Journey of a Dentist for ADC Exam Part 1

Introduction
This story of a dentist talks about the journey of a dentist for ADC exam and the mental, physical and economic sufferings that the whole family went through after his failure.
Ganesh was a general dental practitioner with a nice practice in a class two city. Isha was a tutor in a Dental college in the same city. The couple had been living a happily married life with their 5 years old son and their parents in a joint family.
Traveling towards Dream

Adelaide South Australia

As every couple in India has its own dream, they also had one. They wanted to settle abroad with decent earnings and a bit of respect among their relatives. They decided to try their luck and settle in Australia. So, the plan decided between them was, Isha will be working as usual along with taking care of the home while Ganesh will study hard to pass ADC licentiate examination. Once Ganesh will get a registration as a GP and a job in Australia, Isha will also qualify the ADC exam and will start working there.
The plan seemed very natural.
The Preparations for ADC Exam
Ganesh started preparing though an Online Course, worked very hard and sat in the part 1 examination in 2008 in New Delhi center for his second attempt. The result of the preliminary examination was positive, and the couple was elated for the first time in the last three years. They even started to plan further as to how and where they would prefer to settle in Australia.
Ganesh left for Australia for part 2 practical examination. The examination center was in Adelaide in Royal Adelaide Hospital. The part 2 examination was spanned in two weeks. Ganesh took the joy giving the exam in daytime and enjoyed the evening in the Rundle Mall area and along the northern terrace with his friends as he was confident about his exam result.
The post examination week was full of adventures as he went for a tour in the outback and tasted the great wine in the wineries of Barossa valley. What he didn’t assess was the economics of the trip.
All the time, effort and money were wasted as the result showed a “Fail” with few remarks after a few weeks back in India.
The pair got a huge shock. The parents came forward to console and again, Ganesh decided to take a second chance. He was determined to pass it on the second attempt. Father was ready to spend all his life savings for the great future of his Son.
The Courage
After one year, in the Westmead Hospital, Sydney, the second take of the part 2 practical exam of ADC went well. Although, he was doubtful about his performance at a few moments of the exam, but confident that the examiners would be considerate about his overall performance.
Westmead Hospital Sydney*
He enjoyed his second trip as much as the previous trip a lot and saw the eastern coast extensively, collected a lot of sweet memories with his friends and even decided as to where he will settle in Sydney. He liked the eastern coast a lot.
Back to India, his wife and he started thinking of preparing to pack up. His parents were also highly optimistic about their future and happy even though their lifetime savings had been drained out.
They were full of confidence about refilling the coffer within a year of working in Australia.
The waiting period ended, and the long-awaited letter came. His heart missed a beat looking at the weight and thickness of the envelope. The words of his friends started swirling around in his head, ‘thick envelope means more papers-that again means papers having a lot of suggestions about the future course of action.
The Apocalypse
The world around him started revolving, Ganesh felt dizziness for a while and lost his senses.
He and his whole family lost all hope of the life they had been dreaming of just.
Financially, they were broken. Neither was their courage nor finance to try out one more attempt.
The coming years were much stressful. He did not realize the moment when he became a chronic alcoholic. The strain between the couple remained for years. The marriage was at the stalk. Chronic depression settled in the whole family. His planned journey for settling in Australia resulted in apocalypse.
There always remained the guilt of losing so many years of life, lost family time, hard earned lifetime savings of father and permanent loss of hope for a life the pair dreamt of.
Years afterwards, he used to think, had I taken the help I was constantly offered from so many experienced successful dentists, life would have been happily going on a different path.
This story will continue. I shall write the second part of the story-Painful Journey of a Dentist for ADC Exam after a while.
Read part 2 of the story HERE.
Image source: Internet
copyright & ownership belong to the holder.
*The Pulse, https://i0.wp.com/thepulse.org.au/wp-content/uploads/2021/05/WMH-Emergency-Dept-800x445-1.jpg?w=800&ssl=1

Indications and Contraindications of a Dental Crown

Crown and bridges are being served to dental patients routinely as its manufacturing has become fast, readily available. It is a dependable option.

Although, the crown & bridge is generally considered very safe and it is associated with a low incidence of complications, there are some precautions that need to be considered.

Indications of a Dental Crown

Damage of crown beyond repair
Large filling needing replacement
Fractured tooth
Esthetic enhancement
Dental implant coverage
To fix dental bridges or dentures
Erosion of teeth

The shared Code of conduct

The shared Code of conduct (the code) applies to registered health practitioners in 12 professions including dentistry. The code sets out National Boards’ expectations of ethical and professional conduct for the health practitioners they regulate. It is governed by AHPRA.
The code outlines 11 principles which include information about how to apply the code in practice.

Use of fluoride for caries prevention

Fluoride has been widely used for caries prevention for several decades, and it is considered to be one of the most effective measures in reducing the incidence of dental caries. There are different ways to apply fluoride for caries prevention, including:

Topical fluoride: This involves applying fluoride directly to the teeth in the form of a gel, foam, varnish, or mouth rinse. Topical fluoride works by strengthening the tooth enamel and making it more resistant to acid attacks.

Systemic fluoride: This involves ingesting fluoride in the form of fluoridated water, dietary supplements, or fluoride-containing toothpaste. Systemic fluoride works by strengthening the teeth from the inside out as the fluoride is incorporated into the developing tooth structure.

Fluoride helps to prevent caries by:

Clinical context

Water fluoridation is a safe, effective and ethical way to help reduce tooth decay across the population and has long standing support of peak public health and dental authorities.

Water fluoridation

Water fluoridation is a proven method for reducing the prevalence of tooth decay in communities.

