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Extraction is performed for positional, structural, or economic reasons. Teeth are often removed because they are impacted. Teeth become impacted when gum tissue, bone, or other teeth prevents it from growing into their normal position in the mouth. Impaction is a common reason for the extraction of wisdom teeth. Extraction is actually the only known method that will prevent further problems with impaction.

Teeth may also be extracted to make more room in the mouth prior to straightening the remaining teeth (orthodontic treatment), or because they are so badly positioned that straightening is impossible. In addition, extraction may be used to remove teeth that are so badly decayed or broken that they cannot be restored. In some cases, patients choose extraction as a less expensive alternative to filling or placing a crown on a severely decayed tooth.