The actual procedure depends on the type of extraction that is performed. A simple extraction can usually be performed by a general dentist using only local anesthesia, although anti-anxiety medications may be used for some patients. After the extraction area is numb, the dentist uses forceps to firmly grasp the tooth and loosens it in the socket by rocking it back and forth. After the tooth is loosened, it is removed by simply pulling it out. If the tooth is difficult to loosen, a luxator (device that can be positioned between the tooth and the gum) may be used.

Surgical extractions are more complicated than simple extractions and are usually performed by an oral and maxillofacial surgeon using stronger anesthesia (e.g., conscious sedation, general anesthesia). In some cases surgical extractions can be performed with local anesthesia. Steroids may also be injected to help reduce the swelling that will occur after the surgery. The surgeon reaches the tooth by making an incision in the gum and pulling it back, then removing any bone that may be in the way. The connective tissue that secures the tooth to the jawbone may need to be separated, and the tooth may have to be cut or broken into smaller pieces for complete removal.