Surveys of tooth decay and dental fluorosis must be undertaken regularly, taking into account all fluoride sources and patterns of consumption in a community, in order to confirm the most appropriate water fluoridation concentration for that community or region.

Introduction to Third Molar Surgery: Part 3-Classification of Impaction

Classification of third molar impaction is done to facilitate the communication between clinicians, for record keeping that may be used for audit research purposes.

Introduction to Third Molar Surgery-Part 1

The third molars are the most common teeth that are found to be impacted. This article will provide and introduction to this topic. The difference between simple and surgical extraction along with the aetiologies and frequency of third molar impaction are explained in a simple way.

Mandibular Third Molars

According to George Dimitroulis, there are common and uncommon reasons for the removal of the mandibular third molar.

A 20 Weeks Course for ADC Part 1 exam

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Oral Hygiene

Regular oral hygiene by mechanical brushing and cleaning between the teeth removes soft dental plaque. When dental plaque becomes mineralised (calculus), it must be removed by a dental practitioner. Dental plaque and calculus can cause periodontal disease (eg gingivitis) and dental caries.

Frequent exposure to dietary sugar and carbohydrates leads to an increase in the risk of dental caries. Avoid sucrose in sticky forms and limit other sugars (eg acidic drinks) and carbohydrates as snacks between meals.

Avoid drinks other than water at bedtime after brushing teeth (including milk, formula and expressed breastmilk)—saliva flow diminishes during sleep and the sugar from the drink remains on the teeth overnight. This is a common cause of dental caries in children and the elderly.

Interdental cleaning

Interdental cleaning using floss or interdental brushes is recommended once each day before brushing the teeth. Brushing teeth with a toothbrush does not remove plaque from between the teeth or below the gum line.

Dental floss can be used to wipe the interdental tooth surface to remove plaque (back and forth, then up and down several times on each tooth surface). Manual dental floss, floss-holding devices or automated flossing devices are available—the choice is based on personal preference or level of dexterity.

Interdental brushes areas effective as dental floss in plaque removal, and often more effective for debris removal. They require less dexterity than dental floss. Interdental brushes are particularly useful in patients with gum recession or disease, where the spaces between the teeth are larger.

Interdental wood sticks can remove food particles, but do not effectively remove plaque.

Water jets do not effectively remove plaque.

Tooth and tongue cleaning

Soft-bristle toothbrushes are recommended; hard-bristle toothbrushes are not more effective and can damage the gums and the softer root surface. Children younger than 6 years should use a children’s toothbrush. Powered toothbrushes with a rotation oscillation action are slightly more effective at plaque removal than manual brushes. Powered toothbrushes are useful for people with dexterity or disability problems, and for carers. Toothbrushes should be replaced once damaged or when the bristles become deformed.

Advise patients to use a fluoride-containing toothpaste; for recommended concentrations of fluoride in toothpaste. Toothpastes that do not contain fluoride provide little protection against dental caries. Toothpastes also contain other additives (eg abrasives, detergents, antibacterial, bleaches, remineralising agents).

Toothpastes that do not contain fluoride provide little protection against dental caries.

Advise patients to brush teeth for 2 minutes, twice each day with fluoride toothpaste. Toothpaste should be spat out and not swallowed to minimise fluoride ingestion; the mouth should not be rinsed to allow increased uptake of fluoride from the saliva.

Advise patients to brush or gently scrape the tongue, but not to brush or massage the gums.

Mouthwash

Mouthwash is usually not required as part of a standard oral hygiene routine, provided mechanical cleaning (toothbrushing, interdental cleaning) is performed properly. Mouthwash should not be used as substitute for proper mechanical teeth cleaning.

Fluoride-containing mouthwashes can be used as an additional source of fluoride for people at high risk of dental caries on the recommendation of a dentist.

Mouthwash that inhibits plaque formation (eg chlorhexidine) can be used for a short duration in addition to mechanical tooth cleaning, usually when pain associated with periodontal disease restricts mechanical cleaning (see Management of necrotising gingivitis and Gingivitis).

Alcohol-containing mouthwashes may be associated with oral cancer and are not recommended. See here for further information on mouthwashes.

Specialised oral hygiene

People with dental implants, bridges, crowns that are joined together, and orthodontic brackets should follow the oral hygiene advice from their dentist.

Denture hygiene

Dentures should be regularly cleaned twice a day to remove food particles and plaque. Advise patients to remove dentures from the mouth and clean them with warm water, mild soap and a toothbrush, denture brush or soft nail brush. Avoid cleaning dentures with hot water, toothpaste, kitchen detergents, laundry bleaches, methylated spirits, antiseptics or abrasives (unless instructed to by a dental practitioner). Patients should clean their gums and remaining teeth with a soft toothbrush and toothpaste.

Advise patients to place dentures in a dry environment overnight after cleaning them. Traditionally, it was recommended that dentures were kept in liquid overnight. However, allowing the cleaned denture to dry out at night is more effective for reducing yeast colonisation and plaque accumulation, compared with both denture cleansers and water. Although repeated cycles of hydration and dehydration can change the shape of the denture, these changes are small and not clinically significant.

Dentures should be cleaned then placed in a dry environment at night. If there is a build-up of hard deposits (tartar, calculus), dentures can be soaked overnight in a solution of white vinegar (diluted 1:4), then cleaned as usual. Advise patients to see their dentist for professional cleaning if hard deposits cannot be removed.

Denture-associated erythematous stomatitis is prevented by regular cleaning of the dentures and storing them in a dry environment overnight. Advise patients with denture-associated erythematous stomatitis to optimise denture hygiene—it can take 1 month for symptoms to improve; see Oral candidiasis and Candida-associated lesions for further information.

Ref: Therapeutic Guidelines Limited 2019 (www.tg.org.au)

Academy of Dental Knowledge