Reasons for tooth extraction in a Swedish county dental service: a 5-year longitudinal cohort study with focus on endodontic pathology

AIMS: The aim of this study was to investigate tooth extractions in a Swedish public general dental practice setting, including the proportion of endodontically treated teeth, reasons for extraction, and subsequent prosthetic replacement. MATERIALS AND METHODS: A prospective cohort study was conducted in 20 clinics within the Public Dental Service of Västra Götaland, Sweden. During an 8-week period, general dental practitioners consecutively registered reasons for tooth extraction. Patients' pain levels were assessed. Pre-extraction radiographs were assessed for tooth status. Five-year follow-up data from electronic dental records were used to determine whether the extracted teeth had been prosthetically replaced and to classify the type of replacement. Descriptive and inferential statistics were used. RESULTS: A total of 133 patients (61 men and 72 women; mean age 54.0 years, SD = ± 15.8) underwent extractions. Endodontic pathology (36.8%) and fractures (24.8%) were the most common reasons. Sixty-one patients had previous endodontic treatment, and one-third of extracted teeth were root-filled. Thirty-five teeth were prosthetically replaced, most often with removable prostheses (45.7%). CONCLUSIONS: Endodontically treated teeth, including those with initiated or completed root canal treatment, were markedly overrepresented among extractions, yet prosthetic replacement was infrequent. Younger patients less often opted for replacement, warranting further investigation of factors influencing replacement decisions.