A tooth extraction (exodontia) is a frequent dental procedure used to remove a tooth when it is beyond repair or causing problems for surrounding structures. This is necessary for issues like severe decay, advanced gum disease, or orthodontic needs. The type of dental professional qualified to perform the removal depends entirely on the specific tooth’s condition and location.
What General Dentists Can Extract
All licensed dentists (DDS or DMD) receive foundational training in surgical procedures, including tooth removal. General dentists are fully trained and legally permitted to perform simple extractions. A simple extraction involves a tooth that is fully visible above the gum line and has an intact structure allowing for easy grasping.
During this procedure, the dentist uses specialized tools, such as an elevator, to gently loosen the tooth from the periodontal ligament. Once mobile, forceps are used to remove the tooth in one piece. Simple extractions are typically straightforward, performed under local anesthesia, and have a quick recovery period. This approach is commonly used for teeth damaged by mild decay or those needing removal for orthodontic alignment.
Factors Requiring a Specialist
The complexity of a tooth extraction increases significantly when the tooth is not fully erupted or is severely compromised, often necessitating a referral to a specialist. A common reason for specialized intervention is an impacted tooth, such as a wisdom tooth, which remains partially or completely embedded in the jawbone. Removing these teeth requires surgical techniques, including making an incision and potentially removing a small amount of surrounding bone.
Other complicating factors involve the tooth’s physical structure and surrounding anatomy. Teeth with long, curved, or multiple roots, particularly molars, present a higher risk of fracture during removal. When a tooth is severely decayed or fractured below the gum line, a surgical approach is needed to access the remaining fragments. Furthermore, if the tooth is positioned extremely close to a major nerve (such as the inferior alveolar nerve) or near the sinus cavity, a specialist is often required to minimize the risk of damage.
When an Oral Surgeon is Necessary
An Oral and Maxillofacial Surgeon (OMFS) is a dental specialist who completes four to six years of advanced hospital-based residency training following dental school. This rigorous training focuses specifically on surgical procedures involving the mouth, jaw, and facial structures. Their expertise is required for the most intricate extractions, including all forms of impacted teeth and cases needing significant bone removal or tooth sectioning.
Oral surgeons possess the advanced skills to administer deeper levels of sedation, such as intravenous (IV) sedation or general anesthesia, often needed for complex, lengthy procedures or for patients with high anxiety. They also have hospital privileges and are trained to manage potential surgical complications. Their surgical environment and specialized equipment are designed for these complex interventions, ensuring the highest level of care and precision for cases beyond the scope of a general dental practice.