Epidemiological Assessment of Permanent Tooth Extraction: A Retrospective Crosssectional Study from Hail Dental Centre, Saudi Arabia

Introduction: Tooth loss affects quality of life by impairing chewing, speech, and appearance, and is associated with psychological and nutritional issues. Although the prevalence has declined in developed countries because of improved dental care, permanent tooth extraction remains a common occurrence, primarily caused by dental caries and periodontal disease. Demographic and behavioural factors- such as age, gender, socioeconomic status, smoking, and systemic health conditions- also influence extraction rates. In Saudi Arabia, national studies have explored these causes; however, data from the northern regions, particularly Hail, are limited. Given Hail’s unique demographics and healthcare access, understanding local patterns of tooth loss is essential for targeted public health strategies. Aim: To determine the primary causes of permanent tooth extraction and examine associated demographic and clinical factors. Materials and Methods: A cross-sectional study was conducted at the Department of Oral Surgery Clinics of Hail Dental Centre from May 2025 to July 2025, Saudi Arabia. Data on 381 permanent teeth extracted from 254 patients were retrospectively collected from clinical records. Demographic variables, including age, gender, smoking status, medical history, antibiotic use, the number and type of teeth extracted, reasons for extraction, and and procedural complexity were assessed. Associations between variables were assessed using the Chi-square test, Fisher’s-exact test, and the Monte Carlo correction. Multinomial logistic regression analysis was performed to identify independent predictors. Results: Dental caries (59.3%) was the leading cause, followed by orthodontic treatment (25.7%) and periodontal disease (11.4%). Surgical extractions accounted for 24.8%. Antibiotic use correlated with extraction reasons and medical status (p-value <0.05). Smokers demonstrated higher rates of periodontitis and failed root canal extractions. Multivariate analysis identified age ≥60 years, diabetes, smoking, and female gender as significant predictors. Conclusion: Dental caries and orthodontic treatment were the leading causes of tooth loss in the Hail region of Saudi Arabia. Factors such as age, systemic health conditions, and smoking status were significantly associated with the reasons for tooth extraction, underscoring the need for preventive and integrated oral systemic health strategies in this population.