REPORT NO. 4: MONITORING THE PATIENT AND THE DENTIST
Any successful dental treatment requires that the all the personnel working towards the rehabilitation of the patient be alert and astute enough to recognize the various needs of the situation. These situations can be easily divided into the needs of the dentist who is operating on the patient, and the needs of the patient who is undergoing the treatment.
Therefore, when I am providing assistance, I ensure to keep an eye on the needs of both. The dentist’s needs are different from those of the patient and vice versa, and I have to keep this point in mind. The dentist for example, when carrying out a filling, needs constant suction to remove excess water and debris from the operating field. I therefore, stand near the dentist and ensure that I do so without him or her to tell me to. Similarly, I make sure I remember all the stages of the various procedures and prepare for them before hand. If the dentist is creating a crown and has just finished cutting the tooth, I make sure I am ready with the impression material, so that there is swift working. If the patient comes into the office for the first time and the dentist is conducting an interview, I make sure that I have the dental chart ready and am noting down the necessary details. If the patient then is to be examined, I ensure that the examination tray, gloves, mask etc. are all prepared, so that the dentist has the least convenience. If there is an x-ray to be taken, I make sure that the dentist has no problem in carrying it out by providing him with the x-ray film, x-ray holder and other such requirements.
There may be other areas where I need to look out if the dentist needs my help. During the procedures, due to lack of space, there may be cluttering of instruments. I make sure that I am removing unnecessary items from the working area if they are no longer needed, and placing the new material and instruments during the various stages of the procedure. If there is a root canal treatment underway, I would remove the files and irrigation syringes once the filing is complete and replace it with filling material or sealant, as the need may be.
If the patient needs to have an impression taken, I ensure that there is pomade or Vaseline present to protect the patient’s mouth from drying before the dentist asks for it. The dentist then usually asks for different sizes of the impression trays in order to check for size of the patient’s mouth. I therefore, make sure that the trays are well laid out and ready for the selection. The dentist will then approve the tray and state he or she needs to take the impression. I make sure to remember which impression material the dentist will need to use depending on the need of the case and mix it for him or her.
These are some of the things that I do when I am working with the dentist to make sure the procedures are done efficiently. On the other hand, I also have to make sure that I am attending to the patient’s needs and looking at the various gestures, signals and signs that the patient may be exhibiting. Most of the patients when they first visit a dentist are anxious and need someone to be a communicator for them. At other times, the patients may be interested in knowing more about the dentist before actually engaging with him. During this time, the assistant is very helpful in providing the necessary information and creating a bridge between the two parties. I make sure that if the patient is anxious or confused, I should enquire about what his or her confusion is. I then proceed on to tell the patient a little bit about the dentist, how he or she performs different procedures and try to alleviate his or her anxiety should the need be. During the procedure, if the dentist is busy in any other chore, I try to engage the patient and explain to him various steps that will be undertaken.
During the various phases of the treatment, I also keep check on the physical changes that may be taking place in the patient. The patients may be anxious, have fever or pain, may be experiencing lightheadedness, or may be having blood pressure changes. These changes must be kept in check, for they may point to sometimes serious complications such as allergy to certain ingredients or intense phobia to needles etc. I therefore, make sure that I constantly engage with the patient when the dentist is not around or operating, and make sure that he or she is feeling fine, alleviate his anxiety, and give him information about what he or she should expect during the various phases of the treatment. For example, after the anesthetic injection, I inform him that his lip will start to feel numb and he or she will feel tingling in the area. If he is to receive a filling, I tell him before hand that there will be some drilling which may feel like tickling or vibrations in the area. Patients are usually curious about the materials and instruments the dentists use. I explain to them the use of various instruments and how they are used.
In children, I make sure that they are able to enjoy their dental experience. Therefore, I engage with them through stories, making names for the various instruments and machines, and explaining to them the benefits of tooth brushing. If the children are feeling scared, I try to make them talk about it and then reduce their anxiety by telling them things such as “do you want me to hold your hand while you have your filling?”, or “do you want to hold Mr. Bear while you have the treatment?” etc.
Elderly patients may be easily tired or may be in need of a conversation during the procedure. I try to help by talking to them about the current issues, the weather, the day to day routine, curious incidences etc.
What is important to note is that depending on the case, and the age of the patient, both the dentist and the patient may have different needs. They may need the assistant as a bridge, a communicator, or as a source of information and help. These are the roles that an assistant must understand fully in order to be competent at his work.