Watched a lot of videos on elevation, but this is the best one so far. Thank you for the hack that first move the upper edge of elevator towards the tooth so that we dont harm the adjacent tooth and in final motion, move it away from the tooth for delivery. Or insert in buccal groove instead.
Nice video, it would be great if you included some information on how you support the mandible while applying pressure and how you prevent iatrogenic mistakes (finger placement, elevator inclination, tissues to be aware of) while retaining an ergonomic position.
Thanks Pantelis - it's all in other videos from the course. You're right that it's not demonstrated in the video and perhaps should be, but I have dedicated entire videos to those topics. All the best!
@@Grimreepa220 oof eat lOtS of jello mash potatoes jello and all soft stuff it will hurt for a couple of days. I’ve had 12 oral surgeries so I’m a pro at it now I’m only 11 tho o.o
I'm getting a molar removed in a few days and I'm so scared :S had some bad experiences at the dentist when I was younger and its screwed me up for life
I'm so grateful for this video. I will be extracting my very loose, but painful 3rd molar at home. Seems as though I won't be needing the forceps, but will have it on hand, jic. Fingers crossed! No money, no insurance, and no transportation.
Last week my #19 was extracted instead of a root canal, but while pulling out the adjacent tooth got loose, and now moves and feels unstable. The dentist mentions while extracting #19 the neighboring tooth wants to come out too... I was very annoyed that this tooth need attention because it's not in the same position before the procedure started. I will go to another dentist next week to get help with this new problem, darn.
Wow cant believe i was so lucky to have my wisdom teeth (all 4) done in under 40mins the most difficult part of the process besides me healing currently (day 2) was the shots to numb my mouth which ended up being close to ten cause my tongue and bottom lip wouldnt go numb at first.
Hi. When you used Coupland on the mesial of third molar aren’t u gonna risk fracturing the adjacent tooth tho? Please advise, how do you use Coupland without damaging adjacent tooth. Thank you
Hello - when you check out the video it discusses how to properly move the elevator to avoid putting unnecessary stresses on the 2nd molar. The idea is to fulcrum off the bone. The elevator here is much thinner than a Coupland and fits nicely interproximally. All the best!
My teeth are coming right after this video. Thanks Medicare. I'll give an up date, my pilers don't look the same but, I'm trying anyway & I got 2 to get out, lol.
I had my 4 wisdom teeth removed, best decision. However, I want to get braces and the dentist told me to extract a lower molar. I’m a bit scared that my jaw will end up shrinking or something. Help
You sure could! Although some instruments are better suited for various teeth in the mouth, if you have a forcep that will adapt well to a tooth, that's all you need. You'll find this dilemma at times when teeth are very crowded or mal-aligned. You'll have to select a forcep you may not normally use, just to be able to get access to the tooth. All the best!
I had my lower molar tooth extracted it had a deep root canal infection because the dentist accidentally broke a file into my root canal claiming it was 5% longer and harder to clean it’s been day 4 since extraction I’m not experiencing pain but irritation and tightness I visit my dentist today he said it’s jus inflammation my wound is healing good any advice
Exactly Dean. The upper edge of the elevator moves toward the tooth. That is to luxate it. When I want to lift a tooth out of the socket and really lean on it to complete the extraction via an elevator I would turn the upper edge away from the tooth to engage the tooth with the lower edge of the elevator. As you do this you lever the handle downward in the mandible (upwards in the maxilla) fulcruming off the bone. You have to be careful in these instances to not lean too much on the adjacent teeth. That’s initially why I lean the upper edge toward the tooth to get the tooth moving. I say upper edge and lower edge because you can elevate on all sides of a tooth. In other words sometimes you will be turning clockwise, but not always. Hope that helps.
@@OnlineExodontia ok so top part of instrument towards the tooth to luxate it and away from the tooth to elevate...all while the bottom edge of the instrument is placed mesial/Mesial buccal and worked down the root.
@@landofmilkchillies5832 That sounds about right Dean! Keep in mind you can elevate anywhere you can get a purchase (distal, palatal if it's an upper tooth, buccal, etc).
@@OnlineExodontia ah I see, I haven't tried anything except Mesial and Mesial buccal because our instructors told us that palatal could lead to injury if we're not careful i guess I'll more experience before I try other ways
So my wisdom teeth grew in and it sounds like they want to pull them for cavities, and or invisilign, do these sound like reasonable reasons to you? And how bad would the surgery be!? Like i said fully erupted and no pain, thank you.
If you look up the "Third Molar White Paper" by the AAOMS you'll see a detailed list of all the evidence-based reasons to extract wisdom teeth. The reasons you are describing are certainly reasonable. All the best to you!
Online Exodontia thank you so much for the reply 🙏🏾 I will definitely look into it, but is a fully erupted wisdom teeth extraction way easier then below the surface and impacted? I made a stupid decision and looked at the procedure before even scheduling the date lol, like i know they wont have to make an incision in my gum, use the drill, etc, but i just want to be assured it would be a simple procedure? Even to the extent of being no different from any other tooth being pulled
@@aaronjackson9603 It's hard to give you a guarantee on that as any tooth can be challenging. If you're younger (under 25) it should be easier, if the roots aren't crazy it'll be easier. Sometimes you still need to drill the tooth to get it out, even if it's erupted into the mouth. In fact, that's pretty common. The good news is, it's just noise and water and you shouldn't have any added discomfort before or after the procedure. You'll be great!
I had this, 90 minutes it took my dentists to extract, took half an hour to realise that there was still a nerve not sedated in my tooth, was so panicked I honestly couldn't tell I felt any pain I was just unable to sit still or remember to breathe
@@OnlineExodontia alright.. When we are students we are supposed to follow instructions. So maybe once I can start my independent practice, I'll try and figure it out. Thank you.
