A survey was conducted in Riyadh to determine the main causes of tooth loss in Saudi nationals, resident in Riyadh from 29 June to 18 July 1996 as perceived by both dentist and patient. This survey was conducted in Ministry of Health hospitals, Primary Health Care Centers (PHCC) and private clinics.
Methodology
A cross-sectional study of dental clinics to identify incident cases of tooth loss was conducted. A probability sample of PHCCs, governmental hospitals, and private sector clinics was selected. Any Saudi national with permanent teeth who visited a selected dental clinic and who had any dental problem that led to tooth extraction during the study period in Riyadh was selected. Self-administered questionnaires were given to all selected dentists and their patients. Each record was weighed according to the number of clinics and days of observation in each stratum. Yearly totals were estimated by multiplying by 48 weeks.
Results
There was an average of 4.5 extractions per clinic per week (22,680 per year) in Riyadh, of these only 10% were done in private clinics. The incidence of extraction due to caries decreases with age. Case persons of 15 years of less had 38.7% extractions done due to caries, this decreased to 13.3% in persons aged 45 or above. There were no extractions due to periodontal problem in persons aged under 15 years, whereas 32.3% of those aged 45 years or above had extractions done due periodontal problems. Caries and pain were cited by patients as reasons of extraction followed by mobility in the governmental clinics, compared to 23.5% of patients in private clinics. Only 11.8% of extractions were due to caries. Aesthetic reasons were cited by 11.8% of patients in private clinics but only 1.8% of patients in governmental clinics. In MOH clinics, 356 patients per clinic per week had teeth at risk of extractions. Of these, 35.5% of patients had teeth extracted. Of these extracted teeth all dentists stated that two could have been saved. In the private clinics 25.1% of patients had teeth at risk of extraction but only 1.1% of patients had teeth extracted.
Conclusion
Our data showed that both MOH and private dental clinics practice very little preventive dentistry. Restorative consultations were four times greater than periodontal consultations. Tooth loss in Riyadh was caused primarily by caries in the younger age groups and periodontitis in older age groups. The higher socio-economic levels are less likely to have a tooth extracted if the tooth can be saved. Patients do not generally consult a dentist until it is too late for treatment resulting in loss of the tooth. The public needs to be made aware of dental hygiene, and the role of preventive dentistry. Water fluoridation would reduce the incidence of caries. The number of dentists needs to be increased and their case load decreased. The number of specialists in hospitals needs to be increased.