Treatment planning of damaged teeth: to recover or to extract?

Planning the treatment of a compromised tooth is challenging but the choice should refer to evidence-based criteria. The literature proved that patient-related factors influence the treatment plan, but what happens when the patient is a dentist? Aim of the study was to observe whether the dentist goes for the same option suggested to a patient in a hypothetical scenario.

One hundred volunteers were interviewed singularly in a quiet ambient. Radiographs of 15 compromised teeth were shown and were identified as belonging to a hypothetical patient with non-contributory medical history asking for the best treatment. For each clinical case, the dentist could decide between: extraction (E), endorestorative recovery (R); referral to a specialist (S) to save the tooth. After a 15-minute wash-out, the same radiographs were shown again with the question: if this was your tooth, what would you do? The alternatives could be E or R. Statistical analysis was performed in order to evaluate the discordance between the choice taken for the patient and for the dentist's teeth.

A constant increase in recovered teeth was observed in group D with the only exception of case 12. Concordance ranged from scarce to substantial, while symmetry showed that, when changing their mind, the dentists recovered their own teeth.

The dentists were more conservative on their teeth: this shows the absence of a coherent decision-making pattern and stresses the need for an improvement in the formation of dental practitioners.