TOOTH PRESERVATION VS EXTRACTION: PATIENTS PREFERENCE AND BARRIERS TO CARE IN RURAL SOUTHERN KPK

Abstract

Background: Preservation of natural teeth is a fundamental goal of modern dentistry. However, many patients continue to choose tooth extraction instead of conservative treatment due to various socioeconomic, psychological, and healthcare-related factors. Understanding patients’ preferences and identifying barriers to dental care are essential for improving oral health outcomes and promoting evidence-based dental treatment. Objective: To assess patients’ preferences for tooth preservation versus extraction and to identify barriers to dental care among patients attending selected hospitals in rural Southern Khyber Pakhtunkhwa. Methodology: A descriptive cross-sectional study was conducted in the Dental Departments of LMH Hospital Kohat, DHQ Hospital Bannu, and DHQ Hospital D.I. Khan. The study was carried out under the Faculty of Allied Health Sciences, Dental Department, Gomal University, D.I. Khan. Data were collected from July to September using a structured questionnaire. A total of 230 patients were included through consecutive sampling. Information regarding demographic characteristics, dental history, treatment preferences, and barriers to dental care was collected and analyzed using descriptive and inferential statistics. Results: Among the 230 participants, 57.4% were male and 42.6% were female. The majority of participants were aged 26–35 years. Overall, 60.4% of participants preferred tooth preservation, whereas 39.6% preferred tooth extraction. The most common reason for choosing tooth preservation was the desire to retain the natural tooth. Among those preferring extraction, immediate pain relief and lower treatment cost were the leading reasons. High treatment cost, fear of dental treatment, lack of awareness, distance from dental facilities, and transportation difficulties were identified as the major barriers to dental care. Significant associations were observed between treatment preference and age, gender, educational status, dental pain, treatment cost, and awareness. Conclusion: Most participants preferred tooth preservation over extraction. However, financial constraints, limited awareness, fear of dental procedures, and accessibility issues significantly influenced treatment decisions. Strategies aimed at improving oral health education, increasing access to affordable dental services, and strengthening preventive and restorative dental care may help reduce unnecessary tooth extractions and improve oral health outcomes in rural communities.

Keywords: Tooth preservation, tooth extraction, patient preference, barriers to dental care, rural population, oral health, Khyber Pakhtunkhwa, Pakistan.