I was never much of a coffee drinker when I was younger, but this quickly changed once I got into dental school. Starting with the occasional cup on early mornings, it eventually progressed into a daily routine around Boards studying. I would set the coffee maker to brew the next morning at 6:45am so I could come upstairs to the smell of fresh-brewed, dark roast coffee. Most people—including myself—associate frequent coffee consumption with somewhat of a negative effect – especially esthetically. Staining of teeth and restorations are a common side effect of consistent coffee indulgence. Caffeine is an addictive substance, and can be responsible for withdrawals, producing symptoms such as fatigue and irritability. A person’s circadian rhythm can be affected, which can result in sleep disturbances. What I didn’t realize until reading an article last month in the Journal of the Academy of General Dentistry is that coffee has an incredible number of benefits, summarized as follows:

Liver: Coffee consumption is shown to be inversely related to the development of liver fibrosis. A European study done on over 500,000 men and women over the course of 11 years drew the conclusion that people who consume significant amounts of coffee (3+ cups per day) as opposed to very little (less than 1/2 cup per day) were 72% less likely to develop hepatocellular carcinoma.

Metabolism: Many studies have shown that people who consume coffee on a regular basis are 15-30% less likely to develop Type 2 diabetes.

Mind: The development of Parkinson disease is nearly 25% less likely in males who drink 4 cups of coffee per day, and 40% less likely in women who drink the same amount.

Cancer risk: The presence of chlorogenic acid, an antioxidant that repairs DNA, is likely to explain coffee’s protective effect against numerous cancers.

Heart health & strokes: A negative association has been discovered between coffee consumption and mortality due to heart disease and stroke. This is contradictory to coffee’s short-term side effects of increased heart rate and blood pressure, which is most likely due to the presence of chlorogenic acids and polyphenols.

Kidneys: Protective effects of the kidney associated with the consumption of moderate amounts of coffee, including increased efficiency of kidney filtration. ¹ 

While I’m not advocating for people to start drinking exorbitant amounts of coffee, it is nice to know the great benefits that it offers. More importantly, this is valuable information that we can bestow upon inquisitive patients when asked whether significant coffee consumption can be harmful. Patients will be excited to learn that coffee does more good than harm. So spread the good word on coffee consumption, and go enjoy those pumpkin spice lattes this October!

1. Sideman, L. M., K. N. Eckenrode, I.T. Bloom, & N. Bashirelahi. (2016). What every dentist should know about coffee. Academy of General Dentistry, 64(4). Retrieved from   http://www.agd.org/mtools/imis/contactmanagement/sign_in.aspx?returnurl=/mtools/lqpredirect.aspx&agdredirect= http://www.agd.org/publications-media/publications/general-dentistry/general-dentistry-archives.aspx.

A few summers ago, my parents purchased a new German Shepherd puppy named Heidi. Heidi turned out to be a handful, as we soon learned that she was cleverer and more enthusiastic than any of our previous family dogs. For the next few months, we learned how to train a highly intelligent puppy to be obedient without being neurotic, to be playful without using her canine cuspids (ha, geddit?) to greet people, and to accept us into her “pack” (terminology used by the breeders themselves). As she grew, Heidi’s attention span doubled from about two seconds to four. In order to get Heidi to stay focused on learning how to sit, lay down, and heel, the breeders encouraged us to do two things: 1. Use little bits of hot dog as treats. 2. Keep the treats at our eye level and give Heidi the command, “EYES”, every time her attention slipped away to the endlessly more amusing pinecones in our backyard. The moments when Heidi successfully looked us in the eye before learning a new command, her success rate – and hot dog rewards – skyrocketed.

Having next to zero previous training working with patients, performing intraoral and extraoral exams, navigating Axium’s labyrinth, or staying afloat with lectures and lab work, second year of dental school is enough to make me feel uncannily like an untrained German Shepherd puppy. Dental school (the obedience training program) is meant to teach us dental pups how to be competent without overstepping our limitations, to be affable with patients without showing our frustrations, and eventually to be accepted into a highly respected and vital healthcare profession (our very own dental “pack”). As we graduate from first year to second year to third and fourth, our attention spans (hopefully) lengthen from about two hours to ten.

