• Sever caries:

It is the most common cause of teeth extraction, when the caries is so sever that the tooth can not be restored.

• Pulp necrosis or irreversible pulpitis:

Which is not amenable for endodontic treatment because of the patient refusal, economic status or the root of the tooth is tortuous or the canal is calcified.

• Sever periodontal disease:

 Such condition is usually associated with sever bone loss and irreversible tooth mobility.

• Malposed teeth:

Such teeth are to be removed when they traumatize soft tissue and the tooth can not be repositioned orthodontically.

• Impacted teeth:

Such teeth are to be removed to avoid possible complications.

• Supernumerary teeth:

These teeth are usually unerupted and should be removed.

• Orthodontic reasons:

Usually in case of teeth crowding it is necessary to remove some teeth to allow for proper alignment of the remaining teeth. The most common teeth to be extracted for this reason are the upper and lower first premolars.

• Pre-radiation therapy:

Patients how are to receive radiation for treatment of oral tumors should consider removal of the teeth in the filled of radiation. This is to avoid the possible development of osteoradionecrosis if teeth was extracted after the radiotherapy.

• Esthetics:

A tooth can be removed for esthetic reasons as is the case with sever staining (e.g. tetracycline staining) or severely malposed or deformed teeth when the patient can not afford the more expensive line of treatment.

• Economics:

A tooth is indicated for removal when the patient is unwilling or unable financially to support other lines of treatment to maintain the tooth.

• Systemic Contraindications

The patient general health is compromised so that his ability to withstand the surgical insult is affected.

• Local Contraindications

• History of therapeutic radiation as osteoradionecrosis may develop.
• Teeth located within malignant tumors as the extraction procedure may disseminate malignant cells and hasten the metastatic process.
• The presence of acute infection as acute pericoronitis or acute dentoalveolar abscess as sever posoperative infection may develop.