Iserson Kenneth V
Department of Emergency Medicine, University of Arizona College of Medicine, Tucson, AZ.
Wilderness Environ Med. 2013 Dec;24(4):384-9. doi: 10.1016/j.wem.2013.07.001. Epub 2013 Sep 26.
Extracting a tooth is the final treatment for multiple dental problems. Persons who are not dentists, however, have little experience with tooth extractions. When a remote setting makes it impossible to send a patient for optimal dental treatment, the clinician may need to extract teeth, sometimes using improvised equipment. The following cases of two patients with three carious, painful molars describe such a situation. The non-dental clinicians had to improvise not only appropriate dental tools, but also personal protective equipment, a functional suction machine, medications for a dental block, a dental chair, and dental consent forms and follow-up instructions in the patients' language. In these cases, they also communicated with their patients through a translator. To prepare to do tooth extractions in remote settings, clinicians should learn and practice dental blocks and review extraction techniques before they deploy. If they must do an extraction, clinicians should use the closest approximation available to the appropriate dental tools. When done correctly, a dental extraction can take some time and should not be rushed.
拔牙是多种牙齿问题的最终治疗手段。然而，非牙医人员对拔牙的经验很少。当身处偏远地区而无法将患者送去接受最佳牙科治疗时，临床医生可能需要拔牙，有时还要使用临时拼凑的设备。以下两名患者患有三颗龋齿且疼痛的磨牙的病例就描述了这样一种情况。非牙科临床医生不仅要临时制作合适的牙科工具，还要制作个人防护设备、一台可用的抽吸机、用于局部麻醉的药物、一把牙科椅，以及用患者的语言书写的牙科同意书和后续说明。在这些病例中，他们还通过翻译与患者沟通。为准备在偏远地区进行拔牙，临床医生在出发前应学习并练习局部麻醉，并复习拔牙技术。如果必须进行拔牙，临床医生应使用最接近合适牙科工具的替代品。操作正确的话，拔牙会需要一些时间，不应操之过急。
