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“The Junior Year” by J. Milton Small, 1964

The May 1964 issue of the Washington University Dental Journal was devoted to “A Future in Dentistry.”  Its purpose was to give the school’s alumni information that they could pass on to any patients who might be interested in dentistry as a career.  A series of articles, each written by a member of the four classes, explained “Life in Dental School.”  This article about Junior Year was written by J. Milton Small, who graduated in the Class of 1965.

J. Milton Small ’65

How often have you heard someone say, “I wish I had gone on to school, or I wish I were an attorney or a dentist, but now it is too late”?  There are not many who do or dare to change their field of endeavor, and life passes them by while they wish.  It is not too late, but rather it is a matter of where one sets his goal and the value placed on it.  Granted, when one has been happy and successful in an occupation, has a wife and family to care for, it is not an easy decision to uproot, change the scheme of things and gamble with a desire that has plagued him all of his life.  Yet, some men must do what they have to do, and I am one of those who dared!

I was born in the Big Sky Country of Montana, a descendant of one of the original settlers of that vast and beautiful land where my family made their living farming and ranching.  I too, followed in their footsteps and found many aspects of this way of life dear to my heart, but always within me I carried the desire to become a dentist.  World War II enhanced this desire when I served my country as a Pharmacist’s Mate in the Navy.

Now at forty years of age, I am humbly proud to be a member of the junior class at Washington University School of Dentistry.

The junior year is filled with excitement and challenge.  Thus far, the student has gone to school for what at times seems an eternity, studying the basic sciences and principles of dentistry.  It is now his privilege to begin to integrate these teachings and principles and apply his knowledge in a clinical situation.

With these privileges come added responsibilities.  The student must gain self-confidence and earn the respect and confidence of the instructors.  The clinical routine must be mastered in its entirety.  It is the responsibility of the student to apportion and manage his time, including the scheduling of his patients, so that the requirements of each department are fulfilled.  His personal contact with the patient should be one that creates confidence and develops a harmonious relationship.

The development of a pleasing chairside manner is important and encompasses many factors.  The patient is a fellow human being and is seeking advice and service.  One must listen to his problems and not become preoccupied with the mechanics of dentistry.  It is also important to converse with the patient on his level.  For example, “The bacterial invasion through an enamel fissure has resulted in an incipient carious lesion,” will have little, if any, meaning to most patients.

The diagnosis and treatment of the patient is the student’s responsibility.  Each procedure in all departments is carefully supervised by the instructors.  Thus, being a teaching institution, each procedure contemplated must be approved as well as a step-by-step follow-up.  This close supervision serves several purposes: it creates a more relaxed atmosphere of trust and confidence; the student-patient-instructor relationship is enhanced; assistance is readily available as the needs arise during dental procedures.

Though dental procedures are exacting, they cannot be considered routine.  Each patient must be considered separately.  No two patients, no two restorations are alike.  The needs of each patient must be evaluated with this in mind.  The practice of dentistry does not, therefore, become monotonous.  Each patient, each procedure presents a new and interesting challenge.

The junior year is largely clinical.  However, two hours each day are devoted to additional lectures and theory.  Many of the courses are a continuation from the sophomore year, with emphasis placed on the practical application.  Also, a lecture and technique course in orthodontics is introduced this year.  Here the student is taught some of the basic fundamentals and principles of this important specialty of dentistry.  The laboratory course is designed to teach the student the simple essentials and construction of treatment appliances.

The diagnostic clinic, radiography and oral surgery are three departments in which each junior student spends several days a month.  Each patient that enters the School for dental care is first seen in the diagnosis department by a student on duty.  There a tentative diagnosis is made, and the patient is either assigned to a student for further evaluation and treatment or given emergency treatment as needed.

In the department of radiography the student gains practical experience.  He learns the radiographic technique, processing of the film, interpretation and diagnosis.

In the department of oral surgery the junior student assists during operative procedures.  He removes sutures, gives medications and treatments.  Correlated with the practical experience is a lecture course on surgical procedures.  Upon completion of this course, the junior student begins to do some of the more simple extractions.

Although learning to become a dentist is hard work, there are many rewards along the way.  Perhaps one that will be long remembered is the joy of delivering the first set of dentures.  To see a product of your creation completely transform the countenance and personality of a patient is a satisfaction to behold.

It is rewarding to examine a patient, diagnose the oral condition and produce a plan of treatment.  To carry this plan to its completion, restoring function and oral health, is an added pleasure.

Another pleasure I have enjoyed is that of the uninhibited reactions of a delighted child.  The dental procedure, which may have caused some momentary discomfort, is quickly forgotten upon seeing the shiny new restoration.  In child-like manner, he eagerly exhibits his open mouth to all who will look.

A great man once said, “There are no such things as problems, only opportunities.”  That being the case, the junior year is filled with opportunities, challenges and rewards.


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