All of the following are true about handling extracted teeth except extracted teeth:
Tooth extraction is done using manual dental instruments, to remove nonviable, nonsalvageable teeth. Adequate anesthesia is important. Postprocedure dry socket is to be prevented. Show
Even when indicated, emergency tooth extraction is typically done by a dentist except when a dental professional is not available (eg, in remote areas or some emergency situations).
Absolute contraindications
Relative contraindications
Minimal basic dental instruments include small periosteal elevator (Molt or Freer), #301 elevator, and universal forceps (#150 – upper, #151 – lower). Equipment to do local anesthesia:
* CAUTION: All topical anesthetic preparations are absorbed from mucosal surfaces, and toxicity may result when dose limits are exceeded. Ointments are easier to control than less-concentrated topical liquids and gels. Excess benzocaine rarely may cause methemoglobinemia. † Maximum dose of local anesthetics: Lidocaine without epinephrine, 5 mg/kg; lidocaine with epinephrine, 7 mg/kg; bupivacaine, 1.5 mg/kg. NOTE: A 1% solution (of any substance) represents 10 mg/mL (1 gm/100 mL). Epinephrine causes vasoconstriction, which prolongs the anesthetic effect; this is useful in well-vascularized tissues such as the oral mucosa. Patients with cardiac disease should receive only limited amounts of epinephrine (maximum 3.5 mL of solution containing 1:100,000 epinephrine); alternatively, use local anesthetic without epinephrine.
Some patients require pretreatment:
Prior to the procedure, do periapical or panographic x-rays to evaluate the tooth in question, surrounding alveolar bone, and nearby structures.
Provide local anesthesia
Extract the tooth
The key steps are to
To release the cuff of gingiva, insert the pointed end of a #9 periosteal elevator between the gingival cuff and the tooth. Keep the point in contact with the root of the tooth and advance the elevator along the long axis toward the root tip; as it is inserted, the elevator gently reflects the gingival cuff away from the tooth. Do this circumferentially all the way around the tooth. Also, on the buccal side only, reflect the small triangular papilla of gingiva between the tooth to be removed and the tooth/teeth directly adjacent. Gain initial tooth mobility using a straight elevator (eg, #301 or #92). Gently insert the elevator perpendicular to the tooth into the space between the tooth to be removed and the adjacent tooth. The elevator should be resting on the crest of the bone between the teeth. The elevator has 2 surfaces; the concave surface is the working side and should face the tooth being removed. One edge of the elevator is held against the alveolar bone between the teeth; this edge is kept in place and used as the fulcrum while the other edge is rotated toward the tooth being removed to mobilize the tooth and expand the socket. DO NOT use the adjacent tooth as a fulcrum. Mobilization with the straight elevator is usually first done anterior to the tooth being removed and then posterior to the tooth. The straight elevator also can be inserted vertically along the long axis of the tooth between the root and the socket, and rotated to further expand the socket. Do not use the alveolar bone on the palatal or lingual side of the tooth as a fulcrum. Use the elevator repeatedly in these ways to continue mobilizing the tooth prior to using the forceps. Use of Dental ElevatorA dental elevator is inserted perpendicularly with the concave surface facing the tooth to be removed. The edge towards the root is held in place as a fulcrum while the other edge is rotated towards the tooth being removed. Further mobilize the tooth and then extract it using a forceps (#150 for upper teeth, #151 for lower teeth). Insert the beaks of the forceps beneath the loosened gingiva, along the root of the tooth and parallel to the long axis. Apply controlled apical (toward the tip of the root) force to slide the beaks along the root into the socket as far toward the apex as possible; this helps to further expand the socket. Then grasp the root firmly with the forceps and apply pressure apically, as though trying to push the tooth further into the socket. Place the thumb and forefinger of the opposite hand on both sides of the socket to support it and to help control forces and prevent unintended large fractures of the socket. Next, while maintaining apical pressure, rock the tooth side-to-side, continuing as needed to mobilize the tooth. In essence, this process is a controlled fracture of the socket. When the tooth is sufficiently mobile, remove it from the socket by gently pulling it straight out; do not begin pulling until the tooth is obviously loose and ready for extraction. Use of Dental ForcepsThe beaks of the dental forceps are inserted along the root of the tooth, parallel to the long axis. Irrigate the socket with sterile saline (chlorhexidine solution may be used if significant infection is present). Curette the socket only if chips of tooth, bone, or foreign debris are present. If the socket has been expanded, compress it using digital pressure to return it to its original shape. Place a tightly rolled gauze pad (2" x 2" or 4" x 4"), dampened with saline, directly over the socket (not on top of the adjacent teeth). Have the patient bite firmly on the pad to apply direct pressure on the socket continuously (without letting up even to speak) for 3 to 4 hours.
Click here for Patient Education Which of the following is true of safety data sheets SDS )? Quizlet?Which of the following is true of Safety Data Sheets (SDS)? The SDS should be organized in binders so that employees can locate a particular SDS. In addition to chemical exposure directly damaging the lungs, the organs that can also be affected are: kidneys, brain, and liver.
Which of the following are included in the hazard communication program?The program must include labels on containers of hazardous chemicals, safety data sheets (SDSs) for hazardous chemicals, and training for workers. Each employer must also describe in a written program how it will meet the requirements of the HCS in each of these areas.
Which of the following is the classification for waste that is infectious and requires special handling?Biological (or special) waste is a waste requiring special handling to protect human health or the environment. A solid waste that if improperly treated or handled, could transmit an infectious disease. Examples include microbiological, animal, human blood and blood products, pathological, sharps.
Which of the following is required under the Hazard Communication Standard?HazCom requires us to have a HazCom Program which includes employee training, access to information about chemical products used in the workplace, access to personal protective equipment (PPE), and a written Hazard Communication Plan.
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