Growing up and getting to experience the patient side of orthodontics, I always wondered what goes on behind the scenes. How do you know what kind of wire to put in the braces? Or, how are the different Invisalign aligners made and adjusted over time? All these questions played in my mind as I went through a long road of orthodontics visits. At a young age, I started my orthodontics experience - first with a palate expander, then to braces, and now to retainers. I always hated the pain that the braces caused whenever a new wire was put in, but looking back I am grateful to my orthodontist for helping me fix my problem of crooked teeth and an overbite.
This summer, I was given the opportunity to be an intern at Noxon Orthodontics in Wellesley, MA. I was able to meet some incredible people including the two doctors working at the practice, Dr. Noxon and Dr. Bruno. Orthodontics is a dental specialty focused on aligning your bite and straightening your teeth. The doctors and assistants do this by applying braces, Invisalign aligners, Carrieres, and many other special appliances.
Over my five weeks at the clinic I learned that a very important piece of working within an orthodontics practice is making sure everything stays clean and tidy. Sterilization is a key part in making sure the instruments are cleaned and ready to be used on the next patient. I often helped to load the sterilizer with the equipment that was used by previous patients. The instruments removed from dirty trays were cleaned and prepared for sterilization. After sitting in chemical solutions and ultrasonic cleaners for a while, the equipment would then be loaded into a large autoclave sterilizer to get a deep clean.
When a patient comes in they have a procedure code indicating what kind of appointment they are coming in for. The scheduled appointments consisted of adjustments, braces off, retainer check, and much more. There were different trays of instruments that were used for the various types of appointments. One of my jobs was loading these trays and putting them into the corresponding shelf with the appropriate appointment. Aside from loading the trays, I was also tasked with putting away appointment trays. This meant that when a patient was finished with their appointment I would collect the tray and bring it into the back lab where I could sort instruments to be cleaned. On a busy day this was helpful to the assistants and doctors because if they had more than one patient at a time, I was able to turn down the chairs and remove the trays so they could move on to the next patient.
Aside from cleaning tasks, another one of my jobs was to refill and load brace trays. This was a simple job, however, if not done correctly it could mess up what teeth the assistant put the brackets on. These trays consisted of brackets that made up braces, and every tooth had a specific bracket that corresponded with it within the trays. Whenever an assistant would have a “start” appointment they always used the brace trays so it was important that many of them were filled and ready to go at a time. At the end of the “start” appointments most, or all, of the brackets would be gone and it would be my job to refill the trays all over again.
During my time, I got to experience the assistants taking 3D scans of patient’s teeth and bite to appropriately order retainers for them. Patients need retainers after braces or Invisalign aligners are complete to prevent any movement. After working so hard on straightening their teeth, a retainer helps maintain the alignment and protect their investment. The scanner captures the 3D image which was used to print a 3D model of the patient's teeth in order to make a retainer. When fitting the actual piece, assistants can make adjustments on the fly such as trimming or polishing. After the retainers were complete, my job was to wash the retainers, put them in a case, and label the patient's name. After this was completed, I would enter that the retainers were ready into the system. By doing so, doctors and assistants could see the retainers were ready simply by looking at the patient’s chart. I had the opportunity to experience a teeth scan at the practice by one of the assistants. It was so interesting to see my own teeth in 3D format on the screen.
About three weeks into my internship, Dr. Noxon asked me to sit in on one of his and Dr. Bruno’s meetings. Getting to sit down and listen to the doctors was one of the most interesting parts of my internship. In these meetings Dr. Noxon and Dr. Bruno discussed a complicated case where there could be many different treatment plans. Some cases had teeth that needed to be extracted due to crowding while others needed a special appliance. The doctors looked at countless X-rays and teeth scans in these discussions to see how the patient’s teeth looked currently in addition to what teeth could come in later. They conversed about the best treatment plan for the patient as well as factoring in the patient's wants and needs. It was amazing to witness how much work goes on behind the scenes to ensure they are providing the best care for each and every patient.
This experience interning at Noxon Orthodontics has taught me so much, even beyond growing my understanding of the orthodontic field. I learned the importance of communication, attention to detail, and teamwork. I would like to thank Dr. Noxon, Dr. Bruno, and everyone at Noxon Orthodontics for giving me the opportunity to be a part of this team and work in such a supportive environment. It was a pleasure to meet everyone working at Noxon and their positivity, kindness, and willingness to help me learn meant so much to me. Finally, I would like to thank Mr. Schlanker for helping me through this whole experience and making this incredible internship possible.
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