Exploring motivations to seek and undergo prosthodontic care: a cross-sectional study in a Brazilian adult sample

Developing and validating a scale to measure perceived barriers to prosthodontics treatments among partially edentulous patients

Background

People experiencing tooth loss need dental prostheses to preserve the integrity of their oral structures and replace the missing teeth. Patient-related outcome measures (PROMs) for perceived barriers to prosthodontics treatment are scarce in the literature.

Aims

The aim of this study was to develop a comprehensive scale to identify and measure barriers to prosthodontic treatment as perceived by partially edentulous patients.

Methods

This cross-sectional study was conducted among N = 334 partially edentulous adults who seeking prosthodontic treatment. Data collection was carried out in February to September 2024. Exploratory factor analysis was utilized to elucidate the latent factor structure. A six-factor model was validated through confirmatory factor analysis. Reliability was evaluated using Cronbach's alpha. The convergent and discriminant validity of the final scale were assessed.

Results

EFA produced a 21-item scale grouped into six factors that explain 75.78% of the total variance with eigenvalues >1. All items showed acceptable reliability, ranging from 0.807 to 0.935. The first factor pertained to financial constraints; the second factor was concerning lack of knowledge and awareness; the third factor was related to anxiety and fear; the fourth factor related to negative past dental experiences; the fifth factor included issues related to limited accessibility to dental services; and the last factor was concerning insufficient dental guidance. The CFA results indicate an acceptable model fit, with standardized factor loadings spanning from 0.54 to 0.99. The model factors' convergent and discriminant validity were confirmed.

Conclusion

This study enhances the understanding of barriers to prosthodontic treatment in a Saudi Arabian teaching dental hospital. It introduces a novel scale for further data collection, aiding policymakers and stakeholders in addressing these barriers and improving public oral health. Future studies should validate this scale and explore its applicability in various contexts and populations.

Willingness to accept or refuse mandibular implant overdenture treatment: A prospective study on edentulous enrolled in a clinical trial

BACKGROUND

Several complete denture wearers have major complaints and may be benefitted from implant treatment. However, the factors that shape the demand for and utilization of implants need further investigation.

OBJECTIVE

The aim was to evaluate edentulous patient's willingness to accept or refuse the offer and provision of implant-retained treatment.

METHODS

As part of a clinical trial, edentulous subjects were offered a mandibular overdenture retained by four mini-implants opposing a conventional maxillary denture. Treatment was offered without any financial costs for the patients. Patients' level of interest in receiving treatment was assessed using a 5-point Likert scale, and they were asked to respond to a list of reasons that led to their decision to accept or refuse implants. Those who refused implants received conventional prosthodontic interventions as required, and those who accepted implant treatment underwent surgical planning and implant placement.

RESULTS

Of 175 eligible subjects, 147 accepted the offer of treatment and were invited to take part in the study (69.4% women, mean age 67.4 ± 10.0 years). Overall, 111 patients (75.5%) expressed a positive intention to undergo implant treatment at the initial contact. Implant treatment was performed for 56.3% (9/16) of those who answered 'probably yes' about their level of interest in implant treatment on the Likert scale, and 69.6% (64/92) of 'certainly yes' (p < .001). Older subjects were less likely to receive implants (OR = 0.93; p = .036), whilst those with a positive intention towards implants (OR = 3.15; p = .001), those previously treated by the dental team (OR = 7.89; p < .001), and who actively demanded implants (OR = 18.1; p < .001) were more likely to accept treatment. Improved chewing was the most common reason for accepting implants, whilst fear of surgery was the most reported reason for refusal.

CONCLUSION

Refusal of implants was high among edentate patients even when financial costs were removed. Patients' initial attitude towards acceptance is a key factor in the demand for and uptake of implant therapy.

Key Factors Correlations in Selecting Dental Services

The factors which influence patients in their choice of a dental care office has recently become more complex. Our objective was to assess the correlations between different key factors (demographic aspects, dentists’ professionalism, factors related to dental care offices) that influence the selection of a particular dental care office by adult patients.

An online questionnaire (self-administered survey) was applied to a random sample of 117 adult dental patients in private clinics in Bucharest, Romania. The survey consisted of 12 questions, and it was conducted during a 2-week period. All the collected data were subjected to statistical analysis.

The obtained results revealed statistically significant correlations between studied factors, i.e., elderly patients compared to younger patients considered the use of the state-of-the-art medical devices was important for the dental office (p=0.043, R=0.187). In comparison to women, male patients were searching more often information regarding the dental offices on social media (p=0.002, R=0.284); patients that attached more importance to the dentist’s professional degree were the ones that attached more importance to its reputation (p<0.001, R=0.381) and to the dental office location (p=0.022, R=0.211).

The results highlighted specific patterns in patients’ perception of factors related to the selection of dental offices, as also found in scientific literature.

The present study offers a perspective on how to improve dental care and patients’ oral health.