While tooth extractions are done only as a last resort, it may be necessary if they are severely decayed; others may  have broken in a way that cannot be repaired.

Other teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth), or in preparation for orthodontic treatment.

If a primary molar is removed prematurely, a space maintainer may be inserted to make sure there is enough space into which the permanent tooth can grow.