At the beginning of last winter break, I was relishing in the fact that I had just completed my first semester of dental school and was looking forward to three weeks of school-free bliss. My sister Erin, a pharmacy student at the University of Colorado, was busy studying for her finals, which overlapped with my first week of break. I remember going into her room giddy to be done with school, and her playfully telling me to “Get out of my room with your break-y self!” Once she was done, we had plans to head out to Mexico for a couple weeks of sun bathing and relaxation with our parents.

A week later, my entire life had been turned upside down. My little sister, lifelong roommate, and best friend was gone. She had Cystic Fibrosis. The number 37 was burned into my memory. That is the average life span of a person with CF today. I had always tried to push that number out of my head, but how can you forget something like that? She was only 25.

It all happened so suddenly. It didn’t feel real. She was just here. After the shock came the realization that school would be starting again in a week and a half. I knew I didn’t want to put my education on hold, but I wasn’t sure how I would be able to focus when she was all I could think of. Before school had even started again, I felt overwhelming support from my classmates. They messaged, texted, sent flowers, and some came over to see how I was doing. It was amazing to me how the love and support from people I didn’t know six months before gave me such assurance that I wasn’t alone going forward. Her memorial was held at the school, and people from my class filled the back of the room. Some of my classmates had met her, and some had not, but so many of them were there. It meant a lot to me and my family, and I will always remember it.

Before I started dental school, I had been out of college for three years and didn’t see friends on a regular basis. Erin and I had moved to Denver the year before when she started pharmacy school, and she joked that she was excited for me to start school so “she wouldn’t have to be the center of my social life.” It was true. I often think about how much harder losing her would have been without these friends. I would have felt so alone. It is by far the hardest thing I have ever faced, and continue to face, but having so much support during the most difficult days of my life helped me adjust to my new reality.

When classes started up again, the school was very accommodating and ensured me that if I ever needed more time or to take a day off, to just let them know. But dental school doesn’t slow down for you. You have to take every test and complete every assignment at some point, so pushing things back is just using borrowed time. With this must-keep-going mentality, it’s hard to know whether you are hurting yourself by not taking enough time to process, or if the busy schedule helps alleviate the sadness by retaining your focus. I think it’s some of both. Although dental school seems like our entire lives sometimes, many of us have real life struggles we must face during an already stressful time.

Finding positivity and motivation after such a life changing event requires not only support from others but strength within yourself. One of the most amazing things about Erin was that despite the fact that she had a chronic and sometimes debilitating disease, she never complained and never used it as an excuse. She went to doctor’s appointments regularly, had cabinets full of medications, and spent time every day managing her health. She was also forced to face the reality of what living with a chronic and fatal disease meant for her future. While dealing with all of this, she continued to pursue her education and excelled in pharmacy school. She was witty, insightful, and incredibly smart. Only those who knew her well were aware she had Cystic Fibrosis. She is the one who gives me my inner strength and reminds me that even the most difficult challenges do not justify self-pity and stagnation.

Jennifer Terrio is a second year dental student at the University of Colorado School of Dental Medicine. She graduated from Colorado State University where she majored in Nutrition and Food Science. She enjoys skiing, eating at Torchy’s Tacos, and flossing twice a day.

1. It’s okay to take time for yourself

Going in to dental school we all are warned of the horrors of how difficult it is. How going to dental school is life encompassing. While these statements were not untrue. I felt that they were warnings that I should do nothing but school. My first semester I got groceries once a month, if I was lucky. I had a next to impossible time allowing myself to do anything but study. Looking back, spending that time on myself would not have only improved my grades but my overall health. As I progressed through school I started focusing on myself more. I tried kickboxing which to no surprise I was horrible at. I also started eating more than Chick-Fil-A daily.

