title: Treatment Preferences for Toothache among Working Poor Canadians.
abstract: BACKGROUND
  Working poor (WP) Canadians are those who work ≥ 20 hours/week, are not full-time students, and have annual family incomes <$34,300. They have unique vulnerabilities and face significant barriers to accessing dental care because they rarely receive employment-based dental benefits and are ineligible for publicly funded dental programs. This research aimed to understand whether WP Canadians would prefer extraction rather than tooth restoration and preservation when they have toothache.
  
  
  METHODS
  A cross-sectional stratified sampling study design and telephone survey methodology was used to collect data from a nationally representative sample of 1049 WP individuals aged 18-64 years. A pretested questionnaire included sociodemographic and self-reported oral health questions and asked participants to select their preference for maintaining versus extracting an aching tooth. By using bivariate and logistic regression analyses, we applied the Gelberg-Andersen Behavioral Model for Vulnerable Populations to understand what influences treatment preferences among this population (P ≤ .05).
  
  
  RESULTS
  The majority of participants (86%) preferred to save and fill an aching tooth rather than take it out. Those who were older, partially dentate, reported a history of oral pain, had their last dental visit more than 3 years ago, or who only visited the dentist when in pain were significantly more likely to opt for tooth extraction.
  
  
  CONCLUSIONS
  The majority of WP Canadians value preserving their natural dentition. Effective dental care service delivery in both private and public settings requires an understanding of the possible factors that influence WP persons' preferences for essential treatment modalities in dentistry.
authors.affiliation: Discipline of Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Discipline of Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Clinical Epidemiology and Health Care Research, 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.
authors.forename: Amir
authors.initials: A
authors.lastname: Azarpazhooh
authors.affiliation: Discipline of Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Carlos
authors.initials: C
authors.lastname: Quiñonez
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D010485:Periapical Periodontitis / Q000150:complications* / Q000628:therapy*; D012959:Socioeconomic Factors; D014081:Tooth Extraction; D014098:Toothache / Q000209:etiology* / Q000628:therapy*; D000069602:Working Poor; D055815:Young Adult
keywords: Apical periodontitis; decision making; patient preference; working poor