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.

As a first year dental student, orientation is the first time you hear about a cascade of topics including class expectations, financial aid, student health insurance,  and campus resources.  Then student organizations are introduced, with each group talking about the focus and mission of that association.  Feeling a little overwhelmed but following along, I had a question, “Which group will aid my success throughout dental school and into my career?”

I found my answer within ASDA. My appreciation did not instantly come over a cup of joe with an ASDA leader. Instead, I used the first semester of dental school to test out a multitude of events hosted by a variety of societies. I found myself supplementing my classes with ASDA-run lunch and learns on dental issues—financial stability, corporate dentistry, dental saturation in Denver, etc. As a first year, practicing dentistry can seem like a dream with a very long day of work before that prize. ASDA’s frequent meetings remind me that it is important to become aware of the issues and changes surrounding my career now, even if my reward of practicing is three years away. These lunch and learns also clarified the importance of continuing involvement as a dentist, so that when I’m able to practice, I can transition from being a voice in ASDA, to being a voice of an involved, contributing dentist.

I guess I went to more ASDA events than I realized because in December, our ASDA president notified me that I had earned the most diamonds out of our chapter members. Diamonds are a form of ASDA currency for attending events, and with them, I was able to receive funding for the ASDA Annual Session in Dallas, TX this March. Before Annual Session, I saw ASDA as strong presence at CU for its ability to inform students, encourage community involvement, and provide networking experiences.  After, I saw an even bigger community.

Annual session introduced me to ASDA’s ability to unify dental students’ opinions and concerns into one powerful voice that, as I saw first-hand in Dallas, brings about change for our current position as students and future career as dentists. That’s power. Becoming involved in ASDA is not becoming involved in a CU Dental organization—it’s building yourself as a professional through becoming an active part of an influential, national voice.

For me, the days of orientation are over.  I don’t need to look around at student associations and wonder what each one offers. ASDA allows members to be as involved as you want, whether it’s in social media, community outreach, pre-dental involvement, business chair, social events, health and wellness, etc. It is an environment to excel, specifically in an area that interests you. For me, ASDA is the student organization that most allows me to grow my professional career outside the classroom. “The how” I got involved was a process accelerated by the many opportunities ASDA provides, and “the why” continues to grow as my involvement with ASDA increases.

You know that dream where you’re cutting a crown prep on those dorky little plastic teeth, and all the faculty are gathered around saying, “Wow, that’s amazing!” and, “You were born to be a dentist!”…?

No? Well then I’m sure you’re familiar with the dream where you’re cutting a crown prep on those dorky plastic teeth and you slip and destroy your prep, and can’t quite remember what you were supposed to be prepping anyway, and it just happens to be a practical and Dr. Wollum is standing right by you in stone silence.

I can no longer recall how many of my dental student peers have shown up one morning and related one of these dreams to the rest of us. While this can be a sign that we are losing our minds, I think it is also indicative that we care a lot about our work here in school.

Dental school is an immersive experience; we live it, dream it, and spend most every waking moment thinking about how to become better at it. We become so focused on it, that I often hear or read statements about how we can find balance in our lives while we are in school. I’ve thought a lot about this over the past year and a half since beginning dental school, and I’ve come to a simple conclusion: we will not live a balanced life in dental school. In fact, we will probably never have an equal balance of time between work and leisure until we are nearing retirement. The key to feeling well-balanced, I believe, is to recognize that our situation is a good one, and to commit whole-heartedly to the work before us.

I had intended to write this article about family life while in dental school, and while there are a few additional responsibilities that go along with having a family, everyone still has to find a way to have a life while in dental school.

The first step in having fun while in school, is to actually do well in school. This means that we need to schedule and commit to a significant amount of time studying, practicing in the Sim Lab, or treatment planning for our patients. I have found that two to three late nights each week, along with a couple Saturdays each month work great for me. It gives me ample time to cover lecture material and to practice my drilling. You may need less time, or maybe even more.

This means that I should have two free evenings during the workweek, those nights I have committed to being with my family. My son, Rivers, knows that I will be home to put him to bed every Tuesday and Thursday night as well as the weekends. He knows that I will do nothing else on Sunday but spend time with him. That consistency means a lot to him, and it means a lot to me as well.

If you don’t have a kid, then schedule a couple evenings to spend time with friends.  If you don’t have friends, then spend some time with your dog. And if you don’t have a dog, maybe go workout or something.  Basically, what I am saying is that it is important to find something to do with yourself that is socially enriching.

