An analysis of primary and contributing reasons for extraction of permanent teeth given by the dentist

Racial differences in baseline treatment preference as predictors of receiving a dental extraction versus root canal therapy during 48 months of follow-up

OBJECTIVE

This study aimed to test hypotheses that: a) treatment preference as stated at baseline predicts subsequent receipt of extraction (EXT) versus root canal treatment; and b) racial differences in treatment preference at baseline account for racial differences in receipt of these treatments during follow-up.

METHODS

Data were taken from the Florida Dental Care Study This stratified random sample included at baseline 873 subjects, all of whom were 45-years-old or older, reported race as non-Hispanic African American or non-Hispanic white, and had at least one tooth. At baseline, participants were asked about past dental care characteristics, history of or current presence of various dental diseases and conditions, and sociodemographic circumstance. An EXT/root canal treatment "CHOICE" scenario was also queried at baseline. Predisposing, enabling, and need factors were tested as predictors of EXT/root canal treatment received during follow-up. Bivariate multivariable logistic regression analyses quantified associations between the outcomes (EXT/root canal) and the predictors.

RESULTS

Receipt of EXT or root canal treatment during follow-up was strongly related to race even after people with mobile teeth at baseline were excluded from the analysis. Certain baseline factors (tooth mobility, periodontal attachment level, and ability to pay an unexpected dental bill) strongly predicted EXT/root canal treatment receipt during follow-up, although significant race effects remained; however, including "CHOICE" removed the race effect.

CONCLUSIONS

Baseline treatment preference strongly predicts subsequent receipt of EXT versus root canal treatment. Racial differences in treatment received during follow-up were explained by baseline racial differences in treatment preference, tooth mobility, and periodontal status.

Gender differences in tooth loss among Chilean adolescents: socio-economic and behavioral correlates

OBJECTIVE

To investigate gender differences in tooth loss among Chilean adolescents and its association with selected socio-economic indicators and oral-health-related behaviors.

MATERIAL AND METHODS

Data on 9,163 Chilean adolescents obtained using multistage random cluster procedures. Clinical recordings included information on missing teeth and the participants provided information on socio-demographic factors and oral-related behaviors. Two eruption-time-adjusted logistic regression analyses were used to investigate the associations between gender, tooth loss and socio-economic position/oral-health-related behaviors.

RESULTS

The association between gender and tooth loss remained after adjusting for age, eruption times in both the socio-economic position regression model and the oral-health-related behaviors model. Tooth loss followed social gradients for the variables paternal income and achieved parental education, with students reporting a paternal income < 100,000 US dollars (OR = 2.0), and having a father (OR = 1.8) and a mother (OR = 2.0) who achieved only primary school education being more likely to experience tooth loss. The adjusted regression model for behavioral indicators revealed that students who reported brushing their teeth once a day (OR = 1.6) were more likely to have experienced tooth loss than those who reported more frequent toothbrushing. Students who visited a dentist rarely (OR = 0.8) or never (OR = 0.5) were less likely to have lost first molars and/or incisors.

CONCLUSIONS

The results demonstrate that gender differences in tooth loss among young Chileans are related to socio-economic position; and selected oral-health-related behaviors after adjusting for eruption time variation.

Tooth loss and associated risk indicators in an adult urban population from south Brazil

The aim of the present study was to assess the prevalence, extent, and risk indicators of tooth loss in a representative adult, urban population in the Brazilian state of Rio Grande do Sul. A sample of 974 subjects (ages 30 to 103 years, mean 48.7, SD 13.4) representative of the metropolitan area of Porto Alegre, Brazil was selected by a multi-stage probability cluster sampling strategy. In all, 94% of the subjects had experienced tooth loss. The mean tooth loss was 11.2 teeth, and varied between 5.5 and 20.2 teeth in the 30-39 and 60 + years age groups, respectively. The multivariable analysis, adjusted for age, showed that subjects who had lost 7-13 or > or = 14 teeth were more likely to be females (odds ratio (OR) = 1.4, 2.4), of low (OR = 2.8, 5.1) or middle socio-economic status (OR = 2.3, 3.4), and heavy smokers (OR= 2.0, 2.3) than those with 6 or fewer missing teeth. Furthermore, loss of > or = 14 teeth was associated with presence of > 50% teeth with attachment loss > or = 5 mm (OR= 5.7), and loss of 7-13 teeth was associated with presence of > 50% teeth with attachment loss > or = 5 mm (OR = 2.4) and having 15-30% or > 30% decayed-filled teeth (OR = 2.7 and 4.1). In conclusion, tooth loss is highly prevalent in this urban Brazilian population. Gender, socio-economic status, cigarette smoking, caries experience, and attachment loss are important risk indicators. A reduction in the population's tooth loss may be achieved by the implementation of community programs for the prevention and treatment of dental caries and periodontal diseases.

Incidence and predictors of self-reported tooth loss in a representative sample of Norwegian adults

OBJECTIVES

The purpose of this study was to determine the self-reported 12-month incidence of tooth loss among Norwegian adults and to assess the association between tooth loss and some predictor variables.

