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Tooth extraction may sound easy but in fact experiences as well as the proper teeth extraction techniques are required to ensure that the tooth is safely out of the mouth. Simple or intra-alveolar extraction – Simple tooth extractions are done on teeth that are easily seen in the mouth, usually under local anesthetic. Surgical or trans-alveolar extraction – Surgical extractions involve the removal of teeth that cannot be easily accessed due to the tooth being not fully erupted or the tooth has broken under the gum line. The major portion of the force is directed towards the thinnest and weakest bone in the jaw. Central incisors have straight conical roots with a circular cross section that yields to primary rotation. Second premolars have a stout single root and can be safely displaced in a buccal direction. First and second premolars have a straight single root that is round in cross section therefore amenable to rotation.

Enter your email address to subscribe to this blog and receive notifications of new posts by email. So both in lower and upper jaw it is the buccal bone or the bone oriented toward the inside of the cheek. The forceps is pushed towards the root and the tooth removed in the direction towards the cheek (buccal). The molars should be pushed well up into the root mass before dislodging the tooth with buccal movements while maintaining upward pressure.
Movement should be towards the buccal side with bucco-lingual oscillation and figure of 8 movements.
Often impacted needing surgical removal, they are encased in dense bone of oblique ridge and close proximity to the inferior alveolar nerve and lingual nerve which add to the hazard of removing these teeth. They have less substantial roots that are often resorbed or dissolved away than the permanent teeth. Here bone is removed around the tooth by dissection though the jaw bone after the overlapping soft tissues are retracted as a gum flap.
Hence forceps placement is difficult which is furthermore hindered by the presence of the coronoid process.

The underlying permanent tooth is closely related to roots of the primary tooth and can be damaged by placement of extraction forceps.
Then the forceps is directed towards the opposite side and depending on the shape of the root, rotational or figure of 8 motions are used.
It should be remembered that teeth are not pulled but gently pushed out expansion of the socket. The forceps blade must be placed on either the front or the back root and not in between them. It is usually advisable to leave the root fragments alone and allow natural resorption rather than risk damage to the permanent.

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