Great planning is always key. I do this not only with complex extractions, but all complex restorative procedures as well. I envision the entire procedure from beginning to end, and I "solve" all complications in my mind before even stepping into the operatory.
Wow that’s interesting! Actually i don’t know which is a simple extraction and which is a difficult one. How can you know only by watching the tooth and the rx? Also how do you envision all of it and solve the complications? Im having a hard time with extractions… all i do is break the tooth and it remains inside the alveolar bone
@@irismengri9473 hi...how many years have you been practicing? You will eventually learn which is "simple" , and which is complicated; you won't always be right, but you will be prepared. Another way to look at it is to assume all will be complicated; then when you get the tooth out easily, its a pleasant surprise. I'm not sure how to describe the process of "envisioning it" ....i just play it out in my head like I'm watching a movie. I used to break teeth too, and part of that was trying to force the tooth out, when I really knew it needed to be sectioned; this was likely due to being too timid about using the handpiece and going surgical. Once you lose that fear, things will go along very smoothly. If you have any other specific questions, I will be glad to answer as best as I can.
The way you teach is so warm and nice,very thorough,yes i remember all those times when heart starts pumping faster and i start to sweat alot.I still do but not as much as before.Thank you
Dentists have not been trained in dental schools to extract teeth to give the patient the best outcome. Non-vasoconstrictors anesthetics should be used. All extractions should involve a SLOW speed surgical bone bur used to remove diseased bone and all the periodontal ligament so the socket will heal from the bottom up (as opposed to bone healing over and trapping the waste from anerobic bacteria and creating cavitations in the jaw). Constant Irrigation of saline is used. Dry socket is rarely an issue with this method. Most biological dentists do this. The Huggins Applied Healing Center in Colorado can give you the latest updated protocol. Thank you for this video.
I have been a dentist for 25 years with extensive experience in oral surgery. There are times when access is so difficult especially in upper 7s that it still takes me more than an hour to remove roots in resilient bone. Elevation can take a long time in long hooked root treated brittle roots osseous level especially on the left side of the mouth. Any tips?
My go-to is always the 700 surgical length carbide. It's terrific for troughing roots and it pairs really well with a 3mm luxator. In addition to that of course, would be patient positioning, a headlight w/magnification 3.5x or more and constant suction so you can see what you're doing. After 25 years, I'm sure you know most of the tricks, but the equipment I mentioned was truly a game-changer for me in these situations. Thanks for watching - All the best!
Relatively new grad here (1.5 years out). In this case after the crown snapped off, would you create a flap to better facilitate root removal, especially for endo treated teeth?
You are never wrong to create a flap. Just remember this...access, light, & visibility. If you optimize these three things, you'll make your extractions (or any dental procedure 100x easier). With that in mind, if for some reason the tissue is making you light, access, or visibility less than optimal, don't hesitate to move it with a flap. Personally, I rarely do flaps anymore and if I do, it's generally a small envelop flap that requires no sutures after. All the best!
@@OnlineExodontia same here. When I started out, I was flapping nearly every surgical extraction but now I rarely ever do a flap, unless of course its an impacted third
If my dentist even Sees anything weird ..... Right to the oral surgeon. Get knocked out, dig it out and then suture it all back together so it heals nice instead of walking around with a divot in your mouth for a year or more. Worth every penny !
It depends on several factors, but essentially to sum it up, if the root is healthy, not loose, and just a small fragment, it often will not cause any troubles if left behind. All the best!
One surgeon had a line of people when I went in, he did everything without planning. he was having trouble getting my tooth out because how it was broken.
Doctor my patient is hypertensive . BP was 166/82 pulse 76, is on 2 anti hyper agent . Is it safe tooth extraction ( need surgical Exo )with local hemostasis. Please advise
I just had my second molar extracted then now I'm in my 5 days, but I just noticed something there is a white substance on that area. What was that? do I need to consult again to the dentist? I hope I can get a reply :(
I wish I knew if mine looks normal. I haven't seen extraction that looks like mine. Both molars made huge hole all the way up to roof of mouth. Usually not this big.
It happens! Certainly more when you are just starting. As you do more extractions you'll start to develop a feel as to when you're applying a bit too much pressure and the crown is likely to break. The most important thing is to know what to do next in those situations. Always visualize what could happen prior to starting your extraction and have your plan A, B, & C ready to go with the instruments you'll need nearby. All the best to you!
