ORAL SURGERY Flashcards
what are the risks of XLA?
pain
bleeding
bruising
swelling
infection
dry socket
fractures roots
jaw stiffness
what are the XLA added risks for upper molars/premolars?
OAC
Displacement of roots into the sinus which would require surgical intervention
what are the added risks of XLA to lower molars?
temporary/altered sensation to the lip, side of tongue, cheek, chin
what is the incidence of altered lower lip sensation following XLA?
short term - 5%
long term <1%
what is the incidence of altered tongue sensation following XLA?
short term - 10%
long term - <1%
taste can be affected
explain the XLA procedure to pt
extraction involves removing your tooth from your mouth - you will feel a lot of pressure but no pain as we use LA to make sure you are numb in the area
if we cannot use our normal instruments to grip the tooth, in the case of crown breaking due to decay, we will need to cut into gum, remove some bone, and section the tooth before we can remove
what forceps are used for upper incisors and canines?
upper straight forceps
what forceps are used for upper canines and premolars?
upper universal forceps
what forceps are used for upper left and right molars?
upper left forceps
upper right forceps
what forceps are used for upper narrow single roots or retained roots?
upper root forceps
what forceps are used for upper third molars?
upper bayonet third molar forceps
what forceps are used for lower anterior and premolars?
lower universal forceps
what forceps are used for lower left and right molars?
lower molar forceps
what forceps are used for lower retained roots or narrow single roots?
lower root forceps
what forceps are good at engaging the furcation in lower molars?
cowhorns
what instruments are used to elevate most teeth?
couplands
what elevators can be used to elevate retained roots, upper third molars?
cryers
when would you use warwick james elevators?
elevate third molars
what does the luxator do?
breaks PDL fibres
what general advice is given post op XLA?
- have a restful day - no strenuous activity or heavy lifting
- you are still numb - this lasts 3-4 hours. be careful not to bite lip, cheek, or tongue
- mouth opening will be restricted - this may last 1 week. you should be able to eat semi-solid food but use your own discretion
what post op xla advice is given regarding blood clot preservation?
- avoid touching the area but brush the rest of your teeth as normal
- do not rinse your mouth for the rest of the day
- do not smoke or drink alcohol for 24 hours and minimise it for 1 week
- soft diet for the rest of the day
what post op xla advice would you give regarding infection prevention?
starting tomorrow, rinse gently with warm salt water solution as much as possible but at least after eating
what post op xla advice is given regarding bleeding?
- blood stained saliva is normal for the next 48 hours
- if the socket starts bleeding - sit upright and apply pressure with a clean tea towel for 30 minutes. if it continues, re-apply pressure for another 30 minutes. if it continues after this, contact oral surgery dep or out of hours during evenings or weekends
what post op xla advice is given regarding pain?
- you may experience pain but will gradually improve over 7-10 days. if you need to, take over the counter painkillers that are safe for you.
- if there is a sudden increase in pain after a few days, this may indicate infection, get in contact with dentist or dental school
what post op xla advice is given regarding swelling?
swelling is common after surgery to the jaw - it will reach its max 2-3 days but should resolve from 7-10 days. you can use hot and cold compress to help this
what xla post op advice is given regarding bruising?
bruising of the face occasionally occurs but should resolve within 2 weeks
what xla post op advice is given regarding surgical extractions?
stitches dissolve and drop out after 7-10 days
