s e v i L e h t n Days i of CU s t n e d u t S l a t Den
ThePolicy rest of the story1.A: the rest of the story
Vol. 3 Issue 1
The purpose of The CEJ is to provide a forum for dental students and others to freely express their views and opinions. Each article in the CEJ represents the opinions of the author in their personal capacity; any views or opinions expressed are not endorsed by Colorado ASDA and do not necessarily represent the opinions of Colorado ASDA.
The Colorado Extraoral Journal: Dentistry Outside the Mouth The Official Newsletter of the Colorado Chapter of the American Student Dental Association Editorial Board Editor-in-Chief Ali Lindauer
Design and Content Editor Nikki Kumor
Blog Editor Luke Harden
Executive Council President President Elect Becky Bye Danny Adler Vice President Kyle Lantz
Vice President Elect Ryan Mickle ISP 2 Rep Saniya Setia
Gabriela Andrade John Luke Andrew Riya Bandekar Phoebe Blakely Gabriel Casias Sarah Crepps Yulia Denham Lynn Doan Jordan Duffy Zarrar Duraiz facebook.com/ColoradoASDA
Immediate Past President Kyle Larsen
ISP 1 Rep Olga Hamilton
Lindsey Miller Jamie Muldoon Adam Pink Lissette Ruiz Sierra Schafer Dana Schwartz Kate Sumerfield Stephanie Thomas Matt Thompson Austin Tyler
Kimberly Engols Christopher Friemuth Luke Harden Krista Johnson Nikki Kumor Ali Lindauer Reanna Messer twitter.com/ColoradoASDA
Want to write for the CEJ? Contact Ali Lindauer at email@example.com
Copyright ÂŠ 2016 Colorado ASDA. All Rights Reserved.
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Policy 1.A: The rest of the story
Feature Articles 6 Living with T1D (No, not the amoxicillin regimen) 11
Mary Jane and the Mouth
You are an Olympian
18 The Morphology of The American Student Dental Association 20 Policy 1.A The rest of the story
Vol 3 Issue 1
Meet a Dental Student
Outside the bubble and into the real world: An ACTS Journal
NLC: The Cure for DS1
Dolla, Dolla Bills, Yo!
The Role of ASDA in my US Jouney
Letter from the Editor
EDITOR from the
Ali Lindauer | Editor-in-C hief | C olorado '17
you can take some time out of your day to relax and enjoy these next pages.
Hello Doctors and future Doctors,
Happy New Year! Welcome to the winter edition of the Colorado Extraoral Journal. My name is Ali Lindauer and I am very excited to act as your new ASDA Editor-InChief. I’ve got big shoes to fill (shout out to Rick Collette!) and I am thankful for your support as I take over this role. Whether this is your first issue or your last, I hope
To the ISP Class of 2016, thank you for reading these last couple of years. Thank you for sharing your knowledge of dentistry and some of your culture with us. On behalf of the CU SODM and Colorado ASDA, I wish you farewell and good luck in your future. To the DS Class of 2020, ASDA welcomes you to the CU SODM. You’ve got a lot of good times and great memories-in-the-making sprawling out in the next four years ahead of you. I hope this issue of the CEJ gives you a reprieve from studying for finals and excites you for your future here. This issue tells many stories and serves to acquaint each of you with the writers in these
pages. You’ll read personal accounts of life events and strange stories that led each of the writers here. You’ll read informational pieces about the new legislature that affects licensure of all new dentists in Colorado, and how the legalization of marijuana will affect your future practice. I hope you can take some time out of your day to relax, laugh, and learn something. Again, thank you for reading, and in the words of the great Rick Collette, “See you in the pages!”
Ali Lindauer ‘17
The Colorado Extraoral Journal
Living with T1D (No, not the amoxicillin regimen) By Sarah Crepps ‘19 Anterior Guidance Chair
is a job that demands
both can feel like chronic
a constant awareness of
disease with chronic stress. my blood glucose levels.
t we nt y - fou r
of your daily hours and all seven days of your week.
There is always another exam for which to study, always another patient to schedule, always anothergraduation
to fulfill. Type 1 diabetes
"Don't forget to relish the positive WHEN you can"
(T1D) also requires constant attention; there is in- But… it’s exhausting to T1D sucks sometimes. Essulinto be taken, carbohy- think of dental school
pecially when my blood
drates to be counted, blood
sugar is nose-diving and I
glucose levels to be moni- chronic tensions. Since
have a crown prep practi-
tored. Dental school and
cal exam in fifteen minutes.
diabetes, apparently, have T1D at age seven, I have
(continues on next page)
a lot in common, since
not known life without
The Colorado Extraoral Journal
Thankfully, recent technological breakthroughs have allowed people with T1D to have better control than ever before.
The Colorado Extraoral Journal
Having the chance to live a healthful life in spite of roller coaster blood sugars is truly something for which to be grateful. Like taking care of T1D, dental school is also punctuated with extraordiFor example, a small device im- nary opportunities: to learn planted in the interstitial fluid the nuances of a highly reon the back of my armmea- spected healthcare profession, sures my blood glucose levels as well as to build relationships Below is a photo of Sarah in and sends the information via with remarkable faculty mem- her natural habitat...backBluetooth (whaaaaat!) to my bers, patients, and peers. Every packing in Silverthorne, CO phone. I can now see changes one of us has overcome adverin real time and adjust insulin sity and worked tirelessly to be delivery with an external in- here at the University of Colosulin pump. Thistechnology rado School of Dental Medicine. has lowered my Hb A1c levels from over 7.5% to 6.8%. Longterm diabetes can have devastating complications, so any Allow yourself the grace to help I can get to keep my T1D accept the difficulty of the under control is a blessing “chronic”, and don’t forget to relish the positivewhen you can.
However, it hasn’t been just the technology that has brought my Hb A1c down. 99% of the change came from a shift in attitude – an attitude that directly correlates to tackling the challenges of being a dental student. Instead of despairing when I believe I’ve done everything right and my blood sugar is still out-of-whack, I concentrate on celebrating the hours when I feel healthy enough to climb fourteeners or pursue a DDS degree. Similarly, instead of being discouraged with the mountain of school work, lab work, patient scheduling, who-knowswhat-other- responsibilities of being a dental student, I seek to delight in the smallvictories of nailing the perfect proximal box or getting a hug from my first prophy patient.
Vol 3 Issue 1
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Dentistry IRL By Dr. Brad Lerud, Gradute CU SODM Class of 2016
s a 2016 graduate from UCSODM, I have officially started a job as a dentist in Flagstaff, AZ as an associate, and I am loving it! Many of my classmates decided to continue their education with a residency program or even a specialty program, but I knew pretty early in dental school that this was not the best choice for me. Throughout my 4th year, I was nervous about where I was going to practice, as I have no family members in dentistry, and no clue where I wanted to end up. I learned quickly that the most important factor for me in deciding where to practice was to find a place that I wanted to be long term and raise my future family. I am not a person that wants to switch between jobs and potentially move cities, so I started researching positions and areas to live early on, so that changes would not have to be made later - and so far, so good!
any time during my job search. Again, I want to stress, do this early! I believe I landed a great associateship position because I did not wait and applied early!
ask for more. I plan to grow as a dentist and businessman quite a bit over the next few years, and I am looking forward to every new thing I learn.
Now a little more about my life so far as a dentistâ€Ś
If you have any questions about anything, please message me! I am busy, but I will always find time to reply. My email is Bradley.Lerud@gmail.com! Good luck to all of you as you start, continue, and finish dental school at what I believe is the best school in the country!
