Dental Extractions 2

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Dental Extractions 2
2012-10-15 13:53:14
Clinical Practice ll

Clinical Practice ll
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  1. When is suturing after a dental extraction NOT necessary?  
    • usually not necessary for small teeth - incisors because blood clot fills alveolus, turns to fibrous tissue, and eventually turns to bone
    • gingival tissue may by too fragile to suture
    • area may need to be left open to drain due to an infection
  2. When is it necessary to suture after a dental extraction?
    extractions of larger teeth or several small teeth close together to help it heal faster and prevents alveolar osteitis
  3. What is alveolar osteitis?
    • when blood clot is lost from alveolus, saliva then contacts bone
    • saliva is hyptonic so it increases infections and inflammation
  4. What kind of suture material, size, and needles do we use for dental extractions?
    • absorbable - chromic gut is good
    • 4-0 or 5-0
    • taper needle usually - swaged on
  5. How do we suture after a dental extraction?
    • appose edges of gingiva over extraction site
    • take a biteo on one side
    • pull needle through
    • then take a bite on opposite side and tie off
  6. What kind of suture pattern do we use?
    simple interrupted, cruciate
  7. How many knots do we put in the suture?
    5 - 6 throws
  8. What happens if there is a retained root tip?
    can lead to abscess, infections, sequestra, or inflammation
  9. If there is a retained root tip what do we do?
    • use smaller elevator to extract
    • do not push too hard
    • may force tip through bottom of alveolus
    • may require surgery
  10. When would we have to do surgery for a retained root tip?
    if root tips are retained and cannot be elevated
  11. What kind of dental analgesias can we use?
    • local analgesia
    • regional blocks
    • systemic analgesics
  12. What kind of local analgesia can we use?
    2% lidocaine with epinephrine - no more than 2 mg/kg
  13. What kind of systemic analgesics can we use?
    • opioids (morphine, butorphanol, fentanyl patches)
    • NSAIDs (aspirin, carprofen)
  14. How long should pain relief be provided post-extractions?
    24 - 48 hours
  15. What kind of home care should clients need to know about after extractions?
    • medication directions
    • pet may have blood-tinged saliva for 2 - 3 days following extraction
    • pet should have no difficulty eating normal food
    • pets can swallow small kibbles whole without digestive problems in most pets
  16. Can pets still eat kibbles without any teeth?
    even without teeth, many animals will chew dry food once the gums heal
  17. Should the client change dry food to wet food?  Why or why not?
    • no
    • can cause GI upset
  18. What can you do if the pet refuses his normal dry food?
    add an approximately equal amount of water to the kibbles about 30 minutes before feeding
  19. Animals require general anesthesai and endotracheal intubation for dentistry...what do we expect after extubation?
    minor coughing