Survive your First Extraction

I have to admit, I initially found extractions very intimidating! Exodontia seemed so different from the fine motor skills I employed during operative procedures! Regardless of your preference (I found that students tend to either love or hate extracting), becoming comfortable with extractions is critical to your dental school success. Below, I provide 5 tips for tackling your first extraction! For more advice on oral surgery, be sure to check out my post, Oral Surgery Clinic.

Tip 1: Hands-On Assisting

Before completing your first extraction, I highly recommend assisting an upperclassman. Now, I don’t mean simply suctioning! Instead, you should take the initiative to perform the anesthetic injections, feel a “purchase point,” try elevating for a bit, and then (when it’s very loose) remove the tooth with the forceps. You will need to explain to the upperclassman that you wish to have a hands-on, guided experience. This will help accustom you to the unique positioning and tactile components of exodontia!

Tip 2: Divide and Conquer

This is my BEST advice for building confidence. After assisting, I recommend working with a classmate on a multi-tooth case. You can “divide and conquer” by taking turns. If the classmate is more comfortable/experienced with extractions, let them extract the first tooth and ask questions as they go. When it’s your turn, try to emulate what they did. If you get stuck, ask for their advice. 

Tip 3: Informed Consent and Post-Op Instructions

Before you begin extracting, you will need to obtain informed consent from the patient. After the extraction, you will need to provide the patient with post-op instructions. My best advice is to have these memorized. You will likely be nervous about completing your first extraction. The last thing you want is to have the added pressure of stumbling through the informed consent and post-op instructions. You should be able to obtain copies of these forms from your school’s Oral Surgery department.

To get a general idea, below is a copy of my Alma Mater’s post-op instructions. Feel free to modify these instructions for your specific school!

Tip 4: Review the Radiograph

Believe it or not, this is where your perceptual ability comes into play (sorry if I invoked any DAT-related PTSD)! Examine the radiograph to determine the root morphology. How many roots does the tooth have? Are there any dilacerations? This will help determine the motions you will implement with the forceps. For example, maxillary anterior teeth are single rooted. Therefore, you will be able to luxate with the forceps using buccal-lingual movements as well as rotation. You will quickly discover that exodontia has little to do with brut strength…it’s more about strategy and technique!

Tip 5: Snap a pic!

YOU DID IT! After your first extraction, don’t forget to capture this dental school milestone by snapping a photo (just be sure to follow HIPAA and school policies)!

My first extraction!

Do you remember your first extraction? Any extraction tips for dental students? Comment below!


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