As I said before, I am loving it! I am so fortunate to have joined a 10-op practice in Flagstaff, AZ with Dr. John Bacon. Dr. Bacon is in a position to teach me for around 5 years while I slowly build my own patient base, and eventually take over. For me, this is ideal! I need a mentor for at least a few years, and I knew coming out of dental school that if this wasnâ€™t available, that I would not be interested in the position. Dentistry has become even more fun, challenging, and exciting after leaving school, and I could not
I would highly recommend starting early! By this I mean having 3-4 doctors in mind who you are comfortable with and who have seen your work, so when the time comes they can write you a letter. Seek out a mentor to help you write up a CV and letter of intent. These made me feel comfortable sending out a CV, letter of intent, and letters of recommendation to any office I was interested in, at The Colorado Extraoral Journal
Mary Jane and the Mouth
The Dental Implications of Reefer Madness By John Luke Andrew '18
very day, students treat patients that use marijuana on a regular basis. Often, these patients present to clinic under the influence of the drug. Despite its surging usage, little research has been done on the drug due to its DEA designation as Schedule 1. As a result, students and many practitioners lack an understanding of what clinical considerations may be important for treating this kind of patient. The purpose of this article is to provide an update on marijuana use in the US and how it affects systemic and oral health. Practitioners should use this information to make informed decisions that will improve clinical outcomes and provide safe treatment for patients that are marijuana users. According to the National Institute of Drug Abuse (2009), more than 104 million Americans over the age of 12 had tried marijuana at least once. The National Epidemiologic Survey of Alcohol and Associated Conditions (NESARC) recently published a study suggesting that the prevalence of marijuana use has increased more than two-fold from 2002 to 2013 (Hasin et al 2015). Twenty-six states and the District of Columbia have laws legalizing marijuana in some form. As of the recent election
FUN FACT: Amendment 64, or the legalization of recreational marijuana appeared on the 2012 Ballot in Colorado. January 1, 2014, dispensaries across the state opened their doors to the public over age 21 to purchase the newly legalized substance cycle, eight states have legalized recreational marijuana use. This trend has diminished the taboo surrounding marijuana use and changed perceptions regarding its harmfulness. A 2015 study by Okeneku et. al. found that between 2002 and 2012, there was a significant decrease in the perceived risk associated with occasional and regular marijuana use (Okaneku et al 2015). As health care providers, it is our responsibility to educate our patients about the risks of marijuana use. So how does marijuana affect the body anyway?
Pharmacology: Marijuana is a natural, unprocessed plant containing more than 450 various chemical compounds, most notably, more than 60 unique cannabinoids- the psychoactive components of the drug. It is important to understand that these compounds may differ plant-to-plant in composition, a primary reason the FDA cannot endorse its use as a traditional prescriptive mediation
(Schrot & Hubbard 2016). Users of marijuana employ two primary routes of administration. When smoked or vaporized, the active compound of the drug (Delta-9-Tetrahydrocannabinol or THC) is absorbed into the bloodstream through the alveoli within the lungs and these lipophilic constituents quickly cross the blood-brain barrier, where they competitively bind to endogenous cannabinoid receptors (CB1 and CB2). Marijuana can also be consumed in edible form, where it undergoes first-pass metabolism in the liver before it is carried to the CNS via hepatic venous flow (Howlett et al 2004). Providers should be familiar with the methods of marijuana use, in order to best communicate with patients about their marijuana use. One important concept regarding the pharmacology of marijuana has to do with the immunomodulatory effect exerted by cannabinoids through activated CB2 receptors on immune cells, such as B-cells. Essentially, The Colorado Extraoral Journal
The Colorado Extraoral Journal
through paracrine signaling cannabinoids act to suppress humoral and cell-mediated immune responses and reduce host cell resistance to intracellular and viral pathogens. There is evidence that this could make chronic users more vulnerable to viral-mediated infections such as HPV (Meier et al 2016).
General Health Implications: While the effect of edible marijuana on general health is grossly under-researched, ample evidence suggests clear health risks associated with smoked marijuana. Marijuana affects virtually every system in the body, but it has particularly well-established effect on the periodontium and respiratory system. The most current research was just published this summer. In a longitudinal study published by Meier et. al., the effect of marijuana use on physical health was assessed over 20 years, controlling for tobacco use. Frequency of cannabis use and cannabis dependence was assessed at set intervals. Laboratory measures of physical health were also obtained at these times. It was determined that like tobacco use, cannabis use was associated with decline in periodontal health and lung function (Meier et al 2016). The risk factors that cannabis 14
Vol 3 Issue 1
imposes upon the respiratory system are very similar to those of tobacco. The smoke from a cannabis cigarette, or â€œjointâ€?, has the same contents as tobacco smoke, except for nicotine. This includes carbon monoxide, bronchial irritants, tar and higher levels of other carcinogens than in tobacco smoke. In fact, the pulmonary effects of long term use of 3-4 marijuana cigarettes a day is equivalent to smoking 20 or more tobacco cigarettes a day. This difference is related to the differing pattern of smoking (deep inhalation) and the absence of a filter on marijuana cigarettes (Arteaga). The acute effects of THC on cardiovascular function are also worth mentioning. Cannabis use elicits a dose-related tachycardia of up to 50 percent with widespread vasodilation. Increased cardiac output leads to higher myocardial oxygen demand. Transient hypoxia due to deep inhalation and long inspiratory time may exacerbate this demand. Studies have shown that individuals have an increased risk for acute cardiac episodes (e.g. myocardial infarction) in the first hour after smoking marijuana. The risk is greater for those with known underlying cardiovascular disease (Sidney 2002). Marijuana use is also associated with various psychiatric conditions. Contrary to popular belief, about 9% of adult marijuana users will develop an addiction (Budney et al 2007). Chronic marijuana use has also been as-
sociated with an increased risk of schizophrenia and psychosis, particularly in those with a genetic predisposition. The risk for these psychiatric issues is generally increased in teenage users. Oral
The link between marijuana and poor oral health has been well established. Its use has been correlated with poor oral hygiene habits, diet choices, and attitudes about care. However, marijuana use also directly affects oral cavity. Its use inhibits salivary flow, which may also deteriorate oral health. Increased appetite combined with xerostomia and poor home care may be responsible for the higher DMFT scores observed in marijuana users (Cho et al 2005). Also, as previously mentioned, marijuana users are at a higher risk for periodontal disease. This may be related to the irritant in marijuana smoke as well as the immunosuppressive effects of the drug. Regarding marijuana and oral cancer, more research is needed to establish an association of causation. However, new evidence suggests that the immunomodulatory effect of cannabinoids may leave marijuana users more susceptible to virallyinduced lesions, such as HPVpositive SCC (Gillison et al 2008). Continues on next page CEJ
