u/kingjuliansrightfoot

I'm a recent graduate working as an associate in a private clinic, and this case has been weighing on me.

No amount of RCTs I did in dental school prepared me for this. The patient had such severe dental anxiety that she would start screaming before I had even removed the chamber roof. My boss advised placing Pulpotec in the pulp chamber and bringing her back a week later. It settled her pain, but when she returned, every attempt to continue treatment had to be stopped because of pain. The pulp was still bleeding profusely.

I tried every supplemental anesthetic technique I could (the only one I couldn't do was intraosseous because I didn't have the equipment), along with an intrapulpal injection. Nothing seemed to work.

Eventually, she asked for the tooth to be extracted, and I had to respect her decision.

I'm honestly heartbroken because she's a young patient and the tooth was otherwise restorable. Her dental anxiety was such a huge barrier, which I completely understand, but I keep wishing she'd been able to give treatment one more chance.

Has anyone else had a case where, despite seemingly adequate anesthesia and multiple supplemental techniques, treatment just wasn't possible? How do you manage these situations, especially in highly anxious patients?

So recently i got asked a question, and i ask you the same, 'would you rather travel through space or ocean?'

My answer to that is ocean, because no matter how scary it is, how vast and with so many creatures in it, there's always a reassurance that you're not alone. And then i started watching deep sea documentaries and that made me even more sure about my answer, even if there's no light in deep sea, there are living beings present even in the deepest darkest depths of earth albeit they're scary and can kill you but my point is,

I wouldn't have known about those animals had i not looked on them and numerous others are still unknown, but they're still inhabitants of earth, they're still living with a purpose with such perfect systems you and i can never even fathom. Every plant, every fish from smallest to largest, from predators to preys all of them live in a harmony, with their roles defined..and we dont even know! Like WHY!! One reason that i could see was, that maybe we're supposed to learn from them, maybe when we forget how to live with a purpose, these systems and all these other non human beings are there to let us know 'look its hard but im doing it, and with style too'. I mean they dont even have thoughts!

Like can you believe a fish in the deeeeeepest part of ocean where its complete abyss, has an inbuilt light system (bioluminescence) to attract preys AND they're also transparent so they can camouflage and not become a prey....and its just chilling down there

Everytime i think thats it, what more can life really offer its everyone doing the same thing one way or another to survive and then im like no maybe im part of a system too, i just have more freedom over choosing a purpose. But i also think overthinkers like me would live better as a pufferfish.