STUDY: Natural Tooth Preservation Versus Extraction and Implant Placement

Modern endodontics offers patients advancements in technologies, procedures, and materials. For your patients who have diseased or damaged teeth, giving your patients treatment options to either save their natural teeth or extract teeth and replace with dental implants is beneficial to help meet their aesthetic, functional, and economic needs. It is important to explain all of the options to your patients, so they understand how specific treatments will affect them. Always evaluate your patient’s condition to present the best treatment plans that will give them optimal oral health. An Italian study conducted in 2018 sought to highlight the importance of ensuring the patient’s participation during dental treatment decision-making. Furthermore, researchers wanted to evaluate whether dental treatment cost influences patients’ oral health decisions. 

The aim of this study was to evaluate the patients’ willingness to pay (WTP) values and preference for the treatment of a tooth with very poor prognosis, among two options: root canal therapy and crown positioning or tooth extraction, implant insertion and crown positioning.

Objective of the Study 

The aim of this study was to evaluate the patients' willingness to pay (WTP) values and preference for the treatment of a tooth with very poor prognosis, among these options: root canal therapy and crown positioning or tooth extraction, implant insertion and crown positioning. 

Findings

For this particular study, a total of 103 patients were recruited from a private dental clinic and interviewed. A questionnaire measured individuals' preferences among the two alternative treatments for a tooth with poor prognosis and the maximum amount of money they would be willing to pay for their choice with a starting bid of 2,000 euros in 100 euro increment/decrement. Demographic data, patient choice, median values and WTP association with socio-demographic factors and correlation between variables were revealed. 

Because the treatment decision-making process shifted from the traditional paternalistic model of the 1980s (where the physician is solely responsible for clinical decision-making, while the patient is passive with his/her preferences and opinions) to the new shared decision making-approach, there must now be a balance between the preferences of the patient and expertise of the dentist. 

Results

Seventy-six percent of patients expressed a preference for root canal therapy, while the remaining 24% chose the dental surgery. A fair agreement between previous experience and current therapeutic choice was found (P = 0.0001). The WTP median value was 2,000 euros and 46% of participants would pay an additional sum of money for the therapy (median: 300 euros). The preferred treatment was influenced by previous experience, but no association was found between WTP values and socio-demographic factors. 

Conclusion 

The aim of this study was to evaluate the patients’ willingness to pay (WTP) values and preference for the treatment of a tooth with very poor prognosis, among two options: root canal therapy and crown positioning or tooth extraction, implant insertion and crown positioning. Patients tend to prefer a conservative approach for the treatment of a tooth with poor prognosis and are willing to pay an additional fee to receive their treatment choice.

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References:

https://blog.ddslab.com/dental-implants-the-latest-news-and-research

https://www.nature.com/articles/sj.bdj.2017.271.epdf?no_publisher_access=1&r3_referer=nature