METHODS

Of a two-stage nation-wide, representative random sample (n = 3958), information was obtained from 2682 subjects aged 20-79 years and the response rate was 68%. Telephone or face-to-face interviews by interviewers employed by the Central Bureau of Statistics (CBS) of Norway. Information was collected about demographic characteristics, the number of natural teeth present, the number of teeth lost during the last 12 months, and belief in keeping natural teeth for life. The present analyses are based on 2520 persons 20-79 years of age.

RESULTS

The proportion of respondents who reported losing one or more teeth was 6.45% (95% confidence limits (CL) = 5.49, 7.41). The participants who reported extractions had lost on average 1.54 (range 1-9) teeth. Multiple logistic regression analysis revealed a borderline significant effect of the level of education (OR = 0.68, 95% CL = 0.46, 1.00), i.e. the odds of losing one or more teeth during the last 12 months were lower among persons with more than 12 years of education than among persons with less education. The explained variance was 1.9%.

CONCLUSION

The annual incidence rate of tooth loss among Norwegian adults was found to lie within the range reported from other industrialized countries. After controlling for socio-demographic variables and the number of teeth present, the only borderline significant predictor of the incidence of tooth loss was the level of education.

The reasons for extraction of permanent teeth in Scotland: a 15-year follow-up study

AIMS

Although Scotland has the highest proportion of edentulous adults in the UK, the frequency of edentulousness has fallen by 21% during the last 20 years. This study, carried out in 1999, was designed to establish whether the reasons for tooth loss have also changed since 1984 when they were last determined.

METHODS

The Scottish Dental Practice Board provided the names of every fourth dentist on its list among which 425 general dental practitioners were identified. They were asked to record permanent tooth extractions for 1 week, specifying the age, sex and dental attendance of patients who underwent extractions and the reasons for these extractions. 352 dentists took part: a response rate of 82.8%.

RESULTS

The study confirmed that there has been a reduction in the number of extractions between 1984 and 1999: there were 25% fewer teeth extracted per patient and 30% fewer per dentist per week. From 0-20 years of age, orthodontics has replaced caries as the commonest reason for extraction and in all age groups over 20 years, caries has become the commonest reason in contrast to 1984 when periodontal disease was the principal reason in patients over 40 years old.

CONCLUSIONS

Caries and its sequelae remain the most important cause of tooth loss throughout adult life in Scotland and, therefore, caries prevention and maintenance of restorations are of great importance at all ages.

Changes in periodontal treatment needs. A follow-up study of Oslo citizens from the ages of 35 to 50 years

A random sample of 35-year-old subjects from Oslo took part in a dental survey in 1973 and were re-examined in 1988. Eighty-one subjects (85%) attended the final examination. The need for periodontal treatment was assessed by the Periodontal Treatment Need System (PTNS), and the oral hygiene by the Simplified Oral Hygiene Index (OHI-S). The participants attended a structured interview and answered a questionnaire about general and dental health habits as well as psycho-social factors. Only small changes in the distribution of subjects in the different PTNS categories were found to have taken place during the 15 years. In 1973, 56.8% were in need of scaling (Class B) and 32.1% had one or more deep inflamed pockets (Class C), and in 1988 the scores were 54.3% and 30.1% respectively. A logistic regression model was used to study the associations between risk factors and increased treatment need, as expressed by increase in the number of C-quadrants. Increased number of C-quadrants was positively associated both with short duration of education and with no interdental cleaning. Using a socio-ecological model for periodontal diseases, variables describing the items "behaviour" and "environment" were found to be most closely associated with increased need for periodontal treatment.

Patients' perceptions of the decision-making process leading to extraction of permanent teeth in Norway

Extraction is the final step in a continuous process in which oral health-related factors and psycho-social processes play a role. The purpose of the present study was to investigate the patient's perception of the decision-making process leading to the extraction of permanent teeth and to determine whether and how patient-associated characteristics might influence who made the decision to extract and if the patients felt they had any influence on the dentist's decision. A national random sample of Norwegian dentists (n = 500) recorded reasons for tooth extraction during a period of 2 weeks in 1988. A total of 437 patients responded (73%), of whom 54% were women. Nearly 33% of the respondents stated that it was their own decision to extract, while about two thirds said that the dentist had suggested extraction. Whether the dentist or the patient made the decision to extract teeth was significantly influenced by the patient's dental attendance pattern, place of residence, number of teeth and belief in retention of his/her own teeth for life (P < 0.05). There was no significant bivariate effect of patients' age, sex, educational level, or score on Corah's Dental Anxiety Scale on who made the decision to extract. Only 0.4% of patients said that family, friends or colleagues had influenced the decision to have teeth extracted. A logistic regression analysis with: "Was it the dentist or the patient who made the suggestion to extract teeth?" as the dependent variable, and the four bivariately significant independent variables showed for all patients that none had a significant effect.(ABSTRACT TRUNCATED AT 250 WORDS)