The CEJ Medical marijuana remains a contentious subject despite its growing use. In November of 2013, the American Medical Association released a statement that “cannabis is a dangerous drug and as such is a public health concern,” however, the AMA still encourages continued research of marijuana and potential medical uses (Sabet 2013). Current legislation approves the use of marijuana for the treatment of various disorders, including seizures, severe nausea, and glaucoma. Additionally, particular success has been cited in the use of marijuana as a palliative agent for patients undergoing cancer treatment (Brisbois et al 2011). However, given these treatment recommendations, the FDA has still not approved marijuana as a safe and effective drug for any indication. The agency has, however, approved two drugs containing a synthetic version of a substance that is present in the marijuana plant and one other drug containing a synthetic substance that acts similarly to compounds from marijuana but is not present in marijuana (FDA). Conclusion: Marijuana use within the general population is becoming more common with each passing year. Its use is associated with a number of significant health risks, but it may also have some practical medical applications. Much research is still needed to gain a better understanding of the exact mechanisms at play. In the meantime, dental and medical providers should educate themselves on the subject to the greatest extent possible in order to provide competent care to their patients who use the drug. References: Arteaga, S. Marijuana and Oral Health. 2015. Crest + Oral-B at dentalcare.com Continuing Education Course. Brisbois TD, de Kock IH, Watanabe SM, Mirhosseini M, Lamoureux DC, Chasen M, MacDonald M, Baracos VE, Wismer WV. Delta-9-tetrahydrocannabinol may palliate altered chemosensory perception in cancer patients: results of a randomized, double-blind, placebo-controlled pilot trial. Ann Oncol 2011; 22(9):2086-2093. Budney AJ, Roffman R, Stephens RS, Walker D. Marijuana dependence and its treatment. Addict Sci Clin Pract. 2007 Dec;4(1):4-16 Cho CM, Hirsch R, Johnstone S. General and Oral Health implications of Cannabis Use. Aust Dent J. 2005 Jun;50(2):70-4 FDA and Marijuana, referenced 11/20/2016 <http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm421163.htm> Gillison ML, D’Souza G, Westra W, Sugar E, Xiao W, Begum S, Viscidi R. Distinct risk factor profiles for human papillomavirus type 16-positive and human papillomavirus type 16-negative head and neck cancers. . J Natl Cancer Inst. 2008 Mar 19;100(6):407-20 Hasin DS, Saha TD, Kerridge BT, Goldstein RB, Chou SP, Zhang H, Jung J, Pickering RP, Ruan WJ, Smith SM, Huang B, Grant BF. Prevalence of Marijuana Use Disorders in the United States Between 2001-2002 and 2012-2013. JAMA Psychiatry. 2015 Dec;72(12):1235-42 Howlett AC, Breivogel CS, Childers SR, Deadwyler SA, Hampson RE, Porrino LJ. Cannabinoid physiology and pharmacology: 30 years of progress. Neuropharmacology. 2004;47 Suppl 1:345-58 Meier MH, Caspi A, Cerdá M, Hancox RJ, Harrington H, Houts R, Poulton R, Ramrakha S, Thomson WM, Moffitt TE. Associations Between Cannabis Use and Physical Health Problems in Early Midlife: A Longitudinal Comparison of Persistent Cannabis vs Tobacco Users. JAMA Psychiatry. 2016 Jul 1;73(7):731-40. Okaneku J, Vearrier D, McKeever RG, LaSala GS, Greenberg MI. Change in perceived risk associated with marijuana use in the United States from 2002 to 2012. Clin Toxicol (Phila). 2015 Mar;53(3):151-5. Sabet K. American Medical Association Opposes Marijuana Legalization; Support Health-First Approach to Marijuana Use. American Medical Association. In Featured, Legalization, Marijuana in media, Project SAM, Smart Policy. Posted Nov 19, 2013://onlinelibrary.wiley.com/ doi/10.1002/j.1552-4604.2002.tb06005.x/full Schrot, RJ. Hubbard, JR. Cannabinoids: Medical Implications. Ann Med. 2016;48(3):128-41. Sidney, S. Cardiovascular Consequences of Marijuana Use. J Clin Pharmacol. 2002 Nov;42(11 Suppl):64S-70S.
The Colorado Extraoral Journal
OLYMPIAN By Austin Tyler '20
f you could glimpse
ing team in Canada, 16-year-
at the recent ASDA National
into your future and
old Adam Kreek was told by his
Leadership Conference, Adam
see potential greatness,
coach, “You are an Olympian!
described his feelings when
would you change your
You just don’t know it yet.” His
his coach made that statement.
approach to life? What if you
coach saw something in him
“That sounds like a lot of work,”
glimpsed the future greatness of
that Adam did not see in him-
he thought. Nevertheless, Adam
those around you? Would you
self and at the time, the words
began thinking beyond his am-
change the way you treat them?
felt enormous. Daunting. Over-
ateur rowing team.
After joining an amateur row-
Adam Kreek didn’t know he was a future Olympian, but his coach saw potential for greatness. That potential was reached and surpassed when Adam and his Canadian rowing teammates won the 2008 Olympic gold medal. When Adam was in high school, nobody could have predicted Canada’s rowing victory in the 2008 Olympic games. Nobody could have known that Adam would even be on the Canadian team. Yet his coach’s words had power. “You are an Olympian!” Those words had power because they were backed with vision. Although we cannot see into the future, we regularly project our goals and plans into the future. Such plans and goals often start with vision. Adam’s journey toward who he would become was initiated by the motivational words of a coach who simply saw great potential. Johann Wolfgang von Goethe wrote, “If you treat an individual as he is, he will remain how he is. But if you treat him as if he were what he ought to be and could be, he will become what he ought to be and could be.” It seems that for Adam Kreek, the long journey toward Olympic gold was sparked by his coach’s vision. Would Adam have developed and realized that same vision if his coach had never shared what he saw in Adam? No one can tell. But clearly, those words had a significant impact, such that years later he included that memory in a motivational speech. As we get involved at school and in the community, we have the opportunity to lift and inspire every person we interact with. Regardless of our official positions of leadership or our involvement in organized leadership, we as future professionals are regarded as leaders in the community. Tom Peters wrote: “Leaders don't create followers; they create more leaders.” How do you “create” a leader? Vision may be the place to start. As a leader, what is your vision for those around you? What do you see in them? The way you see those around you, your vision of who they ought to be and could be, will directly influence how you treat them. The way you treat them can have a defining impact on how they see themselves. Are you treating those around you with the respect and greatness they merit? Through your actions, are you allowing them to see their potential for greatness? For all you know, they are Olympians. So why settle for anything less?
"LEADERS DON'T CREATE FOLLOWERS; THEY CREATE MORE LEADERS" -TOM PETERS
The Colorado Extraoral Journal
Vol 3 Issue 1
The Morphology of
the American Student Dental Association By Kyle Lantz ‘18 Vice President Dental school can become monotonous at times; go to classes and labs, stay after to finish those dentures, go home to study anatomy, etc. As a first year, I needed an outlet in some form or fashion to prevent this from becoming the cycle for the entirety of dental school. Becoming involved with ASDA has given me many of these outlets: community service, mentorship to younger students, networking, and learning about organized dentistry. Many people know what their local ASDA chapter is, but I feel as if most students are hardly scratching the surface with what ASDA can provide them. Let’s dig a little deeper and find out a bit more about this great organization.
11 districts with each consisting of around 5-7 schools. Each district elects a trustee from one of these schools, who decides the structure of that year’s executive board. This board consists of students from different schools within the district. The goal of district ASDA is to provide a way for excelling ASDA chapters to idea-share with chapters that may be struggling. It is a great way for students from other schools to meet and discuss things that are going well, or not so well, at their respective schools. In addition, district ASDA acts as a liaison between local and national ASDA, discussed in the next section.
ASDA is the American Student Dental Association, a subsidiary of the American Dental Association (ADA). There are three levels to this organization:
1. Local Each dental school has an ASDA chapter. Chapters usually consist of 10-30 board members, depending on the organization that the executive council would like to see. Local chapters put on many events throughout the year, including community service opportunities, health and wellness activities, and social outings. It is up to the board members to determine how and when these events are run. 2. District There are 60+ dental schools across the nation, organized into
National ASDA is structured in a similar manner to the ADA. The board of trustees includes the trustee from each district, as well as the national ASDA President, two Vice Presidents, Speaker of the House, Editor in Chief, and Executive Director. Along with this board are many committee positions, open to any students who would like to apply. The goal of National ASDA is to serve as a holistic resource to students. They decide the stances that the organization would like to take with regards to specific issues, such as mid-level providers or licensure. They develop policy to be put in place with structure and election specifics. Addtionally, they pass resolutions that help keep the organization running for the coming year. National ASDA is the
umbrella that holds all of the local chapters at schools in check.
