LA + Extractions Flashcards
what is 10 rule for IDB in children?
Age + Tooth number = over 10 IDB
8 + UR6 = ?
14 = IDB
5 + LL4 = ?
9 = LIA
how much of a cartilage per kilo for LA?
10th
How should a child be seated when extracting teeth?
30 degrees to the vertical
Where should the operator be positioned when extracting upper teeth?
In front of patient
Patients mouth level with operator shoulder
Where should operator be positioned when extracting lower left teeth?
Operator in front of patient
Patients mouth level with operator shoulder
Where should the operator be positioned when extracting lower right teeth?
Operator behind patient
Chair as low as possible
What order should teeth be extracted?
Symptomatic teeth first then lower teeth to avoid vision being compromised by blood
What type of forceps are used for upper teeth extraction?
Straight handled
What type of forceps are used for lower teeth?
Right angle beak
What is generally most used to remove primary teeth?
Universal forceps
Which type of forceps can be useful for removing tooth root fragments?
Warwick James elevator
What is the main aim when removing primary teeth?
Protecting the permanent tooth
How are teeth removed (NOT PULL)
Apical directed push and then socket expanding movements
What needs to be supported at all times when removing teeth?
The alveolus
What direction should teeth be removed?
Buccal direction
Routine of removing teeth?
- Identify tooth to be extracted
- Open forceps to slide over crown of tooth
- Slide forceps subgnigivaly against root surface, close and move fingers outside forceps
How to remove upper incisors?
- Use upper straight forceps
- Apply apical pressure
- Rotate tooth clockwise as for as possible then counter clockwise
How to remove mandibular anteriors?
- Use lower universal forceps
- Apply apical pressure
- Rotate clockwise as far as possible then counter clockwise
What is required for multi rooted teeth?
More socket expansion
What should you do immediately after extraction?
Both sides of socket are nipped by fingers as a method of applying pressure to the area
How to achieve haemostasis?
- Place a bite pack into the socket and tell the child to bite firmly for 5 minutes
- Remove pack and examine socket
- Haemostasis must be achieved before child leaves surgery
POI for extractions?
- Must be given verbal and written
- Saliva will cause socket to turn pink - reassure this is normal
- If bleeding re occurs at home - roll up a clean cotton handkerchief and bite for 20 minutes
- If bleeding persists contact A+E
- Good OH
- After LA do not bite chew or suck the lip or tongue
- Avoid injury to socket through food
- Avoid hot drinks
- Do not rinse or spit for the rest of day
- Avoid exercise for 24hrs