I’ve found that when my family and friends know the schedule I’ve committed to, I get a lot of support from them. My wife and son are totally okay on the nights I stay at school until 8:00 or 10:00pm, because they expect it. It makes it so much easier for me to remain committed to my work because I get used to the consistency of my schedule.

I could continue to talk about this subject for quite some time, but I’ll sum it up here. Making a consistent routine out of your time commitments makes everything in dental school go so much smoother for you and for those who care about you and need to spend time with you. This may require you to say no to things that no longer fit into your routine, but that necessity to simplify will more than likely enrich your own personal dental school experience.

We are all so fortunate to be where we are right now. Stay committed to your work, and allow yourself consistent time to fulfill the responsibilities you have to your friends and family.

ex·tern

Webster definition:

:  a person connected with an institution but not living or boarding in it; specifically :  a nonresident doctor or medical student at a hospital

My definition:

Showing up to a different school and being that annoying person asking questions and stalking residents for a week

For those of you who may be interested in specializing, one way to sway you one way or the other is to participate in an externship at a program you may be interested in. (Keep in mind, not all specialties offer externships, and not every school does either). Spending a solid week following residents around can really let you know if it is something you can picture yourself doing.

So, how do you get started?

1. Check out programs online to find an externship you are interested in. I did a perio externship, and there is a list of them on Perio.org
2. When you find a school/program that you are interested in, contact the program director (their name should be listed with the school information) via email and introduce yourself, ask about dates and further information they may need from you. Try to get the dates nailed down.
3. In my case, the program director had three requests. #1 was a letter of intent (I wrote one, sent it to Faye and she printed it on CU letterhead, then I mailed it myself), #2 was a letter from an Associate Dean stating my academic eligibility (good standing, etc) had to be sent, and they also must approve your request if you are missing school. #3, proof of my health insurance (NOT malpractice, just normal health insurance so I scanned my card and emailed it).

Next, get yourself to the school. Book a hotel, stay with a friend if possible, etc.  In my case, I decided to turn an externship in Charleston, South Carolina into a 25-hour (each way) road trip. Maybe not something I would do again, but it was a great way to see a TON of the country- 4000 miles to be exact. And, since it was during spring break- there was time for stops to visit friends along the way, explore new cities (St. Louis, Nashville, Jacksonville…), and eat at some incredible restaurants.

Arrival: show up at the clinic, wherever the program director tells you to meet. Now- this initial day can be the more awkward, uncomfortable portion of the week- meeting the residents and following them around, meanwhile you feel utterly useless and annoying. But- be friendly, polite, and ask questions. Talk to the faculty members. Make friends with the assistants. Act as though you are being watched at all times- because you are. Assist however you can. Pick the brains of the residents because they are your absolute BEST resource on picking programs, learning anything online is seemingly impossible.

Also take time to explore the city you are visiting and see if it’s a place you would want to live! This is a big part of deciding on any residency.

After you leave, it’s a great idea to send thank you cards to everyone you met. Keep in touch with the residents. Remember- you want to stand out, make a memorable impression, and hope that they will invite you back for an interview!

Moral of the story- externships bring residencies to life. Life decisions don’t come easily, but you should know in your heart where your future goals lie after completing this experience.

With an array of things to do over spring break, a couple of us decided to help out with a continuing education course at the dental school. Fun, I know!

In actuality, it turned out to be a great experience.  We met Dr. André Ritter (one of the co-authors for our Operative book), had great free food, and had the opportunity to witness what exactly CE entailed.

The course titled “Achieving Excellence with Direct Composite,” incorporated a lecture on anterior and posterior case studies, followed by two hands-on activities in the sim lab. The educational session was short; we missed most of it due to the fact we had to prepare the sim lab. The sim lab was a mess but we were able to make it presentable for the 20 or so dentists and EDDA’s. That’s right EDDA’s (expanded duties dental assistant).

Dr. Ritter showed us how to restore class IV, class I, and class II restorations using 3M ESPE composites, including body and translucent types. The procedure included using a lingual stent, and building up different layers using the various types of composite. He outlined how to incorporate developmental grooves and mamelons using the translucent type of composite. It was actually quite comforting to know the process was similar to the method we were taught in Esthetic Dentistry, just using slightly altered techniques to make it look more esthetic and, of course, the use of better (more expensive) polishing instruments.

The best part was when the participants were practicing.  We were given the opportunity to pick Dr. Ritter’s brain. Not only was his work on plastic teeth amazing, he was also tremendously approachable and friendly.

For the most part, it was a great experience, and I walked away with some really great tips for using composite!

And since we all know dental students’ relationship with free food, the event was catered by Gourmet To Go, and it was quite tasty!