Surgical Tooth Extraction – When it Becomes Necessary?

Everyone wants their teeth to stay intact for their lifetime but sometimes pulling teeth from its spot in the jaw bone, may be necessary to improve your dental health.

Removal of teeth can be easy, but in some complex conditions, your teeth will be surgically extracted. Surgical tooth extraction is a procedure in which surgical access is required to remove a tooth completely.


This procedure is required for the tooth that is not visible in the mouth, such as impacted teeth, or the tooth which has broken off.

Tooth extractions are performed for several reasons, but most commonly it is used to remove the teeth which have become impossible to restore through tooth decay, periodontal disease or dental trauma.

Reasons for surgical tooth extraction

Sometimes extraction of teeth becomes necessary in adult teeth. The primary reasons for extraction are tooth damage due to breakage or decay. Here are some significant reasons for extraction of teeth –

  • Extracting teeth for braces.
  • Pulling out teeth due to severe tooth decay or infection.
  • Teeth which cannot be restored with crowns and fillings.
  • Fractured teeth.
  • Supernumerary teeth which are blocking other teeth. (1)
  • Teeth are required to remove in advanced periodontitis which affects the supporting tissues and bone structures of teeth.
  • Head and neck radiation therapy.
  • Removal of teeth to save the space such as removal of wisdom tooth which mostly comes out impacted. (2)

Surgical extraction vs. simple extraction of teeth

A simple extraction of tooth involves the removal of a tooth that is visible above the gum line in the mouth. Here forceps of a dentist can easily reach out to the affected tooth and remove it.

Whereas in surgical tooth extraction, the affected tooth is not accessible or visible to oral surgeons. It could be either it has not erupted properly or the tooth has broken off.

Most commonly impacted wisdom teeth are removed surgically. This procedure requires the dentist to cut into the gum tissue to get access inside the inner area of the bone to remove the teeth.

While a simple tooth extraction is done after the wisdom teeth have already erupted through the gum line and are easily accessible by the dentist.

Why surgical tooth extraction becomes necessary?

Surgical removal of teeth sometimes becomes necessary because the tooth can’t be saved and the only extraction of the teeth can enhance the oral health. The tooth is usually extracted due to trauma, disease or crowding.

When a tooth cannot be restored with a filling or a crown because of an accident or severe decay, an extraction may be your best option. Also, teeth that aren’t supported by enough bone due to periodontal disease are eligible for removal.

Wisdom teeth are frequently extracted because of the deviation from the natural position in which they grow behind your molars. Teeth are very commonly removed in orthodontic treatment to make space. (3)

Procedure for surgical extraction of a tooth

When you experience invasive dental procedures such as surgical tooth extractions, your dentist will review your health and dental history.

Your dentist will follow a general procedure to remove your teeth. Following are the steps in the procedure of tooth extraction –

  1. Your dentist will initially numb the area with a local anesthetic. You may also be provided with an anti-anxiety medication or an intravenous sedative.
  2. If the tooth is not visible or partly visible, then an incision is made, and the gum tissues are gently reflected to expose the tooth underneath.
  3. Teeth are attached to jaw bone with periodontal fibers, and it is very important to release these fibers to detach the tooth from the bone.
  4. The exposed tooth may be required to section into individual pieces to remove it safely and without trauma.
  5. The tooth is loosened within the socket by applying leverage with an instrument called an elevator.
  6. Dentist applies pressure directly on to the tooth socket to minimize any bleeding after the tooth is out.

Post-operative care

You are very likely to get stitches after the surgery. Therefore, you will be expected to follow specific post-operative instructions given by your dentist. These tips can be very helpful to speed up your recovery and to avoid any complications.

  • Keep the gauze pad at the place of surgery, it prevents bleeding and should be left in place 2-3 hours with gentle pressure.
  • Apply ice to the cheeks for the first 12-24 hours to reduce the swelling and numb the pain.
  • Avoid unnecessary talking, eating or drinking for the first few hours after extraction.
  • Maintain a proper diet reduce the recovery time, but start with clear liquids and soft foods to avoid irritation on the surgical site.
  • Don’t rinse or brush your teeth vigorously for 12 hours.
  • Avoid the use of straws.
  • Avoid smoking or any tobacco products.
  • Take painkillers and anti-inflammatory drugs as prescribed by your dentist.
  • Visit your dentist if you suspect any difficulty.

Final words

A dental extraction or tooth extraction is the removal of teeth from the socket of the alveolar bone. Surgical tooth extraction is mostly done to extract an impacted tooth or traumatized tooth.


Surgical extraction of tooth involves removal of teeth from crowded dental arches to provide more space to move the remaining teeth to straighten and improve the alignment of dental arches.

Teeth are also frequently extracted in orthodontic treatment. The extraction of several teeth can help you restore the function and beauty of your smile.


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