Exodontia Flashcards
Which 5 clinical evaluations should be considered when extracting teeth?
- presence of infection
- restricted mouth opening
- extent of caries
- tooth mobility
- tooth alignment in the arch
What does presence of infection grade 1 indicate?
no infection present
What does presence of infection grade 2 indicate?
infection confined to alveolar ridge, palate
What does presence of infection grade 3 indicate?
moderate soft tissue swelling in low risk area
What does presence of infection grade 4 indicate?
space infection unilaterally
What does presence of infection grade 5 indicate?
infection spread to bilateral fascial spaces of neck
What does assessment 1 of mouth opening indicate?
normal mouth opening
What does assessment 2 of mouth opening indicate?
TMJ issues
What does assessment 3 of mouth opening indicate?
mouth opening is restricted but adequate for forceps placement
What does assessment 4 of mouth opening indicate?
mouth opening inadequate for forceps placement
When assessing extent of caries, what does grade 1 indicate?
no caries
When assessing extent of caries, what does grade 2 indicate?
decay present but does not influence crown strength
When assessing extent of caries, what does grade 3 indicate?
decay involving most of the crown but root intact
When assessing extent of caries, what does grade 4 indicate?
tooth decayed below the alveolar bone level
When assessing tooth alignment in arch, what does grade 1 indicate?
one or both adjacent teeth missing
When assessing tooth alignment, what does grade 2 indicate?
tooth in normal arch
When assessing tooth alignment, what does grade 3 indicate?
tooth malposed but can be grasped by forceps
When assessing tooth alignment, what does grade 4 indicate?
tooth in linguoversion
What does grade 2 relationship to sinus indicate?
low risk - roots below surface floor
What does grade 3 relationship to sinus indicate?
medium risk - sinus extends into furcation but bone visible around roots
What does grade 4 relationship to sinus indicate?
high risk - sinus surrounds apices of root
What are 7 indications for an extraction?
- pulpal pathology
- perio
- orthodontics
- trauma
- impaction
- pathology (cysts, tumours)
Which type of NHS consent form is the following?
- patient agreement to investigation or treatment
form 1
Which type of NHS consent form is the following?
- parental agreement to investigation or treatment for a child or young person
form 2
Which type of NHS consent form is the following?
- patient/parental agreement to investigation or treatment (procedures where consciousness is impaired)
form 3
Which type of NHS consent form is the following?
- healthcare professionals for adults who are unable to consent to investigation or treatment
form 4
To give informed consent, a patient must be what 3 things?
- over 16 years of age
- mentally competent to understand and judge the implications of the decision
- allowed to make the decision, without pressure of time and away from the environment in which treatment will be performed
What are the 4 steps of an extraction?
- application
- dilation
- disengagement
- restoration
What are 3 uses of elevators?
- to luxate tooth
- to remove fractured or carious tooth
- to remove fractured root
What is a medical consideration for patients with controlled hypertension?
postural hypotension
When treating a patient with a cardio medical condition, what 4 considerations should be made regarding dental treatment?
- treat late morning or early afternoon (endogenous adrenaline levels are lower)
- short apps
- no treatment within 6 months of MI
- limit LA to 2-3 cartridges using aspiration (LA not contraindicated)
Which 2 medications should be avoided in a patient with asthma?
- aspirin
- NSAIDs
What is the therapeutic range for an INR?
2-3
When treating a patient with a haemostasis condition, what 3 considerations should be made regarding dental treatment?
- use local measures routinely
- avoid NSAIDs
- INR should be checked day of or day before surgery
Which 3 antibiotics should be avoided in patients with liver disease due to hepatotoxicity?
- erythromycin
- tetracycline
- metronidazole
Which drugs should be avoided in patient with liver disease due to increased risk of haemorrhage?
NSAIDs
Which 2 drugs should be avoided in patients with renal disease due to nephrotoxicity?
- aspirin
- NSAIDs
When treating a patient with diabetes, what 2 considerations should be made regarding dental treatment?
- apps should be early in the day to avoid interfering with mealtimes
- glucose levels should be checked prior to surgery (safe range 5-15 mmol/L)
Which drugs have the risk of medication related osteonecrosis of the jaw?
bisphosphonates
What is the definition of medication related osteonecrosis of the jaw?
- exposed necrotic bone
- persistent >8 weeks
- history of taking putative drugs
- no history of radiation therapy
What are 7 symptoms of medication related osteonecrosis of the jaw?
- delayed healing following extraction or surgery
- pain
- infection
- swelling
- exposed bone
- paraesthesia
- numbness
Which disease increases the risk of necrosis of the jaw?
pagets disease
What are 3 examples of bisphosphonates commonly used?
- alendronic acid
- zoledronic acid
- risedronate sodium
The symptoms of which complication following XLA is the following?
- blood clot fails to form or is dislodged
- symptoms 1-3 days post op
- very painful
- oral malodour
dry socket (alveolar osteitis)
What are 3 potential reasons for an inability to move the tooth during XLA?
- bulbous or diverging roots
- very long roots
- ankylosis or sclerotic bone
What is a rare complication when extracting primary teeth?
removal of a permanent tooth germ
–> extraction of a deciduous molar with apical infection which causes the permanent premolar tooth germ to become attached by fibrous tissue to the periodontal membrane of the overlying tooth
What are 3 potential causes of excessive bleeding post XLA?
- tissue damage
- hemorrhagic disease
- infection
Adequate haemostasis is dependent upon which 3 factors?
- vessel wall integrity
- adequate numbers of platelets
- adequate levels of clotting factors
What are 4 potential causes of post operative pain following XLA?
- root stump
- sequestrum
- trismus
- hematoma
What are 4 potential reasons for delayed healing of XLA wounds?
- infection
- prolonged bleeding
- radiotherapy
- immunodeficiency
What is the percentage of incidence of dry socket?
3% of all extractions
What are 4 potential symptoms of a oroantral communication?
- salty taste
- change in smell
- air into mouth when blowing nose
- reflux fluids, even food
What is the post op advice given for oroantral communication?
- no nose blowing
- antibiotics
- nasal decongestants
- no smoking
What are the 3 components of an antral regime?
- nasal decongestants
- mucolytic agents
- antibiotic therapy
