Category Archives: Dentistry

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