With a better understanding of the structure of ASDA as an organization, it is essential to realize its importance in a dental student’s life. ASDA isn’t just an organization made to host events with free food, its sole purpose is to protect and advance the rights of dental students and the profession as a whole. Take licensure as a prime example. Many people disagree with the current model and consider it unethical, but what are people doing about it? Last month ASDA published its “White Paper” on dental licensure. This paper cites nearly 70 sources and took many students and ASDA staff hundreds of hours to compile. The main goal of the paper is to convey problems with current licensure exams, explain current alternatives, and provide a recommendation for an ideal licensure exam in the eyes of the organization. The paper is a great read and is just one example of how ASDA is helping advance the interests of dental students.
So get involved with this great organization, and take advantage of all it has to offer. When people talk about ASDA they’re talking about organized dentistry. So get involved early and often, and help move this profession in the right direction for years to come.
The Colorado Extraoral Journal
Policy 1.A: The Colorado Extraoral Journal
the rest of the story By Kyle Larsenâ€˜17, Immediate Past President
ast year, I wrote an article entitled "A World Without Organized Dentistry." I talked about how exciting it was that Christian Piers, former Colorado ASDA President and National ASDA Immediate Past President, had written a resolution that was brought before the Colorado Dental Association's House of Delegates. This resolution would charge the CDA to assemble a task force exploring alternatives to live-patient licensure examinations. I was excited and I would have loved nothing more than for this article to be "Part 2: How the CDA and ASDA worked together to pass new licensure policies in Colorado," but that's not quite how it happened. As you know, the Colorado Dental Association did pass the resolution to form the task force (in fact, it passed with an overwhelming 103 to 10 vote). And following that, the Colorado Dental Board did adopt a revised 1.A policy that allowed for the acceptance of alternative licensure examinations (for more background on the Colorado Dental Practice Laws and Policy 1.A, see our blog post announcing this change). But what exactly happened between those two events? How did the Colorado Dental Board come to their decision?
Vol 3 Issue 1
And why did they choose to accept the NDEB OSCE for in-state initial licensure, but only an outof-state PGY-1 and Portfolio option? Well, here is the rest of the story. Let's start at the beginning with the 2015 CDA Annual Session. Christian's resolution, Resolution 05-15-BA, called for the CDA to not only assemble a task force to determine the feasibility of implementing live-patient licensure exam alternatives (i.e. licensure exams that do not use patients), but also to report on the progress of the task force at the 2016 Annual Session. The hope was that the task force would be formed, find alternatives, and report on them. From there, it would just be a matter of presenting those findings to the Colorado Dental Board and have them vote. So, is that what happened? Unfortunately, no. In fact, almost a year and a half later, the task force still hasn't even been assembled yet. I tried to follow up with the CDA through multiple emails to their leadership, but was told that they would get back to me. I still have not received an update. I do have to give the CDA some credit though. There was always a
CDA representative present at the Colorado Dental Board meetings so we know that they were at least keeping tabs on the issue. They may have even provided testimonial of some kind. What that testimonial said and where it came from we may never know since it most likely would have only been personal opinion and not the voice of the "Non Patient Exam Task Force". In actuality, had the task force been assembled when it was supposed to be and had the testimonial provided by the CDA been the from that task force, things might have turned out differently and we probably would be further along in this issue than we are nowâ€” especially if one of the outcomes of the task force was an in-state portfolio examination proposal. But enough about what didn't happen. Let's talk about what did. Before you start to think that this was a failed attempt at organized dentistry, I have some good news: ASDA pulled through. After an invitation to attend the Colorado Dental Board meetings and largely due to the connections of our very own Christian Piers, ASDA got involved and things moved forward. After a ton of communication with the
Kyle Larsen presenting about Licensure at the District 9 Leadership retreat
Colorado Dental Board and a lot of coordination with everybody involved, a meeting was set up with representative stakeholders. Dr. Jack Gerrow, Executive Director of the National Dental Examining Board of Canada (NDEB), was invited to give a presentation on the Canadian OSCE. Dr. Steven Morrow, Advanced Dental Education Member for the Dental Board of California, was invited to give a presentation on the California Portfolio Licensure Examination. Dr. Bill Calnon, past ADA president, and Dr. Paul Leary, who is heavily involved with New York State Dental Association (NYSDA), were invited to give a presentation on New York's experience implementing a PGY-1 licensure pathway. Dr. Jay Tippets, Director of the GPR at Denver Health Medical Center, was invited to discuss the experiences that GPR residents are given at Denver Health. Jennifer Goodrum, Director of Government Relations at the CDA, was invited to represent the CDA. Dr. Denise Kassebaum, Dean of the University of Colorado School of Dental Medicine, Dr. Lonnie Johnson, Associate Dean of Clinical Operations, and Dr. Daniel Wilson, Chair of the Department
of Restorative Dentistry, were all invited to share testimony on behalf of the dental school. And Christian Piers and I were invited to share testimony on behalf of ASDA. As you can see by the list of attendees, this was no small meeting and it was no small task to pull it off. Presentations and testimonials were given and the Colorado Dental Board then voted on the current 1.A policy. But the question still remains, why not accept in-state PGY-1 or Portfolio models? Why not just accept all alternatives completely? And doesn't that give an advantage to out-of-state students and dentists? Well, as for why they didn't accept an in-state PGY-1 or portfolio, reasons were given as lack of interest of the Colorado Dental Board to develop their own examinations due to fiscal and liability concerns. It may also be that no portfolio models were proposed, the possible outcome from the yet-to-be-formed CDA task force that I mentioned earlier. And yes, it does give an advantage to out-of-staters, especially since no other state currently accepts the OSCE (except Minnesota, but you have to be a University of Minnesota dental student to be eligible), the only truly new option for Colorado dental students.
