Tooth Extraction ( Set up / Elevators / Dental Forceps ) PT 1

 

Extraction

What is extraction (XLA) of the tooth?

Extraction of the tooth is the removal of the tooth from its socket in the bone.

Before the extraction procedure:

On the appointment before the extraction, you should hand the pre-operative (Pre-Op) instructions to the patient and post-operative instructions. I found an example online, please have a look bellow:

 

  On the day before the extraction appointment, it will be ideal if you can call the patient to remind them that they need to take the prescribe medications (unless advised otherwise from the doctor or the dentist) before the appointment, to eat before the appointment and to inform you for any changes in their medical history.

On the day of the extraction appointment, before the procedure starts make sure that you ask the same questions, and you handed the post-operative instructions again and you make sure that the patient doesn’t have any questions. Check the example that I found online :

 

Procedure:

Set up:

Patient’s PPE (Personal Protective Equipment) : Goggles, bib, bib holder (+ plastic cup with mouthwash).

Dental nurse’s PPE (Personal Protective Equipment): Safety visors, mask, apron, gloves.

On the dentist’s tray: Cotton rolls, examination kit, syringe with the right needle and the right cartridges.

On the dental nurse’s side: Always put a line tray or tissue on the counter. Leave few sterilise gauzes next to you and have a polybag with few sterilise gauzes to give it to the patient in the end of the appointment.

You will need a mixing pad, cotton pellets, xylonor gel, suction tip (fast and slow) and surgical tip (See below)

Sterilise gauzes: https://youtu.be/-QaCX8fLDlA

How to make sterilise gauzes : https://youtu.be/jyrHc26UERY

The dentist will us the xyloconor gel with cotton pellets to numb the gum area and then they will inject the area and they will wait few minutes for the anaesthetic to work. They will test the area with the probe  (sharp instrument) to make sure that the area is numb and if it is then they will start the procedure.

They use the elevators first 

                                                                    Elevators 

They may be used to loosen the tooth prior to forcep extraction, to remove roots or impacted teeth, when they compromised and susceptible to fracture or when they malpositioned and cannot be reached with forceps.

Luxators

And the the forceps 

Forceps

We have upper and lower forceps 😃

                                                             

                                                        Upper Forceps 

• Upper Frontal Interior ( Straight forceps )  - they can be used from the left handed and from the right handed as well.

• Upper Forceps for incisors and canine

• Upper Premolar ( Premolar forceps) -  for right and left side 

• Upper Molar Forceps ( Right side ) - Patient's right side

* The break should always be on the buccal side - cheek side. 

                                                                Break👇

Upper Molar ( Left Side) - Patient's left side

*The break should always be on the buccal side - cheek side 

                                                                           Break 👇

• Upper Wisdom tooth forceps

• Upper Root Forceps

Lower forceps - same for right and left side 👋

• Lower anterior forceps 

Forcep for lower canine and premolars

Forceps for lower premolars 

Forceps for lower molars  

Lower wisdom tooth extraction

Lower root forceps

When they have removed the tooth, you will pass them the cotton pack and they will place it in the wound and they will ask the patient to bite on it.

and that's all! You give to the patient the polybag with for cotton packs inside and the post op instructions

In some cases the patient will need stitches, I'll write a post about it, but just to have an idea have a look in this video : How to stitch gums,dental sutures - YouTube  

*None of the pictures and the videos that I used belong to me, I found them all online 😀