Determinants of dentists' decisions to initiate dental implant treatment: a judgment analysis

Do psychosocial patient characteristics influence the decision of a dentist in recommending implant treatment?

This study assessed the importance that dental general practitioners attach to psychosocial patient characteristics when judging the suitability of these patients for dental implant treatment.

The judgment strategy of 30 Dutch dental practitioners was studied by using 2 tasks. Dentists first judged a series of written scenarios representing fictitious patients, each patient being characterized by 4 psychosocial aspects to determine the patients' suitability for implant treatment. The second task involved rank ordering 14 patient characteristics according to their importance in implant treatment decisions.

Dentists judged the personal appearance of the patient and, to a lesser degree, the patient's socioeconomic status to influence decisions to treat. However, these characteristics are ranked as quite unimportant in decision making, whereas motivation, oral hygiene, and level of neuroticism were the most important patient characteristics.

The results on the 2 tasks were clearly not in agreement. There was a substantial disagreement between what dentists say to be important characteristics (rank order task) and the characteristics they actually use to judge the suitability for implant treatment (scenario task). Moreover, it appeared that agreement among the dentists is quite low, especially for the scenario task.