Year : 2026 | Volume : 14 | Issue : 2 | Page : 38 - 44
Preventable Tooth Extractions: A Mixed-Methods Analysis of Socioeconomic and Cultural Barriers to Restorative Care
S. Prabhu 1*, Ajay Kumar Jagdish 2, Parvathy Premnath 3, Monica Jeyasudar 4
1* Professor and Head, Department of Public Health Dentistry, Asan Memorial Dental College & Hospital, Chengalpet, Tamil Nadu – 603105
2 Professor, Department of Oral & Maxillofacial Surgery, Asan Memorial Dental College & Hospital, Chengalpet, Tamil Nadu – 603105
3 Reader, Department of Public Health Dentistry, Asan Memorial Dental College & Hospital, Chengalpet., Tamil Nadu – 603105
4 Lecturer, Department of Public Health Dentistry, Asan Memorial Dental College & Hospital, Chengalpet, Tamil Nadu – 603105
Address for Correspondence:
S. Prabhu,
Professor and Head, Department of Public Health Dentistry, Asan Memorial Dental College & Hospital, Chengalpet, Tamil Nadu – 603105
Email id: prabhu.dent@gmail.com
Abstract
Background: Tooth extraction is common, yet many extractions occur for non-clinical reasons. This study investigated clinical, social, and cultural factors contributing to preventable tooth extractions among adults.
Materials and Methods: An explanatory sequential mixed-methods study was conducted at a public tertiary dental hospital. Consecutive adults aged 25–60 years undergoing permanent tooth extraction (excluding third molars) were enrolled. Clinical restorability was assessed using the Tooth Restorability Index. Participants completed questionnaires on social barriers, cultural beliefs, and dental anxiety (MDAS). Semi-structured interviews were conducted with a purposive subsample. Quantitative data were analysed using logistic regression; qualitative data using thematic analysis.
Results:Of 312 participants, 81 (26.0%; 95% CI: 21.2%–31.1%) underwent preventable extraction. Lack of dental insurance (adjusted OR 4.82, 95% CI: 2.71–8.57), belief that extraction is permanent (adjusted OR 4.31, 95% CI: 2.43 7.64), high social barrier score (adjusted OR 3.67, 95% CI: 2.11–6.39), family tradition (adjusted OR 2.98, 95% CI: 1.69 5.26), dental phobia (adjusted OR 2.45, 95% CI: 1.40–4.29), and low income (adjusted OR 2.12, 95% CI: 1.21–3.71) were independent predictors. All 81 patients with restorable teeth declined restorative treatment. Four qualitative themes emerged: extraction as finality, work/wage loss avoidance, intergenerational influence, and fear of endodontic procedures.
Conclusion: One in four extractions was preventable. Lack of insurance and cultural beliefs favouring extraction was the strongest predictors. Addressing preventable extractions requires financial protection mechanisms and culturally informed, anxiety-sensitive shared decision-making.
Financial support and sponsorship
Nil
Conflicts of interest
There are no conflicts of interest
How to Cite this article: S. Prabhu, Ajay Kumar Jagdish, Parvathy Premnath, Monica Jeyasudar. Preventable Tooth Extractions: A Mixed-Methods Analysis of Socioeconomic and Cultural Barriers to Restorative Care. Int J Comm Dent 2026; 14(2); 38-44. DOI: https://doi.org/10.56501/intjcommunitydent.14.2.ijcd0092
