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

Abstract

Abstract 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.