Exodontia should be considered a last resort in modern dentistry. Our only priority should be the promotion and prevention in search of the preservation of dental structures as part of the general health of individuals.
It is performed at the primary level of care.
It is the surgical act by which teeth are extracted from their alveoli with the least possible trauma. It is a laborious surgery that requires a very careful technique, so accidents and complications from very simple to very complex frequently occur.
The fear of exodontia, especially of anesthetic techniques, is well known. The patient should be treated with kindness, Carpules should be masked from view, and during the anesthesia should be taken with its protector to the patient’s mouth. Do not use words or phrases that frighten the patient even more.
The word pain should not be used, and if necessary, it should be replaced by discomfort. Special care should be taken with the elderly. In very anxious patients anxiolytic premedication is indicated.
Every patient who needs a dental extraction should have a record of this act in clinical history, since this type of surgery, although it may seem simple, can have implications of a medical-legal nature. In this, it should appear fundamentally, the personal pathological history with an emphasis on allergies and blood diseases or history of bleeding. In order to get a free consultation, click dentists Dothan AL
The evolution should reflect the date if accidents occurred, as well as the medications and anesthetic solution used.
In case of risk factors due to systemic diseases and drug treatments, the appropriate consultation should be made. For more information click here
Requirements to perform an exodontia:
Hygienic and sanitary conditions of the operators and the room.
Instruments and materials necessary to perform an exodontia.
Instruments and materials for the application of conventional infiltrative or truncal anesthesia: bib, cap, mask, sterile surgical gloves, mirror, cotton tweezers, metal carpule, swabs, antiseptic solution, or chlorhexidine gluconate, sterile physiological solution.
Instruments and materials for dental extraction: fine, wide, and medium straight elevators, Winter and Barry type elevators, forceps for all adult dental groups, alveolar curettes.
Instruments for the treatment of any complication or accident during the extraction: turbine, micromotor, contra-angle handpiece and handpiece, sector, Bard-Parker No.3 scalpel, scalpel blades No.3 No. 15 scalpel blades, peristomes, gouge forceps, bone files, surgical scissors, straight and curved, small and medium scissors holders, hemostatic forceps, apical elevators, cylindrical burs for turbine and Lindeman burs, as well as the coarse-grained truncated cone-shaped diamond tip. Hemostatic materials.
A) Patient positioning:
For maxillary teeth: place the dental chair so that the patient’s head is at the level of the operator’s elbow.
For mandibular teeth: place the chair low and with the lower arch parallel to the floor, in case of working standing.
Good illumination of the surgical field with dental equipment lamps is essential.
C) Oral antisepsis:
It can be performed with mouthwashes immediately before anesthesia techniques.
D) Anesthesia technique:
For all maxillary teeth, it can be performed infiltratively.
If there is a history of recent sepsis, the Infraorbital or Tuberosity trinocular techniques should be performed.
For the anterior mandibular teeth up to the premolars, infiltrative anesthesia can be used; in recent sepsis, the Antonian or mandibular alveolar trinocular technique should be used. In molars, the mandibular alveolar nerve or mandibular alveolar nerve trunk, or inferior dental nerve trunk should be chosen.
When trinocular techniques are applied, wait for 3 to 5 minutes.
When infiltrative techniques are applied, wait at least 1 minute.
Perform that is not deteriorated previously to all the teeth to be extracted in all their free faces. It is necessary to facilitate the placement of the forceps and to corroborate the symptoms of anesthesia. The ideal syndesmotic should reach the apex of the tooth.