Dental extraction refers to the removal of a tooth from the mouth. Extractions may be performed for a variety of reasons, including severe tooth decay, infection or gum disease. Extractions of impacted or problematic wisdom teeth are routinely performed, as are extractions of some permanent teeth to make space for orthodontic treatment. Simple extractions are performed on teeth that are visible in the mouth, usually under local anesthetic. Surgical extractions, where the tooth may have broken below the gum line or not emerged, are more complicated and may require referral to a surgical specialist.