2014 in Perspective: A Review of Findings

About four months. That's how long I have been researching for my senior project topic. The question I have been trying to answer is, What is the most important factor an orthodontist must consider when treating a patient?

Perhaps my research was merely focused on just one answer, but I find that appliances play a large role in orthodontic treatment. Appliances used by practicing orthodontists include braces, headgear, palatal expanders, and retainers. As I have mentioned in previous posts, such appliances will correct bites and tooth alignment, or do all sorts of other miraculous things to get treatment done. (Proper planning and judgement is necessary to get the right appliance into a patient's mouth, of course, so it isn't as if the orthodontist is being forgotten.)

Basically, orthodontic appliances ARE the treatment and it would be very hard to get much of anything done without them. Combined with an orthodontist's experience and knowledge, appliances are powerful.

I hope that the new year brings forth many other revelations that will help me with my senior project. Happy 2015.

Learning New Things

The more time passes, the more things I get to do around the office. I have been trained to use an autoclave sterilizer, observed the making of molds using alginate (pictured below), and observed the use of many different appliances.

Alginate + water mix

Finished alginate mold. The powder turns purple
when wet and returns to white as it dries.

Two of the appliances I got to see were TADS (temporary anchorage devices) and something called a Powerscope. The Powerscope is a device used to correct class II malocclusion (overbite) and it serves as a semi-permanent rubber band. The appliance attaches to the patient's wires and uses 260 grams of force (using the spring inside) to fix the bite. Supposedly the appliance also reduces treatment time and reduces costs.

So far, the appliances and the amazing things they do are the most interesting thing about orthodontics and there are so many more that I would like to learn about.

EQ

1. I reviewed the rule of three for writing an EQ.

2. Review the following EQs and tell us if each meets the rule of three and why they do or don't.

a) What is the most important factor in healthy weight loss?

The wording is clear, it provides a framework for studies and research, and the question is not a list of facts. However, this EQ does not completely follow the rule of three; the student should be more specific about the means by which a person would be losing weight. The most important factor could be different for daily exercise 

b) What is most important to securing a conviction in a criminal investigation?

This EQ does follow the rule of three; it  specific, allows the student to argue for his position, and is not a yes/no question.

c) What is most important in creating a hairstyle that best satisfies a customer?

 This EQ does not follow the rule of three. The question is too broad.

d) How can an anesthesiologist best treat chronic pain?

This EQ does not follow the rule of three. While the question mentions specific elements such as anesthesiologist and chronic pain, it seems too broad. At the same time it seems like the question limits research to just treatment options for chronic pain (which could be caused by a number of conditions).

3. Working EQ: What is the most important factor an orthodontist must consider when        
    treating a patient?

Lesson 1 Reflection

1. What are you most proud of in your Lesson 1 Presentation and why?

I am most proud of the way I presented. People seemed to be very attentive and engaged by my first lesson, and some of my peers have told me that they learned a few new things from what I had to say. It is very rewarding to know that I have effectively informed people about my topic.

2.  Questions to consider:

a. What assessment would you give yourself on your Lesson 1 Presentation (self-assessment)?

I would give myself a P on this presentation.

b. Explain why you deserve that grade using evidence from the Lesson 1 component contract. 

I met all of the requirements for "P" consideration and I believe I had no concerns with Professionalism or Justification of Foundation. It went so well, I can safely say I did a good job.

 3. What worked for you in Lesson 1?

Speaking loudly and clearly worked well. I was supposed to do that, anyway, but it really helped to keep the whole class's attention. Having many visuals was also great, since my audience got to see what I was talking about and hopefully understand it better. Visuals also kept me on track. I also feel it was helpful to be entertaining while trying to be as professional as possible. Getting the audience laughing here and there kept them interested in what I had to say; orthodontics can be pretty boring without jokes thrown in.

 4. If you had a time machine, what would you have done differently to improve your Lesson 1?

Toward the end of my presentation, I started to speak more quickly in the interest of time. Next time (or if I could do it again), I would definitely slow down so I don't lose my audience in my haste.

Wait a minute, I had braces, too!

That's right, ladies and gents. From 2009 to 2011, I was shackled by those pokey little metal brackets and wires. No soda, no chewy or sticky foods, nothing too hard or crunchy... It was difficult being a sugar fiend with braces. Especially when my wires were tightened. No eating took place for days after visits like those.

