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| ORIGINAL ARTICLE |
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| Year : 2022 | Volume
: 9
| Issue : 1 | Page : 63-71 |
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Pretreatment expectations and posttreatment satisfaction with different prosthodontic treatments in a Saudi population
Ahmed Yaseen Alqutaibi1, Abdullah Faisal Alharbi2, Abdullah Mohammed Alharbi2, Ghofran Ali Karbouji2, Emad Yahya Dagharire2, Afaf Aboalrejal3
1 Department of Substitutive Dental Science, College of Dentistry, Taibah University, Medina, Saudi Arabi; Department of Prosthodontics, College of Dentistry, Ibb University, Ibb, Yemen
2 Graduate Dental Student, College of Dentistry, Taibah University, Medina, Saudi Arabia
3 Department of Oral Biology, College of Dentistry, Ibb University, Ibb, Yemen
| Date of Submission | 08-Oct-2021 |
| Date of Decision | 27-Feb-2022 |
| Date of Acceptance | 21-Mar-2022 |
| Date of Web Publication | 29-Apr-2022 |
Correspondence Address:
Associate Prof. Ahmed Yaseen Alqutaibi
Department of Substitutive Dental Sciences, College of Dentistry, Taibah University, Medina
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/sjoralsci.sjoralsci_52_21
Introduction: The dentist–patient relationship and the patient's expectation before prosthodontic treatment are significant in achieving patients' satisfaction. There are not enough studies in the Saudi population on how the expectation can affect patients' satisfaction for patients rehabilitated with different prosthetic options.
Aim: This study aimed to investigate the effect of gender, prosthesis type, and patients' expectations of different prosthetic treatments on the patient's satisfaction.
Materials and Methods: Data were collected at the dental hospital, Faculty of Dentistry, Taibah University. A total of 125 participants evaluated their expectations of and satisfaction with different prostheses types regarding esthetics, chewing, comfort, and phonetics, also assessed their perception of the dentists' conduct by using a Visual Analog Scale.
Results and Discussion: The study included 125 participants (50.4% females, 49.6% males), with a mean age of 39.76 ± 15.42. Regarding the prosthesis type, there were no statistically significant differences between expectations and satisfaction in all domains except with chewing with a fixed denture prosthesis, in which satisfaction exceeded expectations with a statistically significant difference (P < 0.05). Most participants scored their perception of the dentist's conduct above average and described their dentists as professional, very concerned, and careful. Female participants recorded statistically insignificantly lower expectations and satisfaction scores than males regarding esthetics, comfort, and phonetics with all prosthesis types (P > 0.05).
Conclusion: The study's findings suggested that satisfaction levels were correlated with prosthesis type, pretreatment expectations, and the gender of the treated patients.
Keywords: Expectations, fixed dental prosthesis, implant-supported prosthesis, RDP, satisfaction
How to cite this article:
Alqutaibi AY, Alharbi AF, Alharbi AM, Karbouji GA, Dagharire EY, Aboalrejal A. Pretreatment expectations and posttreatment satisfaction with different prosthodontic treatments in a Saudi population. Saudi J Oral Sci 2022;9:63-71 |
How to cite this URL:
Alqutaibi AY, Alharbi AF, Alharbi AM, Karbouji GA, Dagharire EY, Aboalrejal A. Pretreatment expectations and posttreatment satisfaction with different prosthodontic treatments in a Saudi population. Saudi J Oral Sci [serial online] 2022 [cited 2023 Apr 2];9:63-71. Available from: https://www.saudijos.org/text.asp?2022/9/1/63/344403 |
| Introduction | |  |
The dentist–patient relationship and the patient's expectations before prosthodontic treatment are major factors in achieving patient's satisfaction. The dentist must optimize communication with the patient to overcome any sociopsychological obstacles and avoid factors that may interfere with treatment success.[1]
Most patients have some expectations about the dentist's professional skills and the treatment plan. The dentist has to understand these expectations and assess them to see if they are realistic.[2],[3] Knowledge of the essential components of patient's satisfaction is not enough; dentists should know about their patients' opinions and views to take practical steps to overcome them.[4]
