Psycho‐social perspectives of nonsurgical versus surgical endodontic interventions in persistent endodontic disease

Abstract

Introduction: Patients' experiences related to dental treatment could influence care-seeking behaviour and engender personal bias. Although endodontic retreatment and apical surgery are procedures often performed to manage previously treated teeth with persistent disease, there is lack of information regarding psychosocial perspectives of patients who undergo these treatments. Our aim was to compare experiences of patients who received these two treatment modalities using a qualitative approach.Methods: A purposive sample of patients was taken from our previous study utilizing the Oral Health Impact Profile to compare oral health-related quality of life of 150 patients who received retreatment and apical surgery. Patients who reported impact and no impact were invited to participate in focus group discussions (FGDs).Eighteen patients from the retreatment group and 15 patients from the surgical group participated in six FGDs. Thematic analysis was conducted to identify key themes.Results: Four themes emerged: (1) psycho-social disability associated with dental procedures, (2) physical disability associated with dental problems, (3) reliance on dentist's advice for treatment and (4) self-management to preserve treated teeth.Patients undergoing endodontic retreatment reported significant time loss from work and were less informed of alternative treatment options. However, they were pleased with the aesthetics of their teeth, especially if new crowns were made. Patients undergoing surgery experienced anxiety related to loss of control during surgery and apprehension on visualizing the wound post-surgery. They reported more impact on their diet, social interaction and sleep quality and some felt self-conscious due to post-treatment gingival recession. Patients in both groups placed great trust in professional advice and expressed a clear desire to maintain their natural dentition.There was low awareness regarding long-term care and future sequelae of their treated tooth. Conclusions:Patients reported different psycho-social and physical impacts following endodontic retreatment and apical surgery. Patients undergoing endodontic retreatment were more satisfied with aesthetic outcomes but experienced greater impact related to complexities and length of time taken for treatment. Patients undergoing surgery were better informed of treatment options but experienced greater How to cite this article:

The outcome of single-visit nonsurgical retreatment and patients’ perception of retreatment: a retrospective cohort study with 1-year follow-up

“…Not the quality of dental care, but how the patient perceives the dental care can be assessed, and in general, patients are satisfied with the outcome of root canal treatment (28,29). A recent study showed that patients who underwent nonsurgical retreatment reported significant time loss from work but lower physical and psycho-social disability during the recovery phase in comparison to apical surgery (30). 97.6% of patients in the present study mentioned that they would still choose nonsurgical root canal treatment over surgical intervention.…”

Assessment of the Socioeconomic Status and Analysis of the Factors Motivating Patients to Apply for Prosthetic Treatment by Students of Dentistry at the Poznań University of Medical Sciences

“…It turns out that the self-assessment of the need for prosthetic treatment may depend on the effects of tooth loss, and these effects may have an aesthetic, functional, psychological, and social dimension. Anterior localization of the missing tooth increases the motivation for immediate treatment [9,10] On the other hand, not all patients with missing teeth treat this condition as harmful, and women see a greater impact of tooth loss on quality of life than men [11,12].…”