General Dentistry · Oral Surgery · Last reviewed May 2026
Surgical Tooth Extraction
Done Safely.
Picasso Dental performs surgical tooth extractions in Vietnam, performed under local anaesthetic with optional IV sedation at our hospital branches, every complex case planned on CBCT 3D imaging. Two of our six branches operate inside accredited hospitals (Vinmec Da Nang, Link General Da Lat) for cases requiring on-site anaesthesiologists and emergency support.
What is a Surgical Extraction?
A surgical extraction is the removal of a tooth that cannot be taken out with simple forceps because it has fractured at or below the gumline, has retained roots from a previous failed extraction, is ankylosed (fused to surrounding bone), or sits at an angle that requires surgical access. It differs from a "simple" extraction in that an incision may be made to raise a small soft tissue flap, a minimal amount of bone may be removed, and the tooth may be divided into sections so each piece can be elevated atraumatically. Most patients return to desk work within 2 days; full soft tissue healing takes 10 days.
Simple vs Surgical Extraction
The difference is decided after clinical exam and X-ray, not on the phone. Most extractions are simple, here is how surgical cases differ.
| Aspect | Simple Extraction | Surgical Extraction |
|---|---|---|
| Tools | Forceps only | Scalpel + drill + forceps |
| Indication | Fully erupted, intact tooth | Fractured, retained roots, surgical access required |
| Time in chair | 15 to 20 minutes | 45 to 60 minutes |
| Recovery | 1 to 2 days | 5 to 7 days |
Looking for routine or wisdom tooth extraction? See our main extraction page.
Why Picasso for Surgical Extractions
CBCT 3D Before Any Complex Case
Every complex extraction is planned on a Cone Beam CT scan. Root anatomy, proximity to the inferior alveolar nerve, sinus floor, and adjacent tooth roots are visualised in three dimensions so risk is quantified, not estimated. CBCT is added as a separate line on your written quote when not already included in your treatment plan.
Hospital-Grade Branches
Two of our six branches operate inside accredited hospitals: Vinmec International Hospital Da Nang and Link General Hospital Da Lat. On-site anaesthesiologists, full sedation capability, and emergency support are built in for higher-risk cases and patients with complex medical histories.
Bone Preservation Protocols
Where an implant is planned in the same site, we place a bone preservation graft at the time of extraction. Bone walls are protected so the implant can be placed reliably later, rather than the site collapsing and a larger graft being needed down the road.
Atraumatic Sectioning
Periotomes and gentle elevation rather than crude leverage. Where the tooth must be divided, sectioning is planned so each fragment comes out without splitting the surrounding bone. We do not destroy what could become future implant foundation.
Dissolvable Sutures
Sutures at Picasso are typically dissolvable and disappear over 14 days, no return visit required for stitch removal in most cases. This matters for international patients flying out within the healing window.
Follow-Up Call at 48 Hours
We call every surgical extraction patient at 48 hours to check pain, swelling and bleeding. Anything outside the expected envelope is triaged the same day. A formal review appointment follows at 7 days for the healing check.
Common Surgical Extraction Scenarios
Six scenarios where a simple extraction is not possible and surgical technique is required. Your case is decided after clinical exam and imaging.
Tooth Fractures Mid-Extraction
A simple extraction begins, the crown breaks off the root, and the remaining root must now be removed surgically. Common with brittle, heavily restored or root-canal-treated teeth. Surgical access and sectioning convert the case mid-procedure.
Retained Root Fragments
Roots left behind from a previous failed extraction, sometimes years earlier. Often discovered on a routine X-ray. Surgical retrieval requires a flap, careful bone removal and atraumatic elevation to avoid damaging adjacent teeth.
Ankylosed Tooth
A tooth that has fused directly to the surrounding bone, with no periodontal ligament space to exploit. Forceps cannot rock or elevate it. Surgical sectioning and bone removal are required to release the tooth fragment by fragment.
Severely Decayed Tooth
A tooth where decay has destroyed so much of the crown that forceps have nothing to grip. The remaining root structure must be exposed surgically and elevated out, often after dividing the roots.
Bent or Curved Roots
Roots that hook, dilacerate or curve sharply will not exit along the simple extraction path. CBCT confirms the anatomy. Surgical sectioning between roots allows each curved root to be removed along its own path.
Pre-Implant Site Preparation
Where an implant is planned in the extraction site, we remove the tooth surgically using atraumatic technique to preserve the buccal bone wall, even when forceps would have worked. Better foundation, fewer grafts later.
