Attitudes of orthodontists and laypersons towards tooth extractions and additional anchorage devices

BACKGROUND: This study investigated the attitudes of orthodontists and laypersons towards the choice of extracting second premolars, rather than first premolars, based on tooth condition and the use of additional anchorage devices. METHODS: Questionnaires were sent to two groups: 324 orthodontists who were members of the Thai Association of Orthodontists, and 100 randomly selected Thai laypersons aged above 20 years and who were unrelated to the field of dentistry. Descriptive and chi-square statistics were used to analyze the data. RESULTS: Questionnaires were returned by 142 orthodontists (43.8%) and completed by 100 laypersons. The larger the size of the caries lesion in the maxillary second premolar was found, the more orthodontists and laypersons both chose to extract a carious maxillary second premolar instead of a healthy maxillary first premolar. For orthodontists, the use of mini-implant anchorage was significantly related to their extraction decision. Orthodontists who were familiar with mini-implants usage would choose to extract the second premolar at a lower size of extent of caries. Besides, when larger sizes of caries lesions in maxillary second premolars were considered, laypersons tended to have greater acceptance of the use of additional anchorage devices in order to keep the healthy maxillary first premolar. CONCLUSIONS: In this study, tooth condition and the use of anchorage devices are currently the main considerations by both orthodontists and laypersons when selecting the teeth to be extracted for orthodontic treatment.