Orthodontic extraction practices: a cross-sectional survey of orthodontists in Australia

Objective To survey Australian-based orthodontists regarding their opinions on their extraction practices. Method A pilot-tested electronic-questionnaire was distributed to 465 members of the Australian Society of Orthodontists. Questions pertained to their demographic details, current extraction rates, changes in prescribed orthodontic extraction patterns over the past 5 to 10 years and the factors that may have influenced decisions. Results A response rate of 35.05% was recorded. Orthodontists estimated that they extracted permanent teeth in 21.03% and 22.06% of recently treated adults and children/adolescents presenting with a Class I malocclusion. Respondents were less comfortable carrying out non-extraction treatment in child/adolescent patients (15.4%) than in adult patients (34.7%) when crowding was greater than 6 mm. Most orthodontists (55.89%) who had practiced for more than 5 years believed that the number of patients that were treated by extractions was unchanged over the past 5 to 10 years while 34.55% believed that the proportion had decreased. More experienced orthodontists tended to report increased rather than decreased extraction rates (p = 0.0102). Most of those (88.1-93.17%) who reported decreased extraction rates considered facial aesthetics had a moderate/major influence on their extraction decisions. The increased use of 'combined' interproximal reduction (IPR) and arch lengthening in children/adolescents (55.8%) and IPR in adults (85%) was reported by those whose extraction rates had decreased. Conclusions Orthodontists extracted permanent teeth in just over 20% of their patients who presented with a Class I malocclusion. Most orthodontists considered that their extraction rates had not changed over the past 5 to 10 years. The increased use of IPR with or without arch lengthening procedures, was reported by those whose extraction rates had decreased over the same time period.

Automated summary

This study surveyed Australian-based orthodontists to gather their opinions on extraction practices. Results showed that orthodontists extracted permanent teeth in approximately 20% of patients with a Class I malocclusion. The majority of orthodontists believed that their extraction rates had not changed over the past 5 to 10 years. However, those with decreased extraction rates reported an increased use of interproximal reduction (IPR) and arch lengthening procedures.