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Dentistry948 papers

Loss of teeth

Last edited: 4/14/2026

Overview

Loss of teeth refers to the permanent absence of teeth due to extraction, decay, or other dental conditions, impacting oral function and quality of life.

Diagnosis

  • Clinical assessment including patient history and oral examination 529.
  • Radiographic evaluation (X-rays) to assess tooth structure and surrounding bone 5.
  • Specific grading systems for tooth extraction complications not explicitly detailed in provided abstracts.

    • Management

  • Sedation Techniques:
    • - Oral midazolam vs. nitrous oxide inhalation for anxiety control during extraction 5. - Ketamine-propofol and ketamine-dexmedetomidine combinations for pediatric sedation 14. - Sevoflurane inhalation sedation for outpatient procedures 33.
  • Analgesia: Local anesthetics combined with sedation protocols 529.
  • Post-extraction Care: Instructions on oral hygiene, pain management, and follow-up appointments 5.

    • Special Populations

  • Pregnancy: Specific considerations for Rh D immune globulin administration after pregnancy loss <12 weeks 3.
  • Pediatrics: Use of ketamine-based sedation protocols for safer pediatric tooth extraction 14.
  • Elderly: Increased focus on comprehensive assessment and tailored sedation approaches due to potential comorbidities 29.
  • Comorbidities: Tailored sedation and analgesia plans considering underlying health conditions 529.

    • Key Recommendations

  • Utilize oral midazolam or nitrous oxide inhalation for sedation during tooth extraction based on patient preference and clinical scenario (Evidence: Moderate 5).
  • For pediatric patients, consider ketamine-based sedation protocols to ensure safety and efficacy during dental procedures (Evidence: Moderate 14).
  • Administer Rh D immune globulin following pregnancy loss under 12 weeks gestation in Rh-negative women to prevent alloimmunization (Evidence: Strong 3).
  • Implement structured counseling curricula for medical students to improve early pregnancy loss management and support (Evidence: Moderate 18).
  • Provide comprehensive post-extraction care instructions emphasizing oral hygiene and follow-up to prevent complications (Evidence: Expert opinion).

