Patient regret in tooth extraction for periodontitis: Highlighting the role of patient involvement in decision-making

Abstract

Background Tooth extraction is one of the most common irreversible treatment options in dentistry, and it may lead to complex emotional responses such as patient regret. This study aimed to assess the extent of decisional regret among patients who underwent tooth extraction due to periodontal disease and to identify associated influencing factors.Methods A total of 104 patients diagnosed with periodontitis and who had experienced tooth extraction participated in this self-administered survey. The questionnaire included the validated Decision Regret Scale (DRS), along with items on demographics, treatment characteristics, and decision-making processes. Linear regression analyses were conducted to identify significant associations.Results The mean DRS score in this study was 26.3 +/- 16.7, which exceeds the commonly used clinical cut-off of 25 and indicates a moderate to high level of regret. Greater regret was significantly associated with dissatisfaction regarding outcomes, perceived inappropriateness of the decision, and a lack of consideration of alternatives. Conversely, greater patient involvement in decision-making was linked with lower regret compared with when decisions were primarily made by the dentist.Conclusion These findings suggest that decisional regret after tooth extraction for periodontitis is more common than previously reported in other medical fields and is influenced by how treatment decisions are made. Patient-centered decision-making may help to reduce regret and to improve patient-reported outcomes in periodontal care.Plain Language Summary When patients have experienced tooth extraction due to gum disease, some may later feel regret about their decision. This study examined 104 adults who underwent tooth extraction because of periodontitis and found a moderate level of decisional regret. Higher regret scores were associated with situations in which the outcome did not match expectations or when patients perceived that they had little role in making the treatment choice. In contrast, lower regret scores were associated with greater patient involvement in decision-making. About 89% of patients were unaware of alternative treatment options when making their extraction decision, revealing a significant gap in how thoroughly options are discussed. The degree of regret observed was similar to that in serious medical decisions such as cancer or heart disease care, suggesting that tooth loss carries meaningful emotional weight for patients. When patients shared the decision-making process equally with their dentist, or made the decision themselves, they experienced significantly less regret. These findings highlight the importance of involving patients as active partners in treatment decisions. Aligning care with patients' values and ensuring that patients understand available options may help to support lower decisional regret and improved patient experiences.