Surgical Extraction
In this section, we will cover:
- What is a surgical extraction?
- Why do I need a surgical extraction?
- Do I need to see a specialist?
- What does the procedure involve?
This section will focus on the specifics of a surgical extraction. For general information about dental extractions including the risks and aftercare advice, please see here.
What is a surgical extraction?
A surgical extraction is the process of removing a tooth using additional "surgical" procedures such as making a small incision in the gum and removing some bone around the tooth.
Why do I need a surgical extraction?
In some cases your dentist will be able to pre-determine whether a surgical extraction will be needed. Examples of these include:
- Buried roots
If your tooth has broken and only the roots are left behind in the gum, you may need a surgical extraction to remove these. This is because there is nothing left above the gum/bone for your dentist to grip on to. - Partially erupted and impacted teeth
"Partially erupted" means the tooth is only partway through the gum. "Impacted" means the tooth is stuck under the gum inside the bone. Again, there is not much for your dentist to grip on to so, more often than not, a small incision will need to be made in the gum so they can see the tooth and a small amount of bone removed so they have some tooth to grip on to.
Occasionally a tooth will fracture during a routine dental extraction, leaving behind some root fragments under the gum. Sometimes these fragments can be wiggled out with special dental instruments. If this is not possible, your dentist will either perform a surgical procedure themselves to remove the fragments or refer you to a specialist.
Do I need to see a specialist?
Many general dentists are able to perform surgical extractions to remove buried or broken roots.
In most cases, if you have a partially erupted or impacted (wisdom) tooth which needs removing, you will be referred to an Oral Surgeon (a specialist in removing teeth amongst other oral surgical procedures).
You may be offered to have the treatment completed under local anaesthetic, sedation or general anaesthetic depending on the complexity of treatment and your level of anxiety.
What does the procedure involve?
Each surgical procedure can be managed in different ways but the general steps which are followed are:
- Local anaesthetic
Effective local anaesthetic is the first step in any dental extraction to ensure you are comfortable throughout. Local anaesthetic is given around the tooth to be removed and the teeth adjacent to it. If a lower back tooth is being removed, your dentist will give you what is known as an "ID block" which numbs the teeth, gums, lower lip, chin and tongue on one side of the mouth.
You will still feel pushing and pressure but you should not feel anything sharp or painful. - Raising the gum
Once your are comfortable and numb, a small incision is made along the gum and lifted away from the tooth. This allows your dentist to clearly see the area for the next steps. - Removing bone
Once the gum has been lifted from the tooth, a "gutter" of bone needs to be removed just next to the tooth. Your dentist will remove just enough bone to allow them to fit an instrument between the tooth and the bone to start to mobilise (or wiggle) the tooth. - Sectioning the tooth
For a tooth with more than one root, it is often easier to split the tooth into smaller parts and remove them separately. - Cleaning and suturing the gum
Once the tooth has been completely removed, your dentist will wash the area with a saline solution (salty water) and remove any inflamed tissue from the socket. They will then replace the gum to its natural position and place dissolvable stitches to allow the area to heal. Most dentists use stitches which dissolve themselves within 7-14 days. - Aftercare advice
Please see "dental extractions - what do I need to do after?".