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The Great Dental Drill Off

Rants from the Dental Operatory:  It seems like so many of us have had a crazy month….with school and extracurricular activities in full swing, holidays and all this “dentisting” we do…..we barely have time for a break.  So, this past weekend, I gave myself a break….and indulged in binging the latest season of my obsession with “The Great British Bake Off”.  I know, I know…..nerd alert, right?....BUT I LOVE THIS SHOW! Whose with me???? For those of you who are not familiar with it, it is an amateur baking competition in the UK that highlights unique and exotic baked goods in which the contestants are tasked with a signature, technical and showstopper challenges…..and they are cheered and supported on by two whimsical and pun filled hosts and critiqued and judged by two leading baking experts.  I have watched EVERY season….and I watch it with the same passion of West Philly Eagles fan….by literally tailgating in my family room with my scones and patisseries…screaming at the contestants that if they don’t whipped their egg whites longer their genoise sponge will be so flat that it won’t be able to support the hundreds  of spun sugar angels they’ve crafted to suspend from the edible virgin Mary statue delicately covered in edible gold leaf!!!!  It can get quite intense…..looking for perfection, time constraints, problems solving….takes me back to our old days of dental school practicals.  And… all should know how my mind works by now…, what if we had  “The Great Dental Drill Off”?????….perhaps it would go something like this. (For those of you who know the show…think of this as bantering between Mel and Sue…..if you don’t know the show…. you’ll think I’ve lost my mind but, trust me,  it’s worthy of a Paul Hollywood handshake.)


Colleen:  Welcome to “The Great Dental Drill Off”....I’m your host Colleen Colgate and with me as usual is my dental diva from the dark side, Annie Aquafresh.

Annie:  Well thank you Colleen….and might I say your scrubs are looking quite fetching today, what is that pattern I am seeing?

Colleen:  It’s a tiny replica of a biohazard sign.

Annie:  Biohazard sign?  My goodness, why on earth would you choose that?

Colleen:  Simple darling, it’s Biomaterials week!!!


This week our dentists will tackle working with a variety of biomaterials with a traditional Class II filling in a Signature challenge, a removal and temporalization of a zirconia crown in the Technical and a mind blowing and stunning immediate denture in their Showstopper.  As always, Drs. Paul and Mary will be evaluating our dentists to determine this week’s Star Driller. 


Annie:  Alright now dentists, you will begin with your Signature challenge in the preparation and completion of a Class II filling.  Drs. Paul and Mary would very much like you to incorporate at least two different filling materials and it must include some cuspal coverage.  Patients have been provided for you but you may choose the tooth that you wish to work on. You have 45 minutes for this challenge……on your marks, get set, drill!


Colleen:  There is a flurry in the ops as the dentists are setting up and assessing the proper armamentarium to use in the execution of their fillings.  It appears most of our dentists are opting for the basic #3 MO preparation….a safe choice but will it be enough to impress the impossibly high standards of our esteemed judges.


Annie:  Hmmm…you think our judges are esteemed, huh?


Colleen:  Yes…..otherwise we would see all their dents!!! HaHaHa….see…..esteemed?...steamed?...getting out all their wrinkles and dents…and they are dentist……get it????


Annie:  You’re so punny love.  Now let’s check in with our dentists.  It seems as if poor Dentist A is experiencing some leakage.  In her haste, the wedge was not properly placed and a bit of flowable is leaking past the matrix band.  Will she be able to properly contour and get a spot-on contact with only 10 minutes left…..10 minutes left dentists!!!


Colleen:  Ohhhh….risky…..Dentist B has gone rogue and it trying a mixture of amalgam and glass ionomer.


Annie:  Ionomer?


Colleen:  Yes, ionomer!!!!….and he barely knew her!!!! *wink, wink* Sorry, inappropriate….I know that dentists have fillings too.


Annie:  Oh sod off Colleen…..look now, there is another possibility of a tragedy as Dentist C has chosen to use a bulk fill material but seems to have grabbed the traditional composite instead!....if he doesn’t get the proper cure……we know what will happen.


Colleen:  Yes, disaster.  It will not be fully cured….and he’ll be left with……


BOTH:  A soggy bottom.


Annie:  And Dentist B’s patient is starting to show signs of discomfort….perhaps the filling is going to deep….what could be the chance of it turning into a root canal?


Colleen:  Oh, that would be deeply unnerving.


Annie:  *Blank stare at the camera* Alright now dentists….time is up…please bring your patients us for Dr. Paul and Dr. Mary’s evaluation. 


The three dentists wait for the decision as Drs. Paul and Mary meticulously explore and probe and assess the multi-layered fillings….it is finally announced that Dentist A is the lead for Star Driller this week…… but barely, as she was told that she had a nice bite there, but it had a bit of a sharpness to it, right at the end, where it lingers on your tongue….Come on dentists……Dr. Paul demands perfection, so the dentists need to step up their skills with their drills…… will our Technical Challenge change any of that???


Annie: For today’s technical challenge, you must drill off a bonded zirconia crown using only the instrumentation that can be found in your operatory.  Once removed, then fabricate a temporary crown using the limited instructions left by Paul and Mary.  You have one-hour dentists….get ready, get set, drill!


