Sequel of caries reasons for tooth extraction in Bangladeshi adolescents

Objectives: The aim of this study is to document reasons for permanent tooth extraction in underprivileged Bangladeshi adolescents who are reluctant to seek treatment due to negative attitude towards dental care. Methods: A survey was done in Bangladeshi population sample that has undergone or planned for tooth extraction during three weeks of working activity (24th December 2005-13th January 2006) in University hospital, Dhaka. For each extraction of permanent teeth performed, the selected dentists recorded the age and sex of the patient, type of tooth extracted, and main reasons for tooth extraction as caries and its sequel (pulpitis, crown failure, cellulites/abscess, restorative and endodontic failure), periodontal disease, orthodontics, prosthetics, Surgical indications, Tooth/Jaw injury, occlusal difficulties, patient willingness and others. Results: The results revealed that, 695 permanent teeth were extracted from 470 patients, ranging in age from 11 to 85 years. Males were 52.8% while females formed 47.2%. Overall, caries and its sequel was the most frequent reason for tooth extraction (81.0%), followed by periodontal disease (11.1%), orthodontics (2.7%), surgical indications (2.3%), jaw/tooth injury (0.9%), prosthetic reasons (1.4%) and occlusal difficulties (0.6%). Pulpitis and crown fracture showed the main sequel of caries for tooth extraction rather in older age. Logistic regression analysis for reasons of tooth extraction in this sector revealed that caries and its sequel were the predominant cause of tooth extraction in patients °Ü50 years of age (OR=17.6, P<0.001). Regarding tooth type, lower 1st molars were the main teeth lost due to caries followed by the upper and lower 3rd molars. Conclusion: Caries and its sequel were the main reasons for tooth extraction in Bangladesh and were frequently associated with pulpitis and crown failure. Therefore, in order to reduce the rate of dental extractions in this sector of the Bangladeshi population, efforts should focus on prevention and treatment of caries.