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Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Tooth Extraction


Text Only Home | Graphic-Rich Site | Overview | Reason for Procedure | How Procedure is Performed | Prognosis | Specialists | Comorbid Conditions | Complications | Factors Influencing Duration | Length of Disability | Duration Trends | Ability to Work | Medical Codes | References

Medical Codes

ICD-9-CM:
23.01 - Extraction of Deciduous Tooth
23.09 - Extraction of Other Tooth; Extraction of Other Tooth NOS
23.11 - Removal of Residual Root
23.19 - Other Surgical Extraction of Tooth; Odontectomy NOS; Removal of Impacted Tooth; Tooth Extraction with Elevation of Mucoperiosteal Flap

Related Terms

  • Pulled Tooth
  • Tooth Removal

Overview

Tooth extraction is the removal of a tooth from its socket in the bone, either by pulling the tooth (forceps removal) or by cutting out (excising) the tooth (oral surgery).

Conditions leading to the need for tooth extraction include badly decayed teeth, broken teeth, crowded teeth, inappropriate contact between teeth when the mouth is closed (malocclusion), and teeth that have become loose because of inflammation of the ligaments and bones that support the teeth (periodontal disease).

Source: Medical Disability Advisor



Reason for Procedure

Tooth extraction is performed to achieve a better positioning of teeth or to improve the structure of the mouth for more efficient mastication. Impacted wisdom teeth are commonly removed because of the pressure they may exert on other teeth, causing teeth to shift in the jaw. Teeth may also be extracted to make more room in the mouth, especially if the teeth are going to be straightened (orthodontia) or if the teeth are so badly positioned that straightening is not an option. Extraction is also used when teeth are so badly decayed or broken that restoring them is impossible. Individuals sometimes choose extraction as a less expensive alternative to having a decayed tooth filled or having root canal and placement of a crown.

Oral surgery may be a better option than extraction with forceps when teeth are severely broken or impacted. Sometimes teeth are so severely broken that there is not enough of the tooth above the gum (crown) to be gripped by the forceps. There is also the chance that severely broken teeth may break further or shatter from the pressure of the forceps. Impacted teeth often crowd adjacent teeth so badly that a forceps extraction could damage the other teeth.

Source: Medical Disability Advisor



How Procedure is Performed

Local anesthesia will be used for tooth extraction if the tooth is exposed and the dental surgeon feels that it can be removed easily in one piece. A special instrument (elevator) will be wedged in alongside of the tooth, allowing the dentist to loosen it by rocking the tooth back and forth. The rocking motion progressively widens the space between the tooth and its anchoring attachments in the bone. Once the tooth is dislocated from bone, it is easily removed with forceps.

If the tooth is not fully erupted, the dentist may find it necessary to remove some of the overlying gum and bone tissue in order to free the tooth. If indications are that the extraction may be difficult, the dentist may refer the individual to an oral surgeon, who may administer nitrous oxide, intravenous sedatives, or a general anesthetic to perform a painless procedure. It may be necessary to remove an impacted tooth or a tooth with curved roots by cutting through gum tissue to expose the tooth. Portions of the anchoring bone may also need removal to free the tooth. In some cases, the exposed portion of the molars may be cut longitudinally down between their roots so the tooth may more easily be removed in sections. Stitches may or may not be needed to close up the incision.

Source: Medical Disability Advisor



Prognosis

Extraction usually corrects the underlying problem, and the wound heals completely in about 2 weeks. If multiple teeth are extracted, the healing time may be longer. A 3- to 6-month period may be required for bone and soft tissue to be completely healed and restructured, especially in more complex procedures. More than six teeth extracted in each arch is considered a more complex procedure with increased healing time.

Most extractions result in complete healing without complications.

Source: Medical Disability Advisor



Specialists

  • Dentist
  • Oral/Maxillofacial Surgeon

Source: Medical Disability Advisor



Comorbid Conditions

  • Diabetes
  • Immune system disorders

Source: Medical Disability Advisor



Complications

Potential complications of tooth extraction include bleeding and infection. Besides infection of the extraction site, infection of the membrane that lines the interior of the heart (endocarditis) is possible in individuals with heart murmurs or a history of rheumatic fever. These individuals may be given antibiotics before and after the procedure to minimize risk. Following an extraction, blood begins to nourish the tooth socket, and a clot forms. If a clot does not form, dry socket (alveolar osteitis) may result, in which the underlying bone is exposed to air and food, causing severe pain and prolonging healing time.

In some cases, the underlying support structure of the tooth is weakened in the removal of the tooth, and reconstructive surgery is required at the same time. Occasionally, the alveolar nerve is damaged during extraction of lower molars, causing temporary (and sometimes permanent) numbness in the jaw.

Following an extraction, the teeth begin to shift. This can result in the teeth not meeting properly (malocclusion), which could lead to difficulty chewing and painful complications associated with the joint at the angle of the jaw (temporomandibular joint, or TMJ). That is why the dentist will want to restore the space with a bridge, implant, or denture.

Other complications include jaw fracture and jaw joint pain.

Source: Medical Disability Advisor



Factors Influencing Duration

Factors that might influence the length of disability after tooth extractions include the type of extraction (forceps or surgery), infections, and presence of complications after treatment, such as swelling or bleeding. Dry socket can prolong healing. If oral surgery is performed, surgical complications (e.g., general anesthesia complications) may occur in addition to the dental complications.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

After a surgical or forceps extraction, most individuals will require at least 1 day of rest following the procedure. For the first day or two after tooth extraction, aftercare may require frequent rinsing of the mouth or placement of an icepack to reduce swelling, requiring access to a restroom sink and a source of ice. If bone recontouring is performed for the placement of dentures, healing can be up to 1 week before the individual is comfortable and the dentures stable enough to return to work.

Source: Medical Disability Advisor



References

General

"Oral Health 2000: Facts and Figures." Centers for Disease Control and Prevention. U.S. Department of Health and Human Services. 22 May 2005 <http://www.cdc.gov/OralHealth/factsheets/sgr2000-fs1.htm>.

Source: Medical Disability Advisor