My first experience of extraction!!=)

I EXTRACTED a TOOTH!!!!!!!!!!

Yes,i PULLED OUT a 48 (right third molar) which has severe dental caries!!!!

Without any mental preparation,
Suddenly,Dr.James,my oral surgery lecturer asked me to extract a tooth.....

And i don't know why i'm always so "lucky" to have a special patient as my 1st patient..

Well,what so special about my patient??

She is suspected to have oral submucous fibrosis (OSMF)

(OSMF is a premalignant condition..means usually patient has this condition will have increased risk of getting cancer.It usually caused by betel/areca nut chewing..means "槟榔")



But my patient is so unlucky,because she has no habit of areca nut chewing or smoking or any bad habits,and yet she has suffering for this disease.=(

This was the 1st time i saw a OSMF patient and i had the chance to feel the fibrous band that present in her oral cavity...erm,,,the feeling of touching her buccal mucosa and upper lip is just like stretching a rubber band...and she has a special shape of uvula,a hockey stick shaped uvula....

Well,the characteristic of this condition will be having restricted mouth opening.
Since my patient has the difficulty in opening her mouth and this was my 1st time,Dr.James helped me injecting the LA to the patient.

And he placed the forceps on the tooth and instructed me to hold the forceps and taught me the ways to hold it properly.

"Okay,push the forceps to lingually first"
"Well,now pull it to buccal side...."
"Try to rotate the tooth with the forceps.."
"Yes,good...keep going...keep going....go buccal again...go buccal again...."
"Yes,going to end....keep giving buccal!!"

AND,FINALLY,I'D PULLED THE TOOTH OUT!!
Phew~~~~~~


Pressing the socket by using the gauze,trying to stop the bleeding....
Then checking for any fracture of the extracted tooth,to avoid any fragments left in the socket...
Double confirmed,a complete tooth had extracted!!

Since the patient is suspected for OSMF,Dr.James asked me to be his assistant to help him take a biopsy from the patient's buccal mucosa.

Helping him to retract the mouth and controlling the light...
Seeing him using a surgical blade and did a smooth cut on the right cheek of the patient..
A small piece biopsy had done and it was kept in a formalin-filled bottle to be sent to the lab for investigation.This investigation is done to confirm the diagnosis of oral submucous fibrosis.

Well,even though i didn't do the complete extraction including injecting the local anesthetic this time,but the feeling of extracting the 1st tooth is so so so....erm..GreAt??
well,i know it did sound "scary",but anyway it was a small satisfaction to me,ok??!....=P

I wish i will have a chance to do a full procedure by myself next time.....
hehe....see who will be the "lucky guinea pig" then....oops,i mean my lucky patient...=P

p/s:Dr.James is really a good surgeon + lecturer....He built up my interest in surgery.And don't know why i don't wanna disappoint him,so i promise myself I will perform well in front of him in my next posting..... *crossed fingers* =)