Eliciting Dentists’ and Patients’ Preferences for the Treatment of Teeth with Apical Periodontitis

Background: Teeth affected by apical periodontitis (AP) that could be retained by root canal therapy (RCT) are increasingly being extracted and replaced with implant-supported crowns (ISC). Objectives: 1) To investigate preferences of dentists and patients towards retaining a tooth with AP using RCT...

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Main Author: Azarpazhooh, Amir
Other Authors: Locker, David
Language:en_ca
Published: 2011
Subjects:
Online Access:http://hdl.handle.net/1807/29661
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spelling ndltd-TORONTO-oai-tspace.library.utoronto.ca-1807-296612013-04-19T19:55:55ZEliciting Dentists’ and Patients’ Preferences for the Treatment of Teeth with Apical PeriodontitisAzarpazhooh, AmirPatient PreferenceDecision MakingDental Health SurveysApical PeriodontitisDentistryDental Ethics0567Background: Teeth affected by apical periodontitis (AP) that could be retained by root canal therapy (RCT) are increasingly being extracted and replaced with implant-supported crowns (ISC). Objectives: 1) To investigate preferences of dentists and patients towards retaining a tooth with AP using RCT versus its extraction followed by, no replacement, replacement with an ISC, or with a partial fixed or removable denture. 2) To investigate patients’ preferred role and dentists’ ethical responsibilities in decision-making. Methods: A mail-out survey (sent to: dental specialists, n=195, response rate=39%; patients, n=434, response rate=43%) and a web-based survey (general dentist sample, n=304, response rate =15%) were used to collect data. Statistical bivariate and multivariate analyses were undertaken with P set at < 0.05 with Bonferroni adjustment as necessary. Results: RCT or ISC were the most selected treatment choices for dentists, while the preference for RCT was reduced for teeth treated previously with RCT. Dentists’ preferences were associated with their specialty as well as clinical experience in endodontics and/or implant dentistry. Patients’ stated general preference for saving teeth was associated with higher self-rated oral health, frequent dental check-ups, and higher socio-demographic factors. Those with higher education, regular dental visits and previous experience of RCT preferred to undergo RCT for future treatment in comparison to those who never experienced RCT. Patients preferred a collaborative role with their dentists in making treatment decisions and valued the retention of natural teeth very highly. They also felt that communication with and trust in their dentist was paramount. Conclusion: Dentists should establish rapport with patients in a milieu that values and respects the patients’ autonomy. By following the highest standards of evidence-based care, and transferring unbiased information on treatment options and associated risks/benefits, it is highly probable that dental care will be delivered in a more ethical manner than would otherwise be possible.Locker, DavidMock, David2011-062011-08-29T18:15:49ZNO_RESTRICTION2011-08-29T18:15:49Z2011-08-29Thesishttp://hdl.handle.net/1807/29661en_ca
collection NDLTD
language en_ca
sources NDLTD
topic Patient Preference
Decision Making
Dental Health Surveys
Apical Periodontitis
Dentistry
Dental Ethics
0567
spellingShingle Patient Preference
Decision Making
Dental Health Surveys
Apical Periodontitis
Dentistry
Dental Ethics
0567
Azarpazhooh, Amir
Eliciting Dentists’ and Patients’ Preferences for the Treatment of Teeth with Apical Periodontitis
description Background: Teeth affected by apical periodontitis (AP) that could be retained by root canal therapy (RCT) are increasingly being extracted and replaced with implant-supported crowns (ISC). Objectives: 1) To investigate preferences of dentists and patients towards retaining a tooth with AP using RCT versus its extraction followed by, no replacement, replacement with an ISC, or with a partial fixed or removable denture. 2) To investigate patients’ preferred role and dentists’ ethical responsibilities in decision-making. Methods: A mail-out survey (sent to: dental specialists, n=195, response rate=39%; patients, n=434, response rate=43%) and a web-based survey (general dentist sample, n=304, response rate =15%) were used to collect data. Statistical bivariate and multivariate analyses were undertaken with P set at < 0.05 with Bonferroni adjustment as necessary. Results: RCT or ISC were the most selected treatment choices for dentists, while the preference for RCT was reduced for teeth treated previously with RCT. Dentists’ preferences were associated with their specialty as well as clinical experience in endodontics and/or implant dentistry. Patients’ stated general preference for saving teeth was associated with higher self-rated oral health, frequent dental check-ups, and higher socio-demographic factors. Those with higher education, regular dental visits and previous experience of RCT preferred to undergo RCT for future treatment in comparison to those who never experienced RCT. Patients preferred a collaborative role with their dentists in making treatment decisions and valued the retention of natural teeth very highly. They also felt that communication with and trust in their dentist was paramount. Conclusion: Dentists should establish rapport with patients in a milieu that values and respects the patients’ autonomy. By following the highest standards of evidence-based care, and transferring unbiased information on treatment options and associated risks/benefits, it is highly probable that dental care will be delivered in a more ethical manner than would otherwise be possible.
author2 Locker, David
author_facet Locker, David
Azarpazhooh, Amir
author Azarpazhooh, Amir
author_sort Azarpazhooh, Amir
title Eliciting Dentists’ and Patients’ Preferences for the Treatment of Teeth with Apical Periodontitis
title_short Eliciting Dentists’ and Patients’ Preferences for the Treatment of Teeth with Apical Periodontitis
title_full Eliciting Dentists’ and Patients’ Preferences for the Treatment of Teeth with Apical Periodontitis
title_fullStr Eliciting Dentists’ and Patients’ Preferences for the Treatment of Teeth with Apical Periodontitis
title_full_unstemmed Eliciting Dentists’ and Patients’ Preferences for the Treatment of Teeth with Apical Periodontitis
title_sort eliciting dentists’ and patients’ preferences for the treatment of teeth with apical periodontitis
publishDate 2011
url http://hdl.handle.net/1807/29661
work_keys_str_mv AT azarpazhoohamir elicitingdentistsandpatientspreferencesforthetreatmentofteethwithapicalperiodontitis
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