Purpose: To identify the primary reasons for tooth extraction in a Brazilian adult population. Materials and Methods: Interviews and oral examinations were conducted with 466 subjects aged from 18-76 years in the city of Maceió, Brazil. Frequency distributions, means and medians were calculated and the chi-square test was used to determine the level of significance. A logistic regression model was used to evaluate the variables associated with reasons for tooth extraction. Results: Of the 466 extractions, 295 (63.3%) were due to dental caries, 61 (13.1%) due to periodontal disease, 56 (12.0%) for orthodontic reasons, 32 (6.9%) at the patient's request, 15 (3.2%) for pre-prosthetic reasons, four (0.9%) due to pericoronitis, two (0.4%) due to trauma and one (0.2%) for other reasons. Tooth extraction due to caries and other causes (excluding periodontal disease) shows a significant association with family income, toothache, type of health centre (public or private), educational level (P 0.001) and marital status (P = 0.002). The logistic regression model has shown that patients undergoing treatment at a public health centre, those suffering from toothache or with an incomplete secondary education were more likely to lose their teeth due to caries, with educational level as the strongest indicator. For tooth extraction due to periodontal disease and other causes (excluding dental caries) the variables age, family income, type of health centre, tooth types (anterior or posterior), educational level (P 0.001) and toothache (P = 0.006) were statistically significant, and age was the only associated variable in the logistic regression model. Conclusion: Dental caries was the main cause of tooth extraction in the study group, following tooth extraction due to periodontal disease. Keywords: tooth extraction, adults, dental caries