Level and predictors of agreement between patients and their dentists concerning need for replacement of teeth at the time of extraction

Abstract

The aims were to determine the level of agreement between patient and dentist about the need for a replacement of teeth at the time of extraction, and to identify and assess the effect of predictor variables on the level of agreement. Data were obtained from questionnaires. A systematic random sample of 1,500 Norwegian general dental practitioners were contacted, 67% of them responded and 75% of their patients. The final sample consisted of 427 patients (16-92 years old) and 224 dentists. Overall agreement was 62% of the cases and agreement about replacement 26%. Multiple logistic regression analysis with overall agreement as dependent variable identified tooth type (OR = 2.7 for anterior teeth versus molars, 95% CI: 1.3; 5.6 and OR = 1.9 for molars versus premolars, 95% CI: 1.2; 3.2), service sector, dentist's age and patient gender as significant predictors. Tooth type (OR = 36.0 for anterior teeth versus molars, 95% CI: 12.5; 104.0 and OR = 5.8 for premolars versus molars, 95% CI: 2.7; 12.3), service sector (OR = 7.0, 95% CI: 2.3; 21.1), the number of teeth extracted and the number of remaining natural teeth affected the likelihood of agreement about the need for replacement of extracted teeth. Predictors of no need for replacement were tooth type (OR = 6.7 for molars versus premolars, 95% CI: 3.3; 13.7) and the dentist's age (OR = 2.1, 95% CI: 1.2; 3.6). Clinical factors were the most important predictors of patients' and dentists' likelihood to agree about replacement, but service sector, dentist's age and patient's gender had also a significant impact on the level of agreement.