Are Clinical Decisions in Endodontics Influenced by the Patient's Fee-Paying Status?

A study led by scientists from King’s College London has explored whether the fee status of a UK patient influences clinical decision-making in endodontics – a dental specialty concerned with the study and treatment of the dental pulp.  The research has been published today in the British Dental Journal (BDJ).

In a randomised-controlled vignette study using either an “NHS-funded” or “Privately-funded” or undisclosed fee-status patient, the investigators examined the importance dentists placed on the funding status when deciding to offer patients endodontic treatment, as opposed to extracting the tooth. The research team, including Drs. Koula Asimakopoulou, Dave Gilbert and Ian Walker from the Dental Institute at King’s College London, were pleased to find that there is no strong evidence to suggest that the fee-status of a patient influences the decision-making in endodontic treatment. The researchers commented:  “This is only a small scale study using hypothetical scenarios and highly experienced dentists but on the basis of our findings we have no reason to believe that dentists get unduly influenced by the fee-status of their patients before making treatment decisions.”

One hundred and nineteen experienced dentists participated in the study.  Endodontic treatment can be very successful when it is done to a high standard, however it is a much more costly for the GDP to deliver than extractions, due to it taking longer to perform and requiring the use of expensive, single use instruments and materials.  The investigation set out to discover if the GDP considered the fee paying status of the patient when recommending either methods.  The results showed that the funding status was not an influencing factor when treatment was considered. When taken at face value these findings are encouraging and suggestive that this cohort of participants takes a cost-irrelevant approach in practising dentistry.

“Are Clinical Decisions in Endodontics Influenced by the Patient's Fee-Paying Status?” by Walker et al is published in the British Dental Journal on Friday 11 December 2015.