Objectives: 1. Understand the power of your personal journey to connect with patients at a deeper level.2. Develop and implement soft skills to diagnose beyond the dental chief complaint.3. Identify your place in the stages of change, towards your ideal mode of operation in your practice of dentistry.

AMEN 2021: While It Is Day

Objectives: 1. Understand the power of your personal journey to connect with patients at a deeper level.2. Develop and implement soft skills to diagnose beyond the dental chief complaint.3. Identify your place in the stages of change, towards your ideal mode of operation in your practice of dentistry.

Free sharing permitted under the Creative Commons <a rel="license" href="http://creativecommons.org/licenses/by-nc-nd/3.0/us/">BY-NC-ND 3.0 (US)</a> license.

Adventist Medical Evangelism Network (AMEN)

Dental

Gerardo Toledo

The Potential Global Impact of a Local Dental Office

I come usually to the meeting here in the West Coast.

And it's always, for me, a pleasure to talk about Bangladesh.

I will show you what part of the ministry is.

And 1 of the beautiful things of Bangladesh, this is the sunset.

And it's 1 of the most beautiful sunsets when you go in the villages, when you see the rice fields.

It's a very interesting country to visit.

A poor country, but many pictures to be taken there.

Heavenly Father, we thank you for this meeting, all the things that we are listening, all the testimonies.

I ask you, Lord, that you will inspire us after this weekend to surrender our life to you and help us to be your vessels in reaching others.

So Carlos called me 1 day and said, I'd like to ask you to share at Amen how your office is helping in Bangladesh.

So I thought, boy, I can say that in 2 or 3 minutes.

It is very uncomfortable, really, to share what you do or what you give.

Many verses of the Bible come to my mind.

Let not your left hand know what your right hand does, and so forth.

So to be fair to you, I will tell you the good, the bad, and the ugly.

In some of the things I share, I want to share the faithfulness of God when we follow what he says.

A long time ago, my mom, when I was probably 8 years old, she gave me the book of Luz en la Selva, Light in the Jungle.

Albert Schweitzer, who worked as a missionary in Gabon many, many years ago.

And at that age, after I read that book, I think I finished it in a siesta time, during nap time.

So I always grew up knowing I would be a missionary.

I always wanted to go to Africa because that's where he went.

Actually, my older brother, he ended up in Madagascar, and I ended up in Bangladesh.

So in 1993, I received a call to go to Bangladesh.

And I remember we had those phones that you would have to dial.

Karman called me and said, we'd like to go to Bangladesh.

So my English was even worse than what it's now.

And so I thought, oh, Bangladesh, India, right?

But then after the call, I check in the map, and Bangladesh actually is next to India, to the east.

So Bangladesh was part of Pakistan, was East Pakistan.

So it's Pakistan, India, and Bangladesh, so East Pakistan.

And in the 70s, 1771 was the independent war.

India helped Bangladesh to become Bangladesh, and so it's a new country.

So Bangladesh has the size of the state of Iowa.

So it's the seventh most populated country in the world.

90% is Muslim, 8% Hindu, 2% Buddhist and Christians, and 40% of the people is illiterate.

So if you can imagine a poor country, a small country, with so many people, with so much illiteracy, there is a lot of poverty.

This is an old, the old Daca as they call it, the old part of Daca, and they have these rickshaws.

So you have the rickshaw with the guys pedaling, and then you have the, what we call baby taxi, that's with like a motorcycle.

You go inside, and you see how many people there.

There is actually 1 of the 4 or 5 stars hotels.

So it's the pool, and then there is a wall.

And behind the wall, there is a slam, what they call the slam.

And so there is a big contrast between the rich and the poor.

Karman when he visited probably in the 19...

I was, there was an Australian dentist, and then when he left, I became the director of the clinic there.

I graduated in Argentina dentistry in 93.

So we used to go to the countryside to do extractions, as you guys have done in many mission trips, I know.

And so this was in 98 when I was leaving.

And then I will talk a little bit about Dr.

Moscala, maybe some of you have heard his testimony, he opened 10 slam schools and actually 1 street children's school.

So he was in charge of the dental office.

So the Light Schools, this is 1 of the schools those days.

So we rented the house, or he would rent the house.

And the kids would stay in the floor, sit in the floor, and they will have the classes there.

Moscala, and we raised funds here to send to support his different ministries.

And so in 2013, we knew that we were in disadvantage with other organizations because we were not able to give tax deductible receipt, which is important here as we donate.

And so we started to raise funds to send there.

So let me tell you here a little bit of the testimony.