1. Don’t Panic if you have no idea what you are doing

Starting off in sim clinic, taking your first impressions, dissecting a cadaver, these tasks can make it seem like you are learning in a different language. It is perfectly normal to not know what you are doing. If you are lucky enough to know what you are doing then good luck knowing if you are performing the lab work correctly. The Sunday night before Sim Clinic started I went in to sim clinic to practice placing rubber dams. It took 25 minutes to finally place an acceptable rubber dam. Looking back, I wish I had not panicked because of my lack of knowledge of all things dental. You will get there, at least that’s what I hear. You will learn and understand the information. Who knows you may even be the winner of the “rubber dam rodeo” in transition clinic.

1. Dental school is humbling

You will not do well on everything. We all got in to dental school because we care about our grades, our school work, and we may be slight perfectionists. In dental school, you must remember you cannot always be perfect, whether it’s a test or a lab assignment. There will be something you just aren’t good at the first, second, or maybe thirtieth time. While we are all accustomed to being top of the class and the best at everything you won’t be. Use this humbling experience to motivate you. Do not let a failure in dental school stop you. Use it to try twice as hard the next time, because you will be humbled. It’s part of the process. Learn from it.

Last weekend I flew from Denver to Albuquerque to visit my brother, Zach. He had just moved to Albuquerque to be with his finance. Zach is two years older than me and next October, I am honored to be able to stand shoulder to shoulder as he marries the woman of his dreams. I saw my brother just two months ago when we both happened to be passing through my hometown of Fountain, CO, but we had yet to do our annual brother’s only trip. In 2015, a family friend told us that her two sons, would meet once a year without the parents present. They started when they were both single and over the course of their lives, the meeting grew to incorporate new girlfriends, wives, and then kids. Today, the brother’s and their new families continue to meet up once a year, saving Thanksgiving and Christmas for larger family gatherings.

Zach and I grew up and have remained close over the last 24 years, when he initially welcomed me into his family. For our inaugural start in 2016, we backpacked in Lost Creek Wilderness, CO. We had an incredible experience and further bonded over the course of hiking 33 miles in two days. It was one of the first times that we had spent time together since we had finished college and although we both grew throughout our educations, we did not grow apart. We still knew the foundations that shaped each of us. No one else in this world can share in experiences like stealing a box of Oreos from the pantry and sitting in our dog’s house to indulge in those heavenly delights. I think subconsciously we knew the repercussion of our decision and started to make ourselves feel at home.

This year, with a busier schedule for both of us, we decided to play it a little more low-key and stick around Albuquerque. Zach had not spent more than a week in his new house and I was looking to escape the drama of my Denver house. Zach let me practice my dusty skill of driving stick, we picked some New Mexico peppers, which were roasted on the farm, and we ventured over to the Sandia Mountains to do what we are most passionate about. We laced up shoes, ditched the shirts and hit the dirt trails. Over the course of a few miles, we caught up on new jobs, semesters, girls, friends, homes and how our parents just got back from three weeks in Ireland and France. We also mentioned that because we both have interests in investment, it wouldn’t be long before the Brother’s Trip took us to a castle in Ireland. Between trying to match pitch to Josh Turner while cooking dinner and reading each other’s minds about splitting plates at restaurants, the best part about our weekend was simply being in the same room.

Zach with a pepper pail.

Dental school can be taxing on students and loved ones, but I implore everyone to take a moment to think about how they got into dental school. It is through the support of family and friends that we have made it this far and it is with their help that we will make it through. No matter how busy we might think we are, there is always time to appreciate and continue to enrich the relationships that are most meaningful to us. I value hanging out with friends, I rely on my parent’s advice for problems, but I look forward to my Annual Brother’s Trip the most.

Gabe and Zach.

In 2010 my friend Jordan bet me $43 that I couldn’t finish the mega-stack meal from the Coach House Restaurant in Coos Bay, Oregon. Two full racks of spicy ribs and a side of mashed potatoes later I was victorious, but also in the men’s room regretting my decision. In dental school, pride can be dangerous.  If achieving an ends causes you to become physically sick, maybe you should re-evaluate your goal of getting an A on the Radiology final.

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As a youngster, I didn’t know the difference between an alpaca and a llama.  Eventually I learned that llamas are much bigger and can be characterized by their long banana shaped ears.

