Principles Involved in Oral Surgery

Oral surgery is a surgical discipline which needs firm devotion to a set of principles to deliver the best potential outcomes for the patient. Some principles involved in oral surgery are grouped into four categories. These are:

1. Preoperative evaluation in oral surgery
2. Exodontia
3. Surgical techniques involved
4. Contraindications for tooth extraction

1. Preoperative evaluation in oral surgery
   A thorough preoperative examination is must before any surgical treatment.
   Procedure of preoperative examination involves:

• Initial assessment: By obtaining a concise medical and dental history, a dentist is able to find out the patient’s ability to tolerate the treatment plan.
• Physical examination: Physical examination is done to examine the entire oral cavity for any abnormal conditions for which the patient seeks treatment and any other condition which also needs to be treated.
• Panoramic radiograph: Radiographs of good quality are important to evaluate the condition. They are mainly useful in survey of maxilla/ mandible and teeth.
• Developing a surgical plan: A full surgical plan is developed which mainly includes two components viz. general management (treatment plan) and surgical management (medication and post-care steps).

2. Exodontia
Dental tooth extraction needs to take the following elements into consideration:

• Instrumentation: Several trays containing range of standard sterile surgical instruments should be prepared in advance. Some of the standard tray instruments includes following:
• Sterile surgical dental handpieces
• Fissure and round burs
• Bone file
• Forceps
• Elevators

• Lighting: Dental light should be adequate at the operative site. Headlight proves to be a more beneficial one.

• Asepsis: Aseptic techniques should be strictly followed in oral surgery to avoid contamination and infections. The intermediate objects which can be the reason of cross-contamination involves:
• Light
• Chair adjustment lever
• Electricity switches
• Pen
• Telephone

These weak links can be circumvented by using items like masks, sterile gloves, protective outwear, eye protection, sterile suction tubing on each tray. Dental instruments which can withstand heat should be autoclaved for reuse.

• Analgesia: Oral surgery is preceded by giving local analgesia to the patient at the site of surgery. Intravenous sedatives do not provide local analgesia. Some patients can be effectively treated with local anesthetics while others require general anesthetics
• Surgical assistance: Well-trained surgical assistant helps an oral surgeon to perform the surgery neatly and cleanly.
• Hemostasis: While performing an oral surgery, it is important to control the bleeding at the surgery site. Patients with the history of bleeding problems and those taking anticoagulants require great attention before, during and after the surgery.

3. Surgical techniques involved
A minimal post-operative pain, swelling and bleeding is experienced if the surgery has been done carefully. Steps involved in careful surgical techniques are:

• Access to operative field
• Unhindered path for the removal of tooth
• Controlling bleeding

4. Contraindications for tooth extraction
Contraindication is common in tooth extraction. It can be relative or absolute depending upon the condition of the patient. Some of the common among them are:

• Oral sepsis
• Acute dental infections
• Uncontrolled medical disease

An oral surgeon should adhere to these set of principles to give best possible treatment to patients. Surgical principles are necessary for the successful completion of an oral surgery. We at our San Diego clinic are practicing all the principles of oral surgery.

See Also:

http://www.slideshare.net/safariandentalimplants/laser-oral-maxillofacial-surgery