Dental decortication refers to the intraoperative perforation or removal of cortical bone to induce bleeding and the release of bone forming cells from the underlying marrow. It is routinely used in combination with onlay block grafts or guided bone regeneration (GBR) procedures. In addition to the dental definition, decortication also refers to a medical procedure including the lung, diaphragm, and chest wall. There are a variety of medical disorders that can lead to the need for decortication. These disorders cause a fibrous tissue layer to form over the lung which causes lung complications. Decortication of the lung removes this tissue layer and frees the lungs to move normally. Indications for this process include difficulties that arise from pathogenic disorders such as tuberculosis and pneumonia. When asking how serious is decortication, it should be understood that while the procedure has high success rates, issues with bleeding, infection, or pain at the incision site are still possible.