Tooth extraction Treatment or informally, tooth pulling is the removal of teeth from the dental socket in the alveolar bone. Tooth extractions are performed when teeth becomes un-restorable due to tooth decay, periodontal disease or dental trauma associated with toothache. Sometimes wisdom teeth are stuck and unable to grow normally into the mouth causing recurrent infections of the gum. In orthodontics if the teeth are crowded, sound teeth may be extracted by the dentist to create space so the rest of the teeth can be straightened. Tooth extraction is performed quickly while the individual is awake by using local anaesthetic injections to eliminate painful sensations. Local anaesthetic blocks pain, but mechanical forces are still vaguely felt. Some teeth are more difficult to remove for several reasons, especially related to the tooth's position, the shape of the tooth roots and the integrity of the tooth. Dental phobia is an issue for some individuals, and tooth extraction tends to be feared more than other dental treatments like fillings. If a tooth is buried in the bone, a surgical or trans alveolar approach may be required, which involves cutting the gum away and removal of the bone which is holding the tooth in with a surgical drill. After the tooth is removed, stitches are used to replace the gum into the normal position. A bite pack is used to apply pressure to the tooth socket and stop the bleeding immediately after the tooth is extracted.