Third molar treatment outcome: a comparison of patients' preferences in Sweden and Wales

Key Points MAU methodology allows assessments of both medical and non-medical factors including outcomes of removal and retention of mandibular third molars. Patients' ranking of preferred outcomes was similar, regardless of country. Patients prefer outcomes of third molar non-removal as compared to outcomes following removal. Patient treatment preferences are more stable across national boundaries than dentist preferences. Aim To elucidate and compare patients' outcome preferences for removal and retention of mandibular third molars in Sweden and Wales. Subjects and method The subjects comprised patients referred and scheduled for removal of one or both mandibular third molars in Sweden and Wales. The multi-attribute utility (MAU) methodology was applied to study patients' preferences for outcomes of removal and retention of the mandibular third molar. Results Relative weighting of domains was similar in the two countries. 'Home and social life' received the highest relative weighting in Sweden and 'general health and wellbeing' in Wales. 'Your appearance' received the lowest relative weighting in both countries. In both Sweden and Wales operative jaw fracture was considered to be the outcome with most impact and dentigerous cyst and imbricated incisors the least impact. Outcome ranking was similar in both countries and operative outcomes were considered by patients to be more detrimental to health than retention outcomes. Conclusions This comparison showed that patients' preferences in Sweden and Wales were similar and that the outcomes of surgery were considered worse after third molar removal than retention. Patient-orientated treatment decisions were less subject to variation than clinician-orientated decisions.