There are multiple factors that may affect the satisfaction and the outcome, which included gender, age, retirement grade level, self-perception of oral and general health, as well as dental caries and periodontitis, all have a substantial influence on the participants' oral health-related quality of life.[5] Furthermore, the factors of physical impairment and psychological disturbance were most strongly influenced in rural and urban patients, respectively.[6]
Fixed dental prosthesis (FDP), removable partial dentures, implant-supported FDP, overdentures, and complete dentures are prosthodontic treatment options used to restore missing teeth. Populations have taken implant-supported prosthesis treatments with significant attention.[7] It was determined that the level of reasonableness, awareness, and information regarding dental implants in Saudi Arabia was comparable to the worldwide picture. This awareness was restricted to generic facts, and greater understanding regarding dental implants is needed as they become a more common method of treatment to replace lost teeth.[8] These different prosthesis types may have an impact on the patient's expectations and satisfaction.[9]
To identify the differences between patient expectations and satisfaction, the dentist must establish an effective communication method, allowing patients to express their opinions and expectations. The dentist can explain the limitations regarding the type of prosthesis in a way that patients can understand.[3],[10],[11],[12]
To the best of the authors' knowledge, there are not enough studies in the Saudi population regarding the expectations and the satisfaction of different prosthodontic treatments. Our study aimed to evaluate patients' expectations and satisfaction with different prosthodontic treatments and evaluate the perceptions of the patients toward the dentist's conduct and professionality at the same time.
Our null hypothesis was that there is no difference between expectations before and satisfaction after different prosthodontic treatments and gender affects the expectations and satisfaction.
| Materials and Methods | | |
A cross-sectional study was conducted between August and September 2020 among patients treated at the dental clinics of Taibah University. The study was approved by the Institutional Review Board and Research Ethics Committee, College of Dentistry, Taibah University (TUCDREC/24072020). This study was conducted following the Declaration of Helsinki guidelines. Informed consent was obtained from each participant. The sample size was calculated using a Chi-square test with a 95% confidence interval (CI) and a 5% margin of error. The pretreatment expectations and posttreatment satisfaction of 125 patients treated with Fixed Dental Prostheses (FDP), Removable Dental Prostheses (RDP) implant crowns, and a combination of FDP with RDP were evaluated. The participants were asked to use a Visual Analog Scale (VAS) to assess their expectations before treatment and satisfaction after treatment on the same questionnaire at the same time (i.e., after the treatment) [Appendix 1].
The data were collected by an investigator who had not provided dental care to the patients before. The participants were asked to fill out the VAS regarding four domains: esthetic, chewing, comfort, and phonetic. Each part ranged from 0 to 10, where 0 represented the lowest score (describing the worst possible outcome) and 10 the highest score (describing the best possible outcome).
The participant-associated variables, including age, gender, educational level, and type of prosthesis, were recorded. The participants also evaluated their perception of the dentist's conduct.
Collected data were analyzed using SPSS (statistical package for scientific studies) version 21 (Chicago, IL, USA) for windows. According to the type of data, the data were presented as means and standard deviations or frequencies and percentages; the Wilcoxon test was used to compare the variables that include gender, educational level, and type of prosthesis with satisfaction levels for each group, according to the prosthesis type. The Mann–Whitney test was used to compare responses by gender, and the Kruskal–Wallis test was used to compare expectations before and satisfaction within each treatment group (α = 0.05).
