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Original Research (Original Article) 


Abdulrahman Ayidh Alharbi et al, 2020;4(2):448–453.

International Journal of Medicine in Developing Countries

Patient acceptance, awareness, and perceived cost of dental implants as a treatment modality for replacement of missing teeth: a survey in Riyadh

Abdulrahman Ayidh Alharbi1*, Aziz Mohammed Aloufi1, Jarah Saleh Almutairi1, Thamer Rashed Alharbi1, Turki Khalid Alharbi1

Correspondence to: Abdulrahman Ayidh Alharbi

*Arass Dentistry College, Qassim University, Qassim, Saudi Arabia.

Email: Abdulrhman.aidh [at] qudent.org

Full list of author information is available at the end of the article.

Received: 23 December 2019 | Accepted: 03 January 2020


ABSTRACT

Background:

Although Saudi Arabia is considered economically stable with a high literacy rate and health care is well organized with even remote places having adequate healthcare facilities, people are still unaware of the implant as an option for the treatment of missing teeth. It is important to realize if the patients have enough information about dental implants as a treatment form for the replacement of missing teeth. This survey analysis aimed to assess patient awareness and acceptance of dental implants as a treatment option for the replacement of missing teeth.


Methodology:

A self-administered structured questionnaire was distributed among patients in Riyadh, including questions on the use of dental implants as replacement therapy for missing teeth in addition to sociodemographic data. Data analysis was done using the Statistical Package for the Social Sciences program version 22.


Results:

There was a significant difference between the perception of the participants over different age groups (p-value < 0.001), where participants aging between 31 and 50 years old had the highest level of knowledge (67.2%). Furthermore, students showed a significantly higher level of knowledge (p-value < 0.001). In addition, responders with a university degree showed a significantly higher level of knowledge (p-value < 0.001) (45.3%). Finally, males showed a significantly higher level of knowledge than females (p-value = 0.007) (64.1%).


Conclusion:

Dental implants are widely accepted among patients, with dentists being their main source of information. Further studies in other areas of Saudi Arabia are needed.


Keywords:

Acceptance, awareness, perceived cost, dental implants, treatment modality, replacement of missing teeth.


Introduction

The dental implant has come into focus since it provides excellent long-term results in the rehabilitation of partially or entirely edentulous patients [1]. Dental implants were used for the treatment of edentulous patients and are associated with improved denture retention, stability, efficiency, functionality, and quality of life [2].

In addition, researchers have focused on the degree of patient satisfaction after oral rehabilitation with different types of dental prostheses. They reported that esthetics, phonetics, and chewing efficiency were excellent with implant-supported restoration [3]. The level of awareness about dental implant treatment varied among several studies in different countries [4].

Reports from Saudi Arabia and India found that the levels of awareness about dental implants were 66.4% and 38%, respectively [5,6]. Recently, it has become the focus of the patients’ interest; hence, for dentist, it is vital to assess their level of knowledge with regard to dental implants and whether their perception of dental implants does, in fact, reflect reality to guide patients who do not have the education or background knowledge to make an informed decision between implant-supported dentures and removable dentures [7,8].

It is worth to mention that tooth loss is a common condition that can occur due to dental caries, periodontal disease, facial trauma, endodontic failure, and sometimes by iatrogenic factors [9,10]. As stated by the American Association of Oral and Maxillofacial Surgeons, 69% of adults aged 35–44 years would have lost at least one permanent tooth, and adults above 70–74 years would have lost their entire permanent teeth [11,12].

The World Health Organization categorizes edentulous people as physically impaired due to the loss of an essential part of their body [13]. The results of tooth loss are occlusal problems, chewing disability, esthetics, and temporomandibular disorders, which can have negative impacts on physical and social well-being [14].


Subjects and Methods

A cross-sectional survey was conducted among the patients visiting the various dental outpatient departments of hospitals and private dental clinics in Riyadh using a self-explanatory questionnaire. The respondents involved in the study had their age in the range of 15–55 years.

Confidentiality was assured to all participants who agreed to participate in the study. The respondents were given a brief description of the study and its objectives. The data were analyzed using the Statistical Package for the Social Sciences program, version 22.0. Descriptive statistics were done. A p-value of 0.05 or less was considered to be significant.


Results

Four hundred and two participants responded to the online questionnaire in this study. Only participants who completed all the questions in the survey were included. Sociodemographics of participants and analysis of the questionnaire are shown below.

Of 402 participants, age was subcategorized into three groups, starting with 15–30 years old and ending with more than 50 years old. Most of the responders (44.1%) belonged to the age group between 15 and 30 years old. On the other hand, the age group who were older than 50 years old had the least number of responses, with 20.2% of responses.

Turning to the gender of participants, males constituted 48% of participants, while females were 51%. The educational level was also evaluated; 6.9% were illiterate, whereas 40.9% only had a university degree. Regarding employment status, 33% of the responders were students, whereas 15.3% were housewives. All sociodemographic data are shown in detail in Table 1.

