i did my first amalgam filling today!

i drilled out an old one because radiographically there was caries underneath the restoration, but there was also a crack on half of the tooth, so i got to put the last two years of operative dentistry practical work into use and extended my preparation to create a neat little box...it was really neat. it never really occurred to me before what an interesting concept it is....to condense a silver/mercury alloy into a little space in a tooth. but i'm starting to feel a little bit of the....responsibility that goes along with putting foreign material into someone's tooth. i was just thinking about - or hoping and praying, rather - that the one i put in today would last my patient a long time...wondering if any little flecks or corners or cusps came off, whether i condensed enough...whether i checked excursive movements enough...pondering the outcome of my patient biting into real food tonight...i totally feel responsible for the longevity and durability of that filling, 12 hours after the fact. i had to use the entire appointment time, and a great chunk of it was spent putting on the rubber dam. i could see from the radiograph that the floor of the restoration was well away from the pulp, but still, i had to stop many times, just to make sure that i was still in metal filling. after uncovering the amalgam, i was almost afraid to touch the real floor of the tooth, even with a Q-tip, convinced the pulp was ready to jump out at me...hahahahah! i think the first two years in the pre-clinical lab really prepared us well. i actually started to think about retention and clearance and resistance and outline, and it was really a safe crutch to work from, a good foundation and basis, for sure. miraculously, i placed a matrix, and condensed some new amalgam into the preparation. it became evident, right then and there, (that i wished i had carved more premolars in the past) the utility of having waxed up all of those teeth. i almost felt lost, for a second, in a sea of condensed amalgam! suddenly, I heard Dr. O's voice emanating from around the cubicles, and almost like a pavlovian reaction, i had an instant reaction to get Dr. O over to my cubicle to have a look at the quality of my carving! i felt suddenly transported to year 1! i suppose i wanted some reassurance that nothing was going terribly wrong! unfortunately he wasn't on the floor that day, so i started making some occlusal pits and grooves, just like in pre-clinic (and improvising and creatng new "techniques" on the spot) and things fell into line. i think it ended up looking rather pretty, although i had to carve half of it away when i was checking occlusion. anyway, my very first amalgam experience was industrious and positive, and busy, and i think i've lost a little bit of that...nauseating pre-appointment feeling of doom...

a really busy month ahead.