title: The reasons for tooth extractions in adults and their validation.
abstract: OBJECTIVE
  To investigate the primary reasons for the extraction of permanent teeth in adults and to validate the dentists' reasons for extraction.
  
  
  METHODS
  Twenty-one dentists in the Greater Manchester area took part in the study. These dentists provided extracted teeth stored in 10% buffered formal saline together with details of the patient's age, sex, dental attendance pattern and the reason for extraction. In order to validate the reasons for extraction, teeth were examined for the presence or absence of coronal and root caries. A subgroup of 80 teeth, half of which were extracted primarily for caries and half for periodontal reasons were selected, stained and attachment loss measured at six sites per tooth to validate periodontal reasons for extraction.
  
  
  RESULTS
  Three hundred and eighty-nine teeth were collected of which 37% were extracted primarily due to caries and 29% due to periodontal disease. Caries was the main reason for extraction in patients under 50 years, whereas periodontal disease was the commonest reason in the over-50 age group. Irregular attenders had more extractions for caries than regular attenders but attendance pattern did not affect the proportion of teeth extracted for periodontal reasons. The mean greatest loss of attachment on teeth extracted for periodontal reasons was 12 mm compared with 6.5 mm for caries.
  
  
  CONCLUSIONS
  In this group of patients caries was the most common reason for extraction of teeth but periodontal disease became a more important reason for extraction after 50 years of age. The study validated the dentists' given reason for extraction.
authors.affiliation: Dental Health Unit, Turner Dental School, Manchester, UK.
authors.forename: P S
authors.initials: PS
authors.lastname: Hull
authors.forename: H V
authors.initials: HV
authors.lastname: Worthington
authors.forename: V
authors.initials: V
authors.lastname: Clerehugh
authors.forename: R
authors.initials: R
authors.lastname: Tsirba
authors.forename: R M
authors.initials: RM
authors.lastname: Davies
authors.forename: J E
authors.initials: JE
authors.lastname: Clarkson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003729:Dental Care / Q000706:statistics & numerical data; D003731:Dental Caries / Q000628:therapy; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000473:pathology / Q000628:therapy; D010510:Periodontal Diseases / Q000628:therapy; D019239:Practice Patterns, Dentists'; D015203:Reproducibility of Results; D017213:Root Caries / Q000628:therapy; D012737:Sex Factors; D014081:Tooth Extraction / Q000706:statistics & numerical data; D018677:Tooth Injuries / Q000628:therapy