Simple extraction
Assess indication, imaging, medical risks and restorability. Use controlled luxation, protect adjacent structures and give tailored aftercare.
Understand
Extraction planning starts with a defensible indication and an assessment of roots, bone, adjacent structures, medical risk and alternatives. Force should be controlled rather than escalating blindly.
Assess
Review tooth identity, restorability, radiographs and anticoagulant or antiresorptive history. Examine access and the ability to obtain postoperative haemostasis.
Apply
Consent for relevant risks and explain aftercare. If the tooth does not move as expected, reassess root form or surgical approach instead of using excessive force.
Key distinctions
Pre-operative assessment should include tooth identity, restorability, root anatomy, periodontal support, access, patient preference and medical risk. Explain alternatives including retaining or restoring a tooth where reasonable. Elevators and forceps are used to expand bone and sever periodontal attachment in a controlled fashion. Excessive force can damage adjacent teeth, bone or soft tissues.
Think through a case
A lower molar root fractures during extraction. Pause, re-examine anatomy and decide whether careful surgical retrieval, referral or a documented retained fragment is safest.
The distinction to remember
Do not increase force blindly when the expected movement has not occurred; anatomy may explain resistance.
Test your recall
Why review the whole radiograph rather than only the tooth?
Show answer
Roots, neighbouring teeth and anatomical structures affect risk.