Interesting information. I just had my tooth extracted by a dentist I thought was holistic. The tooth cracked and fell apart as he was taking it out and he seems surprised. My concern is that he did not clean out the area well enough. 10 days later I feel like it’s infected even though he used a laser and PRF. I don’t want to go back to him at this point as I don’t trust him! Not sure what my next step is.If it gets infected does that mean opening up the socket again and cleaning it out? I have a sense that my root was not completely cleaned out. Would appreciate any professional feedback!
Hello - hopefully you're on the mend! Opening the extraction site is an option if there is a need to remove any debris that may be left behind. Most times, as long as the tooth is removed, the site should heal fine. All the best to you my friend!
Ruben - that's very difficult question to answer as it would vary greatly depending where you practice. In Canada you could expect to pay anywhere from $100 - $300CAD for an extraction of a tooth. Difficult impactions would be closing in on $400 - $500CAD. Hopefully that gives you some guidance. Regardless of your compensation, you're making a positive difference in the lives of the people you're seeing so don't discount that! All the best!
Hi Dr.!!! It's been exactly 1 and half a day since my daughter got her molar extracted, and I think her dentist gave her improper instructions after the extraction. He didn't tell her to wet the gauze before putting it on the extraction site, and he didn't tell her to roll up the gauze. He ONLY told her to place the dry gauze on the extraction site, AND to fold the gauze in 1/4, but didn't tell her to put the rounded edge where the socket is. Because of that it took longer to stop bleeding. Will doing what she did take her body longer to form a clot? And is it normal for the dissolvable sutures to take 3 weeks to dissolve? Thank you SO much in advance for your reply!👍🏻
Hello - in response to your question, the position of the gauze will affect the time of bleeding if there isn't adequate pressure. This will have a negligible effect on the healing if the site was to bleed a bit longer. Also, some sutures can take a few weeks to dissolve, but the most common ones come out quicker (3-4 days). If you have any doubts as to whether the sutures should be removed it would be best to follow-up with her provider to see what they say. All the best!
I did all that except curetting the bone and irrigation- I freaked out cause so much blood I just obtained haemostasis gel foam and damp gauze then changed gauze after 5 mins in the chair .. booked review appointment 1 week. I’m a new grad so my experience is minimal
@@nirmalasesha3992 it’s not a treatment if your busting off pieces of jawbone which makes implants an impossibility to place especially since he didn’t out any bone graft in the extraction hole. Shut your mouth please when you have no clue what was done to me.
Great planning is always key. I do this not only with complex extractions, but all complex restorative procedures as well. I envision the entire procedure from beginning to end, and I "solve" all complications in my mind before even stepping into the operatory.
Great insight Ron! Thanks for your support! All the best!
Wow that’s interesting! Actually i don’t know which is a simple extraction and which is a difficult one. How can you know only by watching the tooth and the rx?
Also how do you envision all of it and solve the complications? Im having a hard time with extractions… all i do is break the tooth and it remains inside the alveolar bone
@@irismengri9473 hi...how many years have you been practicing? You will eventually learn which is "simple" , and which is complicated; you won't always be right, but you will be prepared. Another way to look at it is to assume all will be complicated; then when you get the tooth out easily, its a pleasant surprise. I'm not sure how to describe the process of "envisioning it" ....i just play it out in my head like I'm watching a movie. I used to break teeth too, and part of that was trying to force the tooth out, when I really knew it needed to be sectioned; this was likely due to being too timid about using the handpiece and going surgical. Once you lose that fear, things will go along very smoothly.
If you have any other specific questions, I will be glad to answer as best as I can.
4th year dental student here. Great video. Thanks! 🙏
Thanks for watching! All the best!
The way you teach is so warm and nice,very thorough,yes i remember all those times when heart starts pumping faster and i start to sweat alot.I still do but not as much as before.Thank you
Very nice voice he has
Especially the sweating omg it's the worst part 😂
Excelente video. Tengo 43 años de experiencia, pero me refresca ver estos buenos consejos. Siempre es reconfortante
Well explained. You vid was suggested. Now 2022. Amazing.
Can you show with a video or a picture on how you would trough the tooth and bone in that last third scenario?