Then we'll go a little more to the work in Bangladesh, and how is that God led me to share the finances in Bangladesh.

Adrien Charles-Marcel

Compassionate and Effective Treatment for Patients with Dental Infections

I am very grateful to be here, and I remember like it was yesterday, my first Amen Conference, and it's hard to imagine what God has done in my life up until this point.

Our Father in heaven, we thank you so much for bringing us here to this AMEN conference.

We thank you for giving us a little bit more daylight that we can continue to minister for you in the different settings that you've placed us.

I pray that as we discuss today how to take care of patients with dental infections, that we would not only be able to understand the technical aspects, Lord, but more importantly, that we would have your heart towards the patients that you committed to our care.

And we thank you for hearing this prayer in Jesus' name.

So I just wanted to start off a little bit because sometimes I don't feel like a dentist or like a medical student.

But oral and maxillofacial surgery is a journey.

So I don't need to tell you about the length of that journey but These are some of the beautiful people that God has placed in my life along that way.

1 of them being Carlos, the other being Janessa, my fiancee, who incidentally, it was on a mission trip to Bangladesh with Gerardo and Carlos where we started talking.

There are many good reasons to go to Bangladesh.

So, I was thinking, when I was thinking about what to talk about and what to share, primarily because right now I'm in the middle of medical school in my OMFS training, I don't feel like I have a lot of patient contact in a dental sense on a day-to-day basis, and most of you in this room have more experience than me when it comes to taking care of dental problems.

But the 1 thing, or 1 of a couple of things, that as an OMFS resident that you get fairly comfortable with is taking care of patients with infections.

And so I thought that that would be something that I could talk a little bit about and discuss a little bit about what are the indications for how we treat and then also how can we involve spiritual care in the treatment of these types of patients.

So the objectives, I won't read through them 1 by 1, but essentially we wanted to look at what are the signs and symptoms of a dental infection, and then just review the diagnostic criteria, describe a little bit of the treatment modalities that are available for a general dentist or an oral and maxillofacial surgeon for treating a dental infection, and then look at the signs and symptoms of a patient that's in emotional distress, and look at how Jesus treated patients like that, and also review evidence-based guidelines for antibiotic therapy.

So to start off with, if you have, well, we can just look at the verse on the screen, but Matthew 4, verse 23 is a very instructive verse, I believe, in the Bible that talks about how Jesus made his ministry, how he patterned his ministry, and it gives us sort of a blueprint as to how we should pattern our ministries as well.

And so Matthew 4.23 says, "'Jesus went about in all Galilee, "'teaching in their synagogues, "'preaching the good news of the kingdom, "'and healing every disease "'and every sickness among the people.'" And I think sometimes we get into the day in, day out aspect of healing the sickness among the people, but as we've been challenged already by Dr.

Kim and Gerardo and everybody so far at this conference, it's not just the healing the sickness and the disease, it's also the preaching the good news of the kingdom and the teaching.

And so that's what our our goal is, is to integrate all of those things in our care for patients.

So as we talk about dental infections, I'll be referencing a guideline by the ADA that uses this term a lot.

So these are a couple of the different ways you can go when you're treating a patient with dental infections, as we all know.

But this definitive conservative tooth preserving dental treatment is something that you'll see referenced a lot as we go through the presentation.

And that is pulpotomy, pulpectomy, non-surgical root canal treatment, or incision and drainage.

And then the guideline that we'll be looking at doesn't really talk about extractions because it's out of the scope of what they were talking about, but that's another way that dental infections can be treated too.

So we'll start off with the first case, And these are all fictitious cases, but hopefully they'll illustrate the points.

So let's say that it's the beginning of Monday, Monday morning, 8 o'clock, and you have an add-on, and it's a new patient that's in pain, John Doe.

I'm leaving on a week long trip this morning and it's 08:00 right now.

I just need some medicine to get me through this.

He has a history of type 1 diabetes, no allergies, and he's been having pain, dental pain, for a week.

His vital signs, he has a blood pressure of 115 over 72, heart rate of 65, respirations of 13, and a temperature of 98.6.

You do a thorough extra-oral exam, you don't see any swelling anywhere.

An intra-oral exam and you see that tooth number 19 has gross recurrent decay around a PFM crown, lingering pain to cold, and then 10 out of 10 pain on biting with no swelling.

So you look at you get a PA and you see that there's obvious carries, there's an obvious periapical lesion.

He has to leave in an hour, and he's not willing to have any treatment done right then.

So trick question, no antibiotics actually.

And this was a bit surprising to me as well.

Going through the ADA clinical practice guideline, there are many conditions in which they actually do not recommend giving antibiotics.