Surgical Extraction Pricing
Per-tooth pricing is published on our cost guide. Difficulty is decided after clinical exam and CBCT (where indicated), not on the phone. CBCT, IV sedation and bone grafting are itemised separately on your written quote when applicable. Bone graft is only added if an implant is planned in the same site.
How a Surgical Extraction Works
Five steps from imaging through bone preservation. Most surgical extractions take 60 minutes of chair time.
Exam + Imaging
Clinical exam, periapical or panoramic X-ray, and CBCT 3D scan for any complex case so root anatomy and nerve proximity are mapped.
Day 1 · 30 minAnaesthetic + Sedation
Targeted local anaesthetic. IV sedation arranged in advance at hospital branches for anxious patients or longer cases.
Surgery · 10 minFlap + Bone Access
A small soft tissue flap is raised. A minimal amount of bone is removed only where access requires it.
Surgery · 15 minSectioning + Removal
The tooth is divided into sections so each piece elevates atraumatically, preserving the surrounding bone walls.
Surgery · 30 minGraft + Suturing
Bone preservation graft if an implant is planned, dissolvable sutures placed, gauze pressure for 60 minutes.
Same day · 30 minAftercare
Recovery is mostly about protecting the blood clot in the first 48 hours. Follow these instructions and dry socket risk drops sharply.
Ice for 24 Hours
Apply an ice pack to the cheek over the surgical site for 15 minutes on, 15 minutes off, during the first 24 hours. This reduces swelling and bruising. After 24 hours, switch to warm compresses if helpful.
Soft Diet 5 Days
Yoghurt, soup, mashed potato, eggs, soft pasta. Avoid hot food on day 1 (it can dissolve the clot), avoid hard or crunchy food that could lodge in the socket. Gradually return to normal food as comfort allows.
Salt Water Rinses From Day 2
Gentle warm salt water rinses (half a teaspoon in a cup of water), 4 times a day from day 2 onward, especially after meals. Do not rinse aggressively on day 1, the clot is still forming.
No Smoking, No Straws
No smoking for 48 hours minimum, ideally 7 days. No drinking through a straw for 48 hours. Both create suction that can dislodge the protective blood clot and trigger dry socket.
Pain Relief
Paracetamol 1g every 6 hours, plus Ibuprofen 400mg every 8 hours if not contraindicated. Most surgical extraction pain is well controlled with this combination. We prescribe stronger analgesia only when clinically indicated.
Follow-Up at 1 Week
Phone check at 48 hours, formal review at 7 days for healing assessment and removal of any non-dissolvable sutures. International patients flying within the window are reviewed before departure.
Risks & Honest Tradeoffs
Most surgical extractions heal uneventfully in 10 days. Here is what the literature reports, what can go wrong, and how Picasso minimises every avoidable risk.
Dry Socket
Alveolar osteitis at roughly 5 percent of surgical extractions overall, notably higher for impacted lower molars. Painful exposure of bone when the protective clot breaks down too early. Smoking, straws and aggressive rinsing are the main avoidable triggers.
Bruising and Swelling
Visible swelling typically peaks at 72 hours and resolves over 7 days. Bruising on the cheek or under the jaw can appear from day 2 and fade through yellow over a week. Both are expected and not a sign of complication.
Transient Nerve Paraesthesia
Rare with CBCT planning. Where the surgical site is close to the inferior alveolar or lingual nerve, a small percentage of patients experience temporary numbness or altered sensation in the lip or tongue. The vast majority resolve within weeks; permanent change is uncommon.
Infection
Below 2 percent at our protocol with antibiotic prophylaxis where indicated, sterile technique and class B sterilisation. Signs to watch for: increasing pain after day 3, fever, foul taste, persistent swelling. Call us immediately if any appear.
Sinus Communication (Upper Molars)
For some upper molar extractions, the sinus floor sits directly above the root tips. A small communication can occasionally form during extraction. Most close spontaneously within days; larger ones are managed in the chair with sutures or a small flap closure.
How We Minimise Risk
CBCT 3D imaging mandatory for any complex case. Atraumatic sectioning to preserve bone. Autoclave sterilisation. Medical history screening for anticoagulants, bisphosphonates and uncontrolled diabetes. Antibiotic prophylaxis for surgical cases where indicated. 48-hour follow-up call.
