Charlie Steward, a dental therapy student, shares his experience treating his first patient, offering insight into the challenges and lessons he learned.
Last year, my course mate and I began our placement at the University of Suffolk’s newly established dental community interest company (CIC). Here, we treated our first patients.
We were placed into groups of three as this allowed us to rotate job roles: clinician, nurse and computer assistant. A placement supervisor was present to support us in treating patients, as well as observing our clinical skills and giving feedback through reflective sessions.
I greeted my first patient after lunch. I began by reviewing their medical history, including allergies and current medications – standard procedure conducted for each patient. The clinical advisor supported me in obtaining the medical history of the patient and guided me on follow up questions for the patient’s diabetic condition. Explaining my status as a student and obtaining informed consent, I went over the treatment plan.
Overcoming hurdles
Unexpectedly, the patient immediately questioned the necessity for their treatment, believing they were scheduled for a different procedure. I remained confident and carefully explained that the mentioned treatment was already planned for the future.
Applying my recent knowledge of the health belief model, I addressed the patient’s perceived susceptibility by helping them recognise their risk of developing oral health complications if left untreated. I also reinforced the importance of their scheduled treatment in preventing problems such as halitosis, abscesses and tissue or tooth loss.
Beginning with the extraoral examination, no abnormalities were detected. I felt extremely confident performing the different head and neck palpations while asking for consent throughout. This was due to the many opportunities where I’d practised with my classmates.
The intraoral examination was my first attempt in clinic. With this I felt less confident, but my textbook knowledge allowed me to successfully complete this procedure. Going forward, I will plan how I’ll execute this process of the examination for future patients.
The intraoral examination was my first attempt in clinic. With this I felt less confident, but my textbook knowledge allowed me to successfully complete this procedure.
Going forward, I will plan how I’ll execute this process of the examination for future patients.
As the BPE score consisted of threes, with the permission of my clinical advisor, I proceeded to complete a full mouth six-point pocket check.
This was my first time using Sensei Cloud, a dental software with a format quite different to what I was used to as a dental nurse. While charting initially took longer than expected, the support from the placement team helped me to understand the format.
Over the following weeks, I became more confident with navigating the system, taking less time and making far less mistakes.
Oral hygiene advice
Throughout the appointment I made sure I continuously asked for consent while explaining the use and purpose of the instruments. I realised, this made not only the patient comfortable but also made me feel more confident knowing that they understood their treatment.
During the appointment, the patient pointed to a sensitive tooth which they believed to have occurred recently from the extraction of a neighbouring tooth. I gained consent to use the ultrasonic scaler, allowing me to clean the tooth. However, upon sensitivity from scaling, the patient requested that I avoid it. Polishing, although my first time in a clinical setting, felt natural.
During the rest of the treatment I gave oral hygiene advice to the patient. I asked them if they would consider switching from a manual to an electric toothbrush, and they mentioned their unpleasant experience which resulted in tooth sensitivity, so I centred my advice on showing them the modified bass technique to increase the efficiency of their brushing.
I presented the correct Tepe sizes for the patient as well as floss, explaining how to use them. Then, I asked the patient to explain how they’d use the brushes themselves. With success, I reinforced oral health instructions for the patient by informing them to use their Tepes at least once daily due to their heightened risk of calculus and plaque build-up.
Supervisor feedback
I expressed my gratitude for the patient’s time and consent and they seemed satisfied with the treatment provided. After feedback from my clinical supervisor, I was informed that although my appointment was well executed, there are skills that I need to further develop – mainly my ability to advise patients on their oral health.
I didn’t emphasise enough the importance of at-home oral health, missing relations between diabetes and gum disease. This was also the case when asking the patient about their diet. The supervisor told me to not worry if the patient doesn’t seem interested in the advice given, but to be persistent in educating all patients, something I have focused on more as appointments have progressed.
Having successfully seen my first patient, it gave me a strong understanding of how to develop my skills before the next appointment, where I plan to incorporate more of my learned experiences in delivering better care and creating a more trusting relation with future patients.
Follow Dentistry on Instagram to keep up with all the latest dental news and trends.
