General dentists’ treatment plans in response to cosmetic complains; a field study using unannounced-standardized-patient

Abstract

BackgroundThis field study explored general dentists' treatment plans in response to the request for cosmetic services of an unannounced standardized patient (USP) in Mashhad, Iran. MethodsThe researcher, as a USP, visited 24 and 23 offices in a high-income and a low-income area, respectively. The primary complaint was that, according to her friend's comments, a dental student, her smile was "crooked and yellow" due to the congenitally missing tooth number 10 and peg-shaped tooth number 8. The dentists' treatment plans for teeth color and form and the cosmetic services expenses were recorded. The treatment plans of the two areas were compared. ResultsFor dental form, most dentists' treatment plans were categorized as "No intervention" (privileged area: 37.5 %, less-privileged area: 56.53 %, and total: 46.80 %). The percentage of dentists in the privileged area who prescribed cosmetic services was twice that of the less-privileged area (33.33 % versus 17.39 %). The intervention for dental form varied from placing 1 unit of composite veneer to 10 units of ceramic laminates or orthodontics with a wide range of treatment costs ($42.09 to $1079.14). For tooth color, most dentists (privileged area: 62.50 %, less-privileged area: 30.43 %, and total: 46.80 %) were categorized as "Interventionists." For tooth color, the treatment plans varied from scaling and root planing, bleaching, and composite veneer with various costs ($7.19 to $197.84). ConclusionCosmetic treatment plans and expenses varied significantly for a single USP, with many not aligning with the standard treatment plan. Some dentists offered treatments even without a chief complaint from the patient. Dentists in privileged areas were twice as likely to prescribe cosmetic treatments compared to those in less privileged areas. Therefore, cosmetic services necessitate monitoring, establishing clear diagnostic criteria, and implementing educational interventions.