be something interesting ... I will try to tell all of & quot; garlic & quot; and be objective. For those who will master will be a lot of text, for the impatient pictures with commentary. So there you go!
I work four years -hirurgom dentist, the first three on the distribution, including the year of internship. The working day starts at 7-30 doctor, but I come to work somewhere in the 7-40, on arrival the bus (I promised to be honest))), the first pass will still sit on 8-00. The nurse must come a little earlier doctor nurse to ... 7-00 coupons are issued at intervals of 12 minutes, plus there is a repeated patients (bandages, sheets disability) who go without coupons. Break from 11-00 to 11-25. Last ticket 13-12, a total of 24 scheduled coupon. Next to 14-00 work documentation. Officially, the first shift ends at 14-30 and should, in theory, to sit in the office, though 14-00 is already intrudes replaced another doctor. But we have in the clinic for the privilege to leave two hours, the doctors on duty once a month in the output from 8-00 to 14-30 free. Total we have three dentist - surgeon. In the first change, because People are always more than two doctors. Now techniques of 20-25 people (very few), but when I was working alone on the change happened and forty, and in his old polyclinic and almost came to sixty ... Number of people to pay is not affected. Most of the work at the reception - extractions (approximately 15-35 per shift, usually a little more than 20), the treatment of inflammatory diseases of the maxillofacial region, conducting outpatient operations.

Cabinet typical sovochnogo type all the repairs that were made in the clinic bypassed by his side. The floor is worn out, and on the walls crooked tiles laid, piles of hanging wires sticking out of the walls of bolts, screws ... So, not only in my office across the clinic wires hanging like lianas in the jungle. Aesthetics is no ... At the bottom of the third photograph quartz lamp. Once we have established the office in recirculator, the need for it has disappeared, asked to remove but things are there, hanging from the ceiling straholyudina ... But it must be said that the polyclinic Heer. reception, probably the least expensive and requires a minimum of expensive consumables. Tools for removal, while not cheap, but durable when used carefully. It is important to the professionalism of the doctor (so private offices surgeons receive the highest percentage of the income from them) I am happy here, even what my chair has a turbine handpiece and direct with micromotor.




other types of cabinet ...




Using the micromotor and turbine handpiece, I delete without chisel and a hammer. Few nice when it "knock on the head." Probably few of you know, but the most correct removal is when the doctor boron pre-sawing between the roots of the tooth (tooth if multirooted) and removes each root separately. This is called non-invasive removal. Chance to break off the tip of the root, the bone damage is significantly reduced. So, most professionals are not the doctor who removes quickly, and one that makes it neat.
That's tools. This is a -klyuvy forceps to remove the teeth of the lower jaw. Now I only use the forceps on single rooted, moving teeth, severed roots.




All "serious" attempt to remove the teeth elevators (picture one). They are as many different forceps. The one in the photo, our Belarusian production. I do not know whether there is a factory where they produce a medical consultant, but apparently not, because if they work alone is not resharpen impossible, though steel is a very good ... All elevators that we have in the office, I personally went and sharpened at the dental technicians, now they are well suited for the job.




Well, sad to begin the transition to something more interesting ...
Guess how old is the patient? For obvious reasons, I did not photograph his face completely ... Initially he spoke about two months ago with a fracture of the lower jaw in the articular process on the left and the bus could not apply to him because almost no teeth as much as ... He was sent to the regional hospital, where like a sling bandage, and was allowed to go home ... osteosynthesis no he did not. And then two months later, he came to me after at work fell and hit the same place)))) It is "probable" ... But not the point, a guy 25 years old !!! Believes that the teeth are destroyed, because he in hazardous work in the factory working. But it is much more likely reason - the unwillingness to brush your teeth. In the picture you can see how much there is plaque. And so many invent the most incredible reasons: working with acid, the life in the forest, long voyage, the loss of teeth in one month after giving birth, etc. All this may affect to some extent, but in fact all of these patients horrible hygiene and the last visit to the dentist during the reign of Grohe. And our guy but tatuha the entire right hand, and the fact that it do so, he found the time and the money, and desire ... That's our mentality ... to drive expensive cars, ponadelat tatuha, piercing, go to the expensive belongings, but while with dirty ears and unpeeled teeth. Few listeners comes with a level of care that it was possible to carry out a dental intervention. Yes, there is a special index of hygiene, and if it is above a certain value, it can not be deleted. But in fact, deleted, since If a rigorous approach is taken can be 2-3 people per shift, others send to brush your teeth ... But then people come and was surprised to ask why the hole after removing it hurt? No one even had no idea that one of the probable reasons may be a dump in my mouth ... So, my friends, go to the dentist - brush your teeth well (and indeed it is necessary to clean them)), even this small change, you ensure yourself a good attitude doctor because clean mouth - a rarity and a pleasant surprise for the dentist (unfortunately).



And this is his panoramic radiograph. The fact that around the red, it is necessary to remove. In 25 years, this guy should be put removable laminar dentures. It's like you have seen their grandparents in the glasses on the nightstand beside the bed ...