| Results | | |
A total of 125 participants were included in this study with a mean age of 39.76 ± 15.42 years with an age range of 20–88 years old. The gender distribution was 63 females (50.4%) and 62 males (49.6%). Most participants had FDP (90; 72%), followed by RDP (20; 16%), implant crowns (12; 9.6%), and a combination of FDP and RDP (3; 2.4%). Most were well educated and had no health problems [Table 1]. | Table 1: Participant's age, gender, type of prosthesis used, education, health, and social status
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The average scores of the expectations and satisfaction with FDP regarding esthetics, chewing, comfort, and phonetics are shown in [Table 2]. The scores were above average, and there were no statistically significant differences between scores using the Wilcoxon test for esthetics, comfort, and phonetics (P > 0.05). However, there were statistically significant differences between scores regarding chewing (P < 0.05). | Table 2: Participant's average score for pretreatment expectations and posttreatment satisfaction for fixed dental prosthesis regarding esthetics, chewing, comfort, and phonetics
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[Table 3] shows the average expectations and satisfaction scores with RDP regarding esthetics, chewing, comfort, and phonetics. The scores were above average, and there were no statistically significant differences between scores using the Wilcoxon test for all domains (P > 0.05). | Table 3: Participant's average score for pretreatment expectations and posttreatment satisfaction for RDP regarding esthetics, chewing, comfort, and phonetics
Click here to view |
[Table 4] and [Table 5] show the average expectations and satisfaction scores with implant crowns and combined FDP and RDP regarding esthetics, chewing, comfort, and phonetics. There were no statistically significant differences between scores using the Wilcoxon test for all domains (P > 0.05). | Table 4: Participant's average score for pretreatment expectations and posttreatment satisfaction for implants crowns regarding esthetics, chewing, comfort, and phonetics
Click here to view |
 | Table 5: Participant's average score for pretreatment expectations and posttreatment satisfaction for combined fixed dental prosthesis with removable dental prosthesis regarding esthetics, chewing, comfort, and phonetics
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The participants' satisfaction with their dentist is shown in [Table 6]. Most participants show above-average scores. [Table 7] shows patients' evaluation of the dentists' conduct and professionalism using the most appropriate words. More than half (58.4%) described their dentist as very concerned. | Table 7: Perceptions of patients toward the dentist's conduct and professionality
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The comparison between female and male participants regarding expectations and satisfaction with treatment in general is shown in [Table 8]. Female participants had nonsignificantly lower scores for both expectations and satisfaction than male participants regarding esthetics, comfort, and phonetics for all prosthesis types (P > 0.05). The only exception was the expectation of chewing, where females recorded significantly lower scores than males (P < 0.05). | Table 8: Comparison of average Visual Analog Scale scores by gender for pretreatment expectations and posttreatment satisfaction with different types of prostheses
Click here to view |
| Discussion | | |
Rejecting the null hypothesis was the only choice according to the nonsignificant difference between expectations before and satisfaction after different prosthodontic treatments and gender effects on expectations and satisfaction except on one aspect of expectation of chewing, where females recorded significantly lower scores compared to males.
Patients who received FDP presented with satisfaction scores exceeding their expectations regarding esthetics, chewing, and comfort, but not the phonetics, which may indicate that this outcome may need to reinforce the importance of explaining to the patients the advantages and disadvantages of this type of prosthesis to the patients before treatment start. Before constructing FDP, the patient may expect some changes and may not consider the differences in a complaint. In contrast, if the dentist does not explain that to the patient early and the patient faces a problem at the time of prosthesis delivery, the patient might think the dentist is just using an excuse to avoid further adjustments.
The current study indicated that the prosthesis type was strongly associated with the patient's expectation and satisfaction; this may indicate that the dentist's pretreatment explanation could help with the satisfaction after treatment.
A previously conducted study,[13] on patients with FDP after 3 years of follow-up, showed that the patients were very well adapted to chewing with their prostheses resulting in satisfactory masticatory efficiency. In several studies also shown,[14],[15] high percentages of patients were satisfied with their FDPs from a functional and esthetic point of view. Our finding revealed a significant satisfaction level that exceeded expectations regarding chewing in patients who received FDP, which agreed with the previous studies.
