Clinical Contraindications and Restrictions

  • Tooth and Volume Restrictions
    • No impacted teeth.
    • Do NOT book for extraction of more than 3 teeth at any one time.
      • No wisdom teeth that are inverted (upside down) or canines positioned in the nasal region.
        • Root fragments may exceed the 3-tooth limit but require prior tutor consultation.
  • Medical and Treatment History
    • No patients requiring sedation.
    • No patients requiring antibiotic (AB) cover.
      • No patients unable to tolerate treatment sounds and stimulation.
        • Antibiotic cover cases are excluded due to coordination difficulties.
    • No patients who have had previous Radiotherapy (RT) to the head and neck.
    • No patients on anti-resorptive agents (e.g., Bisphosphonates or Prolia).
    • No patients on immunosuppressants (e.g., Azathioprine or Methotrexate).
  • Medication Management (Anticoagulants and Anti-platelets)
    • Warfarin: Patients must have their INR checked within 24 hours prior to the extraction. The patient must bring their INR results to the appointment. - Acceptable INR range is up to 4.0, though 3.5 is preferred.
    • Dual Therapy: No patients on DUAL anti-platelets (e.g., Aspirin and Clopidogrel) or DUAL anti-coagulants (e.g., Aspirin and Rivaroxaban). - These patients experience significant oozing and represent the highest risk for haemostasis failure.
    • Single Therapy: It is acceptable to book patients on a single anti-platelet or a new oral anti-coagulant (Aspirin OR a NOAC). - Includes apixaban, rivaroxaban, and dabigatran; local haemostatic measures are sufficient.

Extractions and Prosthodontics[^7]

Clinical Coordination and Scheduling

  • Bridge Sectioning: If bridge sectioning is required before extraction(s), ensure this is completed prior to the patient attending the extraction clinic.
    • The clinic is not equipped for extensive handpiece work; sectioning can take up to 1 hour, leaving no time for the extraction.
  • Session Capacity: Each chair in the extraction clinic can accommodate two patients per session. Each appointment duration is 1 hour 45 minutes.
    • Students should expect initial appointment durations of 80–90 minutes including waiting times and documentation.

Prosthetic Considerations

  • Denture Insertion: Immediate complete and partial dentures can be inserted in the extraction clinic.
  • Follow-up Care: Review appointments must be organized by the usual student clinician in a CC session.
  • Patient Informed Consent: Patients must be warned that if the prosthesis fails to fit, there is limited corrective action that can be taken within the extraction clinic setting.