If you are a student at the University of Colorado, you might be asking yourself right about now, "if I can't even leave the state by taking the OSCE, is this really even that big of a deal?" Believe me, I feel you. And no, to you personally, it might not be that big of a deal. For most of you, especially those in the class of 2017, you will probably end up taking WREB, CRDTS, or any of the other human-subject licensure exams anyway. But for the few who end up taking the OSCE, it means a lot. And to all of the future students where this will hopefully become a very real option as other states take Colorado's lead in accepting the OSCE, it will mean bigger and bigger things. This also isn't over yet. Hopefully the CDA will form their task force while there is still something for them to do. In the meantime, ASDA will continue to advocate for our ideal licensure examination including advancing both the OSCE and a portfolio model in Colorado. Although this wasn't the exactly the change that we wanted, in the grand scheme of things, this is breaking new ground in the history of licensure reform. Colorado is the first state to accept all existing licensure pathways, in one form or another, and that, my friend, is a massive deal. As I said in my presentation at the beginning of Fall semester, "this is one small step for Colorado licensure policy, one giant leap for licensure reform nation-wide.â€? Additional
WHITE PAPER: Use of Human Subjects in Clinical Licensure Examinations http://asdanet.org/ uploadedFiles/The_ Issues/Licensure-WhitePaper-10-31-16.pdf
The Colorado Extraoral Journal
The Colorado Extraoral Journal
Meet a Dental Student
Gabriel Casias, DS1 1. Howdy! My name is Gabriel Casias and I grew up in Fountain, CO, just south of Colorado Springs. After 18 years in CO, I wanted to see a different part of the country and wound up in San Luis Obispo, CA studying chemistry. 2. During my year off between Cal Poly and UC Denver, I made a rocking chair for a friend’s wedding present that had a value of $20,000. (We gave it as a present) 3. When I was little, I told my parents that I wanted to be a Funiost when I grew up. In my
mind a funiost was not a standup comedian, but someone who brought laughter and smiles to the world around them 24/7. More recently, I’ve been crushed to hear stories of people not having the confidence to smile or laugh in public because of how their teeth look. As a dentist, I want to brighten the smiles and spirits of those holding back laughter. 4. Favorite Ice cream flavor: As a former employee of Josh and John’s in Colorado Springs, I’m had the fortunate opportunity to have tried a lot of flavors. By far my favorite is Purple Mountain Majesty! A dark berry blend for the base with chocolate raspberry
truffles swirled in. 5. My favorite dental instrument as a first year is definitely the PKT2. I can add, carve and polish with just the one tool. 6. When I’m not in dental school, I’m either doing something active outside or building crafts out of ceramics and wood. 7. One of my most embarrassing moments, is anytime that I have to explain the scars that I have. Two of my personal favorites are from literally running into a tree branch (picture jousting) and jumping to swat a mosquito and coming down on a sharp metal corner.
...Now What? 22
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The CEJ Jamie Muldoon, DS2 Jamie Muldoon is a second year dental student from Billings, Montana. He went to Whitman College, in Walla Walla, WA to play soccer and pursue a degree in Biology. Later, Jamie joined the ski team and competed in big-mountain style competitions. After graduating in 2012, Jamie joined Teach for America which took him to Colorado Springs, CO where he taught high school physics and anatomy for two years. Shocked by the need for oral health care in his students, Jamie decided to change his career and
apply to dental school. He then began working part-time as a dental assistant and rock climbing coach while attending Metro State University to fulfill prerequisite classes for his application. When he's not in dental school, Jamie is usually is climbing, mountain biking, or skiing somewhere in the mountains. He is engaged to his beautiful fiance, Nicole, who is currently is graduate school in California-they will get married this August on their 5 year anniversary. Jamie loves being involved in ASDA and is passionate about pre-dental education.
Jamie's favorite dental material is Jet Acrylic. Just kidding, but he loves to make it shine on the pumice wheel. He enjoys strawberry ice cream because of its texture and flavor. I can't think of an embarrassing moment! If I think of one I will send it to you. Feel free to add anything you want to my bio, including an embarrassing moment! (Jamie not including an embarassing moment is your embarassing moment).
The Colorado Extraoral Journal
The Colorado Extraoral Journal
Meet a Dental Student (con't)
Olga Hamilton, ISP 2 1.Name, hometown, college major Olga Hamilton, Republic of Moldova, Bachelor’s in dentistry 2.Do you have kids/fur babies? I have a cat that my husband and I rescued a few years ago. She is arguably one of the smartest cats I had the pleasure to meet. I taught her how to sit, and at the phrase ‘Go’, she will get up from my lap (with lots of protests, but she will) and of course she will come at my command as well. Ok…Ok, we will get a dog once I graduate from the dental program, I just thought that it wouldn’t hurt to start practicing behavioral education on my kitty.
and getting to know patients and providing them with the best care that I can. Dentistry is so much more than just treating disease - a lot of times it involves an elaborate treatment plan, acceptance of the proposed plan, and the execution. So to me, dentistry allows me to be a leader, manager, thinker, artist, and psychologist. CUSDM was the first school that I applied to and it was the first that I knew of to have an International Student Program. The reason that this school interested me is the location: Colorado is the most beautiful state that I happen to live in, and the university itself has some post-graduate programs that I could continue with as well as a research program. It is an honor to be a student at the CUSDM and it allows me to develop professionally from every aspect. 4.What’s your favorite flavor of ice cream? Rocky road! It is made of chocolate ice-cream, that reason alone puts it as the most enjoyable ice cream. And then it has other goodies: marshmallows, nuts, which makes it healthy, right?!
most used instrument in dentistry and there are so many procedures that can be performed with it. 6. What are you doing when you’re not in dental school? I love nature, so when not in school, I mainly spend my time hiking and enjoying some authentic well-deserved meal afterwards. I also try to explore different things that I haven’t done before and are specific to Colorado, like camping, rafting, kayaking, and swimming. I might start an indoor class of rock climbing this year, so that I can be ready to do it outdoors next year. 7. What is the most embarrassing thing that’s happened to you? When I accidentally changed my status from ‘being in a relationship’ to ‘being engaged’ on Facebook without realizing it. I was actually updating some info and did not realize that instead of scrolling down, I was changing data in that specific box. And found out from my boyfriend, who is my husband now, when he asked me if I was proposing to him. We had a good laugh, but it was embarrassing nonetheless. And no, we didn’t get engaged then
...Now What? 3.What made you want to go to dental school originally, then what brought you to dental school here? The dental profession inspired me, because no other profession has such tight connections with the patient. I genuinely enjoy talking
Vol 3 Issue 1
5.What’s your favorite dental instrument? High speed handpiece. It is the
Phoebe Blakeley, DS3 1 Name, hometown, college major Phoebe Blakeley. A little cowboy town in Arizona called Wickenburg. Accounting with a pre-health minor at University of Arizona. Little known fact: I dropped out of college for dental school. 2 Do you have kids/fur babies? No kids or fur babies, but I am obsessed with stealing other people’s dogs. My roommate and I watch dogs on the weekends, and I’m continuously knocking on my friend Kali’s apartment to take her dog, Koda, for a walk. 3 What made you want to go to dental school? My path to dental school started in college when my big sister took me under her wing and showed me dentistry. At the time I was a little lost, trying to figure out what to do with my life and she knew exactly what she wanted to do - be a dentist. My very first
The CEJ experience with dentistry was as an assistant in Mexico where no one spoke English. Despite the language barrier, I knew right away that my sister had made an excellent decision and it was the right career choice for me as well. I was very lucky to have my big sister showing me the way and was extremely blessed to even attend CU with her for two years. 4 What’s your favorite flavor of ice cream, and why? If you know me, you know that ice cream is my absolute favorite food and it is not uncommon that I eat entire pints for meals (yes, even breakfast). To choose a favorite is almost like picking a favorite child. However, I’m going to have to go with Green mint chocolate chip as I have extremely fond memories of having a green mint chocolate chip ice-cream and hot fudge cake for every birthday growing up! 5 What is your favorite dental instrument? I’m going to go with a 330 bur as it was the very first bur I used to cut a
real live human’s tooth! #drillmaster #imalmostarealdentist 6 What are you doing when you’re not in dental school? Balance is key in dental school. For me, I recharge by spending time with friends and family. One of the main reasons I chose CU was that most of my family has migrated to Denver, so I spend a lot of my time with my 3 siblings, 8 nieces and nephews, dad and grandma who all live here. Being Auntie Phoebster is one of my favorite things in the world. With friends, I absolutely love to go two-stepping (country dancing), have BBQ’s and explore the Denver area. 7 Most embarrassing moment Growing up, I used to be so afraid of Javelinas (look them up if you don’t know what they are), that I refused to take the trash out at night. We lived in the middle of nowhere, so at night you couldn’t see very far, and never knew when those awful beasts were there to attack. This may or may not still be an issue in my life.