02.25.2009

Somehow, my experience with braces was not completely terrible. Dr. Banh and his employees (past and current) made the experience much more pleasant. They are friendly, joke with patients, and treat people like family coming in for a friendly visit. There is a warmth that keeps patients like myself coming back. As important and fascinating as the atmosphere is, I must digress.

It's obvious, but people with braces have their own individual reasons for visiting an orthodontist. Some of those reasons are even difficult to see with the naked, untrained eye. In my interview with Dr. Banh, he told me that there are many steps to diagnosing a patient and developing treatment plans. At some point during that process, x-rays are taken to show what is going on in places we can't see. Here is an example of an x-ray from my file.

It's tough to tell, but my maxillary cuspids (canine teeth, top row) in the x-ray are in the roof of my mouth. In order to get those teeth down to their designated positions, I had to have oral surgery to make openings in the roof of my mouth, attach chains to the teeth to pull them, and wear braces in order to keep my teeth straight throughout the process. If I had not gone to the orthodontist to have an exam, my cuspids would have erupted in place of my incisors (front teeth). Orthodontics helps prevent dental abnormalities such as my "vampire teeth."

Blog 8: Research and Working EQ

1. My working Essential Question is as follows:

What is the most important thing an orthodontist must consider so they can help a patient?

2.  After being a patient at my orthodontist's office and volunteering there, I have come up with an answer to my question:

Patients need to understand which treatment options are available to them.

Staff should make patients feel at home and comfortable. 

3. So far, my most important sources that have helped me develop these answers to my Essential Question are experience as a patient and research articles from the ProQuest databases. My experience has shown me that patients that are treated kindly and like family are more likely to return for visits, trust their orthodontist more, and are more willing to keep up their treatment (rubber bands, retainers, avoiding hard/sticky foods..). My research on ProQuest so far consists of many studies on customer satisfaction and how being informed and totally included in the decision making process leaves the patient more content after their treatment is completed.

4. My mentor is Dr. Dan Banh DDS and I do my mentorship at his clinic, Banh Smiles. Right now, what I do at Dr. Banh's office is shadow and observe the staff. This relates to my Essential Question because without actually stepping into an orthodontics office, I cannot fully understand the treatment process, let alone what an orthodontist needs to consider for treatment.

Blog 7: Independent Component 1 Approval

For my 30 hours of service learning, I plan to shadow my mentor and learn what types of procedures are done by an orthodontist and assistants on a day-to-day basis. In addition, I would like to study to become an unlicensed dental assistant. The course requirements for unlicensed dental assistants as specified by the Dental Board of California are as follows:

• A board-approved course in the Dental Practice Act
• A board-approved 8 hour course in infection control
• A course in basic life support offered by an instructor approved by the American Red Cross or the American Heart Association, or any other course approved by the board as equivalent and that provides the student the opportunity to engage in hands-on simulated clinical scenarios.

I will meet the expectation of showing 30 hours of evidence through pictures, certificates, and/or transcripts for the courses I might take.

I feel it is important to attain some form of certification in the dental field because orthodontists are dentists first. Basic dental training is key. Becoming an unlicensed dental assistant may also allow me to be able to be more hands-on during future shadowing.

My senior project hours log can be accessed here.

Getting the Ball Rolling

So far, I have been lucky enough to be able to volunteer at an orthodontist's office where the people are lovely and I am learning things here and there. It is important to note that I am off to a slow start, since I was not working there during the summer and my previous schedule hadn't allowed me to work more than a few hours at the office.


My time spent at Dr. Banh's clinic has been filled with general helping out with menial tasks. My first day was spent filing away patient data (and conducting my first interview), while my second day consisted of organizing papers into packets.

The multitude of patient files in need of being filed away.

After I finished my interview on the first day, one of the assistants, Roberta, showed me a few different appliances that are used by Dr. Banh.

The first appliance (pictured top left) is a skull with TADs, or temporary anchorage devices, screwed into the bone of the mouth in order to move teeth into a desirable position. The second appliance (top right) are different types of palatal expanders. Their purpose is to widen the upper jaw to create a better fit with the lower jaw. The third appliance (bottom left) are braces with clear brackets, which are more aesthetically pleasing than traditional metal brackets. The fourth and final picture (bottom right) is of retainers, which are normally given to patients after their braces are removed in order to prevent shifting of the teeth. At Dr. Banh's clinic, patients are able to design their retainers however they like, and the retainer for the palate has a very cute watermelon design as an example. I thought it was pretty cool to see what types of devices orthodontists use and what purpose those tiny appliances serve.

