Decision-Making for Patients with Permanent Mature Painful Vital Teeth: A Pilot Study in the Australian Public Dental System

Abstract

Introduction: The socio-economic status (SES) of patients influences dental treatment decisions.Aims To investigate the influence of patients’ demographics and SES on treatment choices for permanent mature teeth with painful pulpitis.Methods Records of adult patients who received dental care in public sector were categorised by treatment received (extraction, root canal treatments RCT, vital pulp therapies VPT). Patients age, gender and SES correlation with rendered treatments were investigated. Patients SES was determined using their postcode (SEIFA scores).Results Three groups of n = 25 patients per treatment were analysed. There was no significant correlation between patient age or gender and treatment performed (P = 0.250, P = 0.683) or patients SES and treatment type (P = 0.210). SEIFA scores were highest for VPT and lowest for extraction. Formal diagnosis was undocumented in 8% of VPT, 28% of RCT, and 64% of extraction cases. VPT was never offered in RCT or extraction groups. Pulp exposure guided VPT treatments, while patient preference drove half of RCT and extraction choices.Conclusions Patients age and gender did not affect treatment decisions. Socio-economic status may influence decision-making in permanent painful teeth. Service setting appeared to have a major impact. These findings are relevant for patients seeking treatment in public health systems.