Phoebe with big sister Elizabeth who graduated in 2016
The Colorado Extraoral Journal
The Colorado Extraoral Journal
Outside the bubble and into the real world: An ACTS journal By Michael Hess '17
I will be omitting any names or locations in this piece to protect the innocent and guilty. Day 1 – I woke up at about 4:30am and had my stuff packed in my car. Once I arrived, I met my preceptor and pushed through the riveting orientation materials. The first patient on the schedule was an emergency - the kind of thing that could have any sort of cause. It turns out that this gentleman needed #17 and 18 extracted because there was no coronal tooth structure remaining, and
he was beginning down the road of infection and pain. I managed to get those out after following the plan that I had discussed with my preceptor. Before finishing up, I noticed that he had another tooth, #20, that was also sheared off at the gumline. It wasn’t currently hurting him but after a discussion about its potential to blow up like the previous teeth, he decided to have it extracted today as well. This was going to be a bit harder than the previous two. After attempting the surgical extraction on this tooth with a dilaceration, I put
up the white flag and got to watch my preceptor have some difficulty with it also. I didn’t have much experience with the hand piece but I gained some confidence and strategy. After the procedure, I shook the patients hand and looked forward to the rest of my day. The patient was very grateful and I felt accomplished that I broadened my oral surgery horizons. After today, I’m excited for the rest of my rotation, hopefully the rest of my days are just as eventful.
...Now What? 26
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Day 4 – I was with a different
The CEJ preceptor today, one that I will work with most of the time. Her patient column is more relaxed than others. My morning began with two no shows and two straight forward exams. This preceptor, however, had a family matter to attend to in the afternoon and therefore allowed me to venture over to another dentist’s column. This gentleman is a character! He is your classical old school-type dentist with lots of opinions on materials and tricks that I haven’t seen before. He was very conservative and loved to use glass ionomer, especially in this high risk patient population. A downside was that he preferred to do many of his own procedures which delegated me to more of an observational role. One could look at this as a big downside and fire up a storm of complaints, but at least I was able to gain a new perspective. It wasn’t ideal but every moment is an opportunity to learn. Day 8 – A day full of pedo exams. Today was not an eventful day but I was able to see some hope in the world. I saw four children, ages 2,3,4, and 6. From my previous experience doing Cavity Free at Three exams at another clinic, I was expecting to see a certain level of dental caries and struggle through the challenging conversations with parents about how this negatively affects their children. Today was a different story. Other than the 6 year old with 4 anterior stainless steel crowns, these children’s teeth were in good shape. The 6 year old’s parents must have changed up the routine in their home to prevent the new teeth from getting such bad decay. I enjoyed telling
the mothers that they were doing a good job with their kid’s oral health and for them to keep it up. I told them about cases I’ve seen that required risky anesthesia in a hospital operating room, and how they’re on the right track to avoid it. It was uplifting to see that these children were off to a good start in life. Day 10 – Today was disheartening. My spirits are a little down due to one of my restorative struggles, the class II amalgam. Today ended with worrying about my future capabilities as a practitioner. As you’d expect, the distribution of patients at the school is fairly random: some students are very restorative heavy, some more perio, some removable, and some people all over the place. I hadn’t done any amalgam at the school my first year of clinic. Today was my first amalgam, on ACTS. I felt an obligation from my preceptor to perform as well as my rotation counterpart who had done well over a dozen silver fillings. I was aiming for at least a satisfactory and I think I came close to achieving that goal. At least I only had to redo the restoration once when my marginal ridge crumbled apart. Nonetheless, it was a morale-beating kind of day. Day 11 – Can you guess what my first patient was this morning? A class II amalgam and I nailed it! Faith in myself has been restored, for now. I’ve heard of this from more seasoned dentists - you have very good days and very bad days. To quote one of my favorite faculty members, “Some days you are in heaven, others you are in hell,
but as long as you average out in heaven, you will be okay.” Day 17 – The days are beginning to run together. More than halfway into my rotation things have becoming pretty normalized and routine. Using an assistant is interesting at first because we are not used to having everything ready for us. At this stage it's a welcomed addition to our practice and I dread going back to having our patients hold their own suction at the school. It's strange to think that I go back to the dental school in a week. Last day – Just as I am getting to know all of the team members and get used to the procedural tasks, my rotation is over. I’ve done more dental procedures during the last three weeks than I did in the previous year and half at school. ACTS is a wonderful perk and I’m glad that we have it. Now its time to go back to the land of “start checks” and our patients holding their own suction. I’m already counting down the days until my next rotation.
The Colorado Extraoral Journal
The Colorado Extraoral Journal
The Worst Year Ever A tale of second year
econd year of dental school played out like a classic story. Good clashed with bad. There were plot twists. Tensions erupted. Moments of happiness were clung to. And despite what happened in between, there was an ending. Although, probably not the one you imagined at the beginning of the tale. So relax, put down the hand piece, and let me tell you a story. . . The plot began much like any other one—the characters, fresh and naïve off the lax first year summer semester (Costa Rica ‘15 shout-out), were thrown full force into conflict. Fall semester was an onslaught of classes (mostly dental-related at this point, thankfully) and lab time. Exams appeared weekly and denture lab work poked and prodded at everyone’s sanity. It was a marathon the characters had to run to get to winter break, but it was doable. The characters learned to stay on top of the work and to pace themselves. They had epiphanies involving superb time management and learned a valuable lesson; you can’t win every battle (or class), so choose your fights wisely and persevere onward. After having conquered the chaos of fall semester, spring semester threw the next hurdle at the protagonists. The course load was as strong and as numerous as ever, but there was an added challenge—clinical preparation. Not only did the characters have to manage the numerous classes, but there was the added stress of doing their first cleanings in
Vol 3 Issue 1
By Luke Harden '18
perio lab and, ultimately, seeing their first patients in Transition Clinic—which, for many, was the first opportunity to do a restoration on a real human being. Talk about a real nail-biter. In the end, the characters learned to navigate the spring semester much like the fall; stay on top of the workload, manage your time, and remember to breathe. Summer semester was the plot twist—the wrench thrown into the story that no one could have predicted. For starters, summer semester was the first big leap into clinic life. The characters had their own patient pools to manage, which when they’re stuck in the role of dentist, dental assistant, and front desk manager, the stress that comes with it knows no bounds. Add on lecture classes and the joy (headaches?) of occlusal guards, and the time spent running around like a headless baboon increased exponentially. It was the patients, however, that presented the plot twist. No one could tell them what to expect when treating patients, and no amount of sim clinic labs could completely prepare them for the battlefield of the living, breathing oral cavity. Patients cancelled out of the blue, a simple restoration could suddenly become a crown prep mid-appointment, and the task of navigating clinic chairs and faculty became an art form. It was a test in patience, ability to plan well into the future, and sheer bravery in putting power tools into a person’s mouth with a steadfast hand trying to convey the impression that they had done this a million times. It was a whirlwind of a semester that
had its fair share of frustrations and triumphs, but ultimately left the characters more skilled in the CU clinic circus. And with that, the second year story came to an end. The plotline was far from finished, but it needed a well-deserved two-week reprieve. The characters were much more mature and seasoned than when the story started. And three indispensible lessons were learned: Firstly, you have to roll with the punches—mistakes will be made and opportunities will be fumbled. You will not always impress your patients, and that’s okay (some are unimpressionable, by the way). You’re learning how to be a dentist - you’re not one yet. Secondly, on the reverse side, when a patient is overjoyed with a flawless restoration or hugs you out of appreciation for helping take away their pain, there is no greater feeling of satisfaction and strength. You will feel like King Kong. However, regardless of how your patients react, show them appreciation. They are the reason we get to be here. Finally, at the end of the day, we are here to enjoy our time learning and to have fun. Command your patient pool like a boss captain, but don’t let stress and frustrations compromise your relationships. Keep your friends and significant others close, and take a moment to laugh. Laugh at your patients (preferably not in front of them). Laugh at your classmates. Laugh at yourself. Just, laugh. CEJ
3rd time's year's a charm By Nikki Kumor '17
Below: Luke having animpression taken on a typical day of second year
lmost every “first” in dental school actually happens your third year. First filling. First root canal. First denture. First extraction. First angry patient. First grateful patient. First gold crown. First implant. First suture. Third year is when dental school finally feels like what you expected, and is full of every emotion you never anticipated. The beginning of third year you transition from theory of dentistry to the practice of dentistry. The end of third year you transition from the professor sitting down to help you with everything, to trusting you to try almost anything. Many agree that third year is the best year of dental school. You’ve passed the hundreds of exams you had to take second year, and you mostly spend your day in the clinic. The learning curve is steep, but satisfied patients make it worth it. Third year also gives you the opportunity to find your niche. You’ll do many things you love, and many things you hate. Eventually
