hey dental fans Dr. Rich here, in this video I'm going to show you the instruments I use
to extract a tooth. These are the most common ones that I use and I'm going to kind of go over why I uh use the ones I do and the order I use them in
and to show you how I'm going to do it I'm going to demonstrate on this plastic model of teeth
this one's a little different in that the teeth are actually attached a little rubber bands
to the plastic jaw so to kind of simulate kind of more like a real tooth it even has molars even
have multiple roots okay so won't be any blood on this so you can watch without getting squeamish
and here we go so the first assumption let's assume you know already numbed up the person
so you don't have to worry about that so the first instrument I used is an instrument called a
spoon excavator this is actually an instrument that's used uh occasionally when I'm it's designed
more for cleaning out cavities you know after you drill through the enamel if there's any soft kind
of mushy stuff inside the tooth you can scoop it out with this what i do with this is i'll take it
and i'll just push down between the tooth and the gum all the way around the tooth that i'm going
to be extracting I do this mostly first you know I tell the patient that I'm doing this to make
to check to make sure that the tooth and the gums are numb so the person while I'm doing
this the person shouldn't feel any pain uh they may feel or probably will feel some pressure
and that's it but also while I'm doing this I'm actually starting to separate the gums
around away from the tooth so I'll actually push this in as far as I can uh
you know usually about two, three millimeters down and that starts the process of extracting
the tooth all right so the next instrument I use uh you know two different ones ones
either uh one is called a spade proximator you know it's called a spade because it's got kind
of like a little pointy tip like a little shovel and the other instrument is a luxator
and both of them have very fine points on them the tips of them are very thin and very narrow
so again they work in a very similar way and so teeth are attached to the jawbone
with little ligaments the ligaments are called the periodontal ligament and so with these instruments
they're very thin I'll use these to kind of get in between get the instrument in between
the tooth and the gum and I just kind of press gently in sometimes I'll wiggle it back and forth
and I'll just work my way all the way around the two so I'm doing two different things here by
pressing down I'm starting to cut the periodontal ligament that holds the tooth in into the jaw
bone and I'm also by pushing the instrument in between the tooth and the bone it's expanding
the bone a little bit the actual hole that the part of the the bone that holds the tooth in
when I press it, it'll actually open up a little bit and you can see it here with my fingers
it you know if originally it's holding the tooth in tightly but
by pushing the instrument in it expands a little bit and makes the hole bigger that just makes it
easier to get the tooth out so I'll do that all the way around try to get it down as far as I can
and I'll actually in a lot of situations uh especially if it's just like a uh say
a broken off tooth where there's just the root that's left just by doing this this is enough to
remove the tooth especially for a front tooth which only has one root you can work this all
the way around and a lot of times that's the one instrument I need and basically you just kind of
work push and as you can see the tooth kind of pops up, up and out of the socket and once that
happens it's loose enough sometimes you can just grab it with your fingers pull it out all the way
or your pair of forceps on molar teeth though usually that's just the start of loosening it up
and then and by doing that cutting the ligament and opening the space up in the bone that gives
me some more room to use the next instrument which is a straight elevator so the first one
that I usually grab is called a 301 that's just the size of it this is one of the smaller ones
so it's a similar shape to the luxator except instead of it having a really fine tapered point
it's a little blunter on the end uh but the instrument itself it's a lot
stronger and uh heavier duty you can use a lot more force with this so again I'll use it in
that same way try to push it down in between but I'm also going to start twisting it a little bit
side to side just get it get it down in between there try to get the tooth
and I'll even twist try to get work itself further down in there to again try to pop the tooth up
and to expand the bone and to cut the ligaments and this is strong enough that I will actually
even you know I can even by twisting it you know if I put it in in between I can twist it
and it'll use the leverage of the instrument against the jawbone to try to push the tooth
up and out now with this though twisting it you got to be real careful you don't want to
put any pressure on the tooth next to the tooth you're pulling unless you're pulling that tooth
as well because if you just go in there and twist away you can you can damage the tooth
that you're trying to keep so you have to be very careful as to how you're directing the forces you
only want to push against the tooth and between the tooth and the jawbone and you can use the
jawbone as a fulcrum so you got to be careful to do that and again once once i get the tooth moving
quite a bit a lot of times I can you can actually get the tooth out with just this instrument uh but
the key is to try to get moving as much as you can the more you get the tooth moving the easier it is
you know that's how it's going to come out if I can't get the tooth out with this then the last
instrument I'll grab is a forcep basically this is the fancy dental pliers that we use to pull
a tooth so once I get the tooth moving and but I can't get the tooth out of the socket I'll
use this so this is a lower forcep it's got a little bit different shape than an upper forcep
but this one you grab the tooth and you can just try to rotate it a tiny bit you don't want to go
too much because if you go too much you can snap a root off and then you want to press
it you know towards the cheek towards the tongue and you keep working it until finally
there you go it comes out and you get the tooth out and that's usually those are my
you know the three instruments that I use majority of the time again either
the spade proximator or and or the luxator to start with then this 301 straight elevator
and then finally a type of forcep now there are other instruments I'll use as well depending on
the situation so for a molar lower molar such as this as you can see it's got those two roots all
there's another type of forcep called the cowhorn which is going to be a little bit different so
shape it's got these two prongs on it you know kind of look like the horns of a cow versus
the traditional forcep which grabs
what the two prongs will do is you get it you grab the tooth right at the gum line force it
down as far as you can and then you squeeze and what will happen is you know you by pressing
down and squeezing it forces those tips down under the gums a little bit and it actually
follows the shape of the tooth and tries to pop the tooth up you know ideally you want to get the
forceps down far enough so that they go into the space where the two roots meet into the furcation
and the action you use for that once you get them in there is you pump them you know by squeezing
pump the handle and you know a few times and then take the tooth and you push it towards the towards
the the tongue push it towards the cheek sometimes you'll do even like a little figure eight motion
until finally the tooth will pop out these are nice to have for lower molars because of the shape
there are other a ton of different other elevators uh with different shapes uh here's another one
called a crane pick this one's actually even a different version of the Crane pick this is the
Dr. Murph Crane pick uh that's used a lot for I like using this one for upper molar so pretend
it's an upper molar this one's nice because you can just kind of wedge it in between
and you can because of how its shape you can kind of get it underneath that very last tooth and just
with a twisting motion you can get that tooth out by pressing up against the jaw bone up there and
the tooth will pop out so that works very well and then there's also tons of other designs for
for wisdom teeth have lots of different ones have different angles just so you can get into the back
areas of the mouth a little bit easier and then uh finally our my last thing that I use
is the dental hand piece it's a surgical handpiece and that we can use to either
uh cut the tooth in half because as you can see it's got two roots sometimes cutting it into half
and it's easier to remove one root and then you remove the second root
so we can either do that or we can even remove some of the jawbone from around the tooth
to make basically make the hole bigger so that the tooth comes out more easily and you can
just trough around it usually you just trough on the on the cheek side and then that'll you can
give you some give yourself make yourself some space to you get the elevator in there
to get the root out that works very well if the tooth's very broken down say it's a root canaled
tooth that cracked or it just keeps coming out in pieces and you're gonna have to go digging for it
but hopefully that gives you all an idea of the techniques and the instruments
that I use to extract teeth if you have any questions or comments please leave them down
below thank you guys so much for watching and let me know hey how how was your experience getting
a tooth pulled what did your dentist use did they use the forceps mostly did they use the elevators
did they use something else do they use proximators or luxators let
me know in the comments down below thanks so much bye-bye