Reasons and patterns of adult extractions at CWM Hospital, Fiji

Objectives: Annually 62% of dental treatments in the government service of Fiji are for extractions. We evaluated reasons and patterns of extractions in adults at the Colonial War Memorial Hospital (CWMH) in Suva, the capital of Fiji. Methods: Fourteen dentists recorded data for all permanent teeth extractions on a customized form during the month of May 2005. Retrospective comparisons were made from the Ministry of Health’s records. Results: These dentists extracted 81.6% (n=505) of all teeth extracted in CWMH (n=619) during the study month. Reasons for extraction were caries (59.4%), periodontal diseases (20.4%), pre-prosthetic (5.1%), periodontally compromised teeth with caries (5.7%), orthodontic (2.6%), impacted teeth surgically removed (2.4%), refusal of other treatment offered (0.8%), trauma (0.8%) and other reasons for extraction (2.8%). Females had more teeth extracted (54.9%, n=277) than males, where caries contributed to 62.6% of extractions. Due to periodontal diseases males had more teeth extracted (62.1%, n=64) than females (37.9%, n=39). Many teeth were extracted below 40yrs of age (55.4%) mainly due to caries (82.5%), followed by orthodontic and surgically removed impacted teeth at 4.4% each. Periodontal diseases ranked higher for extraction in ages above 40yrs at 44.8% followed by caries 29%, periodontally compromised teeth with caries 12.2%, and pre-prosthetic at 10.4%. Of the teeth that were extracted, molars accounted for 55.2% (n=279), premolars and anteriors for 23.2% (n=117) and 21.6% (n=109) respectively. First molars accounted for 21.4% of all extractions and were extracted mainly due to caries (76%). Annual figures from 2001 and 2004-5 indicated that caries as a reason for extraction has decreased by 5.3% whilst periodontal reasons have increased by 2.4%. Conclusion: Extractions due to caries in Fiji, which is decreasing slightly remains, the main reason for tooth loss in adults <40yrs and periodontal diseases for adults >40yrs, which is increasing slightly.