We use local anaesthesia. To avoid mucosal injuries, first the gingiva is separated from the root. Then the forceps are applied to the tooth surface for extraction. When removing an inflamed tooth, the inflamed tissue in the socket must also be removed. The dentist pressurize the edges of the wound to close them. In some cases we put suture as well.
In many circumstances simple tooth extraction is not possible. In these cases, we do surgical extraction. For example: radix removal, or strongly curved, divergent roots, impacted wisdom tooth, impacted canine, as well as maxillary molars, when the sinus is too close to the root.
We use local anaesthesia infiltrating the surgical area with 2% Lidocaine. We cut a flap around the tooth, and remove the bone surrounding the root, and then remove the tooth itself. We handle the inflamed tissue as well. We cut the bone edges of the alveolus with a sharp forceps. Then we are ready and close the wound with sutures.
Small alveolar fragments can penetrate the gingiva after tooth removal. The nearby teeth or large restorations can dislocate. The sinus might perforate, in case of lower wisdom teeth the mandibular nerve might be damaged, in which case that side of the jaw might be numb for a few month.