03 Apr A Day in the Life of a Crown House Dentist
For many of you, your only experience of us will be your six monthly check-ups, so you only see us in action for 40 mins a year!
What do we do for the rest of our time though? There’s no such a thing as a ‘normal’ or average day, as each appointment is different and sometimes we will need to provide unplanned treatment if someone is in pain or has had an accident.
However, here’s is a bit of an outline and insight into what we are up to all day!
The staff all start arriving at the practice.
We travel in from different areas – I’m the lucky one though, as I live in Egham, so once I’ve dropped my children off at school, I don’t need to worry about level crossings or parking!
We get changed from our normal clothes into our clinical wear and the nurses set the surgeries up.
The dentists look through any correspondence they have received. This can be from from hospitals, orthodontists or other specialists, or notifications about new guidelines from the NHS, NICE or the local health authority. There are also often notes from reception or the practice manager regarding patients who may have called up or seen another dentist and need to have treatment co-ordinated or are looking for advice.
Anything that needs actioning is noted.
8:30am – 12:30pm
Every single day is different. The morning will be a mixture of treatments including fillings, extractions, crown and bridge appointments (these take 2 visits), denture appointments (these take at least 3 appointments and sometimes up to 5 or 6!), root canal treatment, orthodontics and emergencies, which could be absolutely anything!
Examinations (or check-ups) for adults and children are the most common appointment – so here’s a little run down of what I am up to!
For an adult, we always start off with a chat. I’ll ask if there have been any changes to your health, or if you are a new patient, we will discuss your medical history form. It may seem like we are being nosy, but some medications and medical conditions and treatments can affect what we can do for you, and vice versa so we need to know everything I’m afraid!
We also need to know about your smoking and alcohol habits. Again, we aren’t being nosy, but these two are by far the biggest risk factors for mouth cancer, so we need to know who is most at risk.
We will then chat about any problems that you might be having with your teeth or gums.
I start my check-ups outside the mouth. I will examine the jaw bone for lumps and bumps, the glands under the lower jaw for swellings, the jaw joints to check for clicking, and ensure the joint is working smoothly and evenly on both sides.
Inside the mouth, I will first check all of what we call ‘soft tissues’. These are the cheeks, tongue, floor of the mouth, palate and gums. We check for ulcers, redness, swellings, white patches and anything else out of the ordinary.
We check absolutely everyone for signs of mouth cancer.
Next, we get onto the teeth! (People assume this is all we focus on!)
I use a puff of air to dry the surface of the tooth and blow away any bubbles of saliva (or food…) as it makes the teeth much easier to check.
We use a ‘probe’ (the pointy instrument) to see if there are any soft patches or holes on the tooth which could be decay, and also to check that the edges of fillings, crowns and bridges are nice and smooth and nothing is cracked.
Lastly I use a special instrument to check for signs of gum disease. This measures the gap between the tooth and the gums. The bigger this gap is (we call it a ‘pocket’) the worse the gum disease is.
I may take x-rays if necessary as these allow me to check areas we can’t physically see – such as between teeth and under fillings or crowns. The x-rays also allow me to see the bone that is holding the teeth in. In gum disease, the bone begins to shrink back (which is why teeth can become wobbly) so it’s important that we can see this and treat before things get too bad.
We may have a chat about your oral hygiene and give tips on how to improve your current regime, and your diet and other habits if there are signs that they may be damaging your teeth.
A children’s exam also checks for signs of adult teeth appearing and checking that the teeth are developing properly and in the correct position. I assess whether the child may need orthodontic treatment (braces) and may chat about this to the carers.
If I’ve spotted anything that needs treating (adults or children), we will have a chat about the different options you may have and we work out a treatment plan that everyone is happy with.
12:00pm – 12:30pm
This gap is always reserved for emergencies (in addition to any we may have seen in the morning)
An emergency appointment could be absolutely anything, from a little chip on a tooth that feels a bit sharp and just needs smoothing, to a whole tooth being snapped off or knocked out in an accident.
People may have a nasty infection that presents as a big swelling on their face or in their mouth, or a toothache.
Sometimes a patient may have something painful in their mouth that they can’t pinpoint, so in those cases, I need to put my detective hat on.
We ALWAYS try and get you out of pain, but we can’t always do the full treatment there and then, as we simply don’t know how long we will need until we’ve seen you.
Sometimes I have to rebook a patient back in for a longer appointment to carry out the full treatment, once I’ve patched them up.
After every appointment – regardless of the reason for the visit, there are notes to write on the computer, NHS forms to fill out and submit and I need liaise with reception so they know if the patient needs to come back for any reason. Whilst I am busy with this, the nurse is cleaning down and decontaminating the surgery, and sorting instruments which need to be taken to our central sterilisation room ready to go in the disinfectors and autoclave.
If there are any spaces during the morning session, either last minute cancellations or emergency slots that aren’t filled, I catch up with paperwork that I’ve earmarked first thing, catch up with the practice manager on anything we need to talk about or get on with my studies.
As a dentist, I have to attend a minimum of 20 hours of courses every year to stay registered, in addition to reading journals and keeping up to date with the latest materials and methods in the profession.
(The latter is usually done with a well-deserved cuppa!)
12:30pm to 1:30pm
Lunchtime for the clinical staff.
There is always a receptionist on the desk though as their lunch breaks are staggered. This means we can always answer your phonecalls or help if you come into the practice.
1.30pm – 5.00pm
This follows the same pattern as the morning – with a mixture of exams, treatments and emergencies (and paperwork!)
There are often changes to the day list during the lunch break, so I’ll check my diary for any changes and off we go!
The surgeries are cleaned down, the last of the paperwork is actioned and filed, we change back into our civvies and home we go, ready to start all over again with a whole new, different day tomorrow.