The analogy came full circle to me while listening to Dr. Sutton lecture: “Keep your eyes on me. That’s all you have to do. If you keep your eyes on mine, and your attention on what I’m doing, you will have no choice but to absorb at least eighty percent of what I’m saying. I just need your eyes.” At a time when everything we’re taught is new information and each tidbit could be beneficial for future success in clinic, I’ll gratefully take eighty percent of these dental school “hot dogs” – the skills that can lead to better patient care. While it’s easy to be distracted by fatigue, e-mails, Facebook (heaven forbid), and the Colorado Quickset blog during class, it’s just as easy to keep my eyes on the doctor standing at the front. The game gets easier still when I’m learning in the clinic setting -- undistracted by my shiny computer screen.

Whenever I find my focus slipping because I’ve been sitting in class for six straight hours, all I have to do is think of Heidi’s eyes looking up at me, eager to learn something new, and I am reminded how indispensable her attention is for her success. Attention is simple. If it works for a dog (who is undoubtedly smarter than I am), I trust that it can work for me too.

Dear Class of 2020,

Welcome to the big leagues! Now that you have weathered the long days and (hopefully) fun nights of Orientation Week, the real journey into dental school begins. I would like to offer a few bits of advice as you all navigate the starting blocks of first year.

1. Embrace your variety. The people in your class come from a diverse background. You’ll have those who come from dental dynasties and those who are blazing a brand new trail. You’ll have those who are undergoing a career change and those who are fresh off the college campus. You’ll have those who can speak three languages and those with a killer topspin serve. Everyone in your class has something unique to offer. It may not be obvious this month or this semester, but pay attention and everyone will surprise you at some point over the next few years. That’s the awesome thing about having a small class; you will make friends that you’ll have for the rest of your life.

2. Stop planning for the future. I know this is a difficult one. It’s easy at the beginning to get so caught up in all of the things you have looming in the distant future…a seemingly scary amount of finals, seeing your first patients in clinic, graduation, life as a practicing dentist, etc. Stop it. Live in the present. That’s not to say you should ignore future events altogether, but don’t be consumed by them. Enjoy your time as first years. Even if at times things seem irrelevant or tedious. You will be much less stressed if you take each challenge of dental school one day at a time. (And for the love of all things dental, do not start asking about Boards until at least January…)

3. Take a day off. Memorizing endless anatomy will get stressful, and exams will pile up. You will get tired of burning yourself with wax. You will get frustrated with some of the people around you. When that time hits, give yourself a mental break. Go fishing. Go to a movie. Go adopt a puppy (just kidding, don’t do this on a whim). Take the time to disconnect from school and stress. It’s that reset that is the key to success—not how many sleepless nights you can spend making flashcards.

4. Trial-by-fire is an excellent way to learn. You’ll quickly realize that with dentistry, what is applicable in lecture is limited. You can learn only so much be listening and visualizing. At some point, you just have to do. This can be a frustrating transition, but it’s a transition that will force you to grow and become a better dental student. And this is not just limited to getting your hand skills in lab. Go assist some upperclassmen in clinic. You may not be in the driver seat, but you will learn some lessons that the classroom will never teach you.

5. This is much more than just “school” or the beginning of a “career.” This is the rest of your life. Be extraordinary.

Cheers!

Your ASDA Electronic Editor,

Luke A. Harden

(Shoutout to the nine from Costa Rica '15 for the sand molar...see, you can have fun in dental school)

Oral hygiene is important--no matter how furry you may be. Happy Summer Break to all! --Milo, the Samoyed 

ACTS… those four letters—that one word—marking light at the end of a very long tunnel we all know as dental school. I never thought I’d ever make it through all of the PowerPoints, Scantron exams, lab practicals, and perio lab cleanings before the school would trust me enough to send me off to get a taste of real world dentistry. For my first rotation, I was sent to Grand Junction—on Colorado’s western slope—where I spent three weeks working at the Marillac Clinic.

ACTS stands for Advanced Clinical Training and Service Program. Each student spends approximately 2-3 weeks in a dental clinic or practice (usually in areas that are considered underserved) in a location in just about every corner of the state of Colorado. The student then returns to the school clinics for 2 weeks, and then another 2-3 weeks in a different location. This cycle continues for the summer and fall of the fourth year of dental school.

