Shauna Powell

DENH 437
10/18/14

Service learning reflection

For the past 3 months I have been on external rotations all over the state of
Virginia on service learning rotations. My first rotation was off to park place. I was
very nervous to venture off by myself with random dental students, but I think my
mom was even more nervous for me. I have been to the prison, Goochland,
Northern Neck, and Danville. Out of all of the rotations I have been on thus far, I
would definitely say my favorite has been Danville. Although I went alone with 3
male dental students the clinic was awesome and the staff at the clinic were even
better. After talking to my mom I decided to reach out to the dental students and
see if they would like to carpool to the clinic. We had to leave on Tuesday evening
after clinic at about 6:30 or so. I did not want to make that two and a half hour ride
all by myself in the dark so I was excited when I heard they wanted to carpool. Once
l heard they didnt want me to be the one driving I was even more excited. When we
got to the house we were staying at I was ecstatic to see how big and luxurious it
was. The living room was full of games, a flat screen TV, and lots and lots of movies.
I have some pictures I would like to include in this paper to give more of a visual of
what it was like on this rotation for me. The picture on the left is a picture of the
dental student Mohammad and the house that we called home for a few days. The
picture on the right is the sunrise at about 6:30 am on the way to clinic the first
morning.

The clinic in Danville was the nicest clinic I have been to while being on
rotations. There were 6 cubicles with nice wallpaper in the back. The rooms had so
much space in them and I was so very pleased with the one I was placed in. The
cavitrons all worked amazingly and it was nothing like I have ever seen before.
During this rotation I finally got the chance to put my hygiene diagnosing skills to
the test. This rotation has a full time hygienist and she does the majority of the
cleanings. The hygiene students are taking radiographs, doing an exam, and
cleaning the patients teeth if time allows. I was very excited to be able to look at
radiographs write down what I thought was decay and talk it over with the dentist.

After the 3rd of 4th exam the dentist came behind me and said I was doing excellent
and I was totally getting the hang of this diagnosing thing. When the dentist said
that it was a total ego boost. For once I felt like I did great and he appreciated all of
the help I was giving him. The dentist at this rotation was so enthusiastic to have us
there and he was a genuinely so sweet. He was so nice and eager to help me with
injections. My patient cancelled the first day so he called me over and asked me to
do the dental students injections. (I was in my operatory hiding/staying out of the
way) Dr. Harnigan was a former PHS dentist and has worked in a prison before so we
had lots to talk about while I was there. The patients in this clinic pay for services
based on income. The majority of the patients pay $50-$75 per visit. The majority of
the patients were very thankful to be seen.

On this rotation I had to tell a patient I was not able to see her. This patient
presented in my chair for radiographs and a full mouth gross debridement. The
patient was practically jumping out of the chair when I started taking her blood
pressure. I calmed her down as best I could by explaining everything I was doing
every step of the way. The patient explained her teeth were so horrible because she
has a newborn so she doesnt brush much anymore. I explained to her the
importance or oral hygiene and how it can impact her child and how it even affects
her immune system. I explained to her what a cavitron was and how important it
was to remove all of the calculus and plaque so we could see her teeth. The patient
said she was ready to begin but just as I started she almost jumped out of my chair.
I again stopped and explained to her this is how we have to do it and she reassures
me she was sorry and to go ahead and proceed with her cleaning. Once again just
as I stated on tooth #9 she jumped and hit my hand so hard I dropped the cavitron.
I had about had it after that. I asked the patient is everything okay and is she okay.
She said she was fine and she was just nervous. At this point I was sitting the chair
up. Long story short I had to stop her appointment and explain to her she wouldnt
be seen. Her nerves were so shot she needs to either have nitrous and or
anesthesia to be seen. I explained to her the importance of not hitting my hand. I
explained exactly how she or I could get stuck and that would not be a good visit
what so ever. I had to use my knowledge/experience to know she would not be able

