scared of performing extraction

[neha]

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Hi,

 

[cusp of carabelli]

Hi,
Wanted to know if anyone here is scared of performing extraction.I had a lot of friends back in school who were.Is it the same in dental schools here too?

at first i was terrified...but after you get used to it and realize that the patient is under anesthesia and shouldn't feel much pain, then I felt less timid about using more force and now, extractions come pretty easily. so far i've gotten about 30 extractions in about 3 months worth of clinic time and yeah...it's getting better every time. 🙂

 

[Pi__Guy1]

at first i was terrified...but after you get used to it and realize that the patient is under anesthesia and shouldn't feel much pain, then I felt less timid about using more force and now, extractions come pretty easily. so far i've gotten about 30 extractions in about 3 months worth of clinic time and yeah...it's getting better every time. 🙂

I'm definitely not looking forward to my oral surgery rotation next week. I dunno why my school does it this way but we go from 8am - 8pm 5 days straight.

 

[tinker bell]

Isn't extraction bread & butter to dentists? If you're scared of it, why should you be in this profession in the first place? As you know you will have to do loads of those unpleasant things. You might say that you don't like it, but scared of it?
Hey, once that tooth is out, it's history. It's that easy....

 

[cusp of carabelli]

Isn't extraction bread & butter to dentists? If you're scared of it, why should you be in this profession in the first place? As you know you will have to do loads of those unpleasant things. You might say that you don't like it, but scared of it?
Hey, once that tooth is out, it's history. It's that easy....

it's not always so cut and dry tinker...there's always the risk of possibly damaging a nerve, creating an oroantral fistula, cracking off a tiny bit of the root tip and leaving it there accidentally...or even worse, pushing the root tip into the sinus or into a facial plane while trying to get it out...etc. etc. etc. (sorry pi_guy1..don't mean to scare ya...=oP) true...you can't have any fear when you do the extractions but i think that takes some time to develop for most people. don't forget that some/most patients are screaming their heads off (even if you aren't even close to touching the patient and doing anything and the patient is well anesthasized)at some point in time during the procedure, blood is rushing everywhere, and sometimes the patient will even start reaching for your hand to pull it away. so the natural tendancy is to use less force or back away. I think fear is natural...just have to get over it by being prepared to handle all the different worse case scenerios and just getting experience...it used to take 2 hrs. just to take out 1 molar...last week i extracted 5 molars in 1 hr....like with all things it takes practice, confidence, and faith in knowing what you're doing.

 

[badabooom]

i just had my #32 and #17 extracted over the summer.
general dentist so awesome,
1st visit #17 soft tissue impaction only, anesthesia was 1 carpule mepivacaine with 1:100K epi, 1 elevator and 1 forcep, done in 5 minutes.
2nd visit #32, a little mesial inclined aginst #31 with partial bony imaction ~1mm on distal cusp, same thing, 1 carpule for anesthesia, 1 elevator, a forcep and blade to do a little flap, in and out in 10 minutes.
SO COOL

but of course, he has been in practice for 20+ years.

so what i am saying is... skillz come from experience. You have to start somewhere, and usually while you're still in school. besides, if anything happens, there's always faculty there to back you up.

 

[badabooom]

and i forgot to mention, NO suction or saliva ejector was used during the two extractions.
just gauze! and i'm not talking about like a load of gauze stuffed into my mouth, i'm saying like 1 or 2 pieces!

interesting thing i noticed, these two teeth are bigger than my #19 and #30, i saved them and really look like 1st molars, gonna do endo on these muwahahah.

 

[JesseBrad3]

I watched the dentist I work for recently do an extraction and was amazed at how easy and bloodless it was. He said the key was to finesse the tooth out of there, not by force. He went around with the elevator gently prying on all sides of the tooth and loosening up its hold before he could very easily just pull it out.

 

[Supernumerary]

My school teaches us to use to use varying thicknesses and strengths of string between the tooth and the door knob. Usually three or four good slams of the steel framed operatory doors is all it takes.

 

[texas_dds]

i was scared before i ever did any too
but its not so bad - and you gotta have an assistant to hold down unruly arms, etc. ive not really run into that other than in pedo.
i actually like exos now - my last 46 cases have come out in one piece - its all about making wiggle room. there is nothing worse to me than fractures - just the sound even frightens me. fingers crossed for none until i get to a totally unrelated residency

 

[JawBreakerGTP]

The term "Grip it and Rip it" comes to mind 🙂

 

[cusp of carabelli]

Is it any different forgirls?I know each tooth has a specific technique but initially you never know all that and all we rely on is force .I am a girl and sometimes I find it really difficult especially the molars.

i have a classmate that is 5'0" and like 105 lbs...and she can pull teeth with the best of them. I think if you have good technique is more important than strength in the majority of extractions. in fact using too much force is a main problem in causing fractured roots, etc. just make sure you get good seperation of the tissues, have a clear view, and are using the proper instruments for the task and teeth will be poppin out like pop corn in a movie theatre... 😀

 

[DrRob]

Isn't extraction bread & butter to dentists? If you're scared of it, why should you be in this profession in the first place? As you know you will have to do loads of those unpleasant things. You might say that you don't like it, but scared of it?
Hey, once that tooth is out, it's history. It's that easy....

This is the most innaccurate statement I have ever heard. Now days with Fluoridation / and improved dental- necessary dental extractions (unless for ortho) are becoming less common. There is more money to be made saving teeth. In fact many General Dentists refer out all extractions and still do well. It all depends on what type of practice you want.

 

[River13]

This is the most innaccurate statement I have ever heard. Now days with Fluoridation / and improved dental- necessary dental extractions (unless for ortho) are becoming less common. There is more money to be made saving teeth. In fact many General Dentists refer out all extractions and still do well. It all depends on what type of practice you want.

Ahhhhh. Well said Dr. Rob.

 

[Dino_D]

Hi,
Wanted to know if anyone here is scared of performing extraction.I had a lot of friends back in school who were.Is it the same in dental schools here too?

"Just Do It" as they say. You first few will always be scary, but after you have done a lot (meaning 100+) you will know your comfort zone. It's better to make your mistakes while you're in school. If you don't try now then you will never know what your limits are. Just make sure you have someone more competent at extractions by your side and learn from them. You will actually find that the tougher an extraction is, the more you will learn from it. Anyone can extract a tooth that is "waving in the wind".

I work at a couple of different practices that are at totally different ends of the spectrum. One clinic has patients that are very well educated and have very few problems while at another clinic most of the patients are underserved and are in need of services such as extractions as opposed to root canals. Dr. Rob is right though, most GP's will refer out extractions since they are either too complicated or not worth the time.