I believe I have a video on troughing. Have a run through my channel and it should be there. All the best and thanks for watching!
I always click like on your videos before watching them, so I don't accidentally move on without doing so.
Thanks so much for your support Rajit! All the best!
Very nice video and i learned much from it thank you but if you could do live videos of every situation that will be 100x times better.
Nice presentation. Very helpful.
Thanks for watching! All the best!
Dentists have not been trained in dental schools to extract teeth to give the patient the best outcome.
Non-vasoconstrictors anesthetics should be used. All extractions should involve a SLOW speed surgical bone bur used to remove diseased bone and all the periodontal ligament so the socket will heal from the bottom up (as opposed to bone healing over and trapping the waste from anerobic bacteria and creating cavitations in the jaw). Constant Irrigation of saline is used. Dry socket is rarely an issue with this method. Most biological dentists do this. The Huggins Applied Healing Center in Colorado can give you the latest updated protocol.
Thank you for this video.
Thanks for your input!
Do you cut your throat when you get sore throat? I mean its biological !
I have been a dentist for 25 years with extensive experience in oral surgery. There are times when access is so difficult especially in upper 7s that it still takes me more than an hour to remove roots in resilient bone. Elevation can take a long time in long hooked root treated brittle roots osseous level especially on the left side of the mouth. Any tips?
My go-to is always the 700 surgical length carbide. It's terrific for troughing roots and it pairs really well with a 3mm luxator. In addition to that of course, would be patient positioning, a headlight w/magnification 3.5x or more and constant suction so you can see what you're doing. After 25 years, I'm sure you know most of the tricks, but the equipment I mentioned was truly a game-changer for me in these situations. Thanks for watching - All the best!
So can a person do this that isnt a dentist if you have rhe equipment?
Relatively new grad here (1.5 years out). In this case after the crown snapped off, would you create a flap to better facilitate root removal, especially for endo treated teeth?
You are never wrong to create a flap. Just remember this...access, light, & visibility. If you optimize these three things, you'll make your extractions (or any dental procedure 100x easier). With that in mind, if for some reason the tissue is making you light, access, or visibility less than optimal, don't hesitate to move it with a flap. Personally, I rarely do flaps anymore and if I do, it's generally a small envelop flap that requires no sutures after. All the best!
@@OnlineExodontia same here. When I started out, I was flapping nearly every surgical extraction but now I rarely ever do a flap, unless of course its an impacted third
@@jmatt2871 It definitely seems like overkill at times. Thanks for watching!
All the best!
If my dentist even Sees anything weird ..... Right to the oral surgeon.
Get knocked out, dig it out and then suture it all back together so it heals nice instead of walking around with a divot in your mouth for a year or more. Worth every penny !
Are there any complications to leaving root tips in?
It depends on several factors, but essentially to sum it up, if the root is healthy, not loose, and just a small fragment, it often will not cause any troubles if left behind. All the best!
I haven't come across any root tips causing issues as long as they're small and non-mobile.
One surgeon had a line of people when I went in, he did everything without planning.
he was having trouble getting my tooth out because how it was broken.
Doctor my patient is hypertensive . BP was 166/82 pulse 76, is on 2 anti hyper agent . Is it safe tooth extraction ( need surgical Exo )with local hemostasis. Please advise
I just had my second molar extracted then now I'm in my 5 days, but I just noticed something there is a white substance on that area. What was that? do I need to consult again to the dentist? I hope I can get a reply :(
I wish I knew if mine looks normal. I haven't seen extraction that looks like mine. Both molars made huge hole all the way up to roof of mouth. Usually not this big.
I deeply appreciate it doctor
Please improve the audio quality
I'm still in dental school and fractured the crown just last week when I was elevating *rookie move*
It happens! Certainly more when you are just starting. As you do more extractions you'll start to develop a feel as to when you're applying a bit too much pressure and the crown is likely to break. The most important thing is to know what to do next in those situations. Always visualize what could happen prior to starting your extraction and have your plan A, B, & C ready to go with the instruments you'll need nearby. All the best to you!
I'm terrible at elevating I still don't know how ..do you have any tips
Very helpful!
Thanks for watching Ava!
Sir full mouth extraction?
My dentist just rips it out ,he doesn't even get it a little lose first and I always get a dry socket even if I follow directions
Sorry to hear that. Hopefully future times go more smoothly. All the best!
