Endodontic Misconceptions Among Dental Patients: Prevalence and Association with Tooth Extraction Preference

Part of proper oral health care is recognising and correcting dental myths and misconceptions that often discourage patients from seeking proper treatment decisions. Although general dental myths are well studied, little is known about the prevalence of specific endodontic misconceptions, especially those related to the effects of root canal treatment (RCT) on systemic health and their correlation with patients' preference for extraction over RCT. This study aimed to investigate the prevalence of endodontic myths among adult dental patients and to explore potential associations with demographic variables and with a preference for tooth extraction over RCT.

A self-administered paper questionnaire was distributed in person at 11 dental hospitals and private clinics in Almadinah Almunawarah, Kingdom of Saudi Arabia. Participants in the study included adults without cognitive impairments. The questionnaire collected sociodemographic data, history of previous RCT, agreement with 10 endodontic myths, and preference for extraction over RCT. To ensure understanding and clarity of the questionnaire, a pilot test was carried out. The data were then analysed using descriptive statistics, Chi-square, and multivariable logistic regression tests using the Statistical Package for the Social Sciences (SPSS) version 25.0. The p value was set at p ≤ 0.05.

A total of 463 participants completed the questionnaire. The most commonly endorsed myths were that root canal treatment can only be done in multiple visits (73.0%), that antibiotics are necessary during treatment (68.5%), and that root-canal-treated teeth become weak and brittle (63.1%). Almost a third of the patients (30.9%) believed that a root-canal-treated tooth remains infected; however, myths about systemic diseases were less common; these include beliefs that RCT causes cancer (6.3%), cardiovascular disease or heart attacks (10.8%), or chronic illnesses (14.3%). Older participants, lower educational levels and prior RCT experience showed significant endorsement of specific misconceptions (p 0.05). Bivariate analyses revealed that several misconceptions were significantly associated with a greater preference for tooth extraction, specifically those related to systemic health. Patients who believed that root canal treatment (RCT) causes cancer, that RCT-treated teeth remain infected and that all root-canal-treated teeth should be extracted were more likely to prefer extraction than those who did not hold these beliefs (all p 0.05).

Endodontic myths were common among patients in Almadinah Almunawara. Misconceptions concerning systemic health effects, persistence of infection, and a perceived link between RCT and cancer were associated with a preference for tooth extraction over RCT. Age, educational level, and no previous RCT experience were associated with endorsement of specific misconceptions. Targeted public education and effective dentist-patient communication may help correct these misconceptions, improve acceptance of evidence-based endodontic care, and support preservation of natural dentition.