Objective To analyze the effect of minimally invasive tooth extraction in the treatment of impacted tooth on patients' periodontal injury and pain intensity. Methods A total of 100 patients with impacted tooth admitted to our hospital from March 2022 to March 2025 were selected, and they were divided into the control group and the observation group by the random number table method, with 50 patients in each group. The control group was treated with traditional tooth extraction, and the observation group was treated with minimally invasive tooth extraction. The periodontal injury degree, pain intensity, postoperative recovery indicators and complications were compared between the two groups. Results The periodontal probing depth of adjacent teeth, sulcus bleeding index and attachment loss level of the observation group at 1 week after operation were lower than those of the control group (P <0.05). The VAS scores of the observation group at 6 hours, 1 day and 3 days after operation were lower than those of the control group (P <0.05). The swelling regression time, mouth opening recovery time and wound healing time of the observation group were shorter than those of the control group (P <0.05). The incidence of complications in the observation group (4.00%) was lower than that in the control group (20.00%) (P <0.05). Conclusion The application of minimally invasive tooth extraction in the treatment of impacted tooth can effectively reduce periodontal injury, relieve pain intensity, accelerate postoperative recovery process and reduce the incidence of complications, which has high clinical application value.