Patient and practitioner perspectives on tooth extractions without clinical justification

Nondental factors (ie, financial, psychological, or cultural considerations) can play a role in extraction requests. The purpose of this study was to investigate whether patients' perspectives on extraction without a valid clinical indication align with those of practitioners.

Dentists from 3 centers for special oral health care, oral and maxillofacial surgeons (OMFS) from 3 hospitals in the Netherlands, and their patients participated in this prospective observational study. Patients 18 years and older who requested extraction of permanent teeth other than third molars were included. Patients, dentists, and OMFS completed questionnaires.

A total of 21 dentists and 20 OMFS participated in this study. Among 192 dental patients and 572 patients from OMFS, patients reported nondental reasons more often (7.1% of dental patients, 3.5% of OMFS patients) than professionals (1.6% of dentists, 1.7% of OMFS). Of all extraction requests, 96.4% were granted. Extraction was not performed if both practitioner and patient cited only nondental reasons.

Although dentists and OMFS received few requests for extraction on purely nondental grounds, patients were more likely to report extractions driven solely by nondental factors than practitioners.

The absence of extractions executed purely on nondental grounds is a reassuring finding, as it dovetails with the ethical principles that dental care professionals must adhere to.