Let's learn a few basics about our teeth before we start talking about pulling them out of our mouths. The crown of the tooth is the part you can see in your mouth, above the gum line, while the root of the tooth is hidden below the gum line. The roots are embedded in a socket (a hole) in the jaw bone, along with connective tissues that keep the tooth set firmly in the bone.
Before the procedure, your dentist will perform an oral exam and take X-rays of the tooth (or teeth) to be extracted and the surrounding area to see what's going on below the gum line.
With the prep done, it's time to extract. There are two types of tooth extraction procedures, a simple type and a surgical type.
If you can see the tooth in your mouth then its removal is a simple extraction. If you can't see the tooth in your mouth because it hasn't erupted, is impacted or it has broken at or below the gum line, then its removal is a surgical extraction. There are more than 10 million teeth surgically removed from American mouths every year [source: Boyd].
Let's talk about the simple extractions first.
Simple extractions are usually managed by your dentist and done with local anesthesia. In a simple extraction a tooth is removed with an elevator and a pair of forceps. In this instance an elevator is a special tool used to separate the root of the tooth from its socket, loosening it in the bone. The forceps, also used to loosen the tooth, are used to yank the tooth by its crown. There may or may not be a few stitches to close up the extraction.
Surgical extractions are a little more complicated because they entail removing tooth from bone. These extractions are most commonly performed by oral and maxillofacial surgeons, and patients are given either local or general anesthesia depending on the individual circumstance. Unlike in a simple extraction where the dentist is able to grab the crown of the tooth with forceps, in a surgical extraction, the gum is cut open for access to the tooth. With access below the gum line, the surgeon removes the tooth, sometimes in fragments, from the jaw bone, and stitches the wound closed.
Immediately after a tooth is pulled, your dentist will pack the wound with gauze and ask you to bite down -- this pressure will help speed the formation of a blood clot in the socket, needed for a healthy, uneventful healing.