Dental Extraction Off the Grid

In a survival scenario, the family medic will be called on to care not only for medical issues, but dental as well. Military medics during the Vietnam War reported that they dealt with dental problems almost as often as medical. While dental training was relatively informal back then, A special operations combat medic today may train to become a Special Operations Medical Sergeant, undertaking training not only in dental care (including extractions) but other outside-the-box skills, as well.

When the miracle of modern dentistry isn’t around to save a damaged tooth, we may have to return to tooth extraction as the treatment of choice for most dental emergencies. In any situation that involves long-term loss of power, the medic will eventually be confronted with a tooth that must be extracted. Indeed, the grand majority of dental emergencies can be resolved that way.

Tooth extraction is not an enjoyable experience as it is, and will be less so in a long-term survival situation with no power and limited supplies. Unlike baby teeth, a permanent tooth is unlikely to be removed simply by wiggling it out with your (gloved) hand or tying a string to it and the nearest doorknob and slamming. Knowledge of the extraction procedure with limited supplies, however, will be important for anyone expecting to be the family caregiver off the grid.

Note: Be aware that It is illegal and punishable by law to practice dentistry without a license. The lack of formal training or experience in dentistry may cause complications that are much worse than a bum tooth. If you are lucky enough to have access to modern dental care, seek it out.

Once a decision has been reached to remove a tooth, recent studies suggest that giving 800 mg of ibuprofen before dental procedures helps relieve post-extraction pain significantly. Have a good supply of this useful medication in storage.

Proper positioning will help you perform the procedure more easily. For an upper extraction (also called a “maxillary extraction”), the patient should be tipped at a 60-degree angle to the floor. The patient’s mouth should be at the level of the medic’s elbow. For a lower extraction, (also called a “mandibular extraction”), the patient should be sitting upright with the level of the mouth lower than the medic’s elbow.

Right-handed medics should stand to the right of the patient; left-handers stand to the left. For uppers and most front lower extractions, it is best to position yourself in front. For lower molars, some prefer to position themselves behind the patient.

The medic will want to wash hands and put on gloves, a face mask, and some eye protection. The area around the tooth should be kept as dry as possible, so that the area can be easily visualized. There will be some bleeding, so place cotton rolls or balls around the tooth to be removed (rolled gauze squares will also work in a pinch). These may have to be changed from time to time.

Teeth are anchored in their sockets by ligaments, which are fibrous bands of connective tissue. These ligaments must be severed to loosen the tooth. This goal is best accomplished with dental elevators, instruments which come in various shapes. Some may appear like a screwdriver with a very small head;  others like a tiny chisel, shovel, or arrowhead.

Once loosened, instruments called extraction forceps are used to remove the tooth. These are specialized for each type of tooth (incisors, canines, premolars, molars). Indeed, there are more types of extractors than there are teeth.

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