FREQUENCY AND CAUSES OF MOLAR TEETH EXTRACTION IN ADULTS AT BKCD MARDAN. A CROSS-SECTIONAL STUDY

Background: Molar extraction is among the most frequently performed dental procedures globally, yet its underlying causes and clinical determinants vary across populations. In many low- and middle-income countries, including regions of Pakistan, limited epidemiological data exist to characterize molar extraction patterns and the factors contributing to surgical intervention. Understanding these patterns is essential for strengthening preventive strategies, optimizing treatment planning, and improving oral health outcomes. This study addressed a key evidence gap by examining the frequency, causes, and predictors of molar extraction among adults attending BKCD Mardan. Objective: To determine the frequency and primary causes of molar extraction among adults at BKCD Mardan and to identify demographic and clinical predictors associated with surgical extraction. Methods: A cross-sectional study was conducted among 362 adults (≥18 years) undergoing molar extraction. Demographic characteristics, clinical findings, indications for extraction, and tooth-related variables were recorded using a structured proforma. Bivariate comparisons were performed using chi-square tests, and predictors of surgical extraction were evaluated using multivariable logistic regression. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated to determine independent associations. Results: Dental caries accounted for 45.0% of all extractions, followed by periodontal disease (19.9%) and impaction (14.9%). Most extractions involved lower molars (63.5%) and first molars (41.4%). Surgical extraction was required in 28.2% of cases. Significant predictors of surgical extraction included age ≥40 years (AOR 1.86; 95% CI 1.15–3.01), lower molars (AOR 1.75; p=0.042), third molars (AOR 3.13; p<0.001), and impaction (AOR 4.38; p<0.001). Caries as the primary indication reduced the likelihood of surgical extraction (AOR 0.49; p=0.013). Conclusion: Caries remains the predominant cause of molar extraction at BKCD Mardan. Older age, lower molar involvement, third molar position, and impaction significantly increase the need for surgical extraction, underscoring the importance of early preventive care, timely diagnosis, and targeted management strategies.