The objectives of this study are to measure permanent tooth loss and the factors which influence it. The study will be conducted in two (2) phases. The first phase will be independent of the second and will be a complete study without the second phase.
Specific aims of Phase I are to describe 1) the biological condition of extracted teeth, 2) the sociodemographic, attitudinal, economic, and dental care-seeking characteristics of individuals who have extractions, and 3) selected characteristics of the dental providers who perform the extractions. Phase II will be conducted after the first phase and will collect information on patients whose teeth were treated with dental services that are alternatives to extraction for given biological conditions. These teeth will be controls for the extracted teeth and will allow the estimation of a model which explains the factors which influence the choice between extraction and its alternatives. The same practices will be used for both phases. Data from both Phases will be used to develop a more complete explanation of the relative significance of these factors for tooth loss. The final sample totals 82 private practitioners (not including dentists in the nine clinics) in Connecticut and 68 dentists in North Carolina. Phase I field operations are nearing completion. Data have been collected from 72 dentists (and their patients) in Connecticut and from 60 dentists (and their patients) in North Carolina. In addition, almost all extracted teeth from patients of 60 dentists in North Carolina and 71 dentists in Connecticut have been assessed for caries and periodontal status. Preliminary inspection of the data reveal root caries to be a much greater cause of tooth extraction than previously expected. Finally, fifteen dentists have been recruited in Connecticut to assess the in-vivo periodontal status (pocket depth, attachment loss) of teeth that are subsequently extracted and examined in-vitro.