    • References

    1 Pymar H, Waddington A, Prager S, Shorter J, Thomas J. Guideline No. 460: Diagnosis and Management of Intrauterine Early Pregnancy Loss. Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC 2025. link 2 Nelles-McGee T, Mockler C, Ross-White A, Pudwell J, Smith G. Grief and Bereavement Training in OB/GYN: A Review and Survey of Canadian Residents and Programs. Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC 2025. link 3 . ACOG Clinical Practice Update: Rh D Immune Globulin Administration After Abortion or Pregnancy Loss at Less Than 12 Weeks of Gestation. Obstetrics and gynecology 2024. link 4 Shaaban M, Shepelak ZD, Stanford JB, Silver RM, Mumford SL, Schisterman EF et al.. Low-dose aspirin, maternal cardiometabolic health, and offspring respiratory health 9 to 14 years after delivery: Findings from the EAGeR Follow-up Study. Paediatric and perinatal epidemiology 2024. link 5 Li X, Liu Y, Li C, Wang J. Sedative and adverse effect comparison between oral midazolam and nitrous oxide inhalation in tooth extraction: a meta-analysis. BMC oral health 2023. link 6 Liu S, Athurupana R, Han H, Yang T, Nakatsuka M. Japanese Nursing Staff's Knowledge and Attitude toward Bereavement Care for Couples with Miscarriage/Stillbirth and Its Associated Factors. Acta medica Okayama 2023. link 7 Long-Sutehall T, Bracher M, Mollart S, Wale J. Eye donation from palliative and hospice care contexts: the EDiPPPP mixed-methods study. Health and social care delivery research 2023. link 8 Christoffoli MT, Bachesk AB, Farah GJ, Ferreira GZ. Assessment of Passiflora incarnata L for conscious sedation of patients during the extraction of mandibular third molars: a randomized, split-mouth, double-blind, crossover study. Quintessence international (Berlin, Germany : 1985) 2021. link 9 Ongaro D, Terry J. Reproducibility of Grading in Chronic Intervillositis of Unknown Etiology. Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society 2020. link 10 Thornton R, Nicholson P, Harms L. Creating Evidence: Findings from a Grounded Theory of Memory-Making in Neonatal Bereavement Care in Australia. Journal of pediatric nursing 2020. link 11 Helps Ä, O'Donoghue K, O'Byrne L, Greene R, Leitao S. Impact of bereavement care and pregnancy loss services on families: Findings and recommendations from Irish inquiry reports. Midwifery 2020. link 12 Peshkova AD, Safiullina SI, Evtugina NG, Baras YS, Ataullakhanov FI, Weisel JW et al.. Premorbid Hemostasis in Women with a History of Pregnancy Loss. Thrombosis and haemostasis 2019. link 13 Hom BL, Bause GS. James M. Osgood: An Inventor Behind Sprague's "Self-Watching" Apparatus for G.Q. Colton's Revival of Nitrous-Oxide Anesthesia. Journal of anesthesia history 2019. link 14 Canpolat DG, Yildirim MD, Kutuk N, Dogruel F, Ocak H, Aksu R et al.. Comparison of ketamine-propofol and ketamine-dexmedetomidine combinations in children for sedation during tooth extraction. JPMA. The Journal of the Pakistan Medical Association 2017. link 15 . Prevention is better than compensation. Nursing standard (Royal College of Nursing (Great Britain) : 1987) 2017. link 16 Washburn J. A Room with a View. The American journal of nursing 2016. link 17 . Pregnancy loss and the death of a baby. Nursing management (Harrow, London, England : 1994) 2016. link 18 Marko EK, Buery-Joyner SD, Sheridan MJ, Nieves K, Khoury AN, Dalrymple JL. Structured Teaching of Early Pregnancy Loss Counseling. Obstetrics and gynecology 2015. link 19 Wilson TD, McNeil DW, Kyle BN, Weaver BD, Graves RW. Effects of conscious sedation on patient recall of anxiety and pain after oral surgery. Oral surgery, oral medicine, oral pathology and oral radiology 2014. link 20 Gillespie-Gallery H, Subramanian A, Conway ML. Micro-costing the provision of emotional support and information in UK eye clinics. BMC health services research 2013. link 21 Abdullah WA, Sheta SA, Nooh NS. Inhaled methoxyflurane (Penthrox) sedation for third molar extraction: a comparison to nitrous oxide sedation. Australian dental journal 2011. link 22 Göktay O, Satilmiş T, Garip H, Gönül O, Göker K. A comparison of the effects of midazolam/fentanyl and midazolam/tramadol for conscious intravenous sedation during third molar extraction. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons 2011. link 23 Yong PJ, McFadden DE, Robinson WP. Developmental origin of chorionic villus cultures from spontaneous abortion and chorionic villus sampling. Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC 2011. link34877-0) 24 Moore A. Easing the pain of loss. Nursing standard (Royal College of Nursing (Great Britain) : 1987) 2009. link 25 Lightstone A. Eye health and sight loss: the UK Vision Strategy. The journal of family health care 2008. link 26 Garip H, Gürkan Y, Toker K, Göker K. A comparison of midazolam and midazolam with remifentanil for patient-controlled sedation during operations on third molars. The British journal of oral & maxillofacial surgery 2007. link 27 Kwak HJ, Kim JY, Kwak YL, Park WS, Lee KC. Comparison of a bolus of fentanyl with an infusion of alfentanil during target-controlled propofol infusion in third molar extraction under conscious sedation. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons 2006. link 28 Singh P, Stewart K, Moses S. Pastoral care following pregnancy loss: the role of ritual. The journal of pastoral care & counseling : JPCC 2004. link 29 Manani G, Bazzato MF, Boscolo I, Cordioli ML, Fabris E, Marino D et al.. Combined sedation with oral chlordemethyldiazepam and midazolam by nasal route in third molar surgery. Minerva stomatologica 2004. link 30 Browne M. The nurse's role in helping patients cope with sight loss. Nursing times 2003. link 31 Sandler NA, Sparks BS. The use of bispectral analysis in patients undergoing intravenous sedation for third molar extractions. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons 2000. link90911-x) 32 Rodrigo MR, Fung SC. Comparison of two techniques of patient-controlled sedation with midazolam. The British journal of oral & maxillofacial surgery 1999. link 33 Ganzberg S, Weaver J, Beck FM, McCaffrey G. Use of sevoflurane inhalation sedation for outpatient third molar surgery. Anesthesia progress 1999. link 34 Sidhu HK, McElhinney B, Dornan JC. Transabdominal cervicoisthmic cerclage: initial experience. The Ulster medical journal 1997. link 35 Davies M, Geoghegan J. Developing an early pregnancy assessment unit. Nursing times 1994. link

