Simplifying Extraction Procedures





By Lexi Marino March 10, 2021

Simplify your dental workflow for optimal performance at every step. In this piece, we’ll discuss how to make one of the most stressful procedures in dentistry, extractions, stress-free.

Watch this video to learn how the Isolite System helps you:

  • Have less stress in your workday.
  • Eliminate physical strain and mundane tasks in your dental workday.
  • Allowing your dental assistant to focus on the procedure at hand, rather than suctioning continuously.

Transcription:

Rolando Mia: Good morning, everybody. Welcome to Dr. Tom’s Case of the Week, this week we’ve got something special for you. So, Isolite® is phenomenal is very helpful during restorative procedures. However, the question is how does Isolite help during extractions?

Dr. Tom Hirsch, DDS: Well, here’s the thing about extractions, you never know what you’re going to get.

What you think is going to be simple sometimes turns out to be very difficult. So, today I decided to take out a couple of teeth, the upper deciduous second molars on a 13-year- old. They’ve been in there for a long time. The teeth were not mobile at all.

As you can see from the panorex, the maxillary bicuspids are coming in at quite an angle. So, these teeth had to come out. Therefore, I just decided to use Isolite® to take these teeth and I’ll share with you how it helped me in this procedure.

We Need Good Access With Extractions

First thing that we need to accomplish is having good access. I could have a bite block in her mouth instead of the Isolite and that would have been just fine. The problem with that, is that I would have had to worry about her throat and had to have a throat pack.

Make sure you’ve got the tissue all loosened up, which we did here. Here’s a tip of the day, not about the Isolite product, it is called the Physics Forceps and it’s a pediatric one. Most of the time with these forceps on long spindly roots, you will get the long spindly roots, and they will come right out. However, that didn’t happen here. I broke three roots. I thought I was going to get really lucky and get this thing out in one piece. Nah, wrong did not happen. So we went in there, we took the follicle and took a scalpel and got the follicular sac removed.

Rolando Mia: It looks like she’s not having problems keeping her mouth open.

The Patient’s Mouth is Open Continuously

Dr. Tom Hirsch, DDS: The nice thing about this is, I didn’t have to say, “Open your mouth, open your mouth, open your mouth.” The other thing that was nice about this is, I can position the patient towards me to where I see best and my assistant doesn’t necessarily have to see.

So anyway, there’s the tooth right there. Then we’ve got root tips to dig out which we did and let’s go onto the other side. Same thing, free up the tissue. I like to use a scalpel here. It really severs all the fibers nice. We have great visibility through this whole procedure.

That’s a pediatric physics forcep. We can use big ones, but the pedo one is really small. It’s much less intimidating for kids and you’ll watch the thing pop in a moment here. There we go, see, it just popped. And I think, “Oh great! Everything’s going to come out really easily including all three of those roots.” Wrong! I broke six out of six roots.

Evacuating Blood

So, this is another nice thing you can see from the bleeding and see how the fluid is being aspirated up into the into the Isolite, same as saliva. Both just get sucked right up. So the throat’s protected, which if I was using bite block alone, I’d have to have a throat pack. My assistant would have to be in there continually aspirating in the back of the mouth. Now, he or she can just concentrate on what they’re doing.

So, it makes life easy for my assistant. It makes life easy for me. You don’t have to worry about the tongue getting in the way. Now, we have to go digging.

Rolando Mia: That’s amazing, wow.

Dr. Tom Hirsch, DDS: There we go. Pop that out. We’re seeing if that one root will come out really easy. The other ones didn’t come out quite that easily.

There it is right there; the root just fell down. I should have picked it up with a cotton plyer caused it fell to the back of the mouth, but it wasn’t a problem with Isolite. I’m not at all concerned that it’s going to go down the throat all.

Now, we’re digging the mesial buccal root out in the distal buccal root. I really had to work hard to get these things out. One of the things a mentor of mine told me was, “You go slower to go faster.” So, slow it down, take your time. Don’t rush.

There’s another root tip. Eventually throughout this whole procedure we got all the root tips and cleaned everything out.

Taking the Stress Out of the Extraction Game

Rolando Mia: Fantastic. So in the, in the course of doing extractions and you’re using Isolite, what are some of the things that you’ve heard or are stressful about that process?

Dr. Tom Hirsch, DDS: Well, first of all you have to make sure your patient is numb. So we have to control the pain with anesthesia. That’s very easy to do, but you’ve got to have good access. You’ve got to be able to see what you’re doing. The nice thing when I use an Isolite and I’m doing extractions. I have the entire mouth illuminated with lights. So, I’ve got great access and I’ve got great visibility.

The other thing that we worry about is anything dropping down the throat. We have to protect the airway and the airway is automatically protected. So, I don’t have to put gauze in the back of the patient’s throat. Then, my assistant doesn’t have to be in there retracting anymore and the tongue is always under control. The tongue doesn’t get in the way of my surgical field. Patients always like to go exploring with their tongue.

Another thing that’s really nice is I’m not continually reprimanding the patient, “Stay open, open your mouth, stay open.” The Isolite goes in and I get to concentrate what I’m doing without worrying about blood, about the patient staying open, the tongue getting in the way, and the airway. It makes everything easy.

We’ll take some other on another video on some adult extractions, which are really a lot more fun.

Rolando Mia: So what are tips that you would give to people regarding second molars?

Dr. Tom Hirsch, DDS: The second molars or even all the way in the back, not a problem. The Isolite goes right around there. Everything is really well protected. You can go in there and oftentimes with an elevator you can do an elevator extraction on those second molars if there’s no third molar there. And that would just elevate out of the distal and you just deliver it with a forcep.

Rolando Mia: Awesome. Well, thank you so much for that. That was really cool.