(19) Patterns and Causes of Dental Extractions in a Dental School Setting: A Retrospective Analysis

Abstract:
Statements of the Problem: This research will provide a better understanding of the reasons why the population seeking care at the Université de Montréal undergoes tooth extractions. Various studies have been conducted on other populations worldwide. It would be interesting to understand the differences between these populations and ours to better identify the needs related to dental extractions, which could help in planning dental care at the provincial level.
Methods of Data Collection and Data Analysis: A retrospective chart review was conducted on patients who underwent dental extractions at the Faculty of Dentistry, Université de Montréal. Consent forms were distributed to patients in the surgery department, and data were collected only from those who agreed to participate. The electronic medical records system Salud (Two-Ten Health Limited, Ireland) was used to retrieve data on all extractions performed at the faculty, including prior extractions. The extracted data included the diagnosis leading to the extractions as well as sociodemographic variables.

Descriptive statistics will be used to analyze the data obtained using SPSS 26 (IBM). A total of 372 extractions were performed on 83 subjects. The extractions analyzed were conducted from 2020. Fisher’s exact test was conducted to assess the association between the reasons for dental extractions and various clinical and demographic factors.
Results and Outcomes Data: The primary cause of dental extractions was advanced periodontitis, representing 34.7% of cases, followed by residual roots (28.2%) and dental caries (16.9%). The mean age of participants was 57.7 years. Among extractions due to periodontitis, 62% were performed on patients aged 60 years and older (OR = 1.9). Additionally, complex extractions were twice as likely to involve residual roots, with 29.5% of residual root extractions classified as complex, compared to 17.6% for non-residual root cases that required a complex extraction.
Furthermore, 76.7% of teeth extracted following a diagnosis of periodontitis were performed on female patients (OR = 5.2), whereas 65.7% of teeth extracted following a diagnosis of residual root were performed on male patients (OR = 2.8). A significant proportion of periodontitis-related extractions (95.3%) were simple extractions (OR = 8.6).
Regarding risk factors, 70.5% of teeth extracted following a diagnosis of periodontitis were performed on patients who smoke or have smoked tobacco before (OR = 1.7), and 45.7% of these extractions were on patients who smoke marijuana (OR = 2.8). Additionally, 17.1% of teeth extracted due to periodontitis were performed on patients with a medical history significant for diabetes, and 37.2% involved patients with chronic hypertension.
The data highlights the need for targeted preventive interventions and improved access to dental care to reduce the burden of tooth loss, particularly among patients over 60 years old. The trends observed in this study could inform public health policies and resource allocation to improve dental care accessibility at a provincial level, ultimately supporting better oral health outcomes for older adults.

Conclusion: This study highlights advanced periodontitis as the leading cause of dental extractions at the Université de Montréal, with a higher prevalence in older adults and females. Tobacco and marijuana use were significant risk factors. These findings emphasize the need for targeted dental care strategies, which can be refined by comparing with other populations to better inform provincial dental care planning.

References
1. Aida J, Morita M, Akhter R, Aoyama H, Masui M, Ando Y. Relationships between patient characteristics and reasons for tooth extraction in Japan. Community Dent Health. 2009 Jun;26(2):104-9. PMID: 19626742.
2. Silva-Junior MF, Sousa ACC de, Batista MJ, Sousa M da LR de. Oral health condition and reasons for tooth extraction among an adult population (20-64 years old). Cien Saude Colet. août 2017;22(8):2693-702.
Figure 1. Distribution of reasons of extraction.Figure 2. Distribution of types of extraction.