    Original source

    1. [1]
      Guideline No. 460: Diagnosis and Management of Intrauterine Early Pregnancy Loss. — Pymar H, Waddington A, Prager S, Shorter J, Thomas J Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC (2025)
    2. [2]
      Grief and Bereavement Training in OB/GYN: A Review and Survey of Canadian Residents and Programs. — Nelles-McGee T, Mockler C, Ross-White A, Pudwell J, Smith G Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC (2025)
    3. [3]
      ACOG Clinical Practice Update: Rh D Immune Globulin Administration After Abortion or Pregnancy Loss at Less Than 12 Weeks of Gestation. Obstetrics and gynecology (2024)
    4. [4]
      Low-dose aspirin, maternal cardiometabolic health, and offspring respiratory health 9 to 14 years after delivery: Findings from the EAGeR Follow-up Study. — Shaaban M, Shepelak ZD, Stanford JB, Silver RM, Mumford SL, Schisterman EF et al. Paediatric and perinatal epidemiology (2024)
    5. [5]
      Sedative and adverse effect comparison between oral midazolam and nitrous oxide inhalation in tooth extraction: a meta-analysis. — Li X, Liu Y, Li C, Wang J BMC oral health (2023)
    6. [6]
      Japanese Nursing Staff's Knowledge and Attitude toward Bereavement Care for Couples with Miscarriage/Stillbirth and Its Associated Factors. — Liu S, Athurupana R, Han H, Yang T, Nakatsuka M Acta medica Okayama (2023)
    7. [7]
      Eye donation from palliative and hospice care contexts: the EDiPPPP mixed-methods study. — Long-Sutehall T, Bracher M, Mollart S, Wale J Health and social care delivery research (2023)
    8. [8]
      Assessment of Passiflora incarnata L for conscious sedation of patients during the extraction of mandibular third molars: a randomized, split-mouth, double-blind, crossover study. — Christoffoli MT, Bachesk AB, Farah GJ, Ferreira GZ Quintessence international (Berlin, Germany : 1985) (2021)
    9. [9]
      Reproducibility of Grading in Chronic Intervillositis of Unknown Etiology. — Ongaro D, Terry J Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society (2020)
    10. [10]
      Creating Evidence: Findings from a Grounded Theory of Memory-Making in Neonatal Bereavement Care in Australia. — Thornton R, Nicholson P, Harms L Journal of pediatric nursing (2020)
    11. [11]
      Impact of bereavement care and pregnancy loss services on families: Findings and recommendations from Irish inquiry reports. — Helps Ä, O'Donoghue K, O'Byrne L, Greene R, Leitao S Midwifery (2020)
    12. [12]
      Premorbid Hemostasis in Women with a History of Pregnancy Loss. — Peshkova AD, Safiullina SI, Evtugina NG, Baras YS, Ataullakhanov FI, Weisel JW et al. Thrombosis and haemostasis (2019)
    13. [13]
      James M. Osgood: An Inventor Behind Sprague's "Self-Watching" Apparatus for G.Q. Colton's Revival of Nitrous-Oxide Anesthesia. — Hom BL, Bause GS Journal of anesthesia history (2019)
    14. [14]
      Comparison of ketamine-propofol and ketamine-dexmedetomidine combinations in children for sedation during tooth extraction. — Canpolat DG, Yildirim MD, Kutuk N, Dogruel F, Ocak H, Aksu R et al. JPMA. The Journal of the Pakistan Medical Association (2017)
    15. [15]
      Prevention is better than compensation. Nursing standard (Royal College of Nursing (Great Britain) : 1987) (2017)
    16. [16]
      A Room with a View. — Washburn J The American journal of nursing (2016)
    17. [17]
      Pregnancy loss and the death of a baby. Nursing management (Harrow, London, England : 1994) (2016)
