Reasons for dental extractions in children

The purpose of this study was to investigate the principal reason for primary tooth extraction and the tooth type most frequently extracted in children aged 3-13 years.

The patients selected for this retrospective study were identified by analyzing dental records of children receiving treatment at Franciscan Children's Hospital & Rehabilitation Center, Boston, MA (FCH & RC). In total, 2,000 records were reviewed, and 567 extracted primary teeth were analyzed from 277 patients who had at least one primary tooth extracted under local anesthesia. The criteria for inclusion in this study included children between the ages of 3 and 13 years.

First primary molars were the most common tooth type extracted and comprised 30% of teeth removed. Central incisors were the next common tooth type extracted and accounted for 25% of the extractions. There was no difference, by gender, in the extraction of tooth type but there were striking differences according to age. Almost half of the primary teeth extracted in subjects 3 to 5 years were incisors, and in patients 6 to 9 years the first primary molar was the most common tooth type extracted. Molars were the tooth type most frequently extracted from those patients aged 10 to 13 years. There were significant differences in the reasons for extraction of various tooth types, and, while extractions due to caries predominated overall, this was not the case for all tooth types.

This study has concluded that despite the dramatic improvements in pediatric oral health over the last decades, caries and the resulting pulpal pathology remains the most common reason for extraction of primary teeth.