Anticipating Tooth Extraction: Patient Experiences of a Communication-Sensitive Clinical Moment in Pakistan

Objective Tooth loss is a major public health concern, yet the period between the recommendation for extraction and the procedure remains underexplored. This study explored how adults in southern Khyber Pakhtunkhwa (KP), Pakistan, experience the anticipatory phase of non-emergency tooth extraction and how patient–dentist communication shapes emotional responses, social interpretations and coping behaviours during this period. Methods A qualitative study informed by phenomenological principles was conducted at the Institute of Dental Sciences Kohat, the only public-sector dental hospital in southern KP, Pakistan. Fifteen patients were purposively recruited using maximum variation sampling. Semi-structured interviews were conducted in Urdu or Pashto, audio-recorded, transcribed verbatim and translated into English. Data were analysed using reflexive thematic analysis following Braun and Clarke’s six-phase framework, with interpretation conceptually informed by the Common-Sense Model of Self-Regulation. Results Analysis revealed three interrelated themes characterising the anticipatory phase of tooth extraction: (1) perceived threat and identity disruption, (2) coping and behavioural self-regulation, and (3) clinical communication as a determinant of emotional readiness. Conclusion The anticipatory phase before tooth extraction was experienced as an emotionally and socially significant period that is rarely addressed in routine public-sector dental care. Fear, stigma, and concerns about appearance and social judgement, particularly among women, were prominent, while clear and empathetic clinician communication emerged as essential. These findings suggest the need for brief, culturally responsive pre-extraction counselling, locally appropriate educational and audio-visual materials, and stronger communication training, feedback, and evaluation systems to support more patient-centred care in resource-constrained settings.