    18. [18]
      Structured Teaching of Early Pregnancy Loss Counseling. — Marko EK, Buery-Joyner SD, Sheridan MJ, Nieves K, Khoury AN, Dalrymple JL Obstetrics and gynecology (2015)
    19. [19]
      Effects of conscious sedation on patient recall of anxiety and pain after oral surgery. — Wilson TD, McNeil DW, Kyle BN, Weaver BD, Graves RW Oral surgery, oral medicine, oral pathology and oral radiology (2014)
    20. [20]
      Micro-costing the provision of emotional support and information in UK eye clinics. — Gillespie-Gallery H, Subramanian A, Conway ML BMC health services research (2013)
    21. [21]
      Inhaled methoxyflurane (Penthrox) sedation for third molar extraction: a comparison to nitrous oxide sedation. — Abdullah WA, Sheta SA, Nooh NS Australian dental journal (2011)
    22. [22]
      A comparison of the effects of midazolam/fentanyl and midazolam/tramadol for conscious intravenous sedation during third molar extraction. — Göktay O, Satilmiş T, Garip H, Gönül O, Göker K Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons (2011)
    23. [23]
      Developmental origin of chorionic villus cultures from spontaneous abortion and chorionic villus sampling. — Yong PJ, McFadden DE, Robinson WP Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC (2011)
    24. [24]
      Easing the pain of loss. — Moore A Nursing standard (Royal College of Nursing (Great Britain) : 1987) (2009)
    25. [25]
      Eye health and sight loss: the UK Vision Strategy. — Lightstone A The journal of family health care (2008)
    26. [26]
      A comparison of midazolam and midazolam with remifentanil for patient-controlled sedation during operations on third molars. — Garip H, Gürkan Y, Toker K, Göker K The British journal of oral & maxillofacial surgery (2007)
    27. [27]
      Comparison of a bolus of fentanyl with an infusion of alfentanil during target-controlled propofol infusion in third molar extraction under conscious sedation. — Kwak HJ, Kim JY, Kwak YL, Park WS, Lee KC Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons (2006)
    28. [28]
      Pastoral care following pregnancy loss: the role of ritual. — Singh P, Stewart K, Moses S The journal of pastoral care & counseling : JPCC (2004)
    29. [29]
      Combined sedation with oral chlordemethyldiazepam and midazolam by nasal route in third molar surgery. — Manani G, Bazzato MF, Boscolo I, Cordioli ML, Fabris E, Marino D et al. Minerva stomatologica (2004)
    30. [30]
      The nurse's role in helping patients cope with sight loss. — Browne M Nursing times (2003)
    31. [31]
      The use of bispectral analysis in patients undergoing intravenous sedation for third molar extractions. — Sandler NA, Sparks BS Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons (2000)
    32. [32]
      Comparison of two techniques of patient-controlled sedation with midazolam. — Rodrigo MR, Fung SC The British journal of oral & maxillofacial surgery (1999)
    33. [33]
      Use of sevoflurane inhalation sedation for outpatient third molar surgery. — Ganzberg S, Weaver J, Beck FM, McCaffrey G Anesthesia progress (1999)
    34. [34]
      Transabdominal cervicoisthmic cerclage: initial experience. — Sidhu HK, McElhinney B, Dornan JC The Ulster medical journal (1997)
    35. [35]
      Developing an early pregnancy assessment unit. — Davies M, Geoghegan J Nursing times (1994)
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