There are a few things I learned about ACTS while I was away from school. First, there is a life beyond axiUm (the dreaded patient software) and the endless amount of faculty approvals needed to complete a new patient exam or even a simple restoration. Appointments weren’t spent stalking faculty for a “quick” check or swipe. There was so much freedom! The second thing I learned while on ACTS was that having an assistant is ah-mazing. To be truthful, my clinic didn’t have assistants dedicated to us students. But, there were days when one of the doctors wasn’t in and those assistants were all ours. Fourhanded dentistry, as Dr. DeLapp describes it, is a real thing and it’s something to look forward to. I found myself not having to de-glove every 10 minutes to get up and grab something. These small perks seem to make the strongest impressions. Lastly, we really are well prepared for life after dental school. Being that I was in the first group in my class to go on rotation, I thought I might be at a disadvantage because I was less experienced. For the first couple of days, I was a little unsure of my abilities and myself. As time went on, I gained more confidence and was able to get a patient in and out of the chair in an hour or less. That’s right, dental appointments don’t last two and a half hours on ACTS like they do at the dental school. Sure, we will never know everything there is to know about dentistry. Just know that you won’t be completely lost—even though some people try to tell you otherwise! Just make the most of the experience, and you’ll learn a lot!

Here are some tips to make the most of your ACTS experience:

1. Be confident, but not cocky. Realize that you have some skills! You’ve been seeing patients since fall of second year. You’re a DS3.5 now, you know a little something. Just don’t try to be a hero, know your limits and when to stop and ask for help; that’s why these clinics have preceptors.
2. Don’t just sit around. Some clinics give students their own columns with their own patients and some don’t. If you have an opening in your schedule, look at the other doctor’s schedule and ask if you can see his or her patient for that appointment.
3. The doctors aren’t the only ones providing you with some education. Work with your assistant. They’ll teach you how to do dentistry with another person other than your patient. We get so used to working alone at school or using our patients as assistants to hold the suction. Take advantage of the fact that you have an extra set of hands.
4. Remember, you’re not in Aurora anymore. If you get sent to a distance site, don’t whine about how far you are from home. Instead, adventure out and see what your new town has to offer. Go hiking, fishing, camping, tour a microbrewery, eat at a new restaurant, or something else super Colorado-y.

Good luck!

Up to this point in dental school, I have had the perfect patient for every crown and restoration I’ve ever done. They’ve stayed perfectly still, let me put them in any number of ridiculous positions in order to get direct vision, and let me stretch their cheeks out over their ears if that’s what I needed. Their teeth all had perfect anatomy, their tongue never got in the way, and even if I sent a bur through their cheek, they never complained.

That’s because until this summer, I have only ever done restorative dentistry on a rubber mannequin I refer to as Plaquesico Burress. That all changes now that I have a few class II restorations planned on a living, biting, enamel-wielding patient. The transition into the real clinic is an extremely intimidating and stressful experience for all of us DS2’s, even though we know we’ll get the hang of it. Our class has been told time and time again that we are leaps ahead of where the graduating class was at this point in their second year, but we can’t help feeling like we really have no idea what’s going on.

This short article will give you all of the tips you need to seamlessly transition to the second floor clinic in the second week of May during your second year of dental school. Except that it won’t. (I am just as lost as the rest of you). What it might do is help us realize that even though we don’t know how to do everything yet, we do know how to talk to the right people to help us figure it out. After all, Dr. Woolum hates to see us cry.

So, use the faculty. Even though we’ve all seen some of them sneaking around the school as 5 o’clock approaches, avoiding eye contact so they can sneak out undisturbed to the life they apparently have outside the school, for the most part they just want to help. Remember that they had to jump through all of the same hoops at some point in their lives and I think it’s fair to say most of them want to make it easier on us. You may even surprise yourself and do everything correctly, leading to that awkward moment when all the faculty says to your question is “looks good,” so you leave even more afraid than when you came in.

Next, talk to your coordinator. Frequently. They are all very good at their jobs, but we need to realize they are in charge of managing dozens of students and hundreds of patients. If we need a patient or have an issue with a patient, it is up to us to ask them for help. They can’t make everyone happy all the time, but if you talk to them face to face you’ll usually get what you're looking for.

My third tip is to learn Axium. Thoroughly. That’s about all I can say about it. Hopefully when I reread this article I’ll find it convincing enough that I'll actually sit down for an hour or two myself and make sure I can do everything we need to on that lovely program. After all, it holds the key to us graduating on time.

Finally, practice what you’ve learned in the sim clinic. We all like to think that since we passed our direct restorative lab last summer we’ll be able to fill anything our coordinator throws our way. But maybe we need to go back and see if we even remember how to tighten down a Tofflemire retainer first. The truth is, many of us haven’t practiced those restorations much since then because we’ve been searching for the mythical undercut or figuring out if acrylic provisionals are just a joke the faculty is playing on us. We all love ISTR by the way. So yeah, practice. All parties involved will be very glad you did. Go into your appointments with more confidence, and both your patient and faculty will be more relaxed and cooperative.

