In spite of efforts of both the patient and the dentist ,it becomes necessary to remove the teeth. Usually this procedure is done under patients consent. The patient might need to be Pre medicated, depending on the medical and emotional condition .The extraction procedure could be one of the following:

1. Simple extractions

A Simple extraction is one in which the dentist can remove the tooth simply by loosening the gums around it, grasping the crown above the gumline with a plier-like forceps and then moving it side to side until it loosens from the bone. This process usually takes few minutes to complete.

2. Complex (surgical) extractions

Unfortunately, not all extractions can be done by simply grasping the tooth with forceps and rocking it out. In few cases, it becomes necessary to surgically remove the tooth. This means that the dentist must make an incision into the gums around the tooth and raise a flap of tissue exposing the tooth and its surrounding bone.  

3. Impacted teeth

When a tooth does not fully erupt into the mouth, but remains below the gums, it is said to be impacted. Impacted teeth can present special health problems for most patients, and they are generally removed to prevent future difficulties.


                                          

Instructions To Be Followed After An Extraction

1.When you leave the office, you should have a piece of gauze or cotton over the extraction area. Do not chew on the gauze. Just keep constant, even, gentle pressure on it so that the socket is covered, and the bleeding is stemmed. Remove the cotton within 10 minutes.

2.Do not keep on rinsing or spitting.  If you spit, you tend to suck, and this will dislodge the clot causing renewed bleeding, or even a dry socket. You may gently bring blood and saliva forward with your tongue and wipe it away with a tissue, but avoid forceful spitting at all costs.

3.Wait until the anesthesia wears off before eating anything solid, and when you can feel your mouth, you can eat whatever you can tolerate.
  
4.Take your medications.

5.Do not smoke for 48 hours! If you smoke, you WILL get a dry socket because the chemicals in the smoke get into the saliva and dissolve the clot. Even worse, the continued smoking irritates the bone in the socket and the dry socket will be especially painful and persistent.

6.Do not exercise for at least 12 to 24 hours.

7.If, after 48 hours, the pain gets worse, or you start bleeding again, call the dentist. You could be getting a dry socket, or an infection. 

Complications after extractions
1. Bleeding 
2. Infection
3. Dry Sockets 
4. Broken Jaws
5. Sinus perforation
6.Sequestrii (Broken bone fragments that come out weeks after the extraction) 
7. Retained Roots (Pieces of tooth left in the bone by the dentist)