Decision-making process for treatment of mandibular fractures among minority groups.
OBJECTIVE
While patients' preferences for medical care are widely studied, only a small number of studies have looked at the decision-making process for dental treatment of mandibular fracture. This study examines the decision-making process for treatment of mandibular fractures among minority groups. Study participants were asked to consider Maxillomandibular Fixation (MMF--a non-surgical approach of wiring the teeth for 4-8 weeks) or Rigid Internal Fixation (RIF--surgical placement of bone plate).


METHODS
A qualitative study of patients receiving care at an inner-city hospital for either 3rd molar extraction under general anesthesia or a mandibular fracture were recruited to participate in an hour-long focus group to discuss their preferences. The 3rd molar group was selected as a comparison group exemplifying experience with oral surgery and recovery from general anesthesia.


RESULTS
Seven decision-making factors affecting choice of treatment were discussed by both jaw fracture and 3rd molar groups, including: side effects, effectiveness of each treatment, trusting doctor's recommendation, what to expect from each procedure, use of pictures from previous case studies, surgery location of scar/incision, and size of scar. Rigid Internal Fixation (RIF) participants discussed a different set of concerns compared to Maxillomandibular Fixation (MMF) participants.


CONCLUSIONS
Regardless of gender, the treatment of choice for both 3rd molar and jaw fracture participants was the non-surgical method of wiring of the teeth for 4-8 weeks. The Phase II part of this study will systematically examine patient preferences among a larger sample of 3rd molar and jaw fracture patients by incorporating the patient-reported concerns about treatment of jaw fracture found in this inductive, phenomenological study.
UCLA School of Dentistry, Box 951668, 10833 Le Conte Avenue, Los Angeles, CA 90095-1668, USA. cdermart@aol.com
Claudia
C
Der-Martirosian
Melanie W
MW
Gironda
Edward
E
Black
Richard
R
Leathers
Kathryn A
KA
Atchison
D001741:Black or African American / Q000523:psychology; D000762:Anesthesia Recovery Period; D001294:Attitude to Health; D001860:Bone Plates / Q000009:adverse effects; D002921:Cicatrix / Q000473:pathology; D003657:Decision Making; D003812:Dentist-Patient Relations; D005260:Female; D017144:Focus Groups; D005593:Fracture Fixation, Internal / Q000009:adverse effects; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D019248:Jaw Fixation Techniques / Q000009:adverse effects; D008297:Male; D008337:Mandibular Fractures / Q000208:ethnology / Q000628:therapy*; D008913:Minority Groups / Q000523:psychology; D008964:Molar, Third / Q000601:surgery; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D014081:Tooth Extraction; D016896:Treatment Outcome; D035502:Trust; D014505:Urban Population