to sit still through this appointment and if I proceeded on with the cleaning she
would be putting my health and hers at risk. It wasnt the first time she had jumped
and this time she hit my hand so hard the cavitron went flying out of my hand. I
explained to the dentist what happened he agreed and told me he was proud I told
her the appointment was over. I explained to her she will have to reschedule with
the hygienist for SC/RP so she could get anesthesia and to make it more
comfortable for her. The dentist fully backed me up and this is exactly how it should
be. I could never imagine working for a dentist that does not respect my decision
and or just wants me to put myself or the patient in harms way by finishing the
appointment.
After looking back on that appointment I feel satisfied with the way I handled
myself. Although I was very upset I kept my cool stayed calm and professional and
made sure I explained exactly why we had to end the appointment. We have been
taught to always leave the ball in the patients court. I told her she had to be still on
the first and second incident giving her the choice to either finish the appointment
or not. But after she hit my hand so hard the cavitron went flying, I knew I needed
to end the appointment. Also by this time she was making me very uncomfortable. I
did not think I would be able to properly treat her after this situation. I was not
expecting that to happen so this appointment defiantly through me for a curve ball,
but that is what hygiene is all about. It is about every patient being so different and
every appointment varying. Hygiene is about being flexible and being able to
change up your plans for each appointment in the drop of a dime or cavitron in
my case. This appointment proved to me that no matter what may happen I can
stay professional and keep my cool. I had to stress to that patient I didnt want to
hurt her or myself and I wanted to be able to do my best but I couldnt with her in
pain and jumping around. This situation could have been handled many different
ways, but I think I handled myself in a very professional, and ethical way. This
experience was even better knowing I had the dentist backing me up every step of
the way. I believe this situation has prepared me to now know how to properly
dismiss a patient that cannot behave in the dental chair. I am glad no one was
hurt in this situation but I am a firm believer in everything happens for a reason. I
now know I can properly handle myself in those type of predicaments.
This rotation has definitely also helped further my knowledge of injections. I
am pretty sure I am no longer shaking while I am injecting my patients and I say
that with great pride. When I injected my student partner I almost cried for her
because I just felt so bad. On this rotation the dental students were great about
coming to see if I was busy and letting me do their injections. Although I may not be
as fast as them at it, I did not miss the nerve and they did not have to give their
patients any further anesthesia. Dr. Harnigan was right behind me giving me
pointers on placement of the injections and how much to give.
On this rotation one patient stood out to me the most. She came in with a
Michael Korrs bag, nails done, and nice shoes. I was stunned to see her walking in
my room to be seen for a comprehensive exam and maybe a cleaning if time
permitted. After assessments this patient was diagnosed with severe generalized
periodontal disease. After talking with the patient she stated she knew all of her

teeth needed to come out, but she wanted them to last her as long as she could.
She stated the last lady shoved things in her gums and the pockets were mostly
11s but some 13s and 14s. I didnt tell her but I had never seen someone with
such severe periodontal disease. I walked over to the doctor to see how he wanted
me to handle this and what he wanted to do. We both went to talk with the patient
and explain to her that all of her teeth were hopeless and they all needed to come
out. The patient was okay with that. I explained to her the importance of getting the
teeth out and how her body was fighting off the infections in her mouth so now her
immune system is weaker. I explained to her the importance of preserving the
remaining bone so she would be able to get a denture. After I went through the
whole diagnosis with her and why it was so important to get her teeth out she was
surprisingly thankful. The last clinic told her that all of her teeth needed to come out
and it would cost approximately $2,000 to remove them and make her dentures. Dr.
Harnigan told the patient at their clinic it would take multiple visits and would cost
at least $500. The patient began to cry and explained she didnt want to go without
teeth but she just couldnt afford that price. He stated he was going to call his friend
(a local dentist in town) and see if he can see her and work with the price. She said
she could not afford anything over $200-300. I was not there to see the outcome of
this conversation, but I do know that dentist did everything in his power to please
his patient and make sure she didnt have to go without teeth. He handled this
patient with so much care and trustworthiness. The patient knew she would be
getting a call from Dr. Harnigan in the morning with an answer to what exactly she
needed to do. I want my patients to have as much trust in me as his patients have
in him. I think he went way above and beyond for her and he would do it for any one
of his patients. This was how he practices and I want to be the same way. This
experience showed me not to judge a book by its cover and to treat each and every
patient the same. Although she presented with name brand clothing and bags, she
was struggling and couldnt pay to replace her teeth. I am glad I was present to see
how Dr. Harnigan interacted with that patient.

This is where I got to experience breakfast every morning I was in Danville. The
cooking left me feeling like I was at home eating my moms breakfast. It was fairly
cheap and I just love food so I had to include it in my reflection. I would recommend
anyone in this town to visit this restaurant.

On all of the rotations there have been little things that have proven to me I
am in the right field. This rotation stood out to me the most. These rotations have
opened my eyes in such a dramatic way seeing just how much the folks in these
areas are suffering from the lack of dental care. I do indeed hope that the
knowledge I taught my patients through oral hygiene instructions, oral cancer
screenings, or even just being an ear to listen has impacted them in a positive way.
It takes people like us and volunteers to help these communities in need and help
educate the public. I have not had a bad experience on these rotations and I use all
experiences as lessons to make myself a better hygienist. Now that we are going on
external rotations I am able to put my classroom knowledge to practice in more of a
clinical setting and I am able to experience so much more.

This was a picture of our group on this rotation.

Dr. Harnigan loves taking pictures with his students after the week is up.

Since Halloween is approaching, the office had all

sorts of cute decorations out and this fancy pumpkin stood out to me the most.

While being in Danville we got to participate in the offices

mummy contest. Every department decorated a mummy in their own little way
and put it on display. On my down time I got to help the front desk make this
mummy. We chose to make the mummy a prince.