Prevalence, Predictors, and Reasons for Permanent Tooth Extraction Among High School Students in Saudi Arabia: A National Cross-Sectional Study

Background Tooth loss is a major dental health concern that has adverse consequences on the remaining dentition and on the patient’s general well-being. This present study aimed to assess predictors and causes of permanent tooth extraction among students. Methods This national cross-sectional study in Saudi Arabia included a random sample of school students of both genders from grades 10 to 12 (15-18 years of age) and spanned the period of September 2012 to January 2016. Demographic, social, and medical history were recorded. Moreover, a list of possible reasons for tooth extraction was discussed with participants and their parents. The questionnaire was divided into two parts. They first asked for the patient's gender, age, marital status, education level, history of smoking, and the time of the last dental visit. Periodontal and dental examinations were performed. Multivariable logistic regression was used to determine predictors of tooth loss among the sample. Results A total of 2,435 school students were included in the study. Notably, 24% of the students had extractions of at least one permanent tooth. Nearly 27% of female students had a permanent tooth extraction compared with only 21.7% of male students, which was statistically significant. Students who visited dentists regularly had significantly more tooth extractions (39%) than students who did not (20.6%). Multivariate logistic regression analysis showed that the significant predictors for permanent tooth extraction were age, regular dental visits, and mean probing depth (PD). Caries (15%) followed by orthodontic treatment (6%) were the main reason for permanent tooth extraction among the sample. Conclusion Caries was responsible for most of the tooth loss among the study population. Significant predictors for permanent tooth extraction were age, regular dental visits, and mean probing depth. It follows that there is a need for intensified oral health education and awareness programs in the population with an emphasis on the prevention of dental caries.