Access to Tooth
The first factor to b examined In preoperative assessment Is the extent to which the patient can open the mouth. Any limitation of opening may compromise the ability of the surgeon to do a routine uncomplicated extraction. If the patient’s opening Is substantially compromised, the surgeon should plan for a surgical approach to the tooth Instead of a forceps extraction.Additionally the surgeon should look for the cause of the reduction of opening. The most likely causes are trismus associated with Infection, temporcmandlbular joint (TMJ)) dysfunction ( especially Internal joint derangement with displacement of the disk without reduction), and muscle fibrosis.
The location and position of the tooth to be extracted within a dental arch should be examined . A properly aligned tooth has a normal access for placement of elevators and forceps how ever crowded or otherwise mallopposed teeth may present difficulty in positioning the proper forceps onto the tooth for extraction when access is a problem a compromise forceps must be chosen or a surgical approach may be indicated.