Young People's Valuations of Managing Compromised Molars: A Discrete Choice Experiment.

INTRODUCTION

Limited evidence exists to support optimal patient-centered management for compromised first permanent molars (cFPMs) in young people. Young people's preferences are important when planning their health care.

OBJECTIVES

This study aimed to elicit young people's preferences for pathways to manage cFPMs.

METHODS

An online discrete choice experiment (DCE) was completed by young people (aged 12-16) from the United Kingdom. The design was informed by the literature, interviews with young people, and a concurrent adult-focused DCE. A statistically optimal d-efficient design generated 18 choice tasks across two blocks. Each respondent answered 1 block of 9 tasks. Choice tasks varied across four characteristics: treatment type, care provider, management decision-maker, and number of future visits avoided. An opt-out (no treatment) was included. Conditional (fixed effects) logit models were used for data analysis.

RESULTS

In total, 122 young people completed the DCE. Restoring a cFPM was preferred to having a partial gap, prosthetic replacement with a bridge, orthodontic closure, or a full-unit gap. Preferences ranged from no preference to a preference for spontaneous closure compared to a restoration (odds ratio = 1.40; 95% confidence interval, 0.98-1.99; P = 0.063). Young people had no preference for the health professional providing their care (general dentist, dentist with enhanced skills, or a specialist pediatric dentist). Participants did not have a clear preference for whether treatment decisions were made by the dentist alone, the patient alone, or on a shared decision-making basis between patient, parent, and dentist.

CONCLUSION

Young people wished to manage cFPMs and expressed preferences for restorations rather than any other management, resulting in a gap, and for orthodontic or prosthetic closure. They want and should be included as part of a shared decision-making process for these teeth, rather than their preferences being assumed solely by parental proxies. Young people aged 12 to 16 were able to understand and complete this DCE.Knowledge Transfer Statement:Young people (aged 12-16) attending primary and secondary care dental clinics in the United Kingdom clearly expressed preferences on how compromised first permanent molars should be managed. They want and should be included as part of a shared decision-making process for these teeth, rather than their preferences being assumed solely by parental proxies.