Amalgam preps

Once you learn what is expected of you, the tooth cutting strategy for placing silver fillings actually makes sense. All lines should be crisp, smooth, and flowing. You must cut in such a way that you prevent the tooth from cracking and avoid drilling into the bloody and full-of-nerves pulp. You must also cut in such a way that the silver you place does not crack when your patient bites food. Finally, you must make sure that the silver stays put in the tooth.

Those goals are formalized into a set of millimeter measurements, degrees, and clearance tests. I’m finally familiar with those requirements. However, I’m so nervous when I cut these teeth (well, when I cut their plastic counterparts in pre-clinic). Over the course of a 2 hour practical, you can do enough damage to fail in 3 seconds. Try it, count backwards from 3: 3… 2… 1… ok you just failed your practical. That’s nerve-wracking!

And then there’s the mirror factor.

When you cut into someone’s top teeth, you have 2 options. OPTION 1: you can bend way over and around and look directly at the tooth as you cut. This will result in you having to get your neck fused. This has happened to more than one doctor in our school. OPTION 2: you do all your cutting by looking through a mirror.

So, I’m sitting there literally sweating and my heart pounding as I try to guide this drill, upside down and backwards, over and through this tiny little tooth. I’m trying for option 2, but I’m thinking… I’d rather have terrible posture right now and pass… and then figure out how to do it ergonomically later.

It’s conflicting… do you do what’s best for you now (option 1), with the risk of developing bad, potentially debilitating, habits? Or do you try to do it all at once: good posture, passing grades? It feels impossible. And so you practice at 6:30pm on a Friday night, sitting there all alone in lab… and the 500,000 rpm drill catches, slipping around the mesial buccal cavosurface angle of the proximal box you were cutting… and that’s it. That tooth isn’t going to pass — time to get another on which to practice.

2 comments left



I would go with option 1….if we can’t pass now, we don’t need to worry about getting a bad neck in the future.

Alexander Micek

Can’t help but agree, Kyle. And thanks for stopping by — after 18 months in dental school, you’re the first classmate of mine to stumble upon this place. Google search is a weird, weird thing.

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