The planned removal of a tooth from its socket in the alveolar bone. It is usually accomplished by the use of forceps and elevators, although historically pelicans and tooth keys have been used. Serial extraction is the planned selective and sequential extraction of primary and sometimes permanent teeth to relieve anticipated overcrowding in the permanent dentition. It involves the extraction of selected primary teeth over a period of years. The primary canine teeth are removed when the upper and lower permanent incisors have erupted. This makes room for the permanent incisors. After 2 years, when the first premolars and permanent canines are ready to erupt, more teeth may be removed if necessary, including possibly the first premolars. Surgical extraction requires a mucoperiosteal flap to be raised, followed by the removal of alveolar bone. Extraction may be indicated for many reasons, including caries, pain, sepsis, trauma, failed restorative treatment, periodontal disease, ankylosis, overcrowding, poor patient cooperation, insufficient tooth structure for restorative therapy, pulpal involvement, and a relevant medical history. Complications arising during tooth extraction may include tooth or root fracture, primary haemorrhage, haematoma, nerve damage, and inhalation or swallowing of the tooth or tooth fragment. Complications which may occur following tooth extraction include reactionary or secondary haemorrhage and infection (alveolitis) and, where the extraction has been undertaken using local analgesia, self-inflicted soft tissue trauma and prolonged analgesia due to nerve damage from the analgesic needle.
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