Reasons for tooth extraction in the western states of Germany

The purpose of this study was to collect information on the main causes of tooth loss in the western states of Germany as perceived by dentists and their patients. Sixty-eight dentists, out of 80 that were selected with a systematic random method for an epidemiological study in the western states of Germany, recorded their reason for tooth extraction. Included in the study were only extractions of permanent teeth during a period of 2 weeks (March 1990), up to a maximum of 20 patients per dentist. Of 926 returned questionnaires, 882 could be evaluated. In all 1215 teeth in 882 patients were extracted. The extraction of third molars was included as a reason, when caries, periodontal reasons and others were not indicated. Caries was the reason given for 20.7% of all extractions; periodontal diseases for 27.3%; caries and periodontal reasons for 18.7%; third molars for 14.7%; prosthetic reasons for 11.2%; orthodontic reasons for 4.1%; trauma for 0.4% and others for 2.9%. While caries is a major reason in all age groups, periodontal diseases and the combination of caries and periodontal reasons are more frequent than all other reasons for the age groups beyond 40 or 45 yr, respectively. The third molar was the most often extracted tooth. The patients were asked for their main reason for tooth extraction. For the patients, pain was the major reason for extraction (47.2%). According to the participating dentists periodontal disease is the most frequent cause of tooth extraction for people over 40 yr of age, while for those below 40 yr of age, caries and third molar extractions are the most frequent reasons.