Special Operations Forces Medical Handbook

5-25

4. TOOTH EXTRACTION
   a. This section describes only one extraction technique. Although many types of extraction forceps are
   manufactured, the removal of any erupted tooth can usually be done with one of two instruments: The
   Maxillary Universal Forceps (150) or the Mandibular Universal Forceps (151).
   b. Technique.
   
   
   1. Break the attachment of the gingival tissue to the tooth by forcing a blunt instrument (Periosteal
      Elevator, Woodson Plastic Instrument, etc.) into the crevice between the tooth and the gingiva,
      all the way around the tooth. The tooth-tissue attachment should be broken to the level of the
      alveolar bone.
   
   
   2. Use the free hand to guide the beaks of the forceps under the gingival margin on the facial and
      lingual aspects of the tooth and to support the alveolar process. Apply pressure toward the root of
      the tooth to force the tips of the forceps as far down on the root as possible.
   
   
   3. To loosen teeth with more than one root (molars and upper first bicuspids): slowly rock the tooth
      with progressively increasing traction in a facial-lingual direction. To loosen single-rooted teeth
      combine this rocking motion with rotation. (see Figure 5-7)
   
   
   4. When the tooth is loose, deliver it by exerting gentle traction. Note the direction in which the
      tooth moves most easily and follow this path for delivery.
   
   
   5. Inspect the extracted tooth to determine if the roots have been fractured.
   
   
   6. After the extraction, compress the sides of the empty socket (this repositions the bone that has
   
   
   
   

1 root

1 root

3 roots

2 roots

1 or 2

roots

Figure 5- 7

Associated Roots