The teeth age and decay even with proper oral care. The decay tooth can be repaired with fillings or crown, but when the decay is severe then the tooth is to be removed. Tooth extraction or exodontia is a procedure where a tooth is pulled out from its tooth socket forcefully. Depending on the nature of the tooth, it can be further classified into simple extraction and surgical extraction.     

Causes Of Tooth Extraction

The main cause of tooth extraction are tooth decay and infection. Other reasons are listed below:-

  • Periodontal diseases 
  • Fractured tooth Impaction (symptomatic or prophylactic removal) 
  • Orthodontic purpose 
  • Prosthetic purpose 
  • Teeth in line of fracture 
  • Malformed tooth 
  • Supernumerary tooth, etc 

Simple Tooth Extractions                         

When a tooth is visible or present above the gum-line in the oral cavity, simple extraction can be done. Simple extraction does not require an incision and is removed using an instrument, usually forceps to grasp the tooth. The tooth is then move back and forth with slow and control force until the tooth is loosened from its gum socket and finally extract it. 

When a tooth is fully erupted but not visible above gum-line due to broken or tooth decay then the tooth is recommended for surgical extraction.

Surgical Tooth Extraction 

When a tooth is present below the gums or is not fully erupted, access or visibility becomes difficult then we perform surgical extraction.      

Surgical extractions are mostly performed on impacted tooth. It requires an incision to raise the flap or tissues covering tooth surface to expose the tooth. Similarly, if the tooth is covered with bone then bone removal is also requires to expose the tooth for removal. Sometimes, the tooth may be split into two or multiple pieces for ease of removal and suturing may be done as it aids in healing of surgical wound.  

Wisdom teeth are 3rd set of molars in adult seen in early twenties and the last tooth to erupt in the dental arch. They have equal functions with other molars if provided with enough space in the oral cavity.             

Recent Advances In Surgical Tooth Extraction

Piezosurgery represents a new revolution in bone surgery. Procedures like dental implants, dental extraction and bone grafting, etc can be perform with much easier and gentler compared to the conventional bone drill methods.The vibrations and forces applied can be adjusted according to the specific bone density. It causes less damage to the surrounding structures like soft tissues, nerves, blood vessels and bone. Hence, the healing of surgical sites is more efficient and quick. 

Piezosurgery and Impaction

The recent advances in dental extractions are the use of piezosurgery unit. It is a minimally invasive approach and uses controlled vibrations (microvibrations) to cut bone causing less bleeding and damage to the surrounding structures. The piezosurgery device produces frequency modulation from 22 000Hz –35 000 Hz. 

One of the advantages of the unit is the ability to prepare bony window in the external cortex and provide an easy access to the impacted tooth or root with less bone loss. It also enables the removed bony piece to its original position thereby fasten the healing process and reduce regeneration period.                                 

The Do’s and Don’ts after Tooth Extraction

When To Consider Tooth Removal

Dental extraction is often necessary for teeth that are severely decayed or damaged and cannot be saved by a filling or crown. Extraction can help stop the pain from the decayed teeth or to make space for dentures, bridges or dental implants.

 Extraction of teeth is done in cases where the teeth are not supported by enough bone or gum tissue due to advanced gum diseases. Extractions done on abscessed (infected) teeth that cannot be save by root canal treatment.In some cases, orthodontists might recommend a tooth extraction for overly crowded mouth. 


Dental extractions (either simple or surgical extraction) may sound scary and painful but with advances in technology and anesthesia, dental extractions can be done with no worry and pain-free manner. Above proper examination and diagnosis will help in determining whether a tooth is to be extracted by simple or surgical extraction.