Category Archives: Dentistry

OUR UNSUNG HEROES

My oral hygienist’s chair

We all clapped and cheered for our NHS and other heroes who risked their lives to save ours – and quite right. But what about our Unsung Heroes, who now are coming into the line of fire – workers whose professions bring them into potentially dangerous close contact with us, like our dentists and oral hygienists.

My oral hygienist, who has been helping me keep my remaining teeth for the last 14 years, assures me that the fact that I collect lots of calculus around my teeth, so that they need scaling every 3 or 4 months, is not to do with Central London’s hard water, but the constituents of my saliva. Whatever the cause of my heavy accumulation, a visit to the Oral Hygienist was long overdue.

She has worn a mask and gloves since I first went to her, but she does not, of course, wear full PPE and so is at some risk from patients stupid and uncaring enough not to self-isolate when knowingly exposed to Coronavirus infection. I was interested to see that, when I rinsed my mouth, my washings were disposed of safely, not tipped into the bowl attached to the dental chair as in the past.

Especially now that the number of cases of Coronavirus in the UK is worryingly high, we should appreciate these less popular members of the caring professions even more.

I qualified in medicine after training as a dentist and was always amused by the fact that at the end of a course of treatment, when I had taken great care to cause my patient as little pain and discomfort as possible, my dental patient would shake my hand and say

‘I’m glad I won’t be seeing you again.’

In contrast, as a doctor, I might have had difficulty getting a needle into a vein, making several painful attempts, but my patient would still thank me profusely and say they looked forward to their next visit and discussing their diagnosis and treatment.

I was the same person but the patient’s view of my two professions was so different!!

Read more of Abby’s previous posts in her book Abby’s Tales of then and Now. It is £2.99 for the Kindle version and £12.99 for the 7” x 9” paperback. Both are illustrated in colour. You can Look Inside on the Amazon site to get a taster for free.

ON BEING A KIND SCHOOL DENTIST

I love this 1977 New Zealand Stamp with both Dentist and Patient smiling

I know a lot of people have awful memories of the school dentist and the gas mask they used, but I like to think I was one of the kind ones and treated the children as if they were patients in a private practice.

I’d had an LCC (London County Council) grant to cover my dental degree so I couldn’t have a second grant to cover the Medical training I started in the autumn of 1953. I applied for and was awarded a Hilda Martindale Scholarship which covered my medical school fees and a small amount towards my living expenses. I was still living at home so they weren’t great, but medical textbooks were very expensive and I needed money to cover clothes. I approached the LCC Dental Service for a part-time job two evenings a week and was sent to a clinic in the city.

Both the nurse and I were expecting a miserable old bag, like the school dental nurses we’d met ourselves, so both of us were surprised and delighted. Maureen was a rosy-cheeked Somerset lass with a broad sense of humour and we hit it off at once. We spent the time between patients giggling and exchanging notes on the talent available to us and the latest fashions.

As it was an evening clinic, most of our patients were in senior schools. Once they’d got over their amazement at being greeted by two young women in their 20’s and reassured that I would use a local anaesthetic for any painful fillings and never use gas, they were excellent and very grateful patients. Many of those who’d been through the school dental system hated the gas mask and it left them with a permanent fear of dentists. Although at the time, it was still legal for a dentist to administer a general anaesthetic (usually nitrous oxide) on their own, I would never do so. I could carry out fillings and extractions perfectly well under local.

In our first two years at medical school, covering Anatomy, Physiology and Biochemistry, we had long holidays so I took a two-week locum appointment at a school clinic in West Ham that Christmas. The kids were fine and I again had a very pleasant nurse, but I was appalled at the poverty around me. I was brought up in the East End and we were poor but, as my mother had been a dressmaker and scoured the markets stalls for fabric remnants, I was always reasonably well dressed. Some of these children were almost in rags. I tried to persuade a young teenage boy to take off his blazer – no overcoat. I was worried about getting blood or saliva on it. When he finally agreed, I saw that on this on a freezing December day he wore only a singlet underneath.

‘I only have one shirt, you see. Mum washes it every Friday night ready for school on Monday. I never wear it in the holidays.’

I carried on with my evening clinics after Josh and I got married in 1956, until we started out own dental practice where I worked on Wednesday afternoons – when the male medical students played rugger – and Saturday mornings.

And our lovely Maureen left the LCC service and came to work in our practice until she got married in turn and her husband took a job in the country.

I thank all the lovely people who wrote and commented on my memoir ‘Woman in a White Coat.’

Lots more stories like this in my memoir ‘‘Woman in White Coat’. Buy it on Kindle at £2.99 or as a paperback on Amazon at £9.99

http://bit.ly/Woman_in_a_White_Coat

 

THE PHANTOM HEAD – OR HOW I BECAME A DENTIST

As a student in 1951, removing decay in a tooth embedded in a Phantom Head

I was 17, almost 18, when I started my dental training in October 1949. In our first year, like the medical students, we studied Anatomy, Physiology and Biochemistry with, for us, the addition of Dental Anatomy – the structure and function of the teeth and jaws. The second year was spent learning to make and fit Partial and Full dentures (Prosthetics). We spent  our two final years in the Conservation Department learning how to do fillings, gold inlays and bridges and how to pull teeth either in the General Anaesthetics room (always called the Gas Room because we used nitrous oxide gas as an anaesthetic) or under Local Anaesthetic injection in the Locals Room. We also carried out some minor oral surgery like removing redundant gum flaps or trimming the gum around the teeth – Gingivectomy – and learned how to Scale and Polish teeth – these were the days before this was delegated to Oral Hygienists.