So take it from me, someone who has literally no more experience or knowledge on the subject than you do, the transition to the clinic will go smoothly and will actually be fun. After all, this is what we’re really here for right?

Dental school is a very arduous experience; and solely finishing school doesn’t actually get us what we want – not by itself anyway. To become a dentist in most states throughout the US, there are several requirements, which include, but are not necessarily limited to:

• A degree from an ADA CODA-accredited dental school,
• Passing the National Board Dental Examinations I and II,
• Passing one of the Regional Board Examinations

Though regional board exams are a point of controversy among many in the United States right now, they are still a part of our current situation…. So we have to be able to conquer them! This becomes a daunting process when you are looking to spend upwards of $3,500 and the first things you hear about boards may be tidbits like…. “I still have nightmares about those 2 days,”  “I’ve never felt so much stress in my life,” “It was hell.”

So what was my first step? I assisted candidates taking both of the regional board examinations offered at our school, WREB and CRDTS, to help me decide which one to take.  I can’t emphasize enough how great of a learning experience this was! Not only did I get to see and experience how nerve-wracking boards is, I got to watch a plethora of students make it through the process unscathed!

What did I gain from assisting? I learned that getting good patients is vitally important (including making sure the nearby teeth are also in good shape).  I also learned how important it is to trust your instincts and skills! Another important piece of advice is to practice using all materials and instruments you intend to use on the day of - don’t try anything new you’ve never done before.  Additionally, I learned that you should always do a final inspection of your preparation with the super-sharp explorer that is sent up with the patient, because that’s what your graders will be using.  Finally, I learned how important it is to know the in’s and out’s of the specific test you are taking --- read and learn the instruction manual ahead of time!

Most importantly, I decided on which exam I will be taking.  This is a different decision-making process for everyone because it depends on multiple factors such as where you intend to live and what your specific strengths/weaknesses are.  So to all those 4^th years who passed boards in the last few months – CONGRATS! To all my fellow 3^rd years who will be taking boards less than a year from now – GOOD LUCK! To all of the 2^nd and 1^st years who still have some time – make sure to assist various boards exams, get some cash along the way, and see which exam suits you more.

National Dental Student Lobby Day: my first national meeting and what I would consider the beginning of my involvement with ASDA. Attending what is considered the most influential annual meeting that ASDA holds every year was an honor, and I’m glad to be able to attend again this year. This is an event where over 400 students from schools nationwide come together to lobby about important issues in organized dentistry as a unified voice, seeing that changes occurring in the profession are brought about by the ones who know it best: dentists and dental students.

As the newly appointed vice president of Colorado ASDA and first legislative liaison, it is my responsibility to relay information and updates about any current issues in dentistry. This entails being up-to-date on current legislation that could pass, or has passed, in either the House of Representatives or the Senate. Although these are my duties as the first legislative liaison, it is in everyone’s interest to remain engaged during the legislative process involving these issues because decisions made in the coming years will affect all of us within the profession. While I’m not expecting everyone who reads this to try and set up meetings with legislators (frankly I’m happy you’re still reading), I would like people to be informed with what is going on in the world of organized dentistry, and what issues we are lobbying for in DC this Tuesday. Mid-level providers, access to care, licensure, and student debt are a few considerable issues that are of concern. Student debt and access to care specifically are the two that ASDA has decided to focus on at National Lobby Day this year. Two bills aimed at helping lower student debt are H.R. 649 (Student Loan Refinancing Act) and H.R. 4223 (Post Grad Act). The Student Loan Refinancing Act would allow graduates to refinance their student loans if a lower interest rate becomes available down the road. The Post Grad Act would make it much easier to get subsidized student loans while in school, meaning that students would not accrue interest while in school as well as for six months post-graduation. If both of these bills were to pass, students would have the potential to save tens of thousands of dollars! The third bill that will be lobbied for on Tuesday is H.R. 539 (Action for Dental Health Act of 2015) and addresses the access to care issue. The Action for Dental Health Act of 2015 would allow programs such as Mission of Mercy (MOM) and Give Kids a Smile to apply for readily available funds (around $15 million) that the CDC has set aside for public health projects. This bill is an amendment to the Public Health Service Act due to its current exclusion criteria regarding what sort of organizations can apply for these funds.

Albeit somewhat brief, this is what is going on in the world of organized dentistry at the current time! It would not surprise me if most of this information is foreign to you, but I hope that this new knowledge you now possess will motivate you to stay informed on the current issues in our profession.