A survey of patients' preferences for the treatment of teeth with apical periodontitis.
BACKGROUND
This research aimed to investigate the preference of patients in Toronto, Canada for management of a tooth affected by painful apical periodontitis when considering its retention via root canal treatment (RCT) and its extraction followed by no replacement, replacement with an implant-supported crown, fixed, or removable partial prostheses.


METHODS
Data were collected through a mail-out survey of the University of Toronto Faculty of Dentistry patients, which was complemented by a convenience sample of patients in 10 community practices in Toronto (n = 1000, response rate = 43%). Participants were asked to select their general preference for anterior and posterior teeth with apical periodontitis between saving the tooth or extraction and their specific preference for tooth retention via RCT or extraction. By using bivariate and logistic regression analyses, we applied the Gelberg-Andersen Behavioral Model for Vulnerable Populations to the preference questions to understand the influential factors (P ≤ .05).


RESULTS
Participants' specific preference for tooth retention via RCT was slightly but significantly lower than their general preference (anterior tooth, 93.7% versus 97.2%; posterior tooth, 83.8% versus 89.6%; P < .005). Higher annual income, previous RCT, functional dentition, good/excellent self-rated oral health, and regular dental visits were associated with higher preferences for tooth retention in response to different questions.


CONCLUSIONS
The high preference for retaining a tooth in general was moderated by the specific consideration of RCT to retain the tooth. When RCT and extraction are viable options, patients should be advised about the treatment options in an impartial manner and encouraged to communicate their preferences.
Discipline of Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Discipline of Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment Collaborative, University of Toronto, Toronto, Ontario, Canada. Electronic address: amir.azarpazhooh@dentistry.utoronto.ca.
Amir
A
Azarpazhooh
Thuan
T
Dao
Rafael
R
Figueiredo
Murray
M
Krahn
Shimon
S
Friedman
D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D003442:Crowns / Q000523:psychology; D003657:Decision Making; D003729:Dental Care / Q000523:psychology; D019094:Dental Prosthesis, Implant-Supported / Q000523:psychology; D003829:Denture, Partial / Q000523:psychology; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009864:Ontario; D009909:Oral Health; D057240:Patient Preference; D010485:Periapical Periodontitis / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D012390:Root Canal Therapy / Q000523:psychology; D014081:Tooth Extraction / Q000523:psychology; D019553:Tooth, Nonvital / Q000523:psychology / Q000628:therapy; D055815:Young Adult
Apical periodontitis; decision making; patient preference