Professor of Oral Surgery, King's College London; Honorary Consultant in Oral Surgery, King's College Hospital NHS Foundation Trust and Guy's and St Thomas' NHS Foundation Trust, London
Dental extractions are potentially an unpleasant experience that patients have to undergo. Not only are they losing a tooth that they may have invested significant costs in retaining, but fear and expectation of pain makes the encounter stressful and terrifying for most.
Dental extractions are the most common surgery undertaken worldwide, and usually on conscious patients, unlike other branches of surgery. Patients' most common fear of the dentist is the pain during and after surgery and the experience of injections, both guaranteed when undergoing extractions at the dentist.
Despite universities aiming to make undergraduate dentists able to undertake routine exodontia, ability remains limited. This may be due to foundation training limiting access to routine exodontia practice or a reluctance on behalf of dentists in general to undertake surgical interventions due to their high risk, patient sequelae or risk of complications, which are perceived as poor practice builders.
CPD/Clinical Relevance: This paper aims to provide some clinical tips and information that will assist practitioners in undertaking dental extractions.
Article
Dental extractions are a necessary and common requirement for the dental team. NHS oral surgery commissioning encourages primary care practitioners to provide routine ‘Tier 1’ dental extractions in practice. Those identified referring inappropriate cases may be provided with additional training opportunities.1 Why is it that some dentists will not routinely provide dental extraction services? There may be many answers including lack of education and training, fear and anxiety of managing patients undergoing high risk procedures due to team and personal stress, and/or the fear of litigation.
Despite many universities aiming to make all undergraduate (UG) dentists able to undertake routine exodontia, ability remains limited.2 A substantial number of extractions are required to enable competency and, due to increasing pressures including staff:student ratios, patient choice and commissioning pressures, there is a reduction in the exposure of UGs to dental extractions.3
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