Surgery and Healing in the Developing World - Dartmouth-Hitchcock

Dentistry
Figure 6. Root block diagram and photo (Ref. 1, pg. 15, 16).
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Upper PreMolars
Be gentle, as these teeth have delicate roots. Push the tooth towards the maxilla
and make small side to side rotation movements. After loosening, extract downwards.
Upper Molars
These teeth have three roots, two are on the labial side and one is on the lingual
side. Ensure that you select the correct forceps and apply them with the grooved side
on the labial side of the tooth. Support the alveolus of the tooth between your finger
and thumb, to minimize the chances of breaking the tooth or fracturing the maxilla.
Apply upward pressure combined with side to side rocking motions, finally drawing
out the tooth downwards and labially.
Lower Teeth
The lower molars have two oval roots, the other teeth all have single roots. Apply
downward pressure, rotate and rock the tooth until it is loosened and extract towards
the cheek (Figs. 7, 8).
Post Extraction Care
Immediately following the extraction, the patient should rinse their mouth once
to remove any residual matter. Approximate the medial and lateral sides of the empty
socket and apply a gauze pack. The patient should be instructed to swallow all blood
and saliva. Ask the patient to bite down on the pack 15-30 minutes. The patient
should continue to swallow all blood and saliva for the first twelve hours and to only
consume cold solids or liquids with the opposite side of the mouth. After 24 hours,
begin rinsing with warm salt water and continue for 5 days.
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