Dental extracts (or "exodontia") are one of the most common procedures done by dentists. In this procedure, a tooth is dropped out of the alveolar bone and gums. Procedural dental extracts date back to the 14th century, in which a couple of antique apparati for pulling of teeth, called the "dental pelican" and "tooth keys" were used without the need for anesthesia, making the patient feel excruciating pain and often lead to uncontrolled bleeding because of the lack of X-rays. Nowadays, modern technology has introduced instruments and precautionary tools (such as the X-ray) and drugs (anesthesia) to promote precision of tooth extracts, without the cringing pain felt by the patient. Forceps are the most common tooth extraction instruments, and come in a variety of models, each with its own relative pulling power-designed for both children and adults.

There are a variety of reasons on why some teeth should be extracted from the alveolar bone (or the socket) from which they are connected:

1. Tooth decay or infections that have made their way into the pulp of the tooth, causing severe pain.

2. Hanging baby teeth that are blocking the eruption of permanent teeth.

3. Orthodontic appliances (like braces) may require the extraction of teeth (like first and second premolars) so that the teeth being rolled in will have a place to rest.

4. Infected teeth caused by successful chemotherapy treatments.

5. Wisdom teeth (or the third molars) are usually pulled out because of an affected tooth caused by the former's eruption. Either way, the patient can decide which tooth to pull out: the wisdom tooth or the affected tooth.

Wisdom teeth extracts have different procedural extractions. The overall success of a wisdom tooth extraction depends on the position and location of the wisdom tooth.

There are two types of extracts:

Simple extracts are performed with use of the traditional anesthesia / dental forceps tandem. Often done on teeth that have already erupted or are visible in the mouth, the periodontal ligament is first rocked and removed from its attachment to the alveolar bone, making the tooth loose and disconnected from any bone and gum tissue, and then finally pulling it out of the gums.

Surgical extracts are usually done on teeth that have not been fully depleted or are in an awkward position not easily accessible to the dentist's advantage. The dentist incises the gum of the patient, making the tooth accessible and drills or uses an osteotome to remove the tooth and its root.

There have also been both common and unpresented risks associated with tooth extracts, which usually happened when the patient has not been X-rayed and when the dentist lacks the experience of pulling out teeth:

1. Accidental damage to neighboring or adjunct teeth.

2. Dental infections

3. Post-operative swapping is commonly attributed to the extraction of a second or third molar and usually subsides a few days after the operation.

4. An incomplete extract that leaves the root of the tooth attached to the alveolar bone.

5. A sinus hole caused by the removal of an upper molar. The hole usually heals in three week's time, but if it has not shown any sign of healing in that span of time, accompaniment surgery may ensue.

6. Nerve injury caused by accidently hitting or breaking the inferior alveolar nerve, resulting in temporary to permanent numbness of the tooth.

7. Dry socket (alveolar osteitis) is a common phenomenon that occurs a few days after a wisdom tooth extraction. This happens when the normal blood clot activity within the tooth extraction site is hindered by the exposure of the alveolar bone to the air in the mouth. The expected duration of the pain is between 2-5 days.

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If you have been to a dental clinic, you will find yourself amused at the numerous dental tools and equipments that a dentist makes use of in providing dental treatments. A dentist must be equipped with these equipments in order to provide good if not excellent service to his or her patients.

Examination is the foremost process in any dental appointments. The dentition are inspected and tissues/gum tissues are visually accessed through special tools such as:

• Dental Mirrors, which provides mirror images of teeth located inside the mouth that is difficult or impossible to see from the front on angle. For example behind the teeth.
• Probes such as sickle probe, periodontal probe and straight probes are utilized to measure gum pocket depths for the evaluation of gum tissue health.
• Retractors and props allow the dentist to pull a portion of the mouth for a better access to another area of the mouth and keep the mouth open during procedures, respectively.
• Drills are high/low speed, air driven, friction grip, surgical hand pieces that are used to cut away tooth.
• Dental burs of different types, classifications and shapes (round bur, latch type, Flat fissure, pear-shaped, football, round, tapered, flame, chamfer, bevel, bud bur, steel, inverted cone, diamond, brown stone, greenstone ) smoothen rough edges of the teeth.

The Restorative instruments that help a dentist or dental surgeon accomplish restorative dental treatments such as composite fillings, crowns, dentures and fixed bridges are:

• Excavators (smooth excavator, half hollenbach) remove the soft decay in the mouth.
• Pluggers (Amalgam, 49) are generally utilized to plug the nerve canal once the nerve is extracted.
• Periodontal Scalers (curettes, ultrasonic scalers) are for cleaning and removing dirt between teeth and for gum work.
• Burnishers of various types(flat plastic, ball burnisher, beavertail burnisher, cone burnisher, J Burnisher, pear shaped burnisher) are meant to help in filling of cavities.

Dental extraction or tooth removal is done for various reasons like tooth decay. Some of the instruments which are essential in performing extraction and other surgical procedures of the teeth are:

• Dental Forceps (Upper Universals, Upper Universal Fine, Lower universals, Upper Canine, Upper straight long, Upper straight short, Upper right molar, Upper left molar, Upper wisdom tooth, Greyhound, Root, Bayonet) come in diverse types and classifications which are similar in appearance to tongs and whose primary use is to grasp and extract the tooth.
• Elevators (Narrow and wide straight and curved luxators, Couplands, Warrick James, Cryer, periosteal elevator, root-tip pick, potts, Cogswell-A) are also of distinctive styles and types used in for various procedures like separating of tooth from membranes, extractions, loosening teeth and many more.
• Chisels are most generally used in veterinary dentistry. It is also called as dental hoe. Chisels are osteotomes or instruments for cutting and preparing bone.

Aside from the already mentioned tools, other instruments, though they perform minute roles in dental procedures are worth mentioning. They are Spatula, Fox plane, Willis Gauge, Bunsen burner, wax knife, Le cron, calipers for Removable prosthodontics. Orthodontic instruments include distal end cutters,weingarts. While Endodontic Instruments are K-file, hedstrom file, gates glidden, finger spreader, Lentulo spiral, straight probe, apex locator, microscope and plugger WHT.

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Dental extraction is the process of removing a tooth (or teeth) from the mouth. Various reasons such as problematic wisdom teeth, decayed teeth, or having a tooth that is beyond restoration can be the primary reasons for doing so. Extractions are also done in preparation for some orthodontic treatments.

Why are dental removals needed by patients? Severe tooth decay and other oral diseases can be a reason, as stated earlier. Dental extraction is the best immediate solution to prevent the disease or infection from spreading. The same is true for gum diseases that could affect the way the gum tissues are attached to the tooth.

Dental extracts may also be required for giving space to a growing tooth if another is blocking its way. A wisdom tooth that has insufficient space to grow on is one example for this situation. This causes impaction of the tooth and is called an affected third molar. Any problematic teeth needs to be removed when being prepared for an orthodontic treatment such as attachment of dental braces. Lost teeth after extraction may be replaced with implants to fill the gap.

Surgical extraction and simple extraction are two types of extraction. For simple extraction, a dental elevator, forceps or any other tool for grating the tooth, as well as local anesthetic, are the only materials required to perform the procedure. The tooth is loosened by rocking it back and forth with those materials. Visible teeth are easier to remove with this method. On the other hand, more complex tool like drills and other devices used for cutting and breaking the tooth are required for surgical extracts. The process is usually done for teeth that are not easily accessible such as an affected tooth and may require the tooth to be broken into different pieces for easier extraction.

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