Not all teeth can be pulled via simple tooth extraction. Sometimes, the tooth will be so decayed or broken off that the dentist will have nothing to grasp above the gum line. In cases such as this, the dentist will need to perform a more complex extraction, which involves getting the tooth out below the gum line, as they won’t be able to use the standard method of pulling and rocking motions.
These types of extractions involve the dentist making an incision in the gums around the tooth and raising the flap they’ve cut to expose the bone. Once they have exposed the bone, there may be enough of the exposed tooth for the dentist to grab and remove it using the pulling method. In most case, however, the tooth will be embedded in the bone, meaning that the dentist will be unable to pull the tooth out.
With teeth that are embedded in the bone, the dentist will need to use a drill and chip away at the bone to get to the tooth. This is known as cutting the tooth out and happens to be very common with impacted teeth or teeth that are severely decayed. Once the dentist has cut his way to the tooth and removed it, they will sew back the flap of skin that was cut to get to the tooth. The flap of skin and the socket will heal over time.