My First Extraction !
Wednesday, October 5th, 2005‘My first extraction’ might be misleading. It means not my own tooth kena cabut, but rather, yesterday was my first time cabut orang lain punya gigi.
I guess I’d like to remember my first experience. Hope those who read this will not be frightened and develop phobias towards dental practicioner!
First patient, Malay lady aging 51. Makcik Long Sapiah was those typical warm makcik. Her 38 was mobile and I silently thanked God, tat mobile tooth might somehow be easier to pull out. But half of the crown is gone dt deep caries, the tooth was not vital anymore.
History taking + building rapport, I think I did well. I felt that she was comfortable with me. She went to far (very far) extend to allow me to check her blood pressure as she is hypertensive.
And I gave her LA… And I waited for the numb effect to come. Using a probe, I gently and slowly poked her gums and 38 tooth, carefully watching her eyes for any reaction. My hand was slighly trembling as I gave LA even tho I didn’t take coffee for a couple of days d (my first time on a patient, I suppose. When students injected e.o., my hand was steady)
Anyway, testing for numbness went a little too long. Our lecturer, P.MO, one of the best (but the one who always pressurize students to ‘Faster, Faster, Faster’) came over and said ‘Faster! Faster! Faster!!’ Do you dare to pull out somebody’s teeth when the patient told you that she can still feel? P.Mo asked me to get the forcep and extract already.
Okay… The tooth was the furthest in the mouth. I took a good grip at the tooth and loosen it gently in the socket. It was pretty mobile, so I gripped harder and prepared to PULL it. "Crunch!!!"
The remaining broken crown fractured off. Separated from its roots in the gum… Hehe… Uh-oh. I signaled PMo for attention. Yep, Oral Surgery lecturers are supposed to take care of the complications caused by trainees.
P.Mo was truly helpful and my partner and I watched how he expertly, quickly and not really gently, DIG/ FLICK out the roots from the sockets. Spicules, blood and flabby papilla… Blood flooding her mouth. I asked if he wanted a suction to suck the blood away for better visiblity, he chose to finish things off quickly.
So, Case #1, it wasn’t me who took out the whole 38 tooth. PMo took out the roots, all I did was fractured the crown.
(Now, now… Don’t get the wrong idea. Non-vital tooth esp with half a tooth structure gone is extremely brittle. Fractured crown is much much expected. PMo warned Makcik Long Sapiah even before I gave LA)
Case #2 on the same day, 57 yr old Chinese lady. Another rapport built, praise God. Til the extend this lady can’t stop talking. She insisted to have her 44 extracted.
Time was insufficient and PMo went ‘Faster! Faster! Faster!!’ I took and presented her history. Fixed my LA syringe, took a deep breath, controlled my tremor, found the correct anatomical landmark and injected her.
In my head, I was distracted by PMo’s resounding ‘Faster! Faster! Faster!!’ He was just standing there, observing me ( I really do think so then, altho he was supervising a few of us).
I let a minute passed by and used a probe to poke her, just like I did on Long Sapiah. The probe went deep into the socket, and this lady is succesfully anaesthetised as she didn’t scream upon probing. Kidding. When a person’s eyes didn’t shoot at you or suddenly widened when you poked her deep, it means she’s numb.
PMo went ‘ No need to test already!!!’
I took the correct forcep and gripped her tooth. Now her tooth was in good shape, meaning the whole crown was there, and the forcep made maximum contact and able to deliver even force upon extractions. I gently loosen the tooth bucal lingually.
‘Fasterrrrrrrrrr!!’
P.Mo ( I am not offended at all, I find it funny and I appreciate his involvement) quickly came over and took my position and demonstrated hot to vigorously/ effectively loosen the tooth. He handed the forcep back to me, and stood at the other side to observe me.
Seems like I can’t take my time, I loosen the tooth again and with one smooth short movement, the tooth came out with a low ‘pop’ sound. Complete tooth with the root. A wave of victory sweep over me.
PMo immediately brought me back to reality. ‘The gauze!! Patient’s bleeding!’ I took a gauze to absorb blood welling at the floor of mouth, and another to apply direct pressure to stop bleeding.
I heard ‘Ok’ from PMo and noticed him walked away to pressurise another coursemate of mine. Lady was clearly not in pain as she asked "Where’s the tooth? I wanna see I wanna see!"
She had a good look at the tooth, and she said "Aiya, sayang o….."
Case #2, a total success. Whaha, praise the Lord.
Tat was my first day of extracting tooth. My first patients
