Factors affecting patients’ and potential patients’ choices among anaesthetics for periodontal recall visits

OBJECTIVES: Dentinal hypersensitivity and recurrent disease may necessitate the use of anaesthetic during periodontal recall visits. However, an aversion to injections may affect patient compliance. The objectives of this study were to determine choices patients and 'potential' patients make when provided with information on the risks and benefits of alternative anaesthetic choices for root planing during periodontal recalls and to examine which factors influence these choices. METHODS: Using an interactive computer tool, scenarios described the risks and benefits of root planing during periodontal maintenance and the anaesthetic alternatives (no anaesthetic, an experimental thermosetting gel anaesthetic and traditional local infiltration anaesthesia). Compliant patients for whom anaesthesia was recommended during recall cleanings were recruited from private periodontal practices (n=97). General population subjects (potential patients) were recruited by random digit dialing (n=196) RESULTS: As dental insurance was one of the inclusion criteria, the sample was representative of a working population. Most subjects reported tooth sensitivity (recall 84.5%, general 59.9%). The majority of patients wanted some form of anaesthetic, either gel (recall 82.5%, general 81.0%) or local infiltration (recall 10.3%, general 16.4%). Fifty-five percent of subjects reported moderate or severe pain from their previous dental injection(s). Asked if they were to have a dental needle tomorrow, 52.5% would be somewhat or very anxious. Of those who chose gel, 63.47% would be more or much more willing to return for recall visits if the gel were available. Using multivariate logistic regression, concern about pain and anxiety associated with needles were the only statistically significant characteristics associated with anaesthetic preference. CONCLUSIONS: Concern about pain and anxiety associated with needles dominates preferences for dental anaesthesia. The overwhelming preference for a non-injectable anaesthetic reveals a strong clinical need for such alternatives.