The removal of teeth is can be done by either a dentist or oral surgeons (dentists specially trained in performing surgery).
Initially your dentist will inject a local anaesthetic to help numb the area around the tooth that is going to be removed. A stronger general anaesthetic will be used if your tooth is impacted (stuck in gum tissue usually due to overcrowding) or if you are having more than one tooth removed. A general anaesthetic will make you sleep through the procedure.
In case the tooth is impacted, the gum and bone tissue covering the tooth will need to be cut away so that the dentist can grasp the tooth with forceps. This will allow the dentist to rock the tooth back and forth to loosen it. If the tooth is difficult to pull, it may need to be cut in to smaller pieces before it can be removed.
A gauze pad is packed in to the empty socket to help stop any bleeding. Sometimes dissolving stitches will be used to close gum edges over the site of extraction.