Is it possible to fracture the angle of mandible accidentally with the elevator....I heard a scary story...if so how do you know if you cause the patient a fracture
Yes you could fracture the mandible with an elevator, but in most usual cases that you'd be tackling in younger patients, this would be very unlikely. Extreme force, deeper impactions, underlying pathosis could all contribute. The question will be how much force can I use...the answer would be that you really shouldn't be applying a lot of force to remove these teeth. If you are, you're either not sectioning properly, and/or you need to remove more bone. If you ever apply enough pressure that you begin to wonder if the jaw will hold up, that should be your signal to change it up a bit a reach for the handpiece. Hopefully that helps! All the best!
I still have the inner section of my third lower molar broken above the gum line after extraction last Wednesday. This is the whole inner wall of the tooth now like having a piece of glass in my mouth. The surgeon said it would fall out and I would spit it out like a popcorn kernel. Can you give me your opinion. Ps my tongue keeps getting bumps on it irritated by the broken tooth.
Tim - sounds unpleasant! It' shard for me to comment on the surgery or what the current situation is without actually seeing it, but I can say this: 1) Bits of broken root will eventually be expelled by the body, however these are usually only left behind if they are deep in the jaw (tough to access) or if their retrieval would be potentially more harmful than leaving them in place. It sounds like you're describing a larger portion of the tooth in this case. This process take many months to years for a retained root to be expelled. 2) Sometimes if there is lots of bleeding or visibility is poor it's possible that the surgeon maybe overlooked a sliver of the tooth adhered to the gumline (if the tooth was breaking apart) and therefore he/she may not be aware that a larger bit is still present. 3) Regardless of what remains, you're having significant discomfort. You should visit someone to either smooth off the remaining bit or remove it for you. Hope that helps! Jason
Greetings sir, Very informative video. My question is as you are stating that we can deliver the wisdom tooth lingually so wont there be any damage to the lingual nerve which runs along the lingual plate. Please advise.
Great question. The nerve is high up in this region and can at times be in intimate contact with the bone. I am not recommending, pulling the tooth lingually through the bone / tissue, but rather leaning the forceps in that direction as the bone should have more give to it in most cases due to the reduced thickness. Having said that, the tooth should then be delivered with minimal to no soft / hard tissue trauma and the nerve will remain intact and unharmed. Does that help? All the best!
Hi! I had my upper left last wisdom tooth removed today. My dentist suggested that we might have to think of extracting the lower left last tooth also. (I think its the molar?) But it’s perfectly good and has no issues. He said something about needing to be careful when removing it because of a nerve that is running close by. I cannot remember all the details now. But any idea why he said that? And also he said that its not something we have to do but can keep monitoring..
Sometimes the lower tooth may have lots of tissue behind it, or could be only partly in the mouth. This can create an area that is prone to developing gum infections and discomfort in the future. Removal of the tooth can prevent this. That's just a guess. All the best!
@@OnlineExodontia thank you very much for the reply! I got to know that it’s actually my lower left wisdom tooth which is out (3rd molar), hence the dentist is thinking of preventing any future issues (tooth decay, gum issues) by removing it. I was sad for a moment why my doctor would suggest removing a perfect tooth but I got to know that my dad had to remove his wisdom tooth 4 yrs before in his 70s and had to go through surgery due to the brittles of the tooth. So now I understand why prevention is better for molar. Thank you again. 🤗
Great question, in this scenario it depends on the tooth. Sometimes you can elevate off the distobuccal with a larger elevator. If you have a thin luxator you can work it mesially on the tooth to drive it deeper (more apically) where you can then get a good purchase point. Alternatively, you can section the tooth and deliver the roots with cryers elevators (if the tooth has 2 roots), or you can skip the elevator and go right to a forcep if there is enough coronal tooth structure. In short, there is no single answer, you simply have to assess the situation and select the most appropriate approach. Hope that helps! All the best!
You'll do great - just be sure to communicate well with your dentist. You'll feel some pressure, but pinching, poking, or pain is unusual and can be controlled with proper anesthesia most times. All the best!
Had my upper right wisdom removed, took over an hour. The most awkward part was that my roots were wider than my own crown Edit, he used the cow horn ones but struggled to get good purchase until the latter part
I had tooth number 31 extracted 3 weeks ago. The dentist only used a plier like a tool, he was fighting with the tooth. I am suffering still, I am afraid he fractured my jaw. There is a pain in that area plus pain underneath tooth 30. The dentist was not a surgeon. I had to quit my job because I can't handle pain and discomfort after that extraction. I am scared to go to that dentist because I lost faith in him since he was fighting to extract that tooth.
Hmm that doesn't sound like a very pleasant experience. I would encourage you to seek care from someone that can advise you and assist with your healing. Perhaps a different dentist if you're not comfortable seeing the same one. All the best to you my friend!
how to do it in case of a grossly decayed third molar in the 4th quadrant?I'm right handed and the 4th quadrant becomes an issue especially because of visibility
Your visibility in the 4th quadrant should be quite good if you are positioned behind the patient or in the 9-12 position. When grossly decayed you must consider a flap, sectioning and/or troughing of the buccal bone. All the best!
@@OnlineExodontia for example, lower 6, are we able to move it distally when there is the 7th tooth, btw I'm dental student and don't have alot of info 😅
I’m about to have a lower back tooth extracted. I’ll be totally honest I would rather jump out of a plane over Afghanistan without a weapon or parachute
You'll be good - just be sure you keep your dentist posted while they're working so you can stay comfortable. Alternately, you could have some form of sedation which would make it much easier. All the best!
