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Ethnic differences in treatment preferences among adults in East London


Aim To explore ethnic differences in treatment preferences among adults.

Methods A sample of 1,764 adults from ten ethnic groups were recruited from the adult population in Outer North East London using stratified multistage random sampling. Treatment preferences for a front tooth, a back tooth and an aching back tooth were collected via questionnaires. Ethnic differences in treatment preferences were assessed in regression models adjusting for demographic characteristics, socioeconomic indicators, dental visiting behaviour and clinical dental status.

Results Ethnic differences in treatment preferences were observed, albeit only for back not front teeth. Compared to White British, Black African (odds ratio: 0.85; 95% confidence interval [CI]: 0.74-0.97), Caribbean (0.71; 95% CI: 0.51-0.98) and Other (0.73; 95% CI: 0.61-0.87) were less likely to preserve a back tooth. If the back tooth was aching, Black Others were still less likely (0.82; 95% CI: 0.71-0.93) to opt for restorative than surgical treatment. On the contrary, Bangladeshi were more likely (1.14; 95% CI: 1.06-1.22) to preserve a painful back tooth than White British.

Conclusion Differences in treatment preferences were found among ethnic groups, suggesting that cultural background might influence the choices made and the value placed on dental extractions versus restorative treatment.

Key points

  • Treatment preferences represent a significant element in people's attitudes to the way they value their oral health.

  • This paper reviews the scarce literature on differences in treatment preferences by ethnicity.

  • It discusses potential explanations for ethnic differences in treatment preferences.

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  1. Delgado-Angulo E K, Bernabe E, Marcenes W. Ethnic inequalities in dental caries among adults in East London. J Public Health (Oxf) 2016; 38: e55-62. DOI: 10.1093/pubmed/fdv097.

  2. Delgado-Angulo E K, Bernabe E, Marcenes W. Ethnic inequalities in periodontal disease among British adults. J Clin Periodontol 2016; 43: 926-933.

  3. Abdelrahim R, Delgado-Angulo E K, Gallagher J E, Bernabé E. Ethnic Disparities in Oral Health Related Quality of Life among Adults in London, England. Community Dent Health 2017; 34: 122-127.

  4. Delgado-Angulo E K, Mangal M, Bernabe E. Socioeconomic inequalities in adult oral health across different ethnic groups in England. Health Qual Life Outcomes 2019; 17: 85.

  5. Watt R, Sheiham A. Inequalities in oral health: a review of the evidence and recommendations for action. Br Dent J 1999; 187: 6-12.

  6. Newton J T, Thorogood N, Bhavnani V et al. Barriers to the use of dental services by individuals from minority ethnic communities living in the United Kingdom: findings from focus groups. Prim Dent Care 2001; 8: 157-161.

  7. Gilbert G H. Racial and socioeconomic disparities in health from population-based research to practice-based research: the example of oral health. J Dent Educ 2005; 69: 1003-1014.

  8. Warren C, McGraw A P, Van Boven L. Values and preferences: defining preference construction. Wiley Interdiscip Rev Cogn Sci 2011; 2: 193-205.

  9. Savani K, Markus H R, Conner A L. Let your preference be your guide? Preferences and choices are more tightly linked for North Americans than for Indians. J Pers Soc Psychol 2008; 95: 861-876.

  10. Azarpazhooh A, Quiñonez C. Treatment Preferences for Toothache among Working Poor Canadians. J Endod 2015; 41: 1985-1990.

  11. Tilashalski K R, Gilbert G H, Boykin M J, Litaker M S. Racial differences in treatment preferences: oral health as an example. J Eval Clin Pract 2007; 13: 102-108.

  12. Boykin M J, Gilbert G H, Tilashalski K R, Litaker M S. Racial differences in baseline treatment preference as predictors of receiving a dental extraction versus root canal therapy during 48 months of follow-up. J Public Health Dent 2009; 69: 41-47.

  13. Kelly M, Steele J G, Nuttall N et al. Adult Dental Health Survey. Oral Health in the United Kingdom 1998. London: The Stationery Office, 2000.

  14. Bradnock G, White D A, Nuttall N M et al. Dental attitudes and behaviours in 1998 and implications for the future. Br Dent J 2001; 190: 228-232.

  15. Office for National Statistics. The National Statistics Socio-Economic Classification: User Manual. Basingstoke: Palgrave Macmillan, 2005.

  16. Delgado-Angulo E K, Marcenes W, Harding S, Bernabé E. Ethnicity, migration status and dental caries experience among adults in East London. Community Dent Oral Epidemiol 2018; 46: 392-399.

  17. Kressin N R, Boehmer U, Berlowitz D et al. Racial variations in dental procedures: the case of root canal therapy versus tooth extraction. Med Care 2003; 41: 1256-1261.

  18. Boehmer U, Glickman M, Jones J A et al. Dental Care in an Equal Access System Valuing Equity: Are There Racial Disparities? Med Care 2016; 54: 998-1004.

  19. Dressler W W, Oths K S, Gravlee C C. Race and ethnicity in public health research: Models to explain health disparities. Ann Rev Anthropol 2005; 34: 231-252.

  20. Nordenram G, Davidson T, Gynther G et al. Qualitative studies of patients' perceptions of loss of teeth, the edentulous state and prosthetic rehabilitation: a systematic review with meta-synthesis. Acta Odontol Scand 2013; 71: 937-951.

  21. Hill K B, Chadwick B, Freeman R, O'Sullivan I, Murray J J. Adult Dental Health Survey 2009: relationships between dental attendance patterns, oral health behaviour and the current barriers to dental care. Br Dent J 2013; 214: 25-32.

  22. Re D, Ceci C, Cerutti F et al. Natural tooth preservation versus extraction and implant placement: patient preferences and analysis of the willingness to pay. Br Dent J 2017; 222: 467-471.

  23. Al-Sahan M M, MacEntee M I, Bryant S R. A metatheory explaining how patients manage tooth loss. Gerodontology 2020; 37: 258-270.

  24. Okunseri C, Bajorunaite R, Matthew R, Iacopino A M. Racial and ethnic variation in the provision of dental procedures. J Public Health Dent 2007; 67: 20-27.

  25. Cabral E D, Caldas Ade Jr F, Cabral H A. Influence of the patient's race on the dentist's decision to extract or retain a decayed tooth. Community Dent Oral Epidemiol 2005; 33: 461-466.

  26. Sabbah W, Gireesh A, Chari M, Delgado-Angulo E K, Bernabé E. Racial Discrimination and Uptake of Dental Services among American Adults. Int J Environ Res Public Health 2019; 16: 1558.

  27. Simmons R, Elias C. The study of client-provider interactions: a review of methodological issues. Stud Fam Plann 1994; 25: 1-17.

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The ELOHI study was a collaboration between the Institute of Dentistry at Queen Mary University of London and the Primary Care Trusts of Barking and Dagenham, Redbridge and Waltham Forest. The Barking and Dagenham, Redbridge and Waltham Forest Community Services provided partial funding for the implementation of the study. We thank all participants and the fieldwork team.

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Correspondence to Elsa Karina Delgado-Angulo.

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Naz, S., Bernabe, E., Marcenes, W. et al. Ethnic differences in treatment preferences among adults in East London. Br Dent J (2021).

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