Below: All third years rotate through Healthy Smiles, a pediatric dentistry rotation, for 3 weeks during their third year
you’ll find the techniques that work well in your hands, and figure out just how nice it will be to have someone to suction for you. But third year can be scary. If you’re applying to residency, you must decide what field. You must decide what regional licensure exam you’re planning on taking. Decisions become much bigger than where to go for happy hour. Days are hectic. You often have class and go straight to clinic where you are doing a procedure you’ve never done before, under a faculty you’ve never met. Stress comes in a different form than second year because your patient, a real, live, breathing, feeling, human being is on the other end of your bur. Your morning appointment goes into lunch and you have 1 hour to pour up your denture impression and make it to class by 1. You’ll hear people say, “It’s just as stressful as second year, but a different kind of stress.” Spring semester of third year rolls around and
you’ve started to find your groove in clinic and suddenly you get an email that boards registration is soon, and specialty applications are due. The scramble begins to figure out which state you want to live in so you can register for the appropriate exam, what specialty/ GPR/job you want to do, on top of graduation requirements and social obligations. Amidst all the chaos, it’s important to remember why you’re here. Third year is a year of self-discovery. It’s the year to want to try every type of procedure possible so that you can seek the life you find most fulfilling. You will learn there are many things you hope to never do again. You will also learn that there are many things you would love to do again. Third year is the year when you finally feel like you’re in dental school, doing the dentalschool-type-things you envisioned when you got your acceptance letter. So, try everything third year. Enjoy it. Be humbled by it. The Colorado Extraoral Journal
The Colorado Extraoral Journal
NLC: The cure for DS1 By Dana Schwartz '20
things we should be spending
I interested in any specific spe-
is probably the
our valuable time on are things
cialty? I surely donâ€™t want to close
best word to
that we have control over in the
that door before I even figure it
next few months. Worrying about
out! In reality though, how are we
semester of dental school. After
anything beyond that is unneces-
supposed to figure any of this out
countless questions to upperclass-
sary stress. However, following
until we have been in clinic? In
men, the best advice I received
this advice has proven to be a real
the midst of trying to figure out
was to not worry about every
challenge. How can I not worry
what exactly it was that I want to
single thing that we will face in
about getting good grades? What
do in dentistry, I was also asking
dental school right now. The only
if I want to do a residency? Am
myself the question of how, when,
Vol 3 Issue 1
and what to get involved in to help me on this path. Overwhelmed with all the choices offered in dental school, I was at a loss for command on anything other than the exams in the current week. In the middle of a heavy week of tests, I was offered the chance to go to the National Leadership Conference (NLC) for our ASDA chapter. I had attended many leadership conferences prior to beginning dental school, but I was soon to learn just how important this topic is for future dentists. Leadership is an integral aspect of dentistry, and is often one that is overlooked. No matter where you practice, you will always be in the role of care provider, which is inevitably a role of leadership. At the very basis of your career, you will need to have the skills of leadership and professionalism to take with you into practice. The ASDA NLC is a wonderful source for all of these skills and more. There were a multitude of sessions offered that were full of practical information to help dental students with not only communication skills and practice management, but also motivation for personal goals in both dentistry and life beyond. It was a great weekend to escape from all of those stressful questions and to inspire ourselves to take a step back to see the forest from the trees. One particular session struck me as pretty monumental for taking away some of the “whelm” to help me see the big picture. The session was titled “Building Your Personal Brand” by Dr. Ryan Dulde. He discussed the basics of putting in writing the things that you want to be known for and what makes you stand out from other dentists to enable you to own your brand and use it as a guideline for each day. However, one of the most compelling thoughts that he expressed was that you have to be doing something that is at the intersection of your passions and
skill sets, and that is also an economic engine in order to have a successful and authentic brand. I know I have many skills, and I certainly have many passions; but, to narrow my focus to things that I was both skilled at and passionate about was a new concept that set a clear path for how I was going to get through dental school. This epiphany of sorts, in addition to many conversations with upperclassmen showed me that I already know how to get the most out of dental school. Taking from many of the sessions that I was fortunate to attend, I have found that there are some personal tasks that are important to take some time for every so often. First, it is important to think about your goals. Where do you want to be? What memorable parts of your personality do you think you should enhance? What are some things you could use improvement in? How are your communication skills, selfconfidence, leadership skills, and overall attitude? It is very valuable to take time to step back and look at where you are and who you are to make some goals for now, next month, next year, and when we
are (finally) dentists! From looking at your big picture and goals, you should be able to determine both the passions and skill sets that you possess to be able to see opportunities that are a good fit for you. Getting involved in something like this should be in your most immediate list of goals. Involvement will not only help develop your interests and skills, but also will give you experience in a leadership role that you can take with you for the entirety of your career. It may also give you the chance to attend events such as the NLC that can inspire you to see your potential! Dental school can be extremely overwhelming sometimes, but there are ways to come out a much cooler, calm, and collected version of ourselves that is much better prepared for the career we have all chosen. Take time for yourself, get involved, say ‘yes’ to opportunities even if you have a test - or four - next week, and take a breath every so often to look at where you are and where you want to be. Doing these things may just give you the peace of mind you need to get through dental school successfully. The Colorado Extraoral Journal
The Colorado Extraoral Journal
Dolla, Dolla Bills, Yo! By Phoebe Blakeley '18
The average dental student graduates with $241,097 of Debt (ADA). To put it into perspective, that’s 26,788 burritos from Chipotle, including guacamole. Or 25,378 really fancy drinks from really fancy bars. It’s a lot of money. And that’s where the SUPER exciting topic of budgeting comes into play. Yes, budgeting is a bore, but it is also one of the most important money managing habits you can adopt during your dental school years and, for that matter, for the rest of your life. There are hundreds, if not thousands of budgeting articles, chock full of advice for the average consumer. However, with our mounds (or should I say mountains?) of debt, we aren’t the average consumer. Because the money we are spending is not our own, and paying back what we borrowed is years in the future, over-spending can be a terrible trap. A little extra here and there seems like a very small drop. But if you think about it, that thousand extra that you have to take out each semester adds up, and the interest adds up even more, and eventually your drops have become an ocean. What do you do? You adopt a
budget. Don’t worry, there are tons of ways of going about it. Flexible budget apps like YNAB (You Need a Budget) are a great resource. You can move your money around to best suit your needs. Yes, YNAB costs money, but for a nominal fee to get started, the return is outstanding. If you don’t want to put out for an app, you can always use an excel spreadsheet. There are several template budgets from which you can choose, or you can even make your own. The key is to label every dollar each month so that you have a spending plan. Assign your money to pay all of your fixed costs first. These are the bills that you will have to pay no matter what, such as, rent, internet, phone bill, food etc. It is important to make sure you have enough for all of your monthly bills set aside so that you are never in the situation where you don’t have basic amenities. Next, you should save up for emergencies. Accumulate enough money to meet unforeseen expenses such as medical bills and car repair. The typical budgeting advice is that you need to accumulate at least 3-6 months of living expenses. However, since
we are not actively earning, my personal advice is to set aside only a small chunk (say $500-1000 per semester) for those expenses that you don’t really see coming. The greatest reward for budgeting is that you can spend within your budget without guilt or anxiety. It is important to direct some of your money for fun things as well as for necessities. This is so important since we as students need balance in our lives. When you know how much money you can spend on recreation, it makes spending that money much more satisfying. Managing and thereby minimizing our debt through good budgeting habits will have a significant impact on how soon we can begin a future unencumbered with a monthly payment that rivals a home mortgage. Budget so that your debt is a tool used to launch your career, rather than a burden that follows you far into your future. Practicing good spending habits now will mean that once you actually have a cash flow, you will have the good habits and money managing skills to truly enjoy the fruits of your four years of hard work and dedication as dental students.
