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Dental Technican, Volume 2 - Dentist training manual for military dentists | Next
Request for Administration of Anesthesia and for Performance of Operations and Other Procedures |
CHAPTER 5
ORAL SURGERY ASSISTANCE
INTRODUCTION
Oral surgery deals with the surgical treatment or
correction of diseases, defects, or injuries of the oral
cavity, teeth, and adjacent tissues. A sound knowledge
of surgical assisting procedures is essential if you are
to be an effective oral surgery assistant.
ORAL SURGERY FUNCTION
Oral surgery provides surgical treatment or
correction of diseases, defects, or injuries of the oral
cavity and facial structures. A wide variety of surgical
procedures takes place in the oral-maxillofacial
surgery area. Exodontics is the term used to describe
the extraction of teeth in oral surgery. General dentists
are trained in surgical procedures; however, they may
choose to refer the patient with a more complicated
case to an oral surgeon who has specialized training in
the area. A maxillofacial surgeon is an oral surgeon
who specializes in the reduction of bone fractures and
reconstruction of the maxilla or mandible, and
performs reconstructive surgery.
INDICATIONS AND
CONTRAINDICATIONS
Before a surgical procedure can be done, the oral
surgeon will evaluate each patient's record for
indications and contraindications to treatment. Some
indications for oral surgery include:
Carious teeth unrestorable by restorative
procedures.
Nonvital teeth when endodontic treatment is not
indicated or has little chance of success.
Removal of teeth to provide space in the arch for
orthodontic treatment.
Teeth without sufficient bone support.
Supernumerary or impacted teeth interfering
with normal dentition.
Malpositioned teeth that cannot be aligned.
Root fragments from prior extractions or
surgery.
Removal of soft-tissue.
Removal of exostosis (overgrowth of bone),
such as torus mandibularis and torus plantinus.
Accidental fracture or reconstruction of the
mandible or maxilla.
The oral surgeon will also evaluate the patient for
possible contraindications to surgical treatment.
Extractions should be avoided when an active
infection is present because local anesthesia is difficult
to achieve and the infection can spread to other parts of
the body. Patients suffering from any potentially
serious disease, such as heart disease, diabetes, and
blood disorders, should first be evaluated by a
physician to determine if they can withstand the
prescribed treatment. Patients in the early stages of
pregnancy should have the surgery postponed until
they are in the second trimester.
EXAMINATION AND INFORMED
CONSENT
Examination and informed consent are essential to
determine what treatment is required, and provide all
relevant information to the patient to make an
informed decision regarding proposed treatment.
Examination
The oral surgeon examines the patient to confirm
the findings of the referring dentist and gather any
other additional information to make treatment
recommendations. Oral surgeons should order
radiographs of the teeth, mandible, maxilla, or other
facial areas to verify the treatment recommendations if
not already taken. The radiographs may include
periapical, extraoral of the skull or facial aspects,
panoramic, temporomandibular, and occlusal. A
comprehensive medical history review is essential for
the surgical patient because of the strain surgery places
on the body. If there are any questions regarding the
patient's health or ability to withstand surgery, the
surgeon should consult with the patient's physician
before surgery.
During the examination, the oral
surgeon also discusses appropriate pain-control
methods for the surgical treatment recommended, and
informed consent with the patient or legal guardian.
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