Came across quote while reading media critic Jay Rosen the other day: "When in doubt, draw a distinction."
One was Expertise vs Experience, Captain Parani author of the book Golden Strips has a chapter on this. From the book expertise is gained from:
As an example most of us have a lot of experience using screwdrivers yet many of us lack expertise.
Another example: the medication for toothaches known as Cavit.
Cavit comes as a pre-mixed paste, or a powder you mix with clove oil. Purpose: to temporarily fill a cavity until a dentist can be seen. Problem: mostly, it’s worthless. It requires expertise to insert the pellet of goo into the cavity successfully. Which requires experience. Most captains I’ve spoken with say their initial experiences with cavit have been fails, so they never gain the expertise.
It’s not enough to know what the medication is meant for, or theoretically know how to use it. You have to actually have practice going into the spit-swilled mouth of a frightened man with a pointy object to gain the expertise to use it. I may be wrong, but most medical training classes don’t teach cavit application. Experience and expertise are not gained.
If there are captains out there with success stories. I’d like to hear them.
Yep. That’s it. I’m sure here are skippers with some expertise in using it. I don’t know any. My go-to for a bad toothache: single-dose Toradol to get the swelling down, followed by max ibuprofen, and oral antibiotics, until they can see the dentist, which on our run is 3-7 days max.
I wasn’t the captain at the time but second mate. Back then I had a master unlimited as did almost every other second mate in the company and the second mate was the medic.
On a nonstop voyage from New Zealand to Europe via Cape Horn I used a kit given to me by a friend who was a dentist to successfully fill a cavity caused by the loss of the original filling. The officers wife experienced no further discomfort over the next 10 days until we reached Bremerhaven.
Glad to hear someone is using it.
Considering all the unlikely stuff they train you for in medical classes, it seems to me training how to deal with toothaches should be at the top of the list. Every year we train how to give IVs. Never once have we had to give an IV in 35 years at this company, But we deal with toothaches a couple of times a year at least.
Instead of the simulated arms with veins we train to give IVs on, we should have simulated heads with teeth to pack cavit into. 
The last medical course I took had no dentistry whatsoever but did have a fascinating video on how to pack this new powder into a massive groin injury on a sedated pig.
It was probably to do with transporting cocaine in dead pigs for all I got out of it but hey, ho; another bit of paper for another 5 years.
That would be a coagulant impregnated gauze or powder. I have specific training in it and actually keep some in a trauma bag in my car along with a CAT tourniquet and some gauze and cling wrap. All packaged in a small Molle bag
Yeah, that was it, coagulant powder.
The only thing that was missing was the honey drizzle and then slap it on the barbie.
There is such a thing as too much information that is not necessary for the role.
I did find an old Yorkie in my car the other day; decided that I must have left it there for an emergency. No emergency so left it there.
When you do have to get an IV started the stakes are somewhat higher than a toothache.
I agree with your toothache prescription along with aggressive hydration, but the toothache kit is more of a morale booster. I’m never actually trying to insert it into the cavity properly, more putting on a show and getting some clove oil on there which helps. My at sea medical care experience has shown me the value of appearing competent and confident, as opposed to ‘Oh, gross. I have no idea what to do with that’. The placebo effect on a scared crewman in terrible pain is remarkable.
I would love to see the emphasis on CPR/AED training be shifted to tourniquet/Stop The Bleed type stuff. But, I’d also like to see the emphasis on navigation in the license exams shifted to stability so I’m not holding my breath.
Tried the filling paste. Failed. Then used beeswax from a Gumby suit. Replaced as needed. It kept the air/debris out and the pain down.
Please tell me you’re an Alaskan fisherman. I love the creative no-bullshit solution to a problem. 
When I had to IV a crew member it was mid Pacific and I was appreciative of the excellent guidance from the Royal Australian Flying Doctor service. What I wasn’t prepared for was the difficulty in administering the IV due to the ship’s vibration at full speed and the antiquated IV kit that I had to use.