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Natural tooth preservation versus extraction and implant placement: patient preferences and analysis of the willingness to pay

Key Points

  • Highlights the importance of ensuring the patient's participation during dental treatment decision-making.

  • Suggests dental treatment cost may influence patients' dental visits and oral health.

  • Patients may prefere to preserve natural tooth by a conservative treatment approach


Objectives The aim of this study was to evaluate the patients' willingness to pay (WTP) values and preference for the treatment of a tooth with very poor prognosis, among two options: root canal therapy and crown positioning or tooth extraction, implant insertion and crown positioning.

Methods A total of 103 patients were recruited from a private dental clinic and interviewed. A questionnaire measured individuals' preferences among the two alternative treatments for a tooth with poor prognosis and the maximum amount of money they would be willing to pay for their choice with a starting bid of €2,000 in €100 increment/decrement. Demographic data, patient choice, median values and WTP association with socio-demographic factors (Student ttest and one-way ANOVA) and correlation between variables (Pearson chi-square test) were revealed.

Results Seventy-six percent of patients expressed a preference for root canal therapy, while the remaining 24% chose the dental surgery. A fair agreement between previous experience and current therapeutic choice was found (P = 0.0001). The WTP median value was €2,000 and 46% of participants would pay an additional sum of money for the therapy (median: €300). The preferred treatment was influenced by previous experience, but no association was found between WTP values and socio-demographic factors.

Conclusion Patients tend to prefer a conservative approach for the treatment of a tooth with poor prognosis and are willing to pay an additional fee to receive their treatment choice.

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Figure 1
Figure 2
Figure 3: Association between mean willingness to pay (WTP) values and educational attainment (A) and type of employment (B) of participants within restorative dentistry group.


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Correspondence to S. Taschieri.

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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 222, 467–471 (2017).

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