Surgical tooth extractions.

With some extraction cases a patient's dentist or oral surgeon may decide that the use of some type of surgical procedure will aid in the removal of their tooth. This surgical procedure might involve bone removal, gum tissue reflection or removal, or sectioning the tooth into parts. In those situations where one or more of these techniques is incorporated into the extraction process, it is then, in dental terminology, categorized as a "surgical extraction." (Tooth extractions where these techniques are not required are termed "simple extractions.")

Why might a surgical tooth extraction be required?

There can be a number of reasons why performing a tooth extraction surgically might be the best, or even only, option.

A) Soft tissue and/or bone may need to be reflected or removed so the tooth can be accessed.

In some instances gum tissue and/or bone may cover over or surround a tooth in a fashion that makes it difficult for the dentist to view and/or access it. If so, a gum tissue flap will need to be created and retracted (and some bone tissue may need to be removed) so the dentist can gain the access they require.

This type of scenario is commonplace with wisdom teeth (full and partial impactions). It may also be needed in those cases where there is a history of damage to a tooth's crown (the part of a tooth that lies visible above the gum line). The crown may have been severely damaged or even lost as a result of tooth decay or tooth fracture. If so, some of the upper portion of the tooth's root may need to be exposed so the dentist can make contact with the tooth with their extraction instruments.

There can also be cases where the initial attempt at removing a tooth may have failed and therefore surgical intervention is required. Possibly the crown of the tooth broke off, leaving just the root. Or else a portion of the root itself separated and remains in the tooth socket. If so, a "simple extraction" may need to be transformed into a "surgical extraction" so it can be completed.

B) Using surgical intervention as a way of changing the physical requirements of the extraction.

In some cases a surgical approach will be chosen because otherwise the physical nature of the extraction process might prove to be difficult, damaging to neighboring teeth and tissues, unpredictable, or even impossible.

» Tooth sectioning.

One example of manipulating the physical nature of the extraction process surgically is termed "tooth sectioning." Due to their size, shape (curved, hooked or crooked) or relative positioning (widely divergent), the anatomical form of multi-rooted teeth can prove to be an obstacle to the extraction process. By sectioning a tooth into parts, the dentist can change the nature of the extraction (divide and conquer). The dentist can now focus on removing each individual tooth portion separately.
[ More information: The tooth sectioning process. ]

» Bone removal.

In some instances factors like very dense bone (such as that surrounding teeth that function under a heavy load) or inelastic bone (a change often associated with aging) can dictate that prior to removing a tooth some of its surrounding bone must first be removed. This bone removal may or may not be performed in conjunction with tooth sectioning.

Don't be scared of the idea of having a surgical extraction.

A dentist or oral surgeon will only elect to perform an extraction surgically in those cases where doing so will facilitate the removal of the tooth. Besides making some extractions possible where otherwise they would not be, introducing a surgical aspect to the extraction process may allow it to be quicker, more predictable (less force needed, less potential for unexpected tooth or bone fracture) and create less overall tissue trauma or damage. All of these attributes are very positive, both for the extraction experience as well as the healing process that will follow.

Surgical extractions aren't necessarily a big event.

A surgical extraction may or may not need to be a big production. You will simply need to ask your dentist or oral surgeon what to expect.

At one extreme, performing an extraction surgically may add very little additional time or effort to the tooth removal process. And, in fact, doing so may actually make it so less time and effort are needed. In this type of case, your dentist may numb up your tooth, use their dental drill for a few moments to do that which they need to do, apply selective pressure to your tooth with their elevator or extraction forceps, and have your tooth teased out in no time.

In other cases however, such as the removal of an impacted lower wisdom tooth, the nature of the extraction and the surgical needs associated with it may require a significant amount clinical effort. And in these types of cases you can anticipate a longer procedure time. Additionally, a decision to use some type of patient sedation might prove to be beneficial, both for the patient and the treating dentist.