• The first step is to take a dental x-ray of the tooth being extracted. The x-ray helps in determining the curvature and angle of the root of the tooth that needs to be extracted.
• Next, topical anesthesia is given, followed by local anesthesia in the region of the tooth being extracted.
• The patient may experience the pressure of the tooth being extracted and a cracking sound of the tooth or the bone after the application of local anesthesia but no pain. If the patient still experiences pain, he/she should notify the dentist immediately. The dentist will give an additional dose of local anesthesia to numb the area.
• If it is a simple extraction, the gums are separated from the tooth surface using a moon's probe.

This is followed by the use of a dental elevator to elevate the tooth from its socket.

Tooth removal procedure is done using dental forceps.

A surgical gauze piece is then placed on the wound area and the patient is asked to bite on it to control the bleeding and help in the clotting process.

If it is a surgical extraction, the gums are cut using a surgical knife.

This is followed by the drilling of the bone using surgical dental burs.

Then the tooth is extracted using dental elevators and dental forceps. The tooth may be removed entirely or in pieces in cases of surgical extractions.

The gums are then stitched back using dental sutures and gauze is placed on the wound.

The sutures may be resorbable or non-resorbable. The resorbable sutures dissolve on their own, whereas the non-resorbable sutures require removal by the dentist 7 to 10 days after the extraction.

A dry socket may develop in a few cases after tooth extraction. This occurs when a blood clot is not formed, or the blood clot breaks down too early in the socket of the tooth extracted.

The underlying bone gets exposed to food, giving a very bad odour and taste. This can be very painful and the patient generally starts experiencing pain third day after tooth extraction.

Dry sockets are more common after surgical extractions of impacted teeth and in complex cases. Smokers and women taking birth control pills are also susceptible to dry sockets.

A medicated dressing is usually given by the dentist to relieve the pain and treat a dry socket.

• Sometimes a part of the tooth may be left behind after tooth extraction. The root is generally removed by the dentist to prevent infection. A small part of the root tip may be left behind in the jaw which usually is not very risky.
• The neighbouring teeth may accidentally be damaged, such as a fracture of the tooth or the filling inside the tooth.
• The jaw may accidentally fracture due to the pressure applied on the jaw during tooth extraction.
• The sinus may be accidentally exposed when extracting an upper back tooth. Usually, a small hole closes on its own, but if it doesn’t further surgeries are required to close the sinus.