Surgical Vs. Non-surgical Periodontal Treatment – Factors Affecting Patient Decision Making

Objectives: To explore which factors affect patients’ decisions to have surgical or non-surgical treatment for periodontal disease. Specifically, it was investigated whether the patients’ background factors (gender, age, education, socioeconomic status), dental fear, general anxiety, control beliefs, cost considerations, and relationship with the dentist affected the decision to be treated surgically or non-surgically. Methods: Data were collected from 74 patients (32 male / 42 female; average age: 52.65 years; range: 27 to 83 years) at a regularly scheduled periodontal appointment at which they were informed that periodontal treatment was needed. Dental fear was measured with the Dental Anxiety Scale – Revised (Ronis et al., 1995), and general anxiety with the State-Trait-Anxiety Inventory (Spielberger, 1983). Results: Patients who decided to have surgery did not differ from the patients who decided to have non-surgical treatment in background variables (gender, age, educational background, and socioeconomic status), and the degree to which they wanted to have control over the treatment. However, the surgery patients had less dental fear (5 point scale: means: 1.95 vs. 2.39; p=.026), and general anxiety than the non-surgery patients (4 point scale; means: 1.58 vs. 1.77; p=.09). In addition, while patients in both groups did not differ in their responses to the items concerning how well the dentist had informed them, they did differ in their evaluations of the degree to which they liked the dentists (4.78 vs. 4.41; p=.014), trusted them (4.63 vs. 4.23; p=.014), believed that their dentist was concerned not to inflict pain (4.74 vs. 4.41; p=.041), and listened to them (4.80 vs. 4.27; p=.001), with the surgery patients being consistently more positive than the non-surgery patients. Conclusions: The results showed dental fear and general anxiety affected patients’ treatment decision making. In addition, the quality of the patient–provider relationship is crucial in determining patients’ treatment choices.