Every tooth extraction is different. Some are simple and some require more extensive procedures. Surgical extraction is required whenever the tooth cannot be removed by simple forcep extraction. 3rd molars known as wisdom teeth can become painful, difficult to clean and in most people are not necessary to hold on to. Conditions that warrant surgical removal would include cracked teeth, impacted teeth, severely decayed teeth, or any condition that makes the extraction a bit difficult. Extractions are done by qualified, experienced doctors so that you have nothing to be afraid of.