Determinants of patient regret following tooth extraction due to severe periodontal disease: A cross-sectional survey

Abstract

Objectives: This study aimed to identify factors associated with patient regret following tooth extraction due to severe periodontal disease. The focus was on sociodemographic characteristics, oral health status, autonomy preferences, and patients&apos; experiences with tooth extraction, with the goal of informing the development of personalized decision-support strategies within a shared decision-making framework. Methods: The final analysis included 722 patients who had undergone tooth extraction due to severe periodontal disease and had provided complete survey responses. Data included sociodemographic factors, oral health status (modified Adult Oral Health Standard Set), autonomy preferences in clinical decisions (modified Autonomy Preference Index), and patients&apos; experiences related to tooth extraction (modified Decision Regret Scale). Internal consistency was assessed using Cronbach&apos;s alpha, and ordinary least squares regression was performed to identify significant predictors of regret. Results: Regression analysis revealed significant associations between higher levels of regret and poorer selfreported oral health, stronger preferences for autonomy, inadequate pre-treatment information, and lower alignment between expected and actual treatment outcomes (P < 0.05). Notably, the adequacy of clinicianprovided information and expectation concordance demonstrated the strongest statistical associations with regret. Patients who reported stronger preferences for decisional autonomy also expressed greater regret, dissatisfaction, and perceived harm after treatment. Conclusions: Patient regret following tooth extraction was notably influenced by pre-treatment communication, expectation management, autonomy preferences, and oral health status. These findings underscore the importance of individualized, preference-sensitive, and shared decision-making strategies in enhancing patientcentered care and reducing regret in irreversible dental procedures. Clinical significance: Understanding the determinants of regret can guide clinicians in adopting personalized communication strategies, thereby improving patient satisfaction and reducing decisional regret in irreversible dental treatments.