You might need a tooth extraction for a number of reasons, including: If a tooth is infected or damaged in such a way that root canal treatment would not be effective, an extraction might be necessary. Overcrowding can sometimes necessitate extractions. If gum disease progresses to an advanced stage, it may lead to loose teeth. Even with gum disease treatment, it may still be necessary to have the loosened tooth removed. Getting braces for misaligned teeth may require removing one or more of your teeth. If your tooth is impacted, your dentist might suggest a surgical extraction to alleviate pain or keep you from getting an infection. For people getting chemotherapy for cancer or having an organ transplant, it may be necessary to remove damaged teeth.