The packets I put together on the second day are one of the ways the clinic gets the word out about orthodontic healthcare and their business. The letter portion of the packet was written to the parents of elementary school students, informing them about National Orthodontic Health month and the care Banh Smiles offers. The other paper attached was a coloring page for a contest. The winning class of the contest will win a pizza party sponsored by Dr. Banh. I think the idea is lovely and is an excellent method for promotion and raising awareness. Unfortunately, the packets took all three hours of my time that day and I got cramps from moving papers back and forth. I'm thankful I didn't have to staple them, too.

The informational letters and coloring pages that I was supposed to form into packets.

Blog 6 - Second Interview Preparation

Who is your mentor and where do they work?

My mentor's name is Dr. Dan D. Banh DDS. He works at his privately operated orthodontics clinic, Banh Smiles, in Covina.

What five questions will you ask them about their background?

1. What was your life like growing up? 
2. Where did you attend college? For how long?
3. How do you feel your experience in school has affected the way you practice today?
4. When did you open your clinic? What struggles did you have getting started?
5. What do you find most rewarding about your job?
6. How does your starting salary compare to your current salary?

Blog 5 - Mentorship Reflection

• Describe your experience in how you found your mentorship? If you haven't found one yet, describe your experience so far in the search of a mentor.

I found my mentorship just by going to my regular orthodontist. After much thought, I decided on orthodontics as my topic and visited Dr. Banh's office to ask him to be my mentor. The reason I chose Dr. Banh as my mentor is because I was very satisfied with the results of my treatment and the way he and the staff treat the patients. Since Dr. Banh already teaches regularly at USC's school of dentistry, he was more than happy to mentor me and teach me about the field of orthodontics.

• Research question: What has been your most important article you have read so far and why?

So far, the most important thing I have read was chapter one of Orthodontics: Current Principles and Techniques, titled "The Decision-making Process in Orthodontics." This chapter includes the basics of what an orthodontist should look for in order to diagnose a patient, as well as guidelines for treating a patient. I feel that these two things are crucial to know since they are pretty much the center of an orthodontist's job.

Class Trip to the Library

On Friday, August 29th, my house walked over to Cal Poly's library. We were led by our teacher to a computer lab type room and watched a presentation from one of Cal Poly's librarians about research and using some of the resources available to us through the Cal Poly library's website. From that presentation, I learned to use the ProQuest databases. I really like using ProQuest because there are so many online articles on my topic to choose from, so I have plenty of research options. On the other hand, I have to be sure to narrow my search because I would otherwise be stuck scrolling through hundreds of unwanted ads for orthodontic clinics that opened around ten years ago.

Some of the many results from ProQuest with the keyword "Orthodontics"

In addition to finding out about using the online databases, I had the opportunity to find books for my research on orthodontics for my senior project. I found seven books that piqued my interest, but I was only able to check out five thanks to the library's check-out limit. I checked out the following books:

• An Introduction to Dental Terminology
• Oral Health, Dentistry, and the American Public
• Removable Orthodontic Appliances
• Dental Anatomy and Occlusion
• Orthodontics: Current Principles and Techniques

The five books that I checked out from the Cal Poly library

I spent a good chunk of my Friday looking at these books and they are so interesting. The most interesting part is the pictures. One book has thousands of pictures with cases and diagrams and graphs. There was one case (pictured below) of a woman with bimaxillary protrusion, meaning the woman's teeth on her maxilla and mandible (upper and lower jaw) were excessively protruding forward. Her treatment included having her premolars removed and undergoing an augmentation genioplasty (chin augmentation).

I find it amazing that people can change their appearance with the removal of some teeth and surgery. Even the use of orthodontic appliances like braces and headgear yield impressive results. These books and their content have served to fuel my passion for the medical field and orthodontics. It's all just so fascinating.

A case shown in Orthodontics: Current Principles and Techniques

Examples of appliances for orthodontic treatment from Removable Orthodontic Appliances

Anatomy of the oral cavity

Blog 4: Interview Preparation

1. I intend to interview Irene Fisher from the Banh Smiles office who has been working with my mentor, Dr. Banh, in the field of orthodontics for many years. The reason I would like to interview her is because she has plenty of experience with orthodontics and I feel she can provide a lot of insight that will help me with my project.
2. Aside from the five required questions on the Interview Component Contract, I will ask additional questions such as...
• How satisfied are you with your line of work and job here at Banh Smiles?
• What is it that you enjoy about your job?
• What do you believe are the setbacks to working in an orthodontics office?
• What are some of the worst cases you have come across while working here?
• What is the competition like for a position like yours?
• What is your average workday like? (busy, slow, peak hours, estimated patient count, etc.)
• What do you feel is the most important thing an orthodontist like Dr. Banh or yourself must consider so they can help a patient?

