Oral Surgery & ImplantsIntermediate

Simple extraction, step by step

In a simple extraction, you break the periodontal ligament and expand the socket with elevators, and then remove the tooth with forceps.

Step by step

Medical history and radiograph. If the patient takes anticoagulants, it's decided case by case with their physician.
Local anesthesia.
Detach the gum from around the tooth.
Luxate with the elevator: it goes into the ligament space to break the ligament and loosen the tooth.
Remove the tooth with forceps, using slow, continuous force toward the facial and lingual sides.
Check the socket and control the bleeding: the patient bites on gauze for 1 hour straight, without checking it.

It's called simple when luxating, expanding the bone and using forceps is enough. If you have to cut bone or section the tooth, it's a complex extraction.
Swelling is normal; apply cold on and off, especially on the first day.
The patient needs to come back if the swelling continues or increases after 3 days, or if the pain becomes severe.

ElevatorInstrument used as a lever or wedge to loosen the tooth.

ForcepsPincers used to grasp and remove the tooth.

LuxationLoosening the tooth by breaking the periodontal ligament.

What is the elevator used for before the forceps?

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To break the periodontal ligament and loosen (luxate) the tooth.

Minimally invasive tooth extraction: the science and clinical strategies of socket preservation: a comprehensive review. View source
Safar J. Postextraction Problems. MSD Manual, Professional Version (2026 revision). View source