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      Reasons for Tooth Extractions and Related Risk Factors in Adult Patients: A Cohort Study

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          Abstract

          Background: The aim of this study was to evaluate oral status, the reasons for tooth extractions and related risk factors in adult patients attending a hospital dental practice. Methods: 120 consecutive patients ranging from 23 to 91 years in age (mean age of 63.3 ± 15.8) having a total of 554 teeth extracted were included. Surveys about general health status were conducted and potential risk factors such as smoking, diabetes and age were investigated. Results: a total of 1795 teeth were missing after extraction procedures and the mean number of remaining teeth after the extraction process was 16.8 ± 9.1 per patient. Caries (52.2%) was the most common reason for extraction along with periodontal disease (35.7%). Males were more prone to extractions, with 394 of the teeth extracted out of the total of 554 (71.1%). Male sex (β = 2.89; 95% CI 1.26, 4.53; p = 0.001) and smoking habit (β = 2.95; 95% CI 1.12, 4.79; p = 0.002) were related to a higher number of teeth extracted. Age (β = −0.24; 95% CI −0.31, −0.16; p < 0.001) and diabetes (β = −4.47; 95% CI −7.61, −1.33; p = 0.006) were related to a higher number of missing teeth at evaluation time. Moreover, periodontal disease was more common as a reason of extraction among diabetic patients than among non-diabetic ones (p = 0.04). Conclusions: caries and periodontal disease were the most common causes of extraction in a relatively old study population: further screening strategies might be required for the early interception of caries and periodontal disease.

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          Income inequality and health: pathways and mechanisms.

          The relationship between income and health is well established: the higher an individual's income, the better his or her health. However, recent research suggests that health may also be affected by the distribution of income within society. We outline the potential mechanisms underlying the so-called relative income hypothesis, which predicts that an individual's health status is better in societies with a more equal distribution of incomes. The effects of income inequality on health may be mediated by underinvestment in social goods, such as public education and health care; disruption of social cohesion and the erosion of social capital; and the harmful psychosocial effects of invidious social comparisons.
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            The oral health of people with anxiety and depressive disorders – a systematic review and meta-analysis

            Many psychological disorders are associated with comorbid physical illness. There are less data on dental disease in common psychological disorders such as depression and anxiety in spite of risk factors in this population of diet, lifestyle or antidepressant-induced dry mouth.
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              Reasons for tooth extraction in the western states of Germany.

              The purpose of this study was to collect information on the main causes of tooth loss in the western states of Germany as perceived by dentists and their patients. Sixty-eight dentists, out of 80 that were selected with a systematic random method for an epidemiological study in the western states of Germany, recorded their reason for tooth extraction. Included in the study were only extractions of permanent teeth during a period of 2 weeks (March 1990), up to a maximum of 20 patients per dentist. Of 926 returned questionnaires, 882 could be evaluated. In all 1215 teeth in 882 patients were extracted. The extraction of third molars was included as a reason, when caries, periodontal reasons and others were not indicated. Caries was the reason given for 20.7% of all extractions; periodontal diseases for 27.3%; caries and periodontal reasons for 18.7%; third molars for 14.7%; prosthetic reasons for 11.2%; orthodontic reasons for 4.1%; trauma for 0.4% and others for 2.9%. While caries is a major reason in all age groups, periodontal diseases and the combination of caries and periodontal reasons are more frequent than all other reasons for the age groups beyond 40 or 45 yr, respectively. The third molar was the most often extracted tooth. The patients were asked for their main reason for tooth extraction. For the patients, pain was the major reason for extraction (47.2%). According to the participating dentists periodontal disease is the most frequent cause of tooth extraction for people over 40 yr of age, while for those below 40 yr of age, caries and third molar extractions are the most frequent reasons.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                09 April 2020
                April 2020
                : 17
                : 7
                : 2575
                Affiliations
                [1 ]Department of Head and Neck, Division of Oral Surgery and Implantology, Institute of Clinical Dentistry, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Gemelli, 00168 Rome, Italy; stefano_pagnoni@ 123456yahoo.com (S.P.); giovanbpiccirillo@ 123456gmail.com (G.B.P.); desantisviviana@ 123456gmail.com (V.D.); michelebenegiamo@ 123456hotmail.it (M.B.); raffaele.papa@ 123456gmail.com (R.P.); antonio.daddona@ 123456policlinicogemelli.it (A.D.)
                [2 ]Internal Medicine Department, Fondazione Policlinico A. Gemelli, Catholic University of Sacred Heart, 00168 Rome, Italy; lig.antonio91@ 123456gmail.com
                [3 ]Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, 00185 Rome, Italy; piero.papi@ 123456uniroma1.it (P.P.); giorgio.pompa@ 123456uniroma1.it (G.P.)
                Author notes
                [* ]Correspondence: piercarminepassarelli@ 123456hotmail.it ; Tel.: +39-0630154976
                Author information
                https://orcid.org/0000-0003-4956-9145
                https://orcid.org/0000-0002-0801-7152
                Article
                ijerph-17-02575
                10.3390/ijerph17072575
                7178127
                32283707
                95c049af-1869-4172-b6e1-c9409df9aec7
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 22 March 2020
                : 07 April 2020
                Categories
                Article

                Public health
                dentistry,extractions,oral health,caries
                Public health
                dentistry, extractions, oral health, caries

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