In another study's finding.[16] patient expectations before treatment were more significant than satisfaction after treatment. However, this difference was significant only for esthetics in patients who had received implant-supported FPDs. Our current study regarding patients who received single implanted crowns showed an insignificant difference between expectations and satisfaction scores. This indicates the general satisfaction of those patients with that type of prosthesis, considering the low failure rates, more efficiency, improved comfort, and chewing ability of implant-supported prosthesis as satisfaction factors,[17] regardless of the high cost of dental implants, which may affect satisfaction level.[18]
In another study.[19] the average VAS scores were high for both expectations before therapy and satisfaction after treatment; however, the expectation scores were more significant than the satisfaction levels. In another study also,[20] mastication, esthetics, the number of missing teeth, and speaking ability were all associated with dissatisfaction in RDPs. These data can help a doctor explain a treatment plan and help a patient realize the risk of dissatisfaction when specific criteria are present. With a study,[21] all treatments produced significant improvement in oral health-related quality of life. However, the least amount of improvement was observed in patients with RDPs. With ours, both RDP and combined RDP with FDP showed average scores with insignificant differences, but that score was lower than FDP and implant prosthesis. This result reinforces the importance of the type of prosthesis and its major impact on expectations and satisfaction.
In our current study, most patients described their dentist as a professional, careful, and very concerned with a high score of satisfaction, indicating the importance of the dentist–patient relationship and how that was effective on the outcome overall. In agreement with our findings, a previously published study revealed that pretreatment expectations and patients' perceptions of the dentist's conduct were associated with posttreatment satisfaction. This hypothesis goes along with our findings regarding all prosthesis types.[10]
Our findings revealed that the female participants have lower satisfaction scores than males. This may indicate that females have higher demands with lower satisfaction than males.
| Conclusion | | |
Within the limitations of this study, the following conclusions could be drawn: the satisfaction level was correlated with prosthesis type, expectation before treatment, and the gender of the treated patients.
There is no statistically significant difference between expectations before and satisfaction after different prosthodontic treatments with esthetic, phonetics, and comfort except for chewing in FDP only.
The participants with the implant-supported crown had higher expectations that yielded a higher satisfaction level.
Limitation of the research
This study has limitations, including the number of participants that receive both kinds of prothesis (FDP and RDP) at the same time is quite low compared to those who receive FDP alone or RDP alone. In addition, participants filled their expectations and satisfactions of the treatment simultaneously after the treatment, which will be better if it is filled before and after the treatment.
Future recommendation
It recommends linking more factors (age effect, time of constructing such a prosthesis, and position of the prosthesis) to the satisfaction of getting further explanation and details and getting a complete in-depth understanding of the patient's satisfaction.
Before starting prosthodontic treatment, dental professionals should effectively communicate with their patients and encourage them to ask any questions; any misunderstandings should be thoroughly discussed. Good communication positively affects expectations that result in a high level of satisfaction at the end of the treatment.
Availability of data and materials
The data that support the findings of this study are available from the authors when required.
Consent to participate
Informed consent was obtained from each participant.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| Appendix 1: Pretreatment expectations and posttreatment satisfaction with different prosthodontic treatments in a Saudi population questionnaire. | | |
(Pretreatment expectations and posttreatment satisfaction with different prosthodontic treatments in a Saudi population)
Section One: General questions
Gender:
[ ] Male
[ ] female
Age:
Educational level:
[ ] read and write
[ ] Elementary
[ ] Average
[ ] secondary
[ ] Bachelor's degree
[ ] Diploma
[ ] Master's
[ ] Ph.D
[ ] Other academic degrees
Social status
[ ] Single
[ ] married
Are you on the job (employee)?
[ ] Yes
[ ] no
Section Two: General health
Do you have any health problems?
[ ] There are no health problems
[ ] diabetes
[ ] High blood pressure disease
[ ] Heart disease
[ ] Liver diseases
[ ] Kidney disease
[ ] lung diseases
[ ] Stomach diseases
[ ] Other diseases
Third Section: Expectations before treatment and satisfaction after treatment about dental prostheses.
If the answer to the first question is “no,” please submit the questionnaire.
Thank you very much.
Have you ever been treated with a dental prosthesis?
