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Friday, March 23, 2012

How to Improve your Practical Hand or Dexterity In dentistry.The Secret of that Perfect hand.

Dental Students study various dental courses in dental school,Dentists do various dental hands-on courses, we keep our eye on CDE -Question arises why?
Being a Dentist we are bit different from other health professionals. We treat the patients by working actively inside there mouth. We have superior manual dexterity then any other health professional.Consider average mouth opening of a person- Not more then four fingers wide and what about the Visibility and Accessibility to our operating field? It’s weird!!! We work in a field in which people struggle to put a ‘Burger’ and we are expected to do miracles…… and yes we are doing miracles.Dentist has to perform detailed, meticulous procedures on a minute scale. Margin of error is in micro fractions, our instruments are sharp and invasive, and a blink of an eye or loss of concentration will result in damage of vital tissue which is unacceptable.
Hmmm... I think its enough of self praising!!

So what the hell is this so called “Good practical hand”???
It can be called as clinical dexterity in proper terms, I am going to use this term in whole article.
Let me define Dexterity- skill in performing task especially with hands.
The abilities which involve the use of hands develop over time, starting with primitive gestures such as grabbing at objects to more precise activities that involve precise eye–hand coordination. Fine motor skills are skills that involve a refined use of the small muscles controlling the hand, fingers, and thumb. The development of these skills allows one to be able to complete tasks such as writing, drawing, buttoning and finally doing dental procedures.
Motor skill is a learned sequence of movements that combine to produce a smooth, efficient action in order to master a particular task like doing dental procedures

  • Gross motor skills include lifting one's head,turning,moving head etc.Generally large muscles develop before smaller ones, thus, gross motor development is the foundation for developing skills.
  • Fine motor skills include the ability to manipulate small objects,and various eye–hand coordination tasks. Some examples of fine motor skills are using the pincer grasp (thumb and forefinger) to pick up small objects,like holding endodontic files
  • Ambidexterity is a specialized skill in which right and left both hands are equally dexterous and dentist can use any one of his hands as dominant one while working.
Positioning is very important for engagement in fine motor tasks. A Dentists seat should allow him to sit comfortably with his feet placed firmly on the floor. His hips, knees, and ankles should be at 90 degree angles, with his torso slightly forward. His operating field should be approximately at the level of his elbows when his arms are at rest at his side... Keep in mind that trunk stability is necessary for good mobility of the arms, hands, and fingers.
One more important factor for a dentist is good hand-eye coordination
hand–eye coordination is the coordinated control of eye movement with hand movement, and the processing of visual input to guide reaching and grasping along with the use of proprioception of the hands to guide the eyes. its very important to develop it in dentistry.

Activities that are particularly helpful in building these abilities include-
 Start with simple manipulation of dental materials – how to hold spatula and bowl. What is the correct technique of mixing? Don’t dare to underestimate it. it will build foundation of your dexterity as well as your confidence and in bonus you will learn about properties of dental materials. If a dentist cant maupulate plaster or alginate it’s hopeless.

Wax block carving- Enjoy your carvings. Carve the anatomy of ALL teeth not for completing quota but for fun. Never ask anybody to carve for you. Dedicate as much time as you can in understanding and reproducing the anatomy of tooth. Not only teeth but you can do your imaginary carvings .Get an idea from your surroundings try to carve it on wax block and if you make something good don’t keep it to yourself Show it to your classmates, teachers and seniors get appreciated, this is the secret of building positive attitude, every time you get appreciated your confidence is improved your hand is improved.

Making miniature models/ sculptures out of dental materials like plaster and modeling wax is one of the favorite things I did in my college time. I used to make something out of any dental material which can be manipulated. Fortunately I got Best crafts award in   “Colors 2009” annual function. Try doing!! its real fun. Beside it will improve your dexterity and confidence.

Preclinical- Take your preclinical very seriously. This is the step before handling real patients. This is to prepare and train you for your clinical work. If you try to skip it or take it lightly. You are going to do blunders in your patient’s mouth. Become through with the basic theories try to do work as ideal as possible. Complete your quotas and work hard to do so.

Clinical- A sound practical knowledge is necessary for doing clinical work it’s the humans on which we are working on. we have to read lots of literature to understand and build good practical knowledge. It’s important to note that I am not asking you to mug-up the theories, I am asking you to understand it, analyses it and be able to Execute it when needed
.While working on patients be calm and controlled try to execute the ideal work style ( I know it not 100% possible but try to be close to it)
  if you know you will have particular patient in particular days ex- extractions in  oral surgery posting  then do your preparations. Find books on local anesthesia read the technique for blocks arrange a skull and mandible find some one good in that to demonstrate you the landmarks and technique. Try making mental map and imagine it in patients. Believe me ----if you are prepared you will be less anxious and more confident. Try to apply this in every department, if you know you have to treat patients be prepared for it. Never go empty head you will not get anything accept your frustration and scolding from your teachers.

PATTERN of learning FOR DENTIST-  we READ then we SEE then we DO.
READ- your text before any Demonstration, don’t go blank for any demonstration.
SEE – Observe carefully with full concentration what your Teacher or Guide is demonstrating. Humans have amazing photographic memory use it.
DO- Try to execute it as soon as possible our memory is very volatile try not to rely on it. Doing soon means you retain most of the part of demonstration.

So now we know how it works and how it can be developed. First and foremost thing is your interest in Dentistry. The person aspiring to become Dentist should be self motivated and ready to accept this challenging field. This field require long period of Training, Patience, Hard work, Endurance and Dedications. (It’s important to note I have not written the word intelligence because I don’t think it’s need in starting because you will develop it by time if you have above mentioned qualities)                   
    Its not important where you start its important where you end.
This article is not for those who want to achieve there Goals by hook and crook or just want a Degree. I am writing this article for those who want self improvement and want to achieve there goals by there worth and prove themselves.
This field is for Tough people and Hard workers don’t opt it if u don’t think you are one of them otherwise you will end up in frustration and failure. And if you are dedicated then don’t worry where you stand because one day you will develop these qualities.


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