Trends in Tooth Extraction Indications and Socioeconomic Influences: A Retrospective Study in Western Rajasthan (2022–2025)

Abstract Background: Tooth extraction remains a cornerstone of oral and maxillofacial surgery, driven by clinical indications such as dental caries, periodontitis, and trauma, alongside non-clinical factors including financial barriers and dental anxiety. This study examines these drivers and socioeconomic influences in a rural Indian context characterized by limited preventive care access. Methods: A retrospective cohort study analysed 1,100 anonymized records from the dental outpatient department of a tertiary hospital in Jodhpur, Western Rajasthan, from June 2022 to June 2025. Extraction indications were stratified by age group (paediatric: <18 years; adult: 18–64 years; geriatric: ≥65 years) and evaluated using chi-square tests and multivariable logistic regression, adjusted for tooth type, sex, extraction complexity, comorbidities, and surgical technique. Results: Dental caries (43.9%, n=483) and periodontitis (29.9%, n=329) predominated, followed by non-clinical factors (12.3%, n=135; 60% financial barriers), trauma (11.5%, n=126), and orthodontic needs (0.5%, n=6). Surgical (trans alveolar) extractions comprised 31.6% (n=348), with increased complexity in geriatric patients (p<0.05). Non-clinical indications rose from 8.7% (2022–2023) to 15.3% (2024–2025) (χ²=19.36, p=0.01), amid post-2023 economic challenges. Paediatric patients showed higher trauma rates (14.1%, p<0.01), while geriatric patients exhibited elevated periodontitis (40.1%, p<0.05), worsened by diabetes mellitus (OR=1.92, 95% CI: 1.23–2.99, p=0.004). Conclusion: Clinical factors remain primary, yet the growing impact of non-clinical elements, particularly financial constraints, highlights the urgent need for targeted preventive programs and policy interventions to reduce preventable tooth loss and address socioeconomic inequities in rural settings.