Reasons for extractions, and treatment preceding caries-related extractions in 3-8 year-old children

Abstract

Aim: This was to analyse the tooth types extracted and the reasons for extractions in 3-8 year-old Swedish children. Another aim was to determine what treatments and attendance patterns preceded the caries-related extractions.

Study design and methods: A retrospective study of all 5,045 dental records of the 3-8 year-olds at six public dental clinics in a Swedish county was performed to find all extractions performed during one year and the reason for each extraction. The dental records, that included a caries related extraction of a primary molar, were further analysed to find possible non-attended dental visits and treatments preceding the extraction.

Statistics: The data were analysed using Pearson correlation test, Mann-Whitney U test, and Chi-2 test.

Results: 309 (4 permanent and 305 primary) extractions were performed in 206 (119M, 87F) (4.1%) of the patients. The primary molar was the tooth type most frequently extracted, while the central primary incisor was the tooth most frequently extracted. Reasons for extractions were; caries: 60.5%, orthodontics: 11.3%, trauma: 10.4%, other reasons: 17.8 %. Dental records from 100 children with caries-related extractions of primary molars were analysed. A previous treatment had been performed in 51.0% of the caries-related extractions of primary molars, but only 24.0% had any long term restoration material with glass ionomer cement, composite resin or compomer. Non-attendance frequency prior to caries-related extraction of primary molar was higher (P=0.004) among the non-treated children, but 40.1% of the non-treated children had no missed appointments. Caries-related extractions were more common among boys (p=0.0315).

Conclusions: Every 25th child in the age group 3-8 years had extractions performed during a one-year period. Only every second primary molar had received any treatment before caries-related extraction, and only (1/4) had received long-term restorations. A considerable number (40%) of the non-treated children had no missed appointments before the caries related extractions. The routines for dental care and caries treatment in the primary dentition need a revision.