Sql get or create

I would recommend using it (town_id) as the only primary key (provided my first comment is true about the increment and uniqueness), and the Region/Country IDs should only be foreign keys. This would allow you to have duplicate town names.

You might want to put a unique index on country_id, region_id, town, as I'm pretty sure there's no political subdivision that has two towns of the same name, and it would reflect that business logic.

Your requirements:

The problem is that the user can enter as many values and in whatever order he likes. If he enters less than there are in the database all of them should be removed and replaced with the new ones

suggest that a reasonable option would be your idea:

• DELETE all the rows with same FK,
• then INSERT all the news ones,

both (DELETE and INSERT statements) in one transaction. I tried in SQLdiddle and it worked just fine:

CREATE TABLE Names
(
ID int NOT NULL PRIMARY KEY AUTO_INCREMENT,
ID_ITEM int,
Name varchar(255) UNIQUE
) ;

INSERT INTO Names
  (ID_ITEM, Name)
VALUES
  (1, 'John'),
  (1, 'Amy'),
  (1, 'Joe') ;


START TRANSACTION ;
    DELETE FROM Names
    WHERE ID_ITEM = 1 ;

    INSERT INTO Names
      (ID_ITEM, Name)
    VALUES
      (1, 'John'),
      (1, 'Joe') ;
COMMIT ;

Then:

SELECT * FROM Names ;

returns:

ID   ID_ITEM   Name
--------------------
4     1        John
5     1        Joe