The first step in this common procedure is for the dentist to inject anesthesia into the affected area or “numb up” the tooth, bone and surrounding gum tissue. Before the tooth can be extracted, the dentist needs to “expand its socket” or bone area where the root of the tooth is firmly encased and separate it from its ligament which is the fibrous tissue located between the tooth and  the bone and tightly binds the two together. Much like the back and forth motion required to remove a tent stake deeply lodged in the ground, the dentist needs to rock the tooth from side to side in order to dislodge it from the spongy-like bone which compresses and releases it. Once the tooth is removed, the dentist closes up the surgical site. He does this by gently scraping residual infected and pathological tissue from the socket area, irrigating it with saline solution and inspecting it for any remaining tooth or bone fragments. He then trims or files down any remnants found and addresses any other issues. Finally, he applies stitches where needed and has the patient bite down on gauze to alleviate bleeding. He may provide the patient with postoperative instructions in the event of any complications and prescribe ice for swelling.