Vol 3 Issue 1
The Role of ASDA in my US Journey By Zarrar Duraiz ISP '16
Chinese philosopher, Laozi, said, “A journey of a thousand miles begins with a single step.” I can relate this to the personal growth and journey toward becoming a dental practitioner. Coming from a family of military officials, health care was not an expected career choice for me. Growing up as an optimist in a nation that had been targeted by miscreants, my parents (to whom I owe everything) forced me to intern at a hospital during my summer break in high school. The following fall, a devastating earthquake destroyed a great portion of of my country, Pakistan. I woke up to jolts recorded at 7.6 on the Richter scale, and 'severe' on the Mercalli scale. I vividly remember the ground beneath my feet bouncing around like a ball, and my own excitement with this first time experience. The excitement however, was short lived. The intensity and devastation of that earthquake would have a lasting effect on me. The entire country came together in one of the biggest rehabilitation efforts of Pakistan’s history. After visiting the nearest state run hospital, the sights and sounds of those affected were etched in my memory. Truckloads of patients were driven in, and countless were flown in via helicopter. There were broken bones, deep gashes, and shattered limbs that needed prompt medical attention, but the wounds that were to take longer to heal were the ones that we couldn't quite yet see. The loss of life and of hope was a rehabilitative effort that would continue through the next generation. Unable to provide medical services myself, I organized volunteers to record patient influx and contact families, as well as distribute food and blankets. With a death toll of around 100,000, this earthquake would have many lasting impacts on the lives of those who survived it. Through volunteering, I had the opportunity to interact with individuals
of all ages who had recently encountered severe emotional and physical trauma. Realizing how much physical and emotional rehabilitation many of the victims required was unbelievable. This experience, however devastating, inspired me to pursue healthcare as a profession, and in some ways guided me toward practicing in the United States. The military base I was living on with my family served as one of the bases for the United States Army relief operation. I had never met Americans before, yet I saw them working tirelessly, providing aid and running rescue missions for my people. The image of these soldiers will always be a large motivating factor for me. After finishing dental school I choose to attend my mandatory internship at a military hospital. Here along with dentists I had the opportunity to work in a trauma center. Being a third world country, the concept of, “all hands on board,” is quite often applied in Pakistan. Along with incision and drainage of suppurating wounds, application of P.O.P bandages to fractures and other medical procedures during this time, on numerous occasions I had the experience of giving first aid to victims of bomb explosions and gun attacks. The most profound of these experiences, however, was while covering for the medical doctor on duty so they could get a quick break for food. An explosion had occurred at a busy market place and the casualties were high. Along with the wounded came their hysterical family members, all in shock and disbelief. While establishing I.V. lines for my patients, I had to shout over the chaos and convince their relative to step outside and donate blood. It is incredible how we, as human beings, can sometimes achieve great things under pressure. No matter how saddening and disturbing these experiences were, they convinced me to push myself further and enhance my skills as a health care professional. It was during this internship that I made the decision to go to the United States for
further education. In my two years here at the CU SODM, I have joined several clubs and organizations. In short, I was selected to be historian for ASDA, and a public relations officer for MDDS. It was an absolute delight to be able to get in touch first hand with my community in my new home via these organizations. Under the umbrella of the CU SODM, ASDA and our outreach chair, Kimberly Engols, I was able to attend a wide variety of events and speak with people of all walks of life. The stories you hear when serving food at an emergency shelter, the gratitude you receive from manning a booth for oral health awareness at the Coors Field Opening Day, and dressing up as a tooth fairy on your birthday for smiling children are all priceless experiences. It’s the moments like these that have helped me keep science in balance with the spirit and the art of dentistry. In my view, it would be too easy to get lost in the frustrations of dental school had it not been for events like COMOM, which keep me humbled and inspired. Given the opportunity to associate myself with the ADA, ASDA and the CU SODM, I worked on enlightening the philosophical standards within myself along with focusing on the curriculum of the International Student Program. Although the change was drastic in terms of demographics, I learned to recognize what aspects of dentistry and healthcare were lacking back home. The influence such factors had on my practice of dentistry, and how such variations can be implemented into a system where they were missing, fueled my optimism. CEJ
A journey of a thousand miles begins with a single step. Travelling across oceans has been a wonderful and enlightening experience. Whether it is skiing or climbing a fourteener, I always look forward to that first step in a new journey. It is with great enthusiasm and unyielding fervor that I look towards the future. The Colorado Extraoral Journal
Letter from the President
PRESIDENT Beck y Bye | President | C olorado ASDA
Dear Colorado ASDA, Thank you for reading the Winter 16/17 edition of the CEJ! As the academic semester concludes, your Colorado ASDA chapter will continue to work for you throughout the school year and beyond. We started the school year with a bang. From informational lunch & learns and evening Business Study Club events to social events and “Wax & Relax nights,” Colorado ASDA strives to enhance your educational and professional experience.
Vol 3 Issue 1
Speaking of professional experience, our school recently held a unique geographic advantage for the epitome of dental professional experiences. In October, the American Dental Association held its Annual Session in Denver. As a subsidiary of the ADA, national ASDA and Colorado ASDA maintained a large presence at this conference. I was delighted to see classmates and fellow ASDA colleagues attending workshops and participating in various ways. We were also honored to have Dr. Gordon Christensen make an exclusive presentation to CUSDM students during the ADA convention, which was a personal highlight of the conference! Additionally, Colorado ASDA has continued its efforts to strengthen its relationship with local organized dentistry groups that also fall under the purview of the ADA. From joint social events, educational presentations, or allowing us to use their venues for school events, both the Colorado Dental Association and Metro Denver Dental Society have been
invaluable contributors to our chapter. The Colorado ASDA Executive Board consists of over thirty individuals, representing a wide array of students at the school. We endeavor to meet the evolving needs of our members. Consistent with this notion of self-improvement, we recently sent over twenty students to the annual ASDA National Leadership Conference, where they learned about various aspects of leadership, self-improvement, and chapter-best practices. Our chapter leadership is now more invigorated and enthusiastic than ever. We plan to harness this enthusiasm and knowledge throughout the school year!
Becky Bye ‘18 President
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