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Options include: Local anesthesia. Your dentist or oral surgeon administers local anesthesia with one or more injections near the site of each extraction. Before you receive an injection, your dentist or surgeon will likely apply a substance to your gums to numb them. You're awake during the tooth extraction.
The dentist will first administer an anesthetic to numb the area. Then, a minimal amount of tooth structure will be removed from the teeth on either side of the space to be filled by the new tooth or teeth. This material is removed to provide the needed space for the new crowns. An impression of the area will be made.