In dental school, just because something looks the same, doesn’t mean it is the same.  The mandibular lateral incisors have incisal edges with banana shaped distolingual twists when compared to their mandibular central counterparts. The details are important, pay attention to them, especially if they are banana shaped.

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In elementary school, my favorite class was recess.

In dental school, my favorite class is playing Spike Ball at lunch. It’s important to find a balance between acing tests and acing your classmates with a rubber ball and net.

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In 8^th grade my middle school hosted a pig scramble in November. Nothing quite says Thanksgiving like running after a greased pig. I ran that unfortunate hog down, clutched it tight, and held on to receive my blue ribbon. Somehow still, this triumph didn’t land me a date to the 8^th grade graduation dance.

In dental school, your goals may be slippery and illusive, but if you hold on tight to them, you will eventually get a stable job in a respected profession. This however does not guarantee you will find a spouse. That takes actual charisma and a personality.

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One summer day, I was biking around town with a couple older grade-schoolers. After landing the jump successfully himself, one of the 5^th graders convinced me to try to jump a creek on my bike by saying “it will be fun and you’ll be cool”. With that compelling argument and a head full of steam, I soared directly into creek.

In dental school, upperclassmen provide you with lots of good advice. Listen to that advice. They also have some bad advice. Don’t listen to that advice. If you do, you may very will wind up in the middle of a creek.  Just because one person had success with a particular method doesn’t mean that it will work for you.  

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In high school, I wrote for the school newspaper.  There was one occasion where I was having serious writers block the night before a print deadline. I ended up writing a story about how my childhood experiences had helped me get through high school.  The article was mediocre but the art departments papier-mache masterpieces it contributed to were outstanding.

In dental school, when you have a print deadline for an ASDA blog and you have serious writers block, just go ahead and write an article about how your childhood experiences have helped you survive dental school.  Likely your blog will be a flop, but regardless, thank your readers for making it to the very end and just be internally thankful this blog is digital and your hard work won’t wind up a papier-mache parrot.

Sam doing cool stuff as a kid.

I can still vividly recall that fateful day in August of 2010, when my childhood dream of becoming a dentist finally came to fruition, graduating from Islamic International Dental College, Pakistan with a Bachelor of Dental Surgery degree. Like every other dental school graduate, I had worn my white coat many a times during the course of my studies, but donning one as a professional truly filled me with a sense of mission and pride. I was truly excited to become part of a noble system that provided care for people who silently suffered in pain under the presumption that dental health is only secondary. My determination was not only patient care, but to treat them with a sense of compassion, dignity and otherwise bring change to society through education and service. First venture outside the boundaries of dental school brought me to Pakistan Institute of Medical Science (PIMS), thinking what better place to start a career than a hospital with the largest dental department in the city. I was shocked to witness the state of disarray and utter chaos, when I was first introduced to the emergency room. Often illiterate and with minimal financial resources, these patients were usually referred to other departments for lab work, without adequate directions. I could personally feel their sense of vulnerability further heightened by such insensitive however unintentional treatment, from the very individuals that had taken the hippocratic oath.

Bound by crippling poverty and illetracy, dental care for the poor enmass in Pakistan has primarily been relegated to streetside dentists. Albeit a cheaper alternative, these quacks have exacerbated the spread of hepatitis and other bloodborne infections. See the links below, which provides an overview of the services administered by these street side quacks and their impact on the health of those with limited financial means.

Youtube Video: https://www.youtube.com/watch?v=09XY0u0CQOM

BBC Article: http://www.bbc.com/news/world-asia-25370775

My first week of contact, I remember attending to a middle-aged patient complaining of severe discomfort. Further examination revealed a self-cure acrylic prosthesis installed by one of these quack dentists, where the monomer had caused a hypersensitivity reaction, requiring a healing period followed up with fabrication of partial dentures. How could a person be allowed to endure such pain, only because they were unaware or lacked the means (whether financial or accessibility) for proper treatment? Anger eventually gave way to acceptance and I made it my goal to help those in need. Over the course of the next three years serving at public institutions in Pakistan, I witnessed several other incidents of this nature but instead of being demoralized, it gave me the strength and determination to continue my passion of helping those less fortunate.

