Page 597 - My FlipBook

GENERAL PRINCIPLES. 595

hands. At times it may be necessary to extract while the patient is in
bed or on an operating table ; in such cases the operator must obtain
the best position available. Where an operating table or couch is used
it is well, if possible, to stand at the head of the couch or table and a
little to one side of the patient. By reaching over the head, the for-
ceps shown in Fig. 488 may be used to advantage in work on the lower
jaw; the same forceps may be used for the upper jaw by standing to
one side of the patient. If the operator is ambidextrous, so much the
better, as it is very advantageous to be able to use the instrument in the
left hand, especially in extracting the teeth of the right side of the lower
jaw. If, however, only the right hand can be used, the operator should,
as a rule, stand at the right of the chair, the left arm and hand being
used in various ways to control the head of the patient. The mouth is
opened as far as necessary, and the left hand is then used to hold the
li})s away and keep the jaw as steady as possible. (Sec Figs. 543, 544.)
Selection and Use of Instruments.—The selection of instruments
depends on the nature of the operation to be performed. The means
used in extraction should be of the most simple character. Many de-
ciduous teeth and permanent teeth from about which most of the pro-
cess has been resorbed can often be easily extracted witli the thumb
and finger. Children feel less apprehension with this method than
Avhen an instrument is used. The thumb should be covered with a
napkin and placed on the inner surface of the tooth with the fingers
against the outside of the jaw. The tooth is then forced outwardly
toward the cheek or lips. The roots of the deciduous teeth often break,
but this is of little importance, for when extraction is demanded the roots
are weakened by the natural process of resorption and will soon disappear.
Elevators of the various patterns shown in Figs. 500,501, 536, 537, and
Fig. 536.

Manner of holding elevator Fig. 500.
538 should be used whenever practicable for removing roots, and in some
cases teeth also. Fig. 500 is especially u.sefid in removing the third