Factors associated with patients’ rejection of root canal treatment in a tertiary hospital, Southwest Nigeria: A pilot survey

Abstract

Objective: Root canal treatment (RCT) is a major procedure in dentistry. It aims to relieve the pain of pulpal origin and maintain the affected tooth as a functional unit on the arch. Despite these achievable goals, RCT is sometimes rejected by patients. This study, therefore, sought to assess the reasons for rejection in patients planned for endodontic/RCT. Materials and Methods: This was a cross-sectional pilot survey of patients planned for RCT using a self-administered questionnaire. The questionnaire included sociodemographics, the Index for Dental Anxiety and Fear (IDAF-4C), and questions to assess the reasons for rejection of endodontic treatment. Data collected were analysed with IBM Statistical Package for the Social Sciences software program, version 23.0. Descriptive statistics were used; chi-square was used to test the association between categorical variables. Statistical significance was set at P ≤ 0.05. Result: Thirty-one patients between the age range of 16 and 81 years, with a mean age of 38.16 ± 17.87, participated in the survey. Only nine (29.03%) of the participants declined to have the treatment. The majority 6(66.7%), and 7(77.8%) of those that refused the treatment did so, due to fear of drilling ( P = 0.014) and cost of treatment ( P = 0.001), respectively. Mean IDAF-4C was 1.86 ± 0.9 (standard deviation). The rejection was, however, not affected by past experience, the risk of taking multiple radiographs, and the number of hours or visits for the procedure. Conclusion: The cost of treatment and fear of drilling were the major reasons for the rejection of RCT in this study. Therefore, there is a need to further look into making endodontic treatment a more comfortable, less costly, and less fear-provoking procedure for patients.

A survey of amalgam use to guide dental education curriculums

“…It is widely accepted that amalgam is stronger, less technique sensitive, less cariogenic, and has greater longevity compared to composite resin 13–15 . Despite this, it is evident that amalgam use remains low compared to composite resin, as both this and other studies reflect 4,5 . Although the study results indicate that amalgam use was universally low (0%–10%) for each explanatory variable in the study, clinicians with more experience and clinicians who graduated earlier had higher frequencies of amalgam use.…”

“…However, since the introduction of more environmentally‐friendly materials such as composite resin and glass ionomer, amalgam popularity has diminished 2 . According to Health Canada, amalgam use has declined by 38% from 1979 to 1990 3 and according to other studies, this trend has continued well into the 2000s 4,5 . Despite its diminished use, it is widely accepted that amalgam is still an “effective and safe restorative filling material,” 3 it is superior to composite resin in terms of longevity and secondary caries, 6 and a true alternative to amalgam is not yet available 6 …”