Factors Influencing Primary Tooth Extractions Among School-going Children: A Cross-Sectional Study

Sana Ali; Sundas Sohail; Yousaf Muhammad; Zulkif Ullah; Syeda Zinab Shah

doi:10.65293/jbkcd.v2i01.30

Authors

Sana Ali College of Medical Technology, Mardan, Khyber Pakhtunkhwa, Pakistan.
Sundas Sohail College of Medical Technology, Mardan, Khyber Pakhtunkhwa, Pakistan.
Yousaf Muhammad College of Medical Technology, Mardan, Khyber Pakhtunkhwa, Pakistan.
Zulkif Ullah Abdul Wali Khan University, Mardan, Khyber Pakhtunkhwa, Pakistan.
Syeda Zinab Shah Doctor Institute of Medical Sciences, Mardan, Khyber Pakhtunkhwa, Pakistan.

DOI:

https://doi.org/10.65293/jbkcd.v2i01.30

Keywords:

Tooth Extraction, Dental Caries, Socioeconomic Status, Pediatric Dentistry, Pulpal Infection

Abstract

Objective: Tooth extractions in children are shaped by demographic, socioeconomic, and clinical factors. Identifying these can aid in designing preventive strategies.

Study Design: Cross-sectional study

Place and Duration of Study: College of Medical Technology, Mardan, Khyber Pakhtunkhwa, Pakistan; from July 2023 to December 2023.

Materials and Methods: A total of 245 children undergoing tooth extraction were evaluated. Data on age, gender, residence, socioeconomic status, and reasons for extraction were collected. Logistic regression was applied to assess associations, with odds ratios (OR) and 95% confidence intervals (CI). Significance was set at p < 0.05.

Results: Dental caries (61.2%), pulpal infection (16.3%), and trauma (10.2%) were the leading causes of extraction. Extractions were more frequent in older children (OR = 1.13, p = 0.015) and boys (OR = 1.28, p = 0.018). Children from middle- and high-income families had lower odds compared with low-income groups (OR = 0.67, p = 0.004; OR = 0.43, p < 0.001). Urban residence also reduced extraction likelihood (OR = 0.7, p = 0.008). Pulpal infection increased extraction risk (OR = 1.35, p = 0.031), while orthodontic reasons reduced it (OR = 0.61, p = 0.012).

Conclusion: Socioeconomic disparities and preventable oral health problems significantly contribute to childhood tooth extractions. Public health measures should emphasize preventive dental care, especially targeting rural and disadvantaged groups.

Author Biography

Sana Ali, College of Medical Technology, Mardan, Khyber Pakhtunkhwa, Pakistan.

Corresponding Author: sanaali.kmu@gmail.com

References

1. Medina-Solís CE, Pontigo-Loyola AP, Pérez-Campos E, Hernández-Cruz P, De la Rosa-Santillana R, Navarete-Hernández J de J, et al. Principal reasons for extraction of permanent tooth in a sample of Mexicans adults. Rev Invest Clin. 2013;65(2):141–9.

2. Bansal M, Gupta N, Gupta P, Arora V, Thakar S. Reasons for extraction in primary teeth among 5-12 years school children in Haryana, India- A cross-sectional study. J Clin Exp Dent [Internet]. 2017;9(4):e545–9. Available from: http://dx.doi.org/10.4317/jced.53076

3. Pandey P, Nandkeoliar T, Tikku AP, Singh D, Singh MK. Prevalence of dental caries in the Indian population: A systematic review and meta-analysis: A systematic review and meta-analysis. J Int Soc Prev Community Dent [Internet]. 2021;11(3):256–65. Available from: http://dx.doi.org/10.4103/jispcd.JISPCD_42_21

4. Amin MS, Harrison RL. Understanding parents’ oral health behaviors for their young children. Qual Health Res [Internet]. 2009;19(1):116–27. Available from: http://dx.doi.org/10.1177/1049732308327243

5. Meless GD, Guinan J-C, Sangaré AD, N’Guessan KS, Kouakou KL, Da-Danho V, et al. Oral epidemiological profile of patients attending public oral health services in Haut Sassandra region, in Côte d’Ivoire. J Public Health Africa [Internet]. 2019;10(2):1064. Available from: http://dx.doi.org/10.4081/jphia.2019.1064

6. Mekete G, Mulualem Belay G, Kassa SF. Prevalence of primary tooth extraction and its associated factors among under-five-year-old children in Debre Tabor Town, north-central Ethiopia: Community-based cross-sectional study. Int J Gen Med [Internet]. 2023;16:837–46. Available from: http://dx.doi.org/10.2147/IJGM.S383048

7. Lucas-Rincón SE, Robles-Bermeo NL, Lara-Carrillo E, Scougall-Vilchis RJ, Pontigo-Loyola AP, Rueda-Ibarra V, et al. Interproximal caries and premature tooth loss in primary dentition as risk factors for loss of space in the posterior sector: A cross-sectional study: A cross-sectional study. Medicine (Baltimore) [Internet]. 2019;98(11):e14875. Available from: http://dx.doi.org/10.1097/MD.0000000000014875

