Prevalence and Risk Factors of Post-Extraction Complications in a Western Australian Tertiary Dental Hospital: A Retrospective Cross-Sectional Study.

Objectives: Dental extractions are routine procedures, yet they carry a risk of post-operative complications that can negatively affect patients' quality of life. This study aimed to identify patient-, tooth- and clinician-related risk factors associated with post-extraction complications at Western Australia's only tertiary dental hospital, to inform clinical decision-making and improve outcomes by identifying high-risk groups.

Methods: A retrospective audit of patient records was conducted using data from individuals who underwent dental extractions during the audit period. Extracted variables included demographic details, medical history (e.g., smoking status, diabetes, hypertension), extraction characteristics (e.g., simple vs. surgical, tooth location) and clinician factors (e.g., level of training, anaesthesia type). Post-operative complications were identified through clinical follow-up notes. Descriptive and inferential statistical analyses were used to determine significant associations.

Results: The overall post-extraction complication rate was 11.0%. The most common complications were persistent post-operative pain (4.1%) and alveolar osteitis (3.4%). Statistically significant patient-related risk factors included smoking, uncontrolled diabetes and hypertension. Surgical extractions and mandibular tooth removals were associated with higher complication risks. Extractions performed by students and those conducted under general anaesthesia were also linked to increased complications.

Conclusions: Approximately 1 in 10 patients experienced post-operative complications. Identifying modifiable risk factors and minimising surgical complexity may reduce adverse outcomes. Operator experience and anaesthesia choice should be considered during preoperative planning.

Clinical relevance: This study highlights the importance of structured preoperative risk assessment that integrates medical comorbidities, extraction complexity and operator training level. Tailoring surgical planning and post-operative monitoring based on individual risk profiles may improve clinical outcomes, reduce avoidable complications and support safer, more effective delivery of care in tertiary and teaching settings.