Living in Pakistan, a country deeply mired in the clutches of corruption and violence has sowed in me the desire to effect major change in the way we manage healthcare for the needy. It must become a priority for all dental professionals including recent graduates, practicing professionals and industry veterans to actively organize and participate in dental awareness campaigns and advocate access to affordable healthcare and medication for the poor across all communities and nations alike.

Happy Summer to us! As we enter into the beginning of another year of dental school, I wanted to take some time to thank all of Colorado’s students for taking interest in the blog. This year I have goals to expand the audience of both our writers and readers. I envision CU to be a place of camaraderie and I believe we can start with the blog.

This year, the Blog’s mission displays, “The aim of the Colorado ASDA blog is to celebrate the diversity of the students and faculty here at CU. The hope of the blog is to inspire dental minds and attitudes in an enjoyable reading format.” Not only is the blog meant to collaborate on dental topics, but it is also aiming to shine on our accomplishments and stories outside of dentistry.

I hope you can all look forward to reading the Colorado ASDA blog in the coming months. We have so many exciting changes this year and we want you to be a part of them! You can expect an email in the coming weeks on how to apply to write for Colorado ASDA.

I also want to congratulate the incoming Class of 2021! I am excited to meet you all and I am sure my ASDA colleagues can say the same.

Best,

Sierra

Lobbying on Capitol Hill is one of the most unique activities that happens in Washington D.C. Each year, the House of Representatives and Senate write bills that are passed into law by the President. As the political climate in Washington regularly fluctuates, it is essential that constituents address issues with consistency. Two weekends ago, we saw this in action. Thousands participated in the Tibet National Lobby Day, AIDS Foundation Lobby Day and ADA Dental Lobby Day. All were welcomed and given the ears and time of their elected officials.

For the past two decades, the American Dental Association (ADA) along with the American Dental Political Action Committee (ADPAC) have advocated for the dental profession on Capitol Hill. They have ensured that core concerns that effect our profession, providers and patients are voiced to our legislators. This year, for the first time, the American Student Dental Association (ASDA) joined with the ADA and ADPAC to voice the current issues important to our profession together. We took the following issues to our legislators; The Competitive Insurance Reform Act, the Student Loan Programs under the Higher Education Act and Health Care Reform: Supporting Oral Health.  

This year, a week before our Lobby Day, we saw years of the ADA’s hard work pay off as the 115th House of Representatives voted a 428 to 6 majority on H.R. 372. This repealed the Mccarran-Fergussan antitrust laws for medical and dental insurance companies. Since 1945, insurance companies have been exempt from the McCarran-Fergussan antitrust laws which prohibits companies and business owners to discuss and set similar prices for their products and services. Greater federal involvement in antitrust enforcement should encourage more competition in the healthcare insurance marketplace. More competition will promote lower prices and greater consumer choices for all Americans purchasing medical and dental insurance. This week, we thanked members of Congress for supporting this bipartisan bill and urged our senators to support or even sponsor a sister bill so that it can be passed in the senate as well. 

Rising student debt for undergraduate and graduate students is a prevalent concern for many of us. This concern is being voiced on Capitol Hill.  In 2016, the average student debt for recent dental graduates was $262,119. That is a 5% increase of average dental student debt in 2014. The weight of student debt limits many graduates’ professional pursuits, especially those who want to serve in public service, teaching and research positions. As Congress reauthorizes the Higher Education Act this year, we continued to voice our concerns regarding student debt as we met with members of Congress. Currently, there is a sponsored bill, H.R. 1614, that would allow students to refinance their graduate student loans at anytime through out the life of their loan. This would make keeping our student loans with the federal government more appealing and could save graduates thousands on accruing interest. Currently, the interest rate is fixed for the life of the loan. This week we tried to gather more representatives support for H.R. 1614 so that it will pass when it reaches the House floor. 

