Factors contributing to dentists' extraction decisions in older adults

To evaluate which dental and non-dental factors contributed to dentists' extraction decisions in a sample of older adults, an archival study was conducted using community-dwelling and long-term-care older adults receiving dental care at an urban seniors' clinic. Four dentists who provided dental care to older adults reviewed patient records for whom they had extracted at least one tooth over a 21-month period. They identified one or more factors contributing to their extraction decisions. From 105 adults (mean age, 80.6), there were 221 extractions. Frequent contributors to dentists' extraction decisions included non-restorability in 53.8% of all extractions, dental caries (45.6%), prosthetic considerations (45.2%), and periodontal disease (40.3%). The non-dental contributors in 13% to 17% of extractions included patient/family request, inability to care for one's teeth, and financial limitations. When identifying the "most important" (or "primary") factor in their extraction decisions, dentists most frequently indicated non-restorability, followed distantly by patient/family request, periodontal disease, and financial limitations. This investigation demonstrates that non-dental factors are important in dentists' extraction decisions. Of these, patient/family request and financial limitations appear to be most influential.