The normative need for tooth extractions in older adults in Ontario, Canada.

OBJECTIVE

To determine the reasons for clinically defined need for tooth extractions were examined.

DESIGN

Descriptive survey; interview and clinical data.

SETTING

The City of North York, Canada.

SUBJECTS

1,531 dentate adults aged 65 and over, 69% being nursing home residents.

MEASUREMENTS

Age, sex, type of residence and dental attendance pattern.

OUTCOME MEASURE

Normative need for tooth extraction.

RESULTS

One or more extractions were required by 38% of nursing home residents and 21% of independently-living subjects. The mean number of teeth indicated for extraction were 1.4 and 0.6, respectively. Among nursing home residents, caries was more often the reason for extraction for almost all tooth types, but for independently-living subjects periodontal reasons were more common. Overall, a significantly higher proportion of nursing home residents needed extractions due to both caries and periodontal reasons (25% and 16%) compared to subjects who lived independently (10% and 11%). For nursing home residents in all age groups, more subjects required caries-related extractions, but for independently-living subjects about equal proportions required extractions due to caries and periodontal diseases. Although the percentage of subjects requiring extraction due to caries varied significantly by age and residence type, the percentage needing extractions due to periodontal diseases showed slight variation and remained under 20%.

CONCLUSION

This study indicates that among high risk groups of older adults caries continues to be the major reason for tooth extraction. However, problems with sampling limit the external validity of these results.