8. Ghaeminia H, Nienhuijs ME, Toedtling V, Perry J, Tummers M, Hoppenreijs TJ, et al. Surgical removal versus retention for the management of asymptomatic disease-free impacted wisdom teeth. Cochrane Database Syst Rev [Internet]. 2020;5(5):CD003879. Available from: http://dx.doi.org/10.1002/14651858.CD003879.pub5

9. Mettes TDG, Ghaeminia H, Nienhuijs MEL, Perry J, van der Sanden WJM, Plasschaert A. Surgical removal versus retention for the management of asymptomatic impacted wisdom teeth. Cochrane Database Syst Rev [Internet]. 2012;(6):CD003879. Available from: http://dx.doi.org/10.1002/14651858.CD003879.pub3

10. Yengopal V, Harneker SY, Patel N, Siegfried N. Dental fillings for the treatment of caries in the primary dentition. Cochrane Database Syst Rev [Internet]. 2009;(2):CD004483. Available from: http://dx.doi.org/10.1002/14651858.CD004483.pub2

11. Goel R, Vedi A, Veeresha K-L, Sogi G-M, Gambhir R-S. Oral hygiene practices and dental caries prevalence among 12 & 15 years school children in Ambala, Haryana -A cross-sectional study. J Clin Exp Dent [Internet]. 2015;7(3):e374-9. Available from: http://dx.doi.org/10.4317/jced.52303

12. Khail AAK, Ronis K, Mureed S. Dental caries and Oral hygiene status among primary school children in Quetta, Pakistan: a quantitative approach. J Pak Med Assoc [Internet]. 2022; Available from: http://dx.doi.org/10.47391/jpma.5143

13. Mukhopadhyay S, Roy P. Extraction of primary teeth in children: An observational study. J Cranio-maxillary Dis [Internet]. 2015;4(1):57. Available from: http://dx.doi.org/10.4103/2278-9588.151905

14. Bansal M, Gupta N, Gupta P, Arora V, Thakar S. Reasons for extraction in primary teeth among 5-12 years school children in Haryana, India-A cross-sectional study. Journal of clinical and experimental dentistry. 2017;9(4).

15. Lenzi MM, da Silva Fidalgo TK, Luiz RR, Maia LC. Trauma in primary teeth and its effect on the development of permanent successors: a controlled study. Acta Odontol Scand [Internet]. 2019;77(1):76–81. Available from: http://dx.doi.org/10.1080/00016357.2018.1508741

16. Taqi M, Zaidi SJA, Javaid J, Alam Z, Saleem A, Khan SA. Patient perceptions and experiences of dental fear of different dental specialties: a mixed-method study. BMC Oral Health [Internet]. 2023;23(1):884. Available from: http://dx.doi.org/10.1186/s12903-023-03626-3

17. Shaikh F, Syed S, Jamil B, Ahmed M, Qureshi S. Pattern of tooth extraction in a tertiary care hospital, Karachi, Pakistan. Prof Med J [Internet]. 2022;29(6):6508–13. Available from: http://dx.doi.org/10.29309/TPMJ/2022.29.06.6508

18. Lin Y-T, Lin W-H, Lin Y-TJ. Immediate and six-month space changes after premature loss of a primary maxillary first molar. J Am Dent Assoc [Internet]. 2007;138(3):362–8. Available from: http://dx.doi.org/10.14219/jada.archive.2007.0169

19. Dahaq WAM, Al-Kholani AIM, Al-Kibsi TAM, Al-Deen HS, Al-Shamahy HA, Al-Haddad KA, et al. Tanaka and Johnston’s mixed dentition validity: an analysis among Yemeni adults in Sana’a city. Universal Journal of Pharmaceutical Research. 2021;6(6):1–5.

20. Chhabra N, Chhabra A. Parental knowledge, attitudes and cultural beliefs regarding oral health and dental care of preschool children in an Indian population: a quantitative study. Eur Arch Paediatr Dent [Internet]. 2012;13(2):76–82. Available from: http://dx.doi.org/10.1007/BF03262848

21. Cavalcanti AL, Bezerra PKM, de Alencar CRB, Moura C. Traumatic anterior dental injuries in 7- to 12-year-old Brazilian children. Dent Traumatol [Internet]. 2009;25(2):198–202. Available from: http://dx.doi.org/10.1111/j.1600-9657.2008.00746.x

22. Abbott PV. Indications for root canal treatment following traumatic dental injuries to permanent teeth. Aust Dent J [Internet]. 2023;68 Suppl 1:S123–40. Available from: http://dx.doi.org/10.1111/adj.12989

23. Nadeem N, Khan S, Hussain A, Ali R. Premature loss of primary teeth and its association with occlusal disturbances in Pakistani schoolchildren. J Coll Physicians Surg Pak. 2022;32(4):512–6.

24. Mouradian WE. Disparities in children’s oral health and access to dental care. JAMA [Internet]. 2000;284(20):2625. Available from: http://dx.doi.org/10.1001/jama.284.20.2625