Basic Extraction Skills Flashcards

1
Q

What is the patient positioning for Upper extractions?

A

Head at shoulder/elbow height

Chair at 45 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the operator positioning for Upper Extractions?

A

Stood in FRONT of the patient

  • legs back
  • back straight
  • leaning in towards the pt
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How should the forceps be held?

A

Held from underneath and curve of the handle resting in the palm of hand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When extracting the tooth, what should be done with non-dominating hand?

A

support the alveolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How can you distinguish between LH and RH forceps?

A

The curve of the handle should be on the left for Right Handed operators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which forceps are universal for both LH and RH operators?

A

Forceps for upper anteriors and lower extractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When extracting molars using forceps, where should the beak be facing?

A

Towards the cheek

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

For premolar extractions - how can you tell which forceps to use?

A

They have curved handle but no beak

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Once correct forceps identified and supporting structures what should you do?

A

Ensure correct tooth, blades applied bucco-lingually into gingival crevice, vertically down the long axis of tooth
• ensure fingers are removed from between the handles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What kind of pressure should be applied when extracting?

A

Apical pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What do you do once tooth is extracted?

A

Ensure apices are intact and squeeze the socket to ensure haemostasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the patient positioning for Lower Extractions?

A

head at elbow height, chair at 45 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the operator positioning for Lower Right Extractions?

A

Stood BEHIND the patient

  • legs back
  • back straight
  • leaning in towards the pt
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What movement is used for Lower molars?

A

Figure of 8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What movement is used for Lower Premolar/canine/incisors?

A

Rotational

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What movements are used for Upper Molar extractions?

A

Buccal to midline

17
Q

What movements are used for Upper premolar extractions?

A

Rotational (some buccal movement)

18
Q

What movements are used for Upper incisors/canines?

A

Rotational

19
Q

For Lower Extractions, what should non-dominating hands be doing?

A

Supporting the mandible, ensure thumb is lingual and fingers are buccal and underneath the mandible

20
Q

What are the risks associated with extractions?

A
  • pain
  • swelling
  • bleeding
  • bruising
  • infection
  • dry socket (alveolar osteitis)
  • stiff/painful jaw
  • damage to adjacent teeth
  • tooth fracture
  • time off work
  • generally feeling unwell
21
Q

Who is at greater risk of dry socket?

A
  • Females (taking the contraceptive pill)

* Someone who has had dry socket in the past

22
Q

Which nerve is at risk for extracting Lower 3rd Molars?

A

Inferior Alveolar Nerve and lingual nerve

23
Q

What anatomical structure is at risk when extracting upper 3rd molars?

A

Maxillary antrum

24
Q

What factors are there to consider prior to extraction?

A
  • Access (pt with trismus or little mouth)
  • Mobility of tooth (grade 3 mobile will be easier)
  • Crown of the tooth (is it likely to fracture?)
  • Radiographic picture (number of roots, quality of bone or pathology)
25
Q

What potential relationships to vital structures are there?

A
  • Mental foramen/ mental nerve
  • Maxillary Sinus
  • Inferior dental nerve and lingual nerve
26
Q

What kinds of thing are you looking for with condition of surrounding bone? (on x-ray)

A
  • How dense the bone is
  • radiolucent vs radiopaque
  • apical pathology or furcation involvement that will make XTN easier or tooth more likely to fracture?
27
Q

What kinds of thing are you looking for with configuration of roots on the x-ray?

A
  • number of roots
  • curvature of roots
  • degree of root convergence
  • size and shape of roots (bulbous, conical, long, short, hooked)
  • other: root resorption, caries, RCT, ankyloses, PDL
28
Q

What do you do once the blood clot has formed?

A

Open gauze, roll it into sausage and wet the end. Ask pt to bite on it
• wet it to avoid pulling clot out

29
Q

What are the post-operative instructions for XLA?

A
  • expect pain for first 2-3 days (advise analgesics +/- NSAIDS eg Ibuprofen)
  • severe throbbing pain could be alveolar osteitis
  • bleeding - normal to see blood stained saliva, if occurs bite on gauze for 30mins, if persists get in contact
  • no exercise for 24hrs
  • no smoking or vaping for a week
  • no alcohol for 24hrs
  • no rinsing or mouthwashing
  • warm salt water mouth rinses 24hr post op 3 x daily for 5/7 (1 tablespoon of salt in tumbler)
30
Q

What are the contraindications for NSAIDS?

A
  • not good for asthma
  • COPD
  • pt with GI bleeding
  • pt taking aspirin
  • pt with gastric or duodenal ulcerations
31
Q

Why should you avoid smoking after an XTN?

A

smoking reduces blood supply to the oral cavity which reduces healing

32
Q

What are the steps post extraction?

A
  • compress the socket
  • place wet gauze in the socket (ensure it is visible EO)
  • give post-op instructions (oral and written - include contact details)
  • confirm bleeding has stopped
  • clean around the mouth