- 1Confirm tooth & consent; achieve profound local anaesthesia and test it.
- 2Sever the gingival attachment; luxate slowly with periotome / elevator to expand the socket and tear the PDL.
TIP · Luxate patiently to expand bone and preserve the socket walls — forceps deliver the tooth, they are not a lever.
- 3Apply forceps apically; deliver with controlled buccal–lingual / palatal movements (+ rotation for single-rooted teeth) — slow and sustained.
- 4Inspect the tooth for completeness; curette only if pathology present; compress the socket walls.
- 5Achieve haemostasis with gauze pressure; suture if indicated.
- 6Post-op: bite on gauze 30–60 min; no rinsing, spitting, smoking or sucking for 24 h; soft diet; analgesia.
TIP · Chlorhexidine (0.12–0.2% rinse, or 0.2% gel placed in the socket) reduces dry socket — moderate-certainty evidence; most data are from third molars.
TIP · Smoking and vigorous rinsing in the first 24 h raise dry-socket risk — stress this to the patient.