Participants were asked questions about their perception of dental implantation. Among the participants, 54.9% of the responders agreed that missing teeth should be replaced. Furthermore, 36.7% mentioned that they would undergo a dental implant treatment if required, whereas 29.6% were afraid of undergoing dental implant treatment. All responses are detailed in Table 2.

Table 1. Sociodemographic characters of participants.

Frequency (N) Percentage (%)
Gender
Female 207 51.0
Male 195 48.0
Age
15–30 179 44.1
31–50 140 34.5
>50 82 20.2
Educational level
Illiterate 28 6.9
Secondary education 83 20.4
University degree 166 40.9
Postgraduate study 50 12.3
Graduate 2 0.5
Employment status
Freelancer 80 19.7
Housewife 62 15.3
Student 134 33.0
Unemployed 116 28.6

Participants were also asked about their opinion toward the options to replace missing teeth. 44.6% of the responders chose dental implants as an option for missing teeth, whereas 10.6% did not know how missing teeth would be treated, as shown in Figure 1.

In addition, responders were asked about their source of information on dental implants. Among the participants, 36.7% got their information from the dentist, followed by 35.2% who got it through the internet, as shown in Figure 2.

Participants were asked to evaluate their level of knowledge toward dental implants. Among the participants, 30.8% evaluated their level of knowledge as very good, whereas 12.6% of the participants evaluated their knowledge as poor, as shown in Figure 3.

Participants were asked questions to evaluate their awareness about dental implants. It was found that 34% of responders mentioned that they would not choose dental implants because of their high cost. Furthermore, 38.7% believed that replacement teeth are implanted in the jaw, 36% believed that the biggest advantage of dental implants is that it improves the quality of life, and 33.3% believed that dental implants could remain for up to 10 years.

In addition, 53.2% of responders thought that dental implants require care more than natural teeth. Furthermore, 55.7% thought that dental implants could be performed for everyone, and 28.1% believed that dental implants are better than prosthetic treatment. All responses are shown in Table 3.

Table 2. Responses on perception toward dental implants.

Frequency (N) Percentage (%)
Do you think that missing teeth should be replaced? May be 91 22.4
No 88 21.7
Yes 223 54.9
Are you ready to undergo dental implant treatment if necessary? May be 133 32.8
No 121 29.8
Yes 149 36.7
Are you afraid of performing dental implant treatment? May be 155 38.2
No 128 31.5
Yes 120 29.6

Figure 1. Options for replacing missing teeth.

Figure 2. Sources of information on dental implants.

The level of knowledge proposed by each responder was compared over different demographic variables using the Chi-square test, at a level of significance (p-value < 0.05).

It was shown that there was a significant difference between the awareness of the participants over different age groups (p-value < 0.001), where participants aging between 31 and 50 years old had the highest level of knowledge (67.2%). Furthermore, students showed a significantly higher level of knowledge (p-value < 0.001) compared to other employment status variables.

Figure 3. The level of knowledge of responders toward dental implants.

Table 3. Awareness of teeth implants.

Frequency (N) Percent (%)
What is the reason for not choosing to implant teeth? High cost 138 34.0
Operation 66 16.3
I agree with implanting teeth 79 19.5
Lack of knowledge 68 16.7
Long treatment duration 46 11.3
Where do you think that teeth are implanted in the mouth? Gingiva 120 29.6
Neighboring teeth 48 11.8
Jaw 157 38.7
I do not know 79 19.5
What do you think that is the biggest advantage of dental implants/bridges supported by dental implants? Permanent replacement 123 30.3
Improve the quality of life 146 36.0
Good and comfortable 125 30.8
How long do you think that teeth implant can remain? Up to 10 years 135 33.3
Up to 20 years 97 23.9
Up to 5 years 53 13.1
For life 117 28.8
Do you think that teeth implants need special care and cleaning? It needs care and brushing less than natural teeth 78 19.2
It needs care and brushing similar to natural teeth 104 25.6
It needs care and brushing more than natural teeth 216 53.2
In your opinion, who can we have teeth implants? Anyone 226 55.7
Only rich people 172 42.4
How are the effects of implant therapy compared to common prosthetic treatment? Better 114 28.1
Less 68 16.7
I do not know 107 26.4
Similar 108 26.6

Turning to the educational level, responders with a university degree showed a significantly higher level of knowledge (p-value < 0.001) compared to other educational levels (45.3%). Finally, males showed a significantly higher level of knowledge (p-value = 0.007) compared to females (64.1%). The full comparison is shown in Table 4.

Table 4. Comparison of the level of knowledge over different variables.

Excellent Very good Good Fair Poor p-value
Age >51 10.9% 18.4% 21.5% 14.7% 41.2