Colleen:  The dentists today are tasked with the insurmountable task of removing an all zirconia crown…..additionally, Drs. Paul and Mary have added a challenging component of NOT providing the  dentists with a high-speed handpiece.


Annie:  You mean the dentists can only use a slow speed?


Colleen:  Yes, this crown will be harder to remove than the one Prince Charles finally receives after the queen mum dies.


Annie:  I see our dentists starting to struggle a bit, Dentist A is trying to drill it off and revving the rpms so high there is smoke coming out of the handpiece…..Dentist B has decided that wedging scalers and using a litany of curse words is going to be the magic ticket….whilst Dentist C is trying to think outside of the box and is using his OWN teeth with gummies to gnaw away at the crown.  They all seem to be tackling this technical with different tactics.


Colleen:  So, they are…. Molar opposites. *fanciful wink towards the camera*


Colleen:  We should note here that the dentists are working on typodonts and NOT actually humans….although gnawing on a sticky gummy in someone else’s mouth completely describes my last Thursday night.  Five minutes left dentists!...five minutes left!


Annie:  By some Gordon Christianson dental god miracle, all dentists have removed the crown and are trying to get the temp to fit.  We have open margins and seals that are exposed…..and poor Dentist C placed to much liquid in his jet acrylic and it doesn’t appear as if it will set in time.  Hurry dentists….1-minute left!!!  Dentist A is patching acrylic to close a contact, Dentist B is adjusting the occlusion so much that any trace of occlusal anatomy has just been whisked away…..and Dentist C is now taking the temporary acrylic and balling it up and shoving it down onto the prep as we call …… TIMES UP!


Colleen:  As the judges are scrutinizing the dentistry…..we hear mumblings from Dr. Paul and Dr. Mary….saying things like… “It didn’t set in time, it’s soft and wet.”….”That’s enormous, the trick is to keep it small to begin with.”…”He was trying to get it too thick and hard.” …”Now that’s something I’d like to put in my mouth.”….not certain if the judges are evaluating the work or planning their next date but regardless, it’s Showstopper time!


Annie:  For your Showstopper you will have 3 hours to extract the remaining teeth, take impressions, and fabrication a Maxillary Immediate Full Denture.  Your denture must include teeth #2 thru #15 have impeccable retention and your own signature style incorporated into it….and your time starts NOW!


Colleen:  It seems our dentists are working at an extraordinary rate getting these teeth out bypassing the need for any anesthesia and rather literally knocking them out with an ancient art of acupuncture using none other than……yes, wait for it…..tooth picks.


Annie:  It seems Dentist A is showing us her flawless piping skills by providing perfect border molding….but will it allow for the crestal bone discrepancies…..but WAIT!!!.....the impression gun is jammed!!!…..what will she do????…..I will go see if I can help her.


Colleen:  Meanwhile our other two dentists have chosen to impress using alginate….a daring choice for sure….let’s not forget the alginate anarchy that plagued the country in the mid 50’s ….in fact I think I’ve found an old photo on Instagram somewhere that shows Dr. Mary sporting a T-shirt that says “Algi-NOT!”….our dentists should have done their research to know what the judges like and don’t like.  This competition may already be over folks.

Annie:  I’m back.


Colleen:  Where you able to assist her?


Annie:  No…she waved a toothbrush at me and gave me the brush off. *giggling*


Colleen:  Let’s save the puns for me darling.  Now then…….everyone has their acrylic bases in the Triad….just waiting and watching for their shapes to form.  It will be down to the minute to see if the dentists have achieved seamless midlines, perfect occlusion and a precise VDO.


Annie:  There is a great deal of pressure on their plate.


Colleen:  And their plates MUST be retentive and flavorful!


Annie:  Flavorful?


Colleen:  Wouldn’t you want something to be flavorful if it was going to be in your mouth all the time? 10 minutes dentists!!!!!....10 Minutes!


Annie:  The dentists are scrambling with the final set of the denture teeth.  We see a variety of schools of thought for the final showstopper.  Dentist A has maintained a traditional Class I occlusion A2 color to balance the beauty and symmetry of her patients face.  Dentist B has opted for an edge to edge flat plane occlusion and….. no doubt that was the proper call looking at the straight-line jaw of that brood who clearly whittles wood with his own teeth.  But look…….a dental disbelief!!!!…..Dentist C has chosen to recreate his patients original infected and grotesque teeth buy haphazardly placing the teeth, chipping off incisal edges, yellowing them with primer and yes…..even for a final adornment…..wedging a piece of spinach in between #7 and #8!!!!…impressive young man…..but will that impression pass the judges scrutiny?


Colleen:  Drs. Paul and Mary are appraising the work of our overtasked dentists….and after a long deliberation….and word of mouth tells us….it was decided that Dentist A is our Star Driller!!!!  As a reward… are bequeathed a lifetime of neck and back aches, underpayment from insurance companies, never ending school and office loans……and as a reward from us… get a little plaque!

Happy Drilling Star Dentists!