6 - Extraction complications 2 Flashcards
1
Q
What is the management of a lost tooth?
A
- stop immediately
- ask patient if they felt where tooth fell
- suction tooth if found
- if tooth cannot be located, urgently refer to A&E due to aspiration risk
- reassure patient
- radiograph to locate
2
Q
How do you minimise the risk of soft tissue damage?
A
- always pay attention
- correct placement of correct instrument
- take time positioning instrument at the correct application point
- controlled pressure
- do not use excessive force and support instrument
- be aware of heat from drill
3
Q
Define neurapraxia.
A
Contusion (bruising) of nerve, epineural sheath and axon are maintained
4
Q
Define axonotmesis.
A
Epineural sheath disrupted, axons are maintained
5
Q
Define neurotmesis.
A
Complete loss of nerve continuity, nerve is transected
6
Q
Define anaesthesia.
A
Numbness
7
Q
Define paraesthesia.
A
Tingling
8
Q
Define dysaesthesia.
A
Unpleasant sensation or pain
9
Q
Define hypoaesthesia.
A
Reduced sensation
10
Q
Define hyperaesthesia.
A
Increased sensation
11
Q
What vessels can be damaged during extractions?
A
- veins (bleeding)
- arteries (spurting)
- arterioles (pulsing bleed)
- vessels in muscle or bone
12
Q
What are risk factors for haemorrhage?
A
- local factors (tears or fractures)
- clotting abnormality
- medication
- liver disease
13
Q
How do you manage a soft tissue haemorrhage?
A
- pressure with damp gauze
- sutures
- local anaesthetic
- diathermy
- ligatures if arterial bleed
14
Q
How do you manage a bony haemorrhage?
A
- pressure with damp gauze or blunt instrument
- LA swab or injected in socket
- haemostatic agents
- bone wax
- pack socket
15
Q
How do you manage a TMJ dislocation?
A
- relocate immediately using downwards and backwards pressure
- give advice on analgesia and yawning (ie reduced mouth opening)
- if unable to relocate, inject LA into masseter intra-orally
- if still unable, immediate referral to A&E
