Tooth Extraction

Tooth extraction is a process of removing or uprooting a tooth which decayed, damaged beyond repair and the tooth where the tissues and bones are completely damaged.

Reasons for tooth extraction:

A tooth extraction might be indicated if repairing a damaged tooth is not practical.

Extraction can be done under the following circumstances:

  1. Teeth with extensive decay (dental caries) or
  2. Teeth broken or cracked in such an extreme manner i.e. beyond repairable.
  3. In some cases the obstacles might be so formidable that a repair for the tooth is simply not possible.

In other cases the cost of dental treatment or else a dubious long-term outlook for the success of the treatment may be the reason why an extraction is chosen.

Teeth that are unsuitable candidates for root canal treatment should be extracted.

Malpositioned or nonfunctional teeth may need to be extracted.

Sometimes tooth extraction can be done for the ones which are mal-positioned and create constant irritation to the patients. For example, wisdom tooth which is a constant source of irritation to the person’s cheek can be remove during tooth extraction. Impacted teeth are often extracted. These are teeth with jaw bone positioning that cannot erupt into normal alignment. So by definition, impacted teeth are mal-positioned, precisely why they are often non-functional. This combination of factors makes impacted teeth common candidates for extraction.

Tooth extractions may be required in preparation for orthodontic treatment (Braces)

In an orthodontic treatment the dentist is trying to perfect the alignment of the patient’s teeth. But they can only do so within the confines the person’s jaw size. Especially in cases where a large discrepancy exists between the size of the patient’s jaws and the space needed— for the improved teeth alignment—some strategically located teeth may need to be extracted. Procedure for extracting tooth extraction: Using local anesthesia tooth can be extracted easily. Dentists use a special tool called elevator to loosen the tooth to be extracted by widening the space in the bone. Once the tooth is loosened it can be pulled out with forceps. In cases where the tooth is exposed and appears to be easily removable in one piece local anesthesia is used for numbing the area to be affected of the tooth.. Most dentists or oral surgeons use an instrument called an elevator to luxate, or loosen, the tooth; widen the space in the underlying bone; and break the tiny elastic fibers that attach the tooth to the bone. Once the tooth is dislocated from the bone, it can be lifted and removed with forceps.

Selection of anestthetic agent :

Choice is determined by :

  1. Patient’s desire.
  2. Operating dentist’s personal preferences.
  3. Patient’s physical condition.
  4. Age of the patient.
  5. Type of the operation.
  6. Condition of the operating site is there any infection.
  7. Place of operation.

Local Anesthesia is the choice in majority of cases.

Surgical extraction :


  1. Impacted teeth.
  2. When tooth fails to be extracted under intra alveolar method.
  3. If tooth is broken at alveolar level or the root is broken.


  1. Pre extraction evaluation of patient.
  2. Anesthesia.
  3. Elevation of mucoperiosteal flap.
  4. Bone removal — by chisel/mallet or burs.
  5. Techniques—
    a. Buccal guttering.
    b. Postage stamp technique.
  6. Tooth removal.
  7. Achieving haemostasis.
  8. Wound debridement.
  9. Suturing the mucoperiosteal flap.
  10. Post extraction instructions.
  11. Recall / review after 7 days and suture removal.

Post operative instructions :

Keep the sponge held firmly between your jaw and over the operative site for full half an hour. Do not use mouthwash for six hours after oral surgery; vigorous use of mouthwash may stimulate bleeding. In case of mild bleeding place lukewarm water in the mouth. In case of severe bleeding place a warm soaked tea bag over the bleeding and cover it with gauze biting firmly and call your dentist. In case of swelling and followed by discoloration, patient need not worry because it’s an absolutely normal event. Pain in case or afterwards of surgical procedure is a normal phenomenon. Post operative pain can be controlled by taking medicine. If severe pain develops accompanied by bad taste then return to your dentist for this treatment. To control swelling which develops post operatively apply ice pack or towels wrung out of ice water. Day after operation, apply heat to your face. Rigid cleanliness is necessary of the remaining teeth. Mouth wash in a glass of lukewarm water. This promotes healing. Avoid meat and food difficult to masticate for a few days. Eat plenty of fruits and drink eight to ten glasses of water, fruit juice and other fluids daily.

Post operative vitamin therapy :

  1. After oral surgery there is diminished in take of vitamin therapy i.e. Vitamin C & B complex.
  2. Drugs especially analgesics decrease the level of vitamin C in the body.
  3. Ascorbic acid is essential for the maintenance of normal cellular material of connective tissues, bone, teeth and blood vessels. If vitamin C level falls, healing is retarded, capillary fragility is increased. Some interesting facts about tooth extraction A human baby has 20 baby or milk teeth. These start to develop at about 6 months old and last until they are about 5 – 6 years old. A human adult has 32 teeth called permanent teeth. These start to grow when you are about 5 -6 years old. They replace your milk teeth.

Humans have three kinds of teeth, each carries out a different function:

These are your front teeth and are used for biting into your food. They are chisel or wedge-shaped. A human adult has 4 incisors in each jaw

These are pointed and are used for tearing. An adult human has 2 canines in each jaw.

The next teeth are the pre-molars and the molars. These are at the side of the mouth and are flat-topped. They are used for grinding food. An adult human has 4 pre-molars and 6 molars in each jaw. These are covered with a hard white material called enamel. The tooth is fixed into the bony jaw socket and held in place by cementam and is kept alive by a supply of blood and nerves.