And so in this case, he has symptomatic irreversible pulpitis and symptomatic apical periodontitis, but they do not recommend giving antibiotics for this type of a patient.

There's no swelling, there's no systemic involvement.

And the downsides of giving antibiotics with increased antibiotic resistance and so forth outweigh the benefits.

And so just to review a little bit of the the diagnostic criteria for these different conditions, we have symptomatic irreversible pulpitis, which is spontaneous pain that may linger with thermal changes owing to vital inflamed pulp that is incapable of healing.

Symptomatic apical periodontitis, pain with mastication, percussion or palpation, with or without radiographic signs.

Pulp necrosis and symptomatic apical periodontitis when you have a non-vital pulp, with pain with mastication, percussion, or palpation, and again, with or without evidence of radiographic periapical pathosis and without swelling.

And then the same just with localized apical, acute apical abscess is when you see signs of pure material or localized swelling.

And then acute apical abscess with systemic involvement.

So when you see systemic symptoms such as fever, malaise, lymph node involvement, or greater swelling.

So in a case like this, and I know I've done it before, you prescribe an antibiotic and it's really not indicated.

So this case we'll call her Jillian Doe and she's also coming in with pain.

So Jillian is a 45 year old female and she says I'm having swelling of my upper lip.

You review her past medical history, none, no allergies.

Her vital signs, you have a blood pressure of 119 over 77, a heart rate of 85, respirations of 12 per minute, and temperature of 98.8.

When you examine her extra-orally, you find that there is mild swelling of the left upper lip.

An interoral exam, there's gross lingual decay on tooth number 10, fluctuant swelling in the maxillary vestibule, and then no response to cold when you test tooth number 10, and 10 out of 10 pain on biting.

You take some radiographs, and there is a periapical lesion on tooth number 10.

And Jillian says that she does not want to save the tooth, and she's not interested in an implant in the future.

You can take responses from the audience.

And so, yes, so treatment for this, she has an abscess, so can perform an incision and drainage which I was not taught how to do that in dental school.

I'm just curious, how many people in this room would do an IND?

So, this series of pictures shows the procedure.

Now, she has an infection, and oftentimes, it is harder to get someone numb when there's an abscess, but it can still be done.

And then, essentially, take a scalpel and open it up and use some hemostats, get out the pus, put in a little drain and suture it up.

Now, we'll talk about this in a second, would you give antibiotics?

How many people wouldn't give antibiotics?

All right, so again, actually no, no antibiotics.

And again, this was surprising to me when I was going through this, because A lot of times I think we over rely on antibiotics for a lot of things that it's not actually indicated.

So this is a case where she has pulp necrosis, symptomatic apical periodontitis, and a localized acute apical abscess, but there's no signs of systemic involvement.

So in this case, it's not recommended to prescribe antibiotics.

You give definitive treatment and that's it.

Claudia Moncada

Beyond the Diagnosis: What’s Really Going On?

I just pray that today as we are here, tomorrow throughout the weekend, that we can together pray that we don't walk away the same person that we walked in.

And so before we proceed, let's just go ahead and pray together.

Gracious Heavenly Father, thank you so much for this opportunity that you've given each 1 of us to be here physically and also virtually to be inspired to receive a word from you, Lord.

Yes, we are here for credits and continuing education, But I believe that the greatest education we could receive is not 1 that the world can give, but the 1 that you give to us.

And it's not just education, but it's an invitation to collaborate with you.

I ask and pray, Lord, that as we're here today and just through this weekend, that it will not just be another conference that we attend, that we would walk away refreshed and renewed, but completely different.

Different in outlook, in motives, in desires, and in motive, in yeah, in what, in the way that we approach our practice of dentistry, Lord.

May we see the value of a soul, and may we work while it is day.

Okay, so my objectives were, 1, to understand the power of one's journey to connect with patients at a deeper level.

Secondly, to develop soft skills that go beyond the dental or the tooth diagnosis.

And the third 1, for us, my hope is that we can identify where we stand in the stages of change in order to make changes in our practice and operate in such a way that is winsome.

And what I would like to do is interweave my message with the conference's theme of found in John 9.

I identified 3 different areas in the blind man story found in John 9 that stood out to me that were relevant and I would like to highlight.

The first 1 is where in John 9 where it says that as Jesus passed by, he saw a man that was blind from birth.

And then, secondly, he said, neither this man nor his parents sinned, but that the works of God should be revealed in him.

And then The third 1 is where Jesus says, I must work the works of him who sent me while it is day.

This blind man, if you notice, he was blind with a purpose.

