Reasons for extraction by dental practitioners in England and Wales: a comparison with 1986 and variations between regions.

OBJECTIVES: To compare reasons for extraction in 1997 and 1986, and to consider regional variations for the 1997 data.

METHODS: Random samples of general dental practitioners (GDPs) completed questionnaires for all extractions for 4 weeks in 1986 and in 1997. Reasons for extraction by region were compared for the 1997 data.

RESULTS: 220 and 562 GDPs participated in 1986 and 1997, respectively, averaging 24 extractions in 1986 and 20 in 1997. 'Caries' remained the commonest reason for < or =50-year-olds (excluding 'ortho'), but peaked a decade later than in 1986. One-third of 'perio' extractions in both studies were for 51-60-year-olds, but in 1997 there were fewer such extractions for < or =40-year-olds and more for >70-year-olds than in 1986. In 1997 'caries' and 'perio' extractions remained equally common for patients >50 years, but there were far more extractions for both reasons for >80-year-olds. Patients < or =30 years in S. England and in the Midlands/E. Anglia had more 'ortho' than 'caries' extractions, whereas 'caries' predominated in N. England and in Wales. 'Caries' exceeded 'perio' for patients >40 years in Wales, whereas in the three English regions the two reasons were equally frequent.

CONCLUSIONS: Comparisons of results of two studies conducted a decade apart indicate that there have been some changes in reasons for extraction. Overall, mean number of extractions per dentist has declined, and it appears that the trend is for extractions due to the common dental diseases to be carried out later in life. The 1997 data also suggest that young patients in Wales and N. England are relatively disadvantaged, having more caries and less orthodontic treatment than those in other parts of England.