Key Points
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Caries is the main reason for the extraction of first permanent molars in children.
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Children who are attending dental hospitals for extraction of first permanent molars tend to be older than the optimal age for achieving space closure.
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There is a need for guidelines advising primary care dentists when to refer children for the extraction of first permanent molars.
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This study highlights the need for extensive prevention programmes targeted at those children with high caries risk.
Abstract
Objective
To evaluate and compare the reasons for and pattern of extraction of first permanent molars (FPMs) in three UK dental hospitals.
Design
Prospective multicentre study.
Setting
Hospital.
Subjects
Three hundred children attending Manchester Dental Hospital, Liverpool Dental Hospital and Charles Clifford Dental Hospital (Sheffield) who required extraction of at least one FPM.
Result
The mean age in months was 129 (SD 22.7), 139 (SD 29.4), and 133 (SD 26.8) for Manchester, Liverpool and Sheffield respectively. Forty-five percent and 48% of children had four FPMs extracted at Manchester and Sheffield respectively, compared to 25% in Liverpool. The main reason for extraction was caries with poor prognosis (70%); molar incisor hypomineralisation was the reason for extraction in 11% of cases. General anaesthesia was the main anaesthetic method used in 77%, 55%, and 47% of cases in Manchester, Liverpool and Sheffield respectively. Sixty-eight percent of cases had not received previous treatment for the FPMs and 5% had fissure sealants detected. Forty percent of children had had previous extractions.
Conclusion
The children who are attending the hospitals for extraction of FPMs tend to be older than the recommended age for achieving spontaneous space closure. This study highlights the need for extensive prevention programs targeted at those children with high caries risk.
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References
Skeie M S, Raadal M, Strand G V, Espelid I. The relationship between caries in the primary dentition at 5 years of age and permanent dentition at 10 years of age – a longitudinal study. Int J Paediatr Dent 2006; 16: 152–160.
Williams A, McMullan R. A guideline for first permanent molar extraction in children. London: Royal College of Surgeons of England Faculty of Dental Surgery, 2004. http://www.rcseng.ac.uk/fds/docs/guideline_molar_extraction.pdf
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Franklin, D. Extraction of first permanent molars. Br Dent J 203, 408–409 (2007). https://doi.org/10.1038/bdj.2007.913
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DOI: https://doi.org/10.1038/bdj.2007.913
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