Tooth extractions may be necessary for various reasons, including: Severe tooth decay. When a tooth is extensively decayed and cannot be restored with a filling or crown. Gum disease. Overcrowding. Impacted teeth. Wisdom teeth, also known as third molars, often become impacted or partially erupted, causing pain and potential damage to nearby teeth. Orthodontic treatment. Some orthodontic treatments, such as braces, may require the extraction.