Just a couple of words about hygiene ... Here are two typical patient. One dill on the teeth, the second stone (visible in the mirror). And this is not the most striking examples. Imagine that after removing the bleeding gets to me ... well it's hard to surprise, or disgust, but some can not. Sometimes you just send out of the chair to go brush your teeth. Where? I was not concerned ... so offended !!! The thin nature) was a case such as the one launched accepted, removed a tooth, but warned that if once again with his mouth comes, I will not accept it. He's come-picture is the same. I refused to accept it. It was the first change. In the evening went to the office for some reason, there is a colleague of mine drove reception, looking SID in his chair my morning patients. I asked the doctor if he brushed his teeth guy, and he tells me that this garbage he had not seen even as his mouth ... Curtain ...



Now some interesting cases from the practice ...
Here's an interesting fellow. Not my patient, but asked to see ... A few months ago was injured, a broken jaw, but the doctors did not mention guessed themselves treated in the regional hospital, was discharged, all was well like already, but recently turned to us with osteomyelitis, phlegmon buccal region, unconsolidated (ununited) fracture of the left lower jaw. To reach this state to endure with the onset of symptoms for at least a month ... In the pictures are not visible tooth root. This sequestration - necrotizing, rejects portion of the lower jaw bone. A man will go to the maxillofacial surgeons ...
So do many come only when the pripret unbearable. And then the tears pour, suffer, suffer ... Because most simple, cheap, painless treatment that deals with dental caries in the stage of uncomplicated when the teeth do not hurt and do not cause particular concern. But when there are complications, the volume of intervention, its complexity increases, anesthesia is not effective. Hence the story of how the teeth "on the living tear" that anesthesia does not take ...



It is sequestration, which I took out a pair of tweezers, he just has almost freely lying in the mouth and was not associated with the lower jaw, the other curtailments will remove maxillofacial surgeons in the hospital. Operation called sequestrectomy. In the clinic, such operations can not be done.



Here's another fellow who doterpeli. Apparently he had a disease called subcutaneous (migrating) granuloma. And I do not for one day develop. The infection from the tooth (which can be removed for a long time) is looking for "exit" and finds an external fistula opening on the face. Can abstsedirovat, as in this case.
I it to what? A lot of patients are running ... In the civilized countries of Europe, if you did not come for a visit to the dentist as it should be 2 times a year, you cancel medical insurance and treatment is fabulous money, and why they go, and problems such as our patients there is much less.
We have the same picture is very common when they come, only when a person will spread from the pus, a mouth roots, which should be removed, untreated teeth, but not remove, treat, but once every six months for this reason, sits on sick leave with pay.



This new formation removed from the interior of the soft tissues of the upper lip of the patient three months ago. Syringe close comparison, so you can imagine the size. Guba he was noticeably deformed prior to surgery. But by all indications education suited to benign. Yes, and he said that oncologists do a biopsy and sent to conventional surgery to remove. It removes, everything went well, but the conclusion of histology was not joyous. Cellular atypia, increased mitotic activity of cells (pathological). It was necessary to conduct additional tests. He got a call at my request from the registry, explained the situation, told to come immediately. He promised to come and ... not ... No, not dead, pah-pah ... just did not come. Just sometimes amazed at people which put the bolt.
A lower salivary stone from submandibular salivary gland in a woman during the meal appeared a noticeable swelling of the submandibular area on the left, there was a feeling of tingling, dry mouth. Typical symptoms of the disease for salivary -kamennoy (calculouse sialoadenita). I have it deep in the soft tissue palpated and removed ...



Map stomatologiskogo patient. Zafotkal for the purpose, so that you can estimate the amount of scribbling. We describe a patient with an initial visit to the issuance of sick leave. You can write more, but no time, and write the most basic. Handwriting hopelessly corrupt. I want to note that the issue of sick leave for the same diagnosis of "acute purulent abscess in / hr to the right of 15" three times to write !!! It is necessary for patients ??? A bunch of scribbling at the expense of the treatment process. And, as I mentioned, these cards for change need to write 20-30 ... And still have to work, without nakosyachit hurry.



writings ...



And here is the local lottery ticket brought))) We pass by a dozen Belarusian wooden ... sure ... And subscriptions to newspapers on Saturdays several times a year, Red Cross, Dental Association, on the construction sites, etc. All types of volunteering, but actually forced ...



Sometimes it happens ... In the photo extracted tooth that during endodontic treatment perforated (punched through the tool), and sticking out of his gutaperchivy pin which obturate a root canal, bred in the bone of the upper jaw ... Of course, no one is immune from mistakes, make mistakes, even the most the best, but bad when schools have become the norm for the doctor, he does not make the conclusions and not worry about their jobs. So look for your specialist who will trust and hold it. It is much more like to write, but you can not grasp the immensity, all health, that's all, if you have questions, ask, try to answer)))



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