Differences in total tooth extraction between an urban and a rural area in the Netherlands

Abstract

Differences in total tooth loss between an urban and a rural area (dentist-patient ratio 1:2500 and 1:5700 respectively) have been studied. Patients who participated in this study were those who received total tooth extraction during the calendar yr 1982 (urban area) and 1983 (rural area). The overall dentist response was 90%, the combined patient response was 75%. During the year, in the urban area 137 cases of total tooth extraction were recorded; in the rural area this was 237. This frequency is equivalent to 109 and 226 total tooth extractions per 100,000 inhabitants, respectively. The age and sex distribution of the urban and rural population could not account for this difference. The rural population had a lower educational level and more people insured in a State Health Scheme, which is related to income. The frequency of symptomatic attenders was highest in the rural area among those who were insured in a State Health Scheme. It is concluded that differences in numbers of total extractions between the rural and urban areas cannot be explained entirely by differences in population characteristics.

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

“…Reasons for this finding may be differences between urban and rural areas in the dentist to population ratio, as indicated by Bouma et al (16) and Ashford (17), or higher dental awareness and more concern about dental appearance in urban than in rural areas. That a higher rate of tooth loss has been found in rural than in urban areas tends to support this contention (16,18,19). Dentists who carried out extractions on one or two patients tended to consider clinical diagnosis a primary reason more often than dentists in the other group.…”

Edentulism and Comorbid Factors

“…Additionally, the rate of edentulism appears to be inversely proportional to one's income level; 20 however, while government subsidies of dental care should abate disparities between income levels, one study of two countries with government‐sponsored dental care subsidies showed dramatic differences in rates of edentulism, irrespective of income levels, with one country exhibiting twice the edentulous level as the other 21 . Where one lives in his/her country may be an indicator of the levels of edentulism, as several countries have demonstrated a correlation of edentulism rates to rural versus urban location; perhaps the edentulism rates (which vary from two to three times higher in rural areas) can be attributed to differences in the dentist/patient ratios between the areas 22,23 . All these studies suggest that edentulism appears to be multifactorial, and that the known predictors of edentulism, that is, gender, income, and education levels, appear to be reasonable prognosticators of edentulism rates, while other socioeconomic factors such as culture, dental aptitude, and access to care, may be more difficult to quantify.…”

Pattern of Dental Extraction in Children in a Nigerian Tertiary Hospital

“…These include ignorance, personal dental belief 7 , socio-economic, and cultural factors. [8][9][10] For example, in some parts of Africa teeth are deliberately removed for ritual and traditional purposes. Among Nigerian tribes, the practice of deciduous canine (usually the mandible) germinectomy is believed to guard against symptoms such as high fever, which may be associated with teething in children.…”