Dentists' and patients' opinions of the dental condition at moment of full clearance

Abstract

Reasons for full mouth extraction in an urban and a rural area in The Netherlands (dentist-patient ratio 1:2500 and 1:5700 respectively) have been studied. Patients who participated in this combined sociodental research project were those who received full mouth extractions over a period of 1 yr. The combined patient response was 75% and the overall dentist response 90%. In the urban and the rural areas respectively 137 and 237 cases of full mouth extraction were recorded. When comparing the dentists' diagnoses with the conditions of the dentitions there appeared to be a fair degree of agreement in most of the cases, although some striking deviations were also found. In the relationship between the patient's opinion and the condition of the dentition some unexplained discrepancies were found: 37% of the dentitions in which the teeth and attachment were in a healthy condition were perceived as bad by the patients. Dentists and patients agreed in their perceptions of the dental conditions in 60% of the cases. In 27% there was a strong disagreement. In most of the discrepancies found plausible explanations could be given. In some cases this was not possible. As this involves a substantial minority of cases, dentists should be aware of reasons other than the clinical condition in the disabling treatment of full clearance.

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

“…The clinical diagnoses outnumbered the non-disease considerations as reasons for the primary and secondary causes of extraction. The same tendency was reported for primary reasons for extractions leading to edentulousness in a study in The Netherlands (8). However, it should be noted that the extractions were attributed to a large number of combinations of reasons.…”

“…Studies in the past have only rarely mentioned (9) or considered contributing reasons (7,8). Forcing dentists to give only the main reason for extraction of a tooth may have biased the results.…”

“…The use of pre-extraction radiographs and the effect of the dentist's age on tooth extraction policy were also investigated. Other studies (5)(6)(7)(8)10) have paid little or no attention to reasons contributing to tooth extractions.…”

“…Mostly clinical diagnoses were included as reasons for extraction, and few non-disease considerations were given as reasons. The dentists were asked to record the main reason for extraction, but, although caries and periodontal disease are recognized as the predominant pathologic processes leading to tooth loss, previous studies suggest that the decisions to extract teeth are influenced by additional factors (7)(8)(9).…”