Intro to OS Flashcards
What two techniques can be used to make injection less painful (no topical anesthetic)?
- Hold tissue taught.
- Bevel towards bone.
What are the rules for rinsing the mouth after extraction?
Dont rinse for 24 hours.
What are smokers prone to after an extraction?
More prone to dry socket.
What is advised to a patient if they begin bleeding after leaving the department?
Bite on clean cotton (ex. fabric, paper towel) for 15 mins with pressure. If it does not stop, repeat.
What is HSMW and when is it to be used?
- Hot salty mouthwash.
- Use after 24 hours of XLA to clear the socket of debris.
What are 6 XLA post op problems?
- Pain
- Bleeding
- Bruising
- Swelling
- Infection
- Dry socket
Where do we stand for upper and lower extractions?
- All upper extractions stand INFRONT
- Lower extractions INFRONT except for RIGHT SIDE STAND BEHIND.
How should the patient/ chair be positioned for a lower extraction?
- Patient LOW DOWN (below elbow level).
- Patient slightly reclined.
How should the patient/ chair be positioned for an upper extraction?
- Patient HIGHER UP (elbow height).
- Patient RECLINED FAR BACK.
Is wrong dental extraction a never event?
No longer a never event since 2021 - NO DENTAL RELATED NEVER EVENTS.
Dental term for dry socket?
Alveolar osteitis
Which infiltration should be given last?
Palatal infiltration because as there is not submucosa and thus bevel is easily blunted.
How should a palatal infiltration be done?
Insert needle 10mm away from free gingival margin, bevel pointing towards bone.
What can couplands be used for?
- To facilitate extraction (widen socket).
- To extract (mobilize tooth)
How do the couplands help with extracting?
- Curved surface placed against flat of the tooth and PUSH APICALLY.
- SEVERS THE ALVEOLAR CREST FIBERS AND WIDENS THE LABIAL PLATE –> MAKES SOCKET WIDER THAN TOOOTH AND ALLOWS FORCEP BEAKS TO GO DEEPER.
How can the Couplands be used to extract?
- Place couplands at mesial/ distal between the TOOTH and the ALVEOLAR CREST and push APICALLY then switch position of handle to 90 degrees.
- Turn in a CLOCKWISE direction.
What is the preferred instrument for extracting lower 3rd molars?
Couplands at 90 degrees
When are couplands at 90 degrees not recommended?
when there is a tooth behind as the forces get pushes distally.
What size couplands would you use for lower incisors?
smallest size.
What size couplands eould you use for upper centrals?
medium size?
What size couplands would you use for most teeth (not molars)
medium size.
What size couplands would you use for molars?
Largest size.
What are the functions of the luxator (general).
ONLY used to FACILITATE THE ENLARGEMENT OF THE SOCKET.
How are Luxators used?
- used along VERTICAL AXIS of tooth and PUSH apically.
- DO NOT TWIST (as already curved - no point in twisting) and NEVER USE AT 90 DEGREES.
What is the best instrument for extraction of lingually or palatally impacted premolars?
Warwick james.
What is the best instrument when extracting in tight spaces?
Warwick James.
How are Warwick james used (4 steps).
- Place blade of the cryers interproximally on the SURFACE OF THE TOOTH YOU WANT TO EXTRACT.
- Push apically so the blade engages the tooth you want to remove and the alveolus.
- Push the blade of interproximal with supporting hand and secure the blade of the tooth with your non dominant hand.
- Rotate the blade which pushes the tooth BUCCO-DISTALLY. Can EXTRACT a tooth like this.
How are Cryers used?
- Place blade of the cryers interproximally.
- Push apically so the blade engages the root of the tooth.
- Secure the blade of the tooth with your non dominant hand.
- Rotate the blade which pushes the tooth BUCCO- DISTALLY. Can EXTRACT a tooth like this.
What 2 cases are warwick james useful for?
Impacted premolars
Tight spaces
What instrument is best indicated for extraction of upper third molars?
Cryers.
What instrument is best indicated for retained roots?
Cryer forceps.
How can a distal retained root of a lower 1st molar be removed?
Place cryers mesially into the socket and turn the blade to break inter-radicular septum. This creates a point of application on the distal root and that elevates the distal root.
What are 2 indications for cryers?
- Extraction of upper 3rd molars.
- Retained roots.
What determines if a tooth can be elevated?
- Root morphology. Simple conical roots are easier to elevate.