[ ] Yes
[ ]No
(If your answer is no, please submit the questionnaire, thank you)
What type of dental prosthesis have you been treated with
[ ] Fixed prosthodontics
[ ] Removable dental prosthesis
[ ] Fixed and removable prosthodontics
[ ] Dental implant-based prosthesis
From the questions below, rate from the number one to the number ten, where the number one represents your worst expectation or satisfaction and the number ten represents your highest expectation or satisfaction.
How would you rate your expectation before treatment in terms of esthetics?
(Please circle the number that is right for you)
The worst the best
[10——9—8——7——6——5——4——3——2——1]
How would you rate your expectation prior to treatment about chewing with a dental prosthesis?
(Please circle the number that is right for you)
The worst the best
[10——9—8——7——6——5——4——3——2——1]
How would you rate your expectations prior to treatment regarding your comfort with a dental prosthesis?
(Please circle the number that is right for you)
The worst the best
[10——9—8——7——6——5——4——3——2——1]
How would you rate your expectation before treatment about the exits of letters and words?
(Please circle the number that is right for you)
The worst the best
[10——9—8——7——6——5——4——3——2——1]
How would you rate your satisfaction with the treatment in terms of esthetics?
(Please circle the number that is right for you)
The worst the best
[10——9—8——7——6——5——4——3——2——1]
How would you rate your satisfaction with the treatment with respect to dental prosthesis?
(Please circle the number that is right for you)
The worst the best
[10——9—8——7——6——5——4——3——2——1]
How would you rate your satisfaction with the treatment in terms of your comfort with dental prostheses?
(Please circle the number that is right for you)
The worst the best
[10——9—8——7——6——5——4——3——2——1]
How would you rate your satisfaction with the treatment with regard to the exits of letters and words?
(Please circle the number that is right for you)
The worst the best
[10——9—8——7——6——5——4——3——2——1]
How do you evaluate the behavior of your dentist who performed the dental prosthesis in terms of explaining what the treatment mechanism is and what are the things he needs before the treatment begins?
(Please circle the number that is right for you)
The worst the best
[10——9—8——7——6——5——4——3——2——1]
How would you rate the behavior of your dentist who performed prosthodontics in terms of receiving appropriate dental care?
(Please circle the number that is right for you)
The worst the best
[10——9—8——7——6——5——4——3——2——1]
How would you rate the behavior of your dentist who performed the dental prosthesis in terms of explaining everything that works for you?
(Please circle the number that is right for you)
The worst the best
[10——9—8——7——6——5——4——3——2——1]
How would you rate the behavior of your dentist who performed the dental prosthesis in terms of forming a friendship bond with you?
(Please circle the number that is right for you)
The worst the best
[10——9—8——7——6——5——4——3——2——1]
How would you rate the respectful behavior of your dentist who performed the dental prosthesis?
(Please circle the number that is right for you)
The worst the best
[10——9—8——7——6——5——4——3——2——1]
How would you rate the behavior of your dentist who performed the dental prosthesis in terms of giving you the opportunity to give your opinion of the treatment?
(Please circle the number that is right for you)
The worst the best
[10——9—8——7——6——5——4——3——2——1]
How do you evaluate the behavior of your dentist who did the dental work in terms of making sure that everything is checked when he examines his patients or with you?
(Please circle the number that is right for you)
The worst the best
[10——9—8——7——6——5——4——3——2——1]
How would you rate the behavior of your dentist who performed the prosthodontics in terms of answering your questions?
(Please circle the number that is right for you)
The worst the best
[10——9—8——7——6——5——4——3——2——1]
What are the words that describe your dentist who did the prosthodontics?
[ ] Not caring or not very interested
[ ] Indifferent or slightly disinterested
[ ] A little concerned or interested
[ ] Very interested
[ ] I do not know
What are the words that describe your dentist who did the dental prosthesis?
[ ] professional
[ ] Cautious
[ ] Professional and cautious
[ ] Not professional or cautious
Thank you very much for filling out the survey
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8]
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