Interesting information. I just had my tooth extracted by a dentist I thought was holistic. The tooth cracked and fell apart as he was taking it out and he seems surprised. My concern is that he did not clean out the area well enough. 10 days later I feel like it’s infected even though he used a laser and PRF. I don’t want to go back to him at this point as I don’t trust him! Not sure what my next step is.If it gets infected does that mean opening up the socket again and cleaning it out? I have a sense that my root was not completely cleaned out. Would appreciate any professional feedback!
Hello - hopefully you're on the mend! Opening the extraction site is an option if there is a need to remove any debris that may be left behind. Most times, as long as the tooth is removed, the site should heal fine. All the best to you my friend!
Excellent explanation. Thank you!
Use Physics forceps wherever possible. It's makes your life so much easier
Great job 👏
How much does an extraction cost? I’m here in Mexico working thinking I don’t get paid enough for the extractions I’ve done.
Ruben - that's very difficult question to answer as it would vary greatly depending where you practice. In Canada you could expect to pay anywhere from $100 - $300CAD for an extraction of a tooth. Difficult impactions would be closing in on $400 - $500CAD. Hopefully that gives you some guidance. Regardless of your compensation, you're making a positive difference in the lives of the people you're seeing so don't discount that! All the best!
I paid $630 today to have 1 wisdom taken out bottom right 17 I believe
@@jeremiahfisher6994 Yowsers! How are you doing?
hey relax man, no matter how you get paid im a dentist in albania, and extractions go for 20-30euro to like 70euro for third molars :D
@@kikothecat3700 in Ukraine I remove all teeth
for 10-30 dollars
one straight elevator from the toolkit)
Hi Dr.!!! It's been exactly 1 and half a day since my daughter got her molar extracted, and I think her dentist gave her improper instructions after the extraction. He didn't tell her to wet the gauze before putting it on the extraction site, and he didn't tell her to roll up the gauze. He ONLY told her to place the dry gauze on the extraction site, AND to fold the gauze in 1/4, but didn't tell her to put the rounded edge where the socket is. Because of that it took longer to stop bleeding. Will doing what she did take her body longer to form a clot? And is it normal for the dissolvable sutures to take 3 weeks to dissolve? Thank you SO much in advance for your reply!👍🏻
Hello - in response to your question, the position of the gauze will affect the time of bleeding if there isn't adequate pressure. This will have a negligible effect on the healing if the site was to bleed a bit longer. Also, some sutures can take a few weeks to dissolve, but the most common ones come out quicker (3-4 days). If you have any doubts as to whether the sutures should be removed it would be best to follow-up with her provider to see what they say. All the best!
@@OnlineExodontia thank you so much for your reply!👍🏻 Really appreciate your reply!
such an informative video thankyou
Good video doc👍
Hello sir.....you have explained so beautifully, thank you 😊
Great! Thanks for that. All the best!
Love it! thank you!
tnks doc
👍 for different sinarios
Thank you so much
pls continue with your videos ❤️❤️🌹
I did all that except curetting the bone and irrigation- I freaked out cause so much blood I just obtained haemostasis gel foam and damp gauze then changed gauze after 5 mins in the chair .. booked review appointment 1 week.
I’m a new grad so my experience is minimal
This was two days ago btw
It can be rough in the beginning for sure, but in time it gets better! All the best!
Thank you , that is helpful!
so basically i fight my battle in my mind before i actually extract. Just like that scene from the movie, "Hero".
your Kung Fu is way too good.
I pull my own teeth, this is very helpful. Thanks.
Extraction can only be learnt by experience . A very simple extraction with limited mouth opening is a very difficult job.
CE courses in exodontia are pointless. Either you get it or you don't, no CE courses will change that
Wish my dentist did this instead of tearing my gums to pieces getting my broken teeth out 🤦♂️
😭
Same here 😐
Every case has different treatment plan..kindly respect the fellow dentist
@@nirmalasesha3992 it’s not a treatment if your busting off pieces of jawbone which makes implants an impossibility to place especially since he didn’t out any bone graft in the extraction hole. Shut your mouth please when you have no clue what was done to me.
@@nirmalasesha3992 agree
"...Successfully Every Time ..." ....why not add "painless" as well ... this is pure nonsense
Ki