Dr. Renna Hazboun is currently a Research Fellow at the West Los Angeles Veterans Affairs medical center working on hospital dentistry and oral surgery related research projects. She has also completed 2 general practice residencies and an oral surgery internship at UCLA. In six years she has been on a total of 9 humanitarian dental and surgical related trips in 3 different countries.
Renna’s favorite quote and why:
“Be the change that you wish to see in the world.” – Ghandi
That has really inspired me to take action on what I see that I want to change. It’s what kind of pushes me through and makes me seek the opportunities that I want to fulfil my dream for.
“Everything in moderation , including moderation.”
That kind of teaches me balance in my life. Working in a hospital can be a very serious environment. So it’s good to have that seriousness, but it’s also good to remember to go to the extremes of fun and relaxing every once in a while.
“Regrets, I’ve had a few. But then again, too few to mention.” – Frank Sinatra, My Way
While things can go bad, once you get past them, it’s always good to keep them in mind. But then again, it’s not always good to keep talking about them. It’s a quote that helps me move past a lot of things.
What she does for the dental profession:
I guess I would generally describe what I do as I feel that I take dentistry into the medical world, and I kind of bring the medical world into dentistry. GPRs (General Practice Residency) are all around the nation, and all of them have their own personality and their own sort of goals during the residency. My first GPR, I consider it a very strong hospital dentistry residency and that was at UCLA. We treated a group of patients in the operating room on a weekly basis. These were generally young patients, but they could be about 15 years old and anywhere to adult ages, 30, 40, even 50 sometimes. And they are usually affected with a very serious condition such as cerebral palsy or severe autism or they are in a situation where they cannot be treated in a dental clinic. So we would have to take them in the operating room and put them to sleep. Those are scheduled on a weekly basis.
We also saw a group of patients in our clinic that were not as severely disabled; also with similar conditions such as mental retardation or cerebral palsy. Some of the older patients had Alzheimer’s or Dementia, but we were able to do a mild sedation in our clinic. And we would do their dental work in a clinic and it will still be a long procedure, take a morning or an afternoon to run the sedation and do the procedures. But it was a chance for us to be able to do a lot of work on, that we won’t be able to do while they are awake or they wouldn’t be able to tolerate.
We also do see patients in a normal, clinical setting. They may have mild forms of disabilities. And we also see a lot of cancer patients; patients who have conditions that require a little bit more expertise as far as what they are able to get as far as dental treatment; patients who have had radiation therapy, patients who have been on Bisphosphonates for a long time. A lot of the head and neck cancer patients have had different parts of their jaw or face removed, so, this provides a dental home for them to come, where they wouldn’t normally be able to be treated on the outside, or find practitioners who are comfortable treating them.
My second hospital dentistry residency, I’d also consider it a strong hospital dentistry residency. It was a little less going into the operating room, but this clinic was situated within the hospital within the VA medical center. So we were able to see patients that were staying in the hospital. We also saw patients in a hospital at UCLA. That was an important component, but the hospital was across the street. And so, we would do extractions bedside at UCLA for patients who are about to receive cardiac or lung transplant, and they needed their mouth clear or free of disease before they underwent transplant.
We also do similar things at the VA medical center in the dental clinic there. It was a different population. We would see a lot of patients with liver disease or we see a lot of patients with liver disease. Older patients, geriatric patients, a lot of psychological disorders, patients that also have difficulty seeking treatment in the community; we treat veterans of wars as the VA.
Then after that, I went back to UCLA and completed an oral surgery internship. This really taught me very intense hospital patient management. I was seeing patients in the emergency room for trauma. I would have to admit the patient. I’d have to manage the patients while they were in house, whether it was major infections and writing orders and dealing with nursing and the hospital staff, making sure everything for that patient was taken care of. And it was our decision when that patient would also leave. So that taught me a lot about really managing a hospital patient. And we went to the operating room a lot. I did a lot of extensive surgical procedures and I enjoy working with residence in that hospital and academic environment.
