Surgical Removal of Broken Teeth

A surgical extraction is required to remove a tooth/root that may have broken off at the gum line or is impacted (incomplete eruption). These teeth should be removed to treat or prevent infection.

Teeth with a poor prognosis even if restorative treatment is attempted might have the following conditions:

Crack/split that runs under the gum
Extremely large cavities
Severe gum disease with extensive bone loss
Root resorption

These are situations when an extraction may be selected and a tooth replacement planned for, for a more predictable long term outcome.

If the tooth was broken as a result of an accident, the cost of the extraction and its replacement may be fully or partially paid for with a successful claim against personal accident insurance.

Also , if you are a Singaporean or Singapore PR, the surgical fees may be fully or partially claimable from Medisave.

Why is a tooth surgically removed?

When a tooth breaks, the shape of the tooth structure that remains may make it impossible to extract it intact. Occasionally, a tooth that is fairly intact may need to be sectioned to remove it with minimal trauma to the surrounding tissues (bone, nerves etc), especially when an implant is planned to replace it.

How is a surgical extraction different from a regular extraction?

In a regular extraction, the whole tooth including the roots are removed in one piece. Usually no bone is removed in the process.

Surgical Removal of Broken Teeth at Elite Dental

Step 1: Consultation and examination

The damaged tooth needs to be assessed clinically and with X-rays. Your treatment goals and the overall prognosis for the damaged tooth will be discussed.

Should the tooth require extraction, you will be advised on the potential risks and whether or not your tooth needs to be removed surgically. After the assessment is done, we will then inform you about the difficulty level of the surgery.

Tooth replacement is also discussed. If you are planning to have an implant, bone grafting can be done at the time of extraction to minimize the natural bone resorption that will occur.

Bone resorption begins soon after the loss of a tooth. Therefore, in order to minimise bone loss, we may recommend several options such as an immediate dental implant or a tooth socket bone graft to replace your extracted broken tooth. Dental implants will also help to recreate balance in your bite, as it is a functional replacement for the tooth that is lost.

Step 2: Pre-surgical preparation

1-2 days prior to your surgery, a thorough scaling and polishing is done. An oral probiotic is also given to boost the numbers of beneficial bacteria in the saliva so that healing is as smooth as possible.

Step 3: Removing the broken tooth

The surgical extraction is always done under a local anaesthetic. If you are very nervous or anxious, IV sedation administered by an anaesthesiologist can be very helpful to ensure an anxiety free experience, especially if the surgical extraction is anticipated to be difficult.

An incision along the gum line will be made to expose the tooth’s roots. Some bone may be removed to allow the tooth to be more easily separated from the bone. If necessary, the broken tooth will be divided into smaller, more manageable pieces to be removed.

The gum will then be repositioned with stitches which will be removed after a few days.

Post-op medication and care instructions will then be given to you to ensure a speedy recovery.

Topics

Frequently Asked
Questions

Got questions? We’ve got answers! Check out our FAQ section for common inquiries and helpful information to guide you.

What is surgical tooth extraction?

Surgical tooth extraction is a procedure to remove a tooth that cannot be extracted using simple techniques, typically because the tooth is broken below the gum line, severely damaged, or has complex root anatomy. Unlike simple extractions where the tooth is visible above the gum and can be removed with forceps, surgical extraction may require incisions in the gum tissue, removal of bone around the tooth, or sectioning the tooth into smaller pieces for removal.

Surgical extraction is commonly needed for broken teeth when insufficient tooth structure remains above the gum line to grasp with instruments, or when the fracture extends deep below the gum or bone level.

When does a broken tooth need surgical extraction?

A broken tooth requires surgical extraction when it cannot be restored or when the fracture compromises the tooth’s structural integrity beyond repair. Key indications include teeth with fractures extending significantly below the gum line, root remnants with open root canals accompanied by infection, and teeth with fracture necrosis (loss of vitality due to fracture) showing progressive bone loss.

The decision to extract versus retain a broken tooth should consider both tooth-related factors (extent of damage, presence of infection, restorability) and patient-related factors (overall health status, ability to maintain oral hygiene, and risk of complications). In some cases, severely broken teeth can be saved using alternative treatments such as surgical extrusion, crown lengthening, or orthodontic extrusion, which we can discuss with you.

What happens during surgical tooth extraction?

During surgical extraction,the process that we adopt at Elite Dental Group is that we will first administer local anesthesia to numb the area completely. The procedure typically involves making an incision in the gum tissue to expose the broken tooth and surrounding bone, removing any bone that blocks access to the tooth, and then extracting the tooth—sometimes in sections if it’s severely broken.

For broken teeth, we may need to section the remaining tooth structure into smaller pieces to remove it safely without damaging surrounding structures. After removal, the socket is cleaned, any sharp bone edges are smoothed, and the gum tissue may be sutured closed to promote healing. The entire procedure typically takes 20 to 60 minutes, depending on the complexity of the case.

Is surgical tooth extraction painful?

You should not feel pain during the extraction itself due to local anesthesia, but you will likely experience some discomfort and pain after the procedure once the anesthesia wears off. Pain is typically most intense approximately 5 to 6 hours after the procedure, reaching peak levels during the first postoperative day. Pain generally decreases significantly by day 5 after extraction. We will prescribe appropriate pain medication to manage postoperative discomfort effectively. (to emphasise at EDG they offer IV sedation to patients who are fearful of pain.)

What pain medication will I receive after surgical extraction?

For most patients, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen 400 mg, alone or combined with paracetamol (acetaminophen) 1000 mg, are the first-line treatment for pain after tooth extraction. These medications are more effective than opioid-based pain relievers for dental extraction pain and have fewer side effects.

At Elite Dental Group, we recommend NSAIDs with or without paracetamol as the preferred option, r only for situations where first-line therapy is inadequate or contraindicated. Your dentist will prescribe the minimum effective dosage to achieve pain relief while minimizing adverse effects. Maximum daily doses are 2,400 mg for ibuprofen and 4,000 mg for paracetamol. (mention arcoxia, its their first line of medication) Also prescribe steroids for anti swelling

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