When We Refer Out
Most surgical extractions are well within scope at our clinic and hospital branches. There are three honest exceptions where we refer rather than treat.
Suspected Oral Cancer
If clinical exam, X-ray or biopsy raises concern for malignancy, we refer directly to oncology. The tooth and any associated lesion are managed by an oncology team, not by general or surgical dentistry. Speed of referral matters more than convenience.
Severe Medical Comorbidity
Patients requiring hospital admission for cardiac, haematological or other medical reasons during their extraction are referred to a hospital with admission capability. Our hospital-partner branches manage many borderline cases; some need full inpatient settings.
Large Jaw Cysts
Very large cystic lesions of the jaw requiring extensive bone reconstruction or affecting major anatomical structures are referred to a maxillofacial surgeon. Smaller cyst removal is handled in-house by our oral surgery team.
Your Surgical Team
Surgical extraction cases at Picasso are handled by general dentists for routine surgical work and by Dr. Hung Le, our implant specialist, for complex retained roots and pre-implant atraumatic cases. Doctor assignments are made at booking based on case complexity and branch.
Dr. Thao Tran
General Dentist. Handles routine surgical extractions across our branches.
Dr. Nhung Duong
General Dentist. Handles routine surgical extractions across our branches.
Dr. Hung Le
Implant Specialist. Handles complex retained roots, near-nerve cases and pre-implant atraumatic surgical extractions.
Dr. Emily Nguyen
Founding Clinical Director. Sets surgical protocols, case selection criteria and bone preservation standards group-wide.
Common Questions
Does it hurt?
Local anaesthetic is profound, you feel pressure during the procedure, not pain. Most patients describe the post-operative experience as 5 days of swelling and tenderness controlled with Paracetamol and Ibuprofen. IV sedation is available at our hospital-partner branches for anxious patients or longer surgical extractions.
How long does recovery take?
Soft tissue closes in 10 days. Swelling peaks at 72 hours then resolves over 7 days. Bone fills in over 6 months, this matters if you are planning an implant in the same site.
When can I eat normally?
Soft diet for 5 days, then gradually return to normal food as comfort allows. Avoid the surgical site when chewing for the first week. No straws for 48 hours, the suction can dislodge the protective blood clot and cause dry socket.
Do I need stitches?
Yes, surgical extractions are routinely sutured to support healing and protect the blood clot. Sutures at Picasso are typically dissolvable and disappear over 14 days. If non-dissolvable sutures are used, removal at 10 days is.
What about dry socket?
Dry socket (alveolar osteitis) is a painful exposure of bone that occurs when the protective blood clot breaks down too early. Published rates are 5 percent of extractions overall and notably higher for impacted lower wisdom teeth. To prevent it: no smoking for 48 hours, no straws, no aggressive rinsing, follow the written aftercare exactly.
Can I work the next day?
For a single straightforward surgical extraction, many patients return to desk work the following day. For longer or multiple-tooth surgical cases, plan 3 days off. Avoid heavy physical exertion and gym sessions for the first 7 days.
Will I need a bone graft?
Only if an implant is planned in the same site, in which case a bone preservation graft at the time of extraction maintains the bone walls so the implant can be placed reliably later. Bone graft after extraction starts at. If no implant is planned, a graft is not needed.
Can I have IV sedation?
Yes, IV sedation is available at our hospital-partner branches in Vinmec Da Nang and Link General Da Lat, administered by qualified anaesthesiologists with full recovery monitoring. in addition to the surgical fee. You must arrange a ride home and avoid driving for 24 hours after sedation.
Will I be conscious?
Under local anaesthetic only, yes, fully conscious but pain-free. Under IV sedation, you are deeply relaxed and typically have little or no memory of the procedure, though you remain breathing on your own and responsive to verbal cues. We confirm the plan at booking.
Can I get an implant straight after?
Sometimes. Immediate implant placement is possible when bone walls are intact, gums are healthy, and there is no acute infection at the site. Your CBCT scan tells us on day one whether your case qualifies. Where conditions are not right, we extract atraumatically with a bone preservation graft, allow 4 months of healing, and place the implant into preserved bone. See our dental implants page for full pricing.
Start Here
Get a Surgical Plan
Before Anything Comes Out.
Book a free consultation. We will examine the tooth, take the right imaging including CBCT where indicated, tell you whether surgical extraction is genuinely the right call, and quote the case in writing before any clinical decision is made.