This past year and a half or so, I’m going to my second year. I’ve been doing oral surgery and hospital dentistry research at the VA. So I plan on completing that. And hopefully staying within a residency and teaching in that aspect. It was during this residency that I’ve been offered to go on multiple opportunities during my second GPR or hospital dentistry residency, I was in the right place at the right time, and I was asked to go to Fiji. And I said, “Absolutely. No one is going to say no to that.” So that was a great experience. And then also during my oral surgery internship at UCLA, I’ve gone down to Mexico multiple times now. So that’s also been a very been different and interesting humanitarian experience.
Her difficult time story:
During my first year, I was so excited to be doing what I was doing in working in a hospital; I thought nothing could get me down. And just one afternoon, just when you least expect it, I was working on a patient and it was just a culmination of events, and I ended up nicking up the floor of her mouth. The situation just surprised me. And I expected to see blood because that area, when you are concerned about injuring it, you’re most concerned about bleeding. I remember looking at I didn’t see blood – I saw clear fluid. We managed the patient appropriately. I had no problems with anything that happened. And these things happen. And we gave her antibiotics, she was fine and she wanted to go.
We monitored her for I think an hour or two after the procedure. She seemed fine. I wasn’t on call that night. I told her I was totally available to her. I remember she left. And then later that evening I had a phone call from the paging service and it was her. And she could barely speak and I guess the floor of her mouth had swollen. And looking back at what happened, it was the salivary gland duct had pretty much become so inflamed that it closed off. And it built an accumulation of saliva in her salivary gland, and creates a swelling on the floor of the mouth and elevates her tongue and creates a not very good situation. It can, if it’s extensive enough, can become life threatening, just because her tongue can cut off her airway.
So I told her to come to the hospital and let me take a look. I kind of asked around what to do and I had an idea how to manage it. She lived far away and she didn’t wanna come to UCLA, so she went to her local area. And I told her, “As soon as you get to the emergency room, have the doctor call me.” She said that she passed of the information and the doctor never called me.
I found out later trying to track her down that she was admitted to the hospital. I must have called that hospital at least 25 times in the course of 2-3 days. And I was not getting a phone call back. The situation elevated and escalated to the point where I couldn’t give my input and my doctors were acting with what information they knew. They decided that she had some major infection and that she was going to need to undergo a tracheostomy. So, they put a breathing tube in her throat, and it just tore me apart that my patient had to undergo this and that she was admitted to the hospital and she had to deal with this. It really affected me. I am so passionate about what I do and about this population that I serve, that this was happening to somebody.
She ended up being fine and she came back to us for service, and everybody was ok. But I was devastated while this was happening. And I wanted to crawl into a little hole and not talk to anybody. And after that time, the director of my program, he’s amazing; he’s one of the best hospital dentists that I’ve ever encountered. I told him, “I don’t wanna come in today,” after I realized what was happening with my patient. And he goes, “I know you don’t wanna come in, but you are going to have to. Even if you don’t do anything, I need you to just come in here and sit.” I said, “I don’t want to.” He goes, “I know you don’t. but you have to. You don’t have a choice right now. I’m not giving you a choice.” I said, “Ok, fine.”
So I went in and I went through the motions and that moment really taught me what it meant when they say, ‘Getting back on the horse after you get kicked off.” I really don’t think I ever really understood what that meant. It took me a couple of weeks of going through the motions and not really being into what I was doing, that I started to get my desire to keep doing dentistry. I mean, I thought I was at a point where I wanted to quit; I didn’t wanna deal with this anymore. It was just too much for me to take on. Him pushing me forward and pushing me through that really taught me that these things happen, but it’s ok and you can get back on that horse and life goes on.
“Everything is okay in the end. If it’s not okay, then it’s not the end.”
