Role of Assistant during Extraction
For a successful outcome in any surgical procedure, it is essential to have a competent assistant. During the extraction the assistant plays a variety of important roles that contribute to making the surgical experience atraumatic, The assistant helps the surgeon visualize and gain access to the operative area by ref!e~ting the soft tissue of unobstructed view of the surgical field Even during ‘a closed extraction, the assistant can reflect the soft tissue so that the surgeon can ‘apply the instruments to loosen the soft tissue attachment and adapt the forceps to the tooth and tooth root in the most effective manner.
Another major activity of the assistant is to suction away blood, saliva and the irrigating solutions used during the surgical procedure. This prevents fluids from ‘. accumulating and makes proper visualization of the surgical field possible. Suctioning is also important for patient comfort, because most patients are unable to tolerate an accumulation of blood or other fluids in their mouths. During a surgical procedure it is almost.impossible for the assistant to suction too much.
During the extraction the assistant should also help to protect the teeth of the opposite arch, which is especially important when removing lower posterior teeth. If traction forces are necessary to remove a lower tooth, occasionally the tooth releases suddenly and the forceps strike the maxillary teeth and sometimes fracture a tooth cusp. The assistant should hold either a suction tip or a finger against the maxillary teeth to protect them from an unexpected blow.
During the extraction of mandibular teeth, the assistant may play an important role by supporting the mandible during the application of the extraction forces. A surgeon who uses the hand to reflect the soft tissue may not be able to support the mandible. If this is the case, the assistant plays an important role in stabilizing the mandible to prevent TMJ discomfort. Most often the surgeon stabilizes the mandible, which makes this role less important for the assistant.
The assistant also provides psychologic and emotional support for the patient by helping alleviate patient anxiety during the surgery. The assistant is important in gaining the patient’s confidence and cooperation by using positive language and physical contact with the patient during the preparation and performance of the surgery. The assistant should avoid making casual, offhand comments that may increase the patients’ anxiety and lessen their cooperation.