We learned how to remove decay (caries), trim the cavity so a filling would hold – in those days often mercury amalgam – and also how to cast and fit gold fillings when they were more suitable.

All this was carried out using a Phantom Head – not a Virtual Head (hardly even dreamt of in 1951) – but a solid one made of metal with a jaw that opened and closed.

Teeth that weren’t too broken down – perhaps had been removed for overcrowding or because they were loose – were collected in the extraction rooms and stored in antiseptic solution. Our first task when we joined the Conservation Department was to fish out a set of 28 teeth – 4 upper and 4 lower incisors; 4 upper and lower premolars and 4 upper and lower molars. We didn’t bother with third molars – wisdom teeth – not everybody had them anyhow.

I developed enough skill to get a Distinction in my Dental Surgery Finals but for me it was always a question of thinking ‘right a bit’ and ‘left a bit’. I wasn’t a natural and had to plan very carefully how to go about any task, though I learned to be competent.

But during our course we had lectures on Medicine, Surgery and Pathology and I fell in love with the whodunit of Pathology – but that’s another story.

I thank all those lovely people who wrote to say they had read and enjoyed my memoir ‘Woman in a White Coat.’

‘Woman in White Coat – the memoir of girl growing up the East End making good.

Buy it on Kindle at £2.99 or as a paperback on Amazon at £9.99

Woman in a White Coat paperback

http://bit.ly/Woman_in_a_White_Coat

Fantastic! ‘Woman in a White Coat’ in Paperback as well as on Amazon Kindle

So pleased that after a fairly horrendous experience with a company putting my memoir Woman in a White Coat on Amazon, my memoir is available for pre-order at £9.99 from Amazon or from your local bookstore. Had a wonderful trio of professionals – Nathan Burton Cover designer, M Rules Typesetters and Clays the Printers.

Another colourway

The cover designer, Nathan Burton, produced lots of possible designs for the cover. I could have chosen any one – they were so great. I chose the blue and turquoise version of this design but nearly picked this one instead.

 

Cover used for publication

 

 

 

it’s bright and cheerful but I felt the colourway I chose had more gravitas!!

 

 

Abby as a young dental stud

 

This was the most striking design but I didn’t want to use a picture of me. I chose to write my memoir under the pseudonym of Dr Abby J Waterman and so I didn’t pick this one.

The original photograph is of me with a ‘phantom head’ – a metal skull into which plaster casts are fixed bearing real teeth that have ben extracted for reasons such as periodontal disease.

We practiced cutting cavities and inserting fillings and crowns on them. We gave them names and got quite fond of them!!

TO HARLEY STREET FOR A SCALE AND POLISH

One of the many Medical Houses
One of the many Medical Houses – complete with boxes to be delivered and rubbish bags waiting to be collected
Free toothpaste samples
My present of free toothpaste samples

Josh and I started our NHS dental practice in Harley Street in 1957 when I was still a medical student. We looked after each others’ teeth but now we’ve both retired I have my teeth looked after at a colleague’s practice .

I’ve had the same great hygienist, Norah, for 14 years and thanks to her have kept my teeth in reasonable state to the great age of 84.  I’ve outgrown dental decay – only two fillings in 20 years.

Of course being given free samples of toothpaste to take on trips abroad always helps.

I BUY MY TIGHTS IN BOOTS THE CHEMISTS

My local Boots
My local Boots

 

All kinds of tights
All kinds of tights

These days Boots the chemists widen their range all the time. You can understand makeup and electrical products related to teeth or hair but one wonders what next?

Well – tights. I suppose it started with support tights and compression stockings and went on from there. In the winter I wear the heavier 40 denier tights – they don’t ladder like the sheer ones I wear with a skirt. At £6 for three pairs they’re great.

Chocolates and sweets ??
Chocolates and sweets ??

We’re used to seeing sandwiches and drinks and even some packed lunches but sweets and chocolates only a few yards from the dispensing of drugs to deal with diabetes and caries preventing toothpaste?? Time to rethink how to stop the scourges of life-threatening obesity and the ever increasing tooth decay in children.

‘The checklist manifesto’

By Atul Gawande published by Profile Books
By Atul Gawande published by Profile Books

I’ve always made lists – topics to discuss lists, lecture lists, shopping lists, to-do lists, what to take on holiday lists, ingredients for a cake lists, every type of list you can imagine.
Atul Gawande’s The Checklist Manifesto charts the course of an attempt to introduce an Aviation            Pilot-type checklist into major surgery.  The results show that in hospitals from the richest, best equipped in the USA to the poorest in Africa and India, the use of a checklist before commencing major surgery saves lives and reduces complications. But there was resistance to their introduction, as there is resistance to the use of checklists in other fields.
For me, one of the most interesting aspects was the requirement to get all those involved to feel themselves a team, with input from the lowliest member. I suspect that most of us  introduce checklists top down. With more import from the most junior member of the team maybe we could have done much better – at home, in our John Dobbie toyshops, in our dental practice and in the pathology departments where I worked.

Phantom Head

The Phantom Head
The Phantom Head

I am a retired consultant pathologist but I qualified in dentistry before I studied medicine.

In our third year we learned how to do fillings, carry out extractions and perform minor oral surgery. If they are not too broken down, extracted teeth are kept, cleaned and mounted in plaster blocks fixed to a metal head with opening and closing jaws – A Phantom Head. On these we learned how to drill out caries (decay), mix fillings and pack them into the cavities. Mostly we used amalgam – a mixture of mercury and metal powder – but we also learned how to cast gold fillings.

From my memoir Woman in a White Coat