Review of dental operative procedures and the causes of tooth extraction at the railway general hospital rawalpindi

To study the frequency of various dental procedures and the causes of dental extractions at Railway General Hospital Rawalpindi and to suggest measures to improve the existing scenario. A descriptive cross-sectional study The study was conducted at IIMCT, Railway General Hospital from June 2014 to May 2015. All consecutive patients undergoing dental operative procedures at IIMCT Railway General Hospital were studied. The patients were examined clinically and by dental X-Ray when required. The extent of caries was ascertained and Miller's Mobility Index was used to grade the extent of Periodontitis. Tooth extraction was done in patients having broken down roots, gross caries, tooth mobility grade >2 and those with impaction, trauma, cysts etc. A total of 3116 dental procedures were done that included 1902 [61.0%]tooth extractions, 930 [29.8%] fillings, 166 [5.3%] scalings and 118 [3.8%] root canal treatments. The number of scalings and root canal treatments significantly, increased with addition of an extra dental surgeon [p<0.001]. A total of 1902 teeth were extracted from 1560 patients. Caries was the leading cause of tooth extraction [60%]. Most of the patients with advanced caries presented with broken down root [763/1902,40%]. Gross caries was the reason for extraction in 380/1902 [20%], periodontitis with mobile teeth [grade >2] in 569/1902 [30%] and other reasons like cysts, impaction and trauma etc. in 190/1902 [10%] of patients. Conclusion: Caries and periodontal infections are the commonest dental problems and the reason for tooth extraction at the Railway General Hospital Rawalpindi where people mostly come from the lower socio-economic status. The quality of work in a public sector dental setting like Railway General Hospital can be improved by providing adequate number of dentists and other resources