What is concerning or exciting Renna right now in dentistry:
I see this shift, (or I hope I’m seeing) this large shift of health care. It’s not just the financial stuff and Obama care and all the stuff that America is dealing with, but there’s a shift of healthcare that’s pushing it into hospitals or a more comprehensive way of treating patients. It’s not just dentistry is over here on the side and then these medical doctors are over here, and then there’s a foot doctor over here, and then there’s a, you know, a different practice over here; it’s more comprehensive approach to treating somebody and people coming together and communication between the different fields, there’s this management of care of patients.; a more complete management of care. And I see it in my work at the hospitals, which excites me.
And I’m actually also seeing that on my mission trips when I go to one trip when I go to Fiji, it wasn’t just a dental trip; we traveled with many other practitioners. We traveled with gynecologist, and physical therapist and psychiatrist and all sort of different people coming together to help treat and address the needs of a population. So I think there’s going to be more communication between medicine and dentistry. And I’m hoping this gap is bridge between and dentist and medicine.
The best advice she has ever received:
I probably recently receive some good advice from the doctor that I work for right now, that I work on doing my research with. He’s a very smart man. And I’ve been going through the idea of applying to a different specialty other than hospital dentistry. But it wasn’t working out. And he told me, “We are all in second place.” And I said, “What?” And he said, “Do you think I want to be here working at the VA for the past 40 years? No. I wanted to be a medical doctor somewhere else. I didn’t even wanna be a dentist, but here I am. You kind of make the best of it. Do you think the director of some program in the middle of the country wanted to be the director? No. He probably wanted to be the head of some national organization and that didn’t work out for him, so this is what he’s doing. We all end up in second place.” It’s kind of like, “Shoot for the moon. And even if you miss, you’ll land among the stars.” You just have to be happy where you are. And sometimes, it’s just what’s meant to be.
The other advice is my mom said to me one time, “Trust is like a glass vase. And if you break that trust, you can put the vase back together; you can glue it, you can use different materials to put it back together. But no matter what you use, that glass never quite looks the same. It’s not really the same as what it started with. So be very careful with that trust.” And I take that with me when I deal with my patients. And I want to build a trust with them. And I value it very much. I also value it very much in my personal life too.
The one habit that contributes to her success:
When I want something, I can be very annoying; I ask a lot of questions to multiple people, and I’ll keep asking those questions. And I always find if you call the right amount of phone numbers or look it up enough times, you’ll find the answer that you are looking for.
Management or marketing pearl (tip):
Don’t be afraid to think abstractly about a patient’s medical history. Don’t be afraid to ask them probing questions. Because as dentist, the mouth is connected to the rest of body and I truly believe it’s our responsibility to know a patient’s medical history. If something goes wrong, we need to know what we’re dealing with.
Internet / App resource that she feels is awesome:
Epocrates – enables clinicians to instantly access valuable drug prescribing and safety information on their mobile devices right at the point of care, including important information about drug dosing, pricing, adverse reactions and black box warnings, as well as a world-class drug-drug interaction checker, Pill ID tool and a range of helpful medical calculators.
Her book recommendation:
“Little and Falace’s Dental Management of the Medically Compromised Patient” by James W. Little DMD Microsoft, Donald Falace DMD, Craig Miller DMD MS, Nelson L. Rhodus DMD MPH
“Oral and Maxillofacial Surgery Secrets” by A. Omar Abubaker DMD PhD, Kenneth J. Benson DDS
Her recommendation for those who are about to start new or restart:
Piece of advice that I give a lot of graduating dental students, is I really encourage them to do a GPR (General Practice Residency) or an AEGD (Advanced Education in General Dentistry). I think it’s a very valuable transition from dental school to the real world. You can learn about yourself and style of practice, or something that you are interested in. You might even find that you wanna pursue a specialty, because you’ve been given this opportunity to work with different specialties.
Dr. Renna Hazboun can be reached at:
- Email: rennahazboun.dmd@gmail.com
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