Blog 3: Topic Choice and Working EQ

1. The topic I have chosen for my senior project is orthodontics.
2. What is the most important thing an orthodontist must consider so they can help a patient?

Summer Mentorship Component

Literal  

1. A log my mentorship hours:

https://docs.google.com/spreadsheet/ccc?key=0AqjYoq8XhtlcdFJCSDBfelZVS1d2OGRlTWFTWVZ1V2c&usp=drive_web#gid=0

2. Volunteer contact information:

Ernest Romero 

Teen Services Librarian at the West Covina Library

(626) 962-3541 

emromero@library.lacounty.gov

3. What questions were raised because of your 10 hours of experience? 

• Can I create an EQ from the work I do at this place/my topic?
• Is this what I want to use for my senior project topic?
• How can I apply what I do and learn here to my senior project throughout the year?
• Can I make an hour-long presentation out of this at the end of the school year?

Interpretive

4. What is the most important thing you gained from this experience? Why?

The most important thing I have gained from this experience is the knowledge of how to deal with people. By people, I mean people of all ages. The ability to deal with people is priceless because it is something I will be doing indefinitely, and thinking on my toes as I do when helping others at the library is a universal skill. Another part of dealing with other people is explaining how to do something, which I feel I am proficient at thanks to my experience volunteering at the library.

Applied

5. What is your senior project topic going to be?  How did what you did help you choose a topic?  Please explain.

My senior topic will be Library Teen and Youth Services. My volunteering over the summer has helped me choose this topic because I had a surprising amount of fun volunteering at the library, have met excellent people, and feel that the employees at the library are doing a great service by reaching out to the youth of the community. I felt inspired and as if I could do a lot with the library for my senior project.

Blog 1: 2-Hour Presentations

From the 21st through the 29th of May, I have had the privilege of watching senior presentations. Admittedly, not all of them were spectacular, but I learned plenty from each and every one of them. I am thankful to have gotten the opportunity to see the fruits of their labor.

1.  What presentations did you see?

• "Social Work for Abused Children" by Debora Martinez
• "Teaching Elementary" by Regina Rizo
• "Criminology" by Analysa Gallegos
• "Neonatal Nursing Intensive Care" by Michelle Ortega
• "Pediatric Dentistry" by Nitjasin QP
• "EMT (First Aid)" by Jeremy Ethridge
• "Personality Disorders" by Kimberly Gallardo
• "Microbiology" by Vanessa Machuca
• "Angioplasty" by Angel Arredondo
• "Homelessness" by Bradley Yamashita
• "Medical Missionary" by RJ Baron
• "Linguistics" by Lara McConnaughey
• "Hip Hop Dance Choreography" by Mark Patena
• "Internal Medicine" by Alfonso Esquivel
• "Automotive Repair" by Junior Rico
• "Structural Engineering" by Wesley Wu

2. What questions do you have that haven't been answered about the senior project? This can be about the senior project in general, any components or about a presentation topic you saw or what they said.

One thing I feel was not answered about each topic is how much time people in that field spend working. Of course, senior project is not about careers and is about specific topics but I feel the career aspect is also important since we have to do mentorship and learn about working with said topics first-hand.

I also would have liked to know how linguistics is applied in the world outside of learning. Is it simply translation or studying the acquisition of new, second languages?

What components led up to the final presentation, aside from the interview with a mentor? Are there a lot of small components, or are they difficult and spaced apart?

3. What has the most important part of the senior project based on what you are seeing in the 2-hour presentations?

I believe mentorship is the most important part of senior project. Without any mentorship, there is little opportunity for in-depth experience and learning from an expert. Research can only teach a person so much about a topic in comparison to interaction with a person who can answer all of your questions and teach you what you need to know and more. However, I do think research is equally important. Research is where solid facts and figures come from. Research can also be used as a guide and reference for almost anything you need to know for this project.

4. What topic are you considering doing and why?

I am considering doing my senior project on obstetrics, which is "the branch of medicine and surgery concerned with childbirth and the care of women giving birth." I would like to do this topic because obstetrics has always piqued my interest and I would like to make a career out of it in the future.

5. What are you doing for your summer mentorship?

For my summer internship, I plan to shadow and do volunteer work at USC Medical Center with an obstetrician. It will most likely involve learning about how regular appointments are conducted and procedures in the event of labor.