So that the works of God may be revealed in him.

Today you and I would stand more on Christ's shoes, I don't know if you would agree, because we are the ones that are seeking to do the works of God while it is day.

But the question that I have is, has the light dawned in our hearts?

Has God's light been revealed in our hearts?

And this is what I refer to in my title as the restorative work.

When I was asked earlier this year to share about my journey here at Amen with you all, I was rather astonished and daunted.

At first, I was surprised because I really didn't consider that I was doing anything special for the Lord.

I thought I was doing business as usual in my day-to-day practice.

But then I began to wonder, perhaps I'm not the only 1 that feels the same way.

And secondly, I was daunted because speaking in public is something that scares me.

But here I am, after some prayer, I just got this sense of boldness that came over me and I said, okay, God, if you called me to it, then you obviously have something you want me to share.

But I must admit, part of me is like, what are you thinking?

And I think this is what Moses must have felt like when he was asked to go talk before the Pharaoh.

And cute story, as I was going back and forth with God, I thought, well, I have to desensitize myself for the fear, you know, to overcome my fear of public speaking.

What better to do than to ask God for opportunities?

Well, just like when you ask for divine appointments, God will surely answer your prayer to speak in public.

And here I was, the next call I got was a call to stand before or go speak before this intimidating group.

They're scary because they could all of a sudden burst out crying, or they may just stare away and ignore you all together.

Would you guys guess who my audience was?

But this Crater Roll experience was really an object lesson for me.

Because although I have this idea of what I would like my dental practice to look like and to function in order to do ministry, There is a temptation to feel that since I'm not there yet.

I'm currently working in a situation where I'm an associate.

So my thoughts of how I would want to do things may not seem like they are happening at this moment for me.

And at the end of the day, what God challenged me was, I can't wait until the circumstances are favorable in order to start doing something for God.

And I can choose to be faithful in the little things, so that I could be faithful in the big things 1 day.

And this is where Ellen White says in Ministry of Healing, let none pass by the little opportunities to look for larger work.

It is by doing with your mind what you find to do that you will develop aptitude for larger work.

It is by sliding the daily opportunities, by neglecting the little things right at hand that so many become fruitless and withered.

A few months ago, I would consider that I was in a transition phase in my life and in my ministry.

I'd call it a season of brainstorming, of prayer, and honestly, just stressing about it.

But ultimately, what It really was that, although I was in a very, I am in a very amazing situation.

I work with amazing people, an amazing team.

But inside, there was this sense of, am I really fulfilling my purpose through dentistry?

Again, because what I want to consider ideal is I'm not there yet.

So why do I, Why am I so, why was I so discontent?

And it's because to be honest with you in my story, in my journey, I struggled to separate ministry from dentistry because if it wasn't for God leading me to become a dentist, I wouldn't be saved.

Really, it was in my story and journey to dental school that the Lord took a hold of my heart.

And this is a little bit of what I want to share with you today, actually.

So let me give you a brief look into my journey.

I grew up in a Catholic home, and I spent some extra years doing my undergraduate studies due to difficult life circumstances.

It was through my aunt, who was the only relative that I have, that I learned about Loma Linda and through a providential visit to Loma Linda, and a compassionate counsel that I received there, that I ended up moving from Florida to California just to take some classes at La Sierra.

Joseph, and I just wanted to share with you a little bit of that interaction.

He used to have this devotionals on Friday mornings before our dreaded quizzes, and he was always so excited and emphatic about Sabbath coming.

He had a little story where he told us 1 time, you know, Sabbath, I put away all of my worries, all of my concerns, even my children, you know, and he told those stories.

And all of Sabbath, I don't think about any of this.

And then at the end of Sabbath, I take it back, it's been blessed, it's been touched by God, so usually God takes care of all my issues.

Series

Dental

Beyond the Diagnosis: What’s Really Going On?

Transcript

Description

Parent Series

Parent Conference

Sponsor

Recorded

ACM: 4 The Mystery of God

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3. Practical Helps for Igniting Your Prayer Experience

36m

Acts: First Generation Lessons for Last Generation Believers

2. Discipline

1h

He Shall Lift You Up

Abiding

43m

Kickstarter Series '15-'16

First and Second Barcelonians

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Time No Longer Part 2

1h 20m

Spiritual Gifts

40m

GYC 2011 Seminar: The Greatest of All Our Needs

Conditions & Hindrances for Spirit Filling

2h 27m

Plenary

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1h 45m

Plenary

Sent

2h 13m

Acts: First Generation Lessons for Last Generation Believers

7. Guile

57m

Sound Doctrine