primary extractions

Question 1

at what angle should a child be positioned?

Answer 1

at 30 degree angle from the vertical

Question 2

what teeth require an operator to stand behind the patient?

Answer 2

the lower right molars

Question 3

where should you stand except for lower right molars?

Answer 3

rhs and infant of patient

Question 4

what is the operator position for all upper teeth?

Answer 4

infront of pt- RHS- straight back- pt mouth at level of the our shoulder

Question 5

what is the operator position for lower left Q?

Answer 5

RHS infront of pt- mouth at elbow level of operator

Question 6

what is the operator position for lower right q?

Answer 6

behind pt- with patient and chair as low as possible

Question 7

what teeth should be extracted first?

Answer 7

symptomatic and lower teeth

Question 8

why should lower teeth be extracted first?

Answer 8

bleeding from uppers will reduce visibility

Question 9

what instrument do you use for extractions?

Answer 9

universal forceps

Question 10

what shape are forceps for upper teeth?

Answer 10

straight

Question 11

what shape are forceps for lower teeth?

Answer 11

right angled beak

Question 12

what elevator may be used for deciduous teeth?

Answer 12

Warwick James elevator

Question 13

why would WJ elevator be used?

Answer 13

to remove root fragments

Question 14

what should the non-working hand be doing during an extraction?

Answer 14

protecting soft tissues and supporting the jaw

Question 15

what is the mechanism to remove teeth?

Answer 15

an apically directed push and then socket expanding movements

Question 16

in what direction should tooth removal be?

Answer 16

in a buccal direction

Question 17

how do you extract a tooth?

Answer 17

open forceps and slide subgingivally against the root-then close forceps and have handle against the palm of the hand for best force

Question 18

how do you remove upper anteriors (single rooted)?

Answer 18

straight upper universal forceps- slide subgingivally and apply apical pressire- twist as far clockwise as poss then anticlockwise

Question 19

how do you remove lower anteriors?

Answer 19

right angle lower universal forceps- slide subgingivally and apply apical pressire- twist as far clockwise as poss then anticlockwise

Question 20

for molars, how do you remove?

Answer 20

for uppers slide straight universal forceps subgingivally, push apically and expand in buccal direction

for lowers slide right angle forceps subgingivally, push apically and expand in buccal direction

Question 21

if molars move only a little with buccal expansion, what should you do?

Answer 21

do full rotations- then remove bucally

Question 22

what is haemostasis?

Answer 22

blood clotting in response to injury

Question 23

how do you achieve haemostasis after extraction?

Answer 23

nip both sides of socket to apple pressure- then use a bite pack

Question 24

what instructions do you give to a child when applying a bite back?

Answer 24

to bite down firmly for 5 mins

Question 25

when can a child leave the surgery following an extraction?

Answer 25

when haemostasis is achieved

Question 26

what do you do if the bite pack does not achieve haemostasis ?

Answer 26

repeat the process for another 5 mins

Question 27

how should POI be given to patients and parents?

Answer 27

verbally and written including phone number

Question 28

what may saliva do after an extraction?

Answer 28

may cause pt to think bleeding is still happening- reassure that a pink tinge is ok

Question 29

what should a to do if socket bleeds at home?

Answer 29

roll up clean hankerchief and bite down firmly for 20 mins

Question 30

if bleeding persists at home, what advice should be given?

Answer 30

call surgery and if out of hours go to a&e

Question 31

what other instructions are important after an extraction?

Answer 31

LA POI

Question 32

what 4 other bits of advice should be given?

Answer 32

• do not rinse for 24 hrs
  -do not exercise for rest of day
  -avoid foodstuffs that can traumatise socket
  -avoid hot and spicy food

Question 33

when should pain relief be started?

Answer 33

before LA wears off

Question 34

what pain relief can be administered for 1-5 yo?

Answer 34

120-250 mg paracetamol every 4-6 hrs

Question 35

what pain relief can be administered for 6-12yo?

Answer 35

250-500mg paracetamol every 4-6 hrs

Question 36

what Ian relief can be given to over 12s?

Answer 36

500mg paracetemol every 4-6 hrs

Question 37

what pain medication is a contraindication in children?

Answer 37

aspirin

Question 38

when should an extraction be reviewed?

Answer 38

after 1 week- to check gum is healing

Question 39

what can deteriorate post-extraction?

Answer 39

oral hygiene in that area- must e reinforced at review

Question 40

what may be required after early loss of deciduous teeth?

Answer 40

space retention orthodontics

Question 41

what is the rule of 10 for LA?

Answer 41

Childs age+tooth number

Question 42

if LA number is over 10, what would you do?

Answer 42

IDB

Question 43

what would you do in place of palatal/lingual injection?

Answer 43

inter papillary infiltration

Question 44

if la number is less than 10, what would you do?

Answer 44

infiltration

Question 45

how do you work out the maximum LA dosage for child?

Answer 45

1/10th cartridge to 1kg body weight