Since the instatement of The Affordable Care Act (ACA) the uninsured rate for Coloradans has dropped from 14.7% to 6.7%. Additionally the recent medicaid expansion in Colorado, passed in May of 2013, expanded coverage to more than 200,000 Colorado residents. As a direct result we have seen the number of hospital dental visits go from $11 million dollars to $1 million dollars annually in Colorado. We want to continue this progress as the expanding coverage reaches many of our small towns in eastern Colorado and in the Western slope. This was emphasized to our representatives by our doctors who practice in these areas. As health care is a hot topic on Capitol Hill right now we also discussed the importance and need for dental insurance transparency. Our doctors from the CDA have seen many patients who sign up for dental insurance and find out they aren’t covered until they pay for 24 months of premiums. Overall, we advocated for more transparent dental insurance plans so that our patients know what they are purchasing and what to expect from us.   

During our Lobby Day we were able to visit all 6 of our district representatives and both senator’s offices to discuss the issues above. It was great to see the impact we could make on organized dentistry by voicing our concerns to our legislators! It made me proud that we are included in a profession that stands united in protecting and advocating for our patients and doctors!

I’m rushing, I know I’m rushing. I feel the beat of my heart beating throughout my entire body. Underneath my yellow gown, I can feel myself getting sweatier and sweatier. Good thing I remembered to put on deodorant today. My anxiety levels are shooting out of the roof. Why? I got out of class late, and I’m trying my darndest to set up for my medically complex patient in time. I’m under a particularly particular faculty, and I feel nowhere near prepared. I’m getting to the point where I’m so stressed; I’m forgetting the little things. Have I gathered all of the materials I need? Do I even know exactly what I’m doing today? Have I looked up all of my patient’s medications, so I can give that stellar start check? As dental students and young practitioners we’ve all been here. In the journey to become a dentist, it is almost impossible to not experience the stress and anxiety similar to above. For some of us, it may be every single clinical experience, and for others it may be during our competencies and testing situations. No matter what, it would be remiss to ignore the effects that stress has on our work.

It’s in moments like these that we need strategies to deal with this tension. Lucky for us, there is a myriad of methods to prevent stress, anxiety, and other debilitating emotions from taking hold of our lives and our dental careers. My personal favorite is Mindfulness Meditation. You’ve probably heard of it, as it’s a bit of a “hip” topic in the psychology world. This is for good reason, as there are plenty of scientific studies to back it up.                               Photo Credit: http://www.huffingtonpost.com/lisa-firestone/mindfulness-benefits_b_2965648.html

Often, when people think of meditation they think that it is the absence of thoughts and feelings—a spiritual experience that only monks who practice for lifetimes get to go through. They couldn’t be more wrong. Mindfulness is actually being very present in the current moment. It is accepting and not judging your current situation. The very key to mindfulness is not that your mind doesn’t think of things, but that when it does you bring yourself back to the task at hand.

Mindfulness is a skill that can be practiced and honed. You probably won’t be very good at it in the beginning, but being good at it is not the point. The point of mindfulness is to not let your emotions and thoughts control you. Having mindfulness meditation in your “tool box” can take the hectic situation from above and flip it on its head. Mindfulness is most definitely not a cure-all to all stresses in life. However, after practicing mindfulness, when you start to feel those familiar feelings of stress and anxiety creep up on you before a challenging clinic session, you will have a tactic to no longer succumb to those pressures. Rather than freaking out over the things you cannot change, you take on the procedure one step at a time. You will make less mistakes, and most importantly you will provide your patient with the best care possible.

There are four different ways of practicing of mindfulness: breathing meditation, body scan, loving-kindness meditation and observing-thought meditation. The key is finding which one works for you. You can find a myriad of different sources to learn about each type and to get resources to help you out. Those include apps with guided meditations (Headspace is my personal favorite), podcasts, and videos on YouTube. Whether you are a mindfulness expert or simply a beginner, I encourage you to continue down the path to a healthier, happier you and a less stressful, more enriching dental school career.