Tooth Extraction

Question 1

Systemic Contraindications for extraction

Answer 1

Severe/Uncontrolled Metabolic Diseases
Uncontrolled Leukemia or Lymphoma
Uncontrolled Cardiovascular Systemic Disorders
Pregnancy: 1st Trimester
Severe Blood Dyscrasia or Disorders
Steroids, Immunosuppressive and Cancer Medications

Question 2

Local Contraindications for extraction

Answer 2

Acute Infection
On-going radiation therapy
Teeth with malignant tumors

Question 3

Essentials in oral surgery

Answer 3

RAFFLES

● Radiographs - Must have diagnostic value
● Anesthesia - suitable agent or profound
● Forceps and Elevators - Specific for the tooth
● Flap Tray - Instruments needed for a flap
● Lighting - Visibility of the surgical site
● Efficient assistant - Efficient surgery
● Suction - Visibility of the surgical site

Question 4

T or F: Grip the root surface firmly and as high as possible

Answer 4

F: As low as possible

Question 5

T or F: Grip the root surface firmly and as low as
possible

Answer 5

T

Question 6

Where should the elevator fulcrum be placed

Answer 6

On bone and not on adjacent tooth

Question 7

T or F: elevators are needed in 3rd degree mobility Cases

Answer 7

F. No need na daw

Question 8

In 1st Class Levers
○ Resistance: ______
○ Effort: _______

Answer 8

○ Resistance: tooth
○ Effort: bone

Question 9

usual position when extracting lower anteriors

Answer 9

12 o clock

Question 10

Patient position for maxillary teeth

Answer 10

tilt the backrest until the patient is about 45° - 60° from the vertical

Question 11

(Patient position) adjust chair height so level of maxilla is about the level of the ___________

Answer 11

Operators elbow

Question 12

Patient position for Mandibular teeth

Answer 12

occlusal plane is parallel to the floor

Question 13

(Patient position) Height of mandibular occlusal plane

Answer 13

should be at the level of mandibular occlusal plane is at or slightly below the dentist’s elbow

Question 14

When doing multiple extractions, start from the
most _____ tooth going ________

Answer 14

Posterior to anterior

Question 15

Rationale for multiple extraction tooth extraction sequence

Answer 15

○ Anterior teeth are easier to extract than posterior teeth, but what happens is that all the blood will flow backwards
○ If you start at the back, your bleeding points are going backwards while you’re going forward. There is better visibility when extracting the anterior teeth afterwards

Question 16

Dentist position when extracting Maxillary anteriors

Answer 16

8 o’clock position

Question 17

Dentist position when extracting at the right side of the patient

Answer 17

Dentist at 7 or 8 o’clock position

Question 18

Dentist position when extracting at the left side of the patient

Answer 18

Dentist at 7 or 8 o’clock position

Question 19

Difference in patient position between left side and right side extractions

Answer 19

Right: Patient’s head looks forward
Left: Patient’s head slightly turned toward dentist

Question 20

Method of extraction sequence

Answer 20

• Anesthesia
• Loosening Tissue attachment from around the tooth
• Luxation of teeth using an Elevator
• Adaptation of forceps to the tooth
• Movement of forceps
• Removal from the socket
• Palpation of the socket
• Debridement of the socket
• Irrigation of the socket
• Compression of scoket
• Pressure back

Question 21

These are the only teeth we can rotate because they have straight and conical roots

Answer 21

• Maxillary centrals (11, 21)
• Mandibular first premolars (44, 34)

Question 22

Post-op diet prescription

Answer 22

Soft and cold food for the first 24 hours
After 24 hours, Diet As Tolerated (DAT)

Question 23

T or F: Brushing the area near the extraction site is vital to avoid infection

Answer 23

F. toothbrush may cause bleeding or disrupt flap

Question 24

Complication that usually can be seen in traumatic procedures or elderly

Answer 24

Ecchymosis

Question 25

complication seen when using standards handpiece rather than surgical handpiece which streams water(not aerosolized)

Answer 25

Air emphysema

Question 26

How to manage edema?

Answer 26

NSAIDs and cold compress

Question 27

Most common post-op problem

Answer 27

Pain