A Dental School Clinic Versus a Dental Clinic in the Real World – Ava Lindert (UNE ’17, District One Trustee)

Ava’s operatory view – not soooo bad!

A personal perspective from Ava Lindert (District 1 Trustee, UNE 2017) on her externship in the rural locale of the White Mountains of NH

As a student at UNE, I had the opportunity to spend twelve weeks of my summer on a “clinical externship.” I put this in quotes because I can’t count the number of people, both clinic staff and patients, that asked what the difference between an internship and an externship was. I will pass the definition on to you in case any of you ever receive this question. An externship is completed by a student in a professional program who has not yet received a degree (i.e. a pre-doctoral dental student), whereas an internship is completed by a student in a professional program who has already received a degree (i.e. a medical doctor who has recently graduated medical school).

This externship was served during my final summer as a dental student. At UNE, we begin seeing patients in our clinic during the spring of our second year, and the patient exposures gradually increase over time. We start by doing screenings, comprehensive exams, prophylaxis, and simple procedures. That said, I had a good amount of experience prior to beginning my externship, but I would hardly have considered myself confident in doing procedures on my own.

Fast-forward to the midway point of my externship. I’ve begun to refine my techniques, maximize my time with patients, and really hit a stride – feeling like a dentist rather than a student. In this time, I’ve also realized a few things are different in a rurally located private-practice compared to an urban dental school clinic. In school, everything is ideal – ideal treatment plans are constructed and presented to patients. Often times, if the ideal is not a realistic treatment for the patient because of budget, timeline or needs/desires, then the patient may leave the clinic and pursue other options that are more flexible in the treatment rendered.

Some of the best experiences that I’ve had during my externship have been utilizing that flexibility with patients who cannot afford the ideal treatment. Many of these situations have been focused on patients that are elderly, when dental treatment is not a high priority, likely because of other health concerns or financial constraints. It’s exciting to be adventurous and seek a treatment that works for the patient’s current needs but that may not be something that follows an ideal (or even typical) treatment plan.

As an example, a patient presented with a crown broken off of tooth number eight at the gingiva. A bridge was an option but the patient decided that he would like to pursue implant placement, although he could not afford the treatment at the time. As an interim solution, an Essix retainer was constructed using a model of the patients arch and clear plastic filled with composite and acrylic to replace number eight.  This allowed the patient to have a normal appearance and it had the added benefit of the area not being plagued with the constant irritation that flippers can sometimes cause. It also was easier on his wallet as the Essix can be constructed in-house, saving the lab fees associated with a flipper.

Now I will admit, I was hesitant to begin a twelve-week rotation over my summer semester. First, I was newly engaged, and my fiancé was going to be seven hours away from me all summer. Second, summer is the only time people actually want to be in Maine, and I was going to be away from the food, beaches, nightlife, and my friends. But I will be the first to tell you that the experience definitely paid off and I was sad to leave at the end of those twelve weeks. If this opportunity presents itself to any of you, I implore you to jump in and take advantage of all the things a rural community rotation has to offer!

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