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Patients' preferences for selective versus complete excavation: A mixed-methods study.

Falk Schwendicke1, Roxana Mostajaboldave2, Isabella Otto3

  • 1Department of Operative and Preventive Dentistry, Charité University of Berlin, Germany.

Journal of Dentistry
|January 23, 2016
PubMed
Summary

Most patients prefer complete caries excavation over selective removal, fearing endodontic treatment. Patient personality, education, and dental anxiety influence this preference, impacting clinical decisions.

Keywords:
Dental anxietyEndodontic treatmentMixed methodsPatient preferencesSelective caries removalTreatment decision

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Area of Science:

  • Dental research
  • Patient-centered care
  • Caries management

Background:

  • Selective caries removal is evidence-based but underutilized.
  • Patient acceptance is a potential barrier to adopting selective caries removal.
  • Understanding patient preferences is crucial for clinical implementation.

Purpose of the Study:

  • To assess patient preferences for selective versus complete caries excavation.
  • To identify predictors influencing patient choice between excavation methods.

Main Methods:

  • Sequential mixed-methods approach combining focus groups and a survey.
  • Content analysis of focus group transcripts informed survey design.
  • Survey (n=150) used case-vignettes to evaluate treatment attributes and regression analysis for predictor identification.

Main Results:

  • Focus group participants viewed complete excavation as reliable but feared endodontic treatment.
  • 82.7% of survey respondents preferred complete over selective excavation.
  • Selective excavation preference linked to emotional stability, higher education, low dental anxiety, and acceptance of lesion progression.

Conclusions:

  • Patient preferences for caries excavation are shaped by treatment attributes, demographics, personality, and dental history.
  • Dentists should consider informative and empathic communication in clinical decision-making regarding caries removal.