Page 238 - My FlipBook

234 OPERATIVE DENTISTRY

neck serves to retain the tooth firmly in the alveolar process, and
constitutes its principal retention, by the process grasping the
tooth at this point, assisted by natural adhesion of the tissues.
Opening Mouth of Alveolus. The alveolar process is just a lit-
tle thicker or heavier at the neck of the tooth than just below.
The gingival part of the alveolus, the tooth's socket, is called the
mouth of the alveolus. This mouth once opened, Avhich can be ac-
complished by slight fracture at this point, the removal of a normal
tooth is made easy.
How Can This Best Be Accomplished? By application of force
in the line of least resistance. This varies in different teeth, owing
to the difference in anatomical structure, the number of roots and
direction of eruption.
Three Forces Are Applied in the Extraction of a Tooth: Trac-
tion, Rotation and Pressure.
Traction is a pulling force ; rotation is a motion, given the hantl
in using a screw driver, but moving the hand first in one direction
then in another. Pressure is the force we would apply to a tooth
in endeavoring to push it in or out of the mouth at an angle to its
long axis.
Position and Movements. If the patient is of mature years and
as is often the case possessed of as much or more strength than the
dental surgeon, it is very essential that Ave consider position and
movements and that Ave have so calculated these matters that the
patient is at all times fully under the control of the operator. It
is not Avell to give the patient to understand that avc think this
particular tooth is a very difficult one to extract, or that we are in
the least timid about performing the operation.
Securing Patient's Confidence. After it has been decided to
extract the tooth, the more precise and deliberate the operator's
actions, the more confidence the patient Avill haA^e, hence a firm but
gentle hand instills into the patient's mind confidence in the oper-
ator's ability. In giving the positions of the patient and operator,
it is assumed that the latter is right handed. If such is not the
case, the positions Avould be reversed.
Ci)
Position of Patient's Head. The patient's head should be in-
'''
clined backward.
'-^ It should be firmly fixed and absolutely under
the control of the operator. This can be accomplished in different
[[_
Avays in the absence of a dental chair Avith its head rest and other
conveniences, in Avhich case the operator may be compelled to re-
sort to very primitive means.