There are two main types of dental extraction, simple extraction and surgical extraction. Simple dental extraction is used to remove teeth that can be seen and are easily accessible, whereas surgical dental extraction typically requires an incision into the connective tissue to gain access to the tooth to be removed. Both types of dental extraction are covered in more detail below.
Simple Dental Extraction
Simple dental extraction involves the removal of teeth that are visible in the mouth. General dentists often carry out this procedure in their dental practices, using a local anesthetic to numb the area and reduce the pain experienced by the patient.
Instruments to elevate the affected tooth and grasp the visible portion are needed, such as an elevator and dental forceps. The elevator is used to loosen the tooth and the forceps to grasp the tooth for its extraction.
Young boy during dental extraction. Image Credit: ARZTSAMUI / Shutterstock
The tooth can then be moved back and forth until the periodontal ligament breaks enough to loosen the tooth from the alveolar bone so that it can be removed. This requires applying a controlled force on the tooth with steady pressure from the dental forceps.
Surgical Dental Extraction
Surgical dental extraction involves the removal of teeth that are not easily accessible inside the mouth. This may be because they have not erupted through the gum completely or they have been fractured under the gum line.
In this case, it is necessary to make an incision into the connective tissue surrounding the tooth to gain access to it for extraction. For example, the soft tissues that cover the tooth may be elevated, or a drill or osteotome may be needed to remove some of the nearby jawbone during the extraction procedure.
In many cases of surgical dental extraction, the tooth may need to be fragmented into several pieces to allow it be removed.
Given the more complex nature of surgical dental extractions and the pain that is associated with the procedure, it is typically carried out under general anesthetic by an oral surgeon in a dental hospital setting. However, in some cases, a general dentist may also perform the procedure.
Comparing Simple and Surgical Extraction
Both types of dental extraction help to reduce the overall risk of complications, such as infection, pain, and inflammation. Other complications associated with both types of dental extraction include:
- Osteitis or dry socket caused by premature loss of the blood clot that occurs following extraction.
- Delayed healing may occur with medications such as bisphosphonates or corticosteroids, which should therefore be temporarily ceased before dental extraction to reduce the risk of complications.
- Osteoradionecrosis or secondary bone death for patients who have a history or radiation treatment in the area of the head and neck.
- Movement of remaining teeth leading to misalignment of teeth and altered bite, which may damage other healthy teeth.
- Loss of vertical dimension of occlusion, or collapse of bite, which can lead to changes in the muscle contractions needed to chew and consequent results such as dry lips.
Overall, simple tooth extractions are preferred whenever feasible, because they are easier to carry out and are associated with fewer adverse effects than surgical tooth extractions. However, there is not usually a choice between the two options; a simple tooth extraction is always carried out if the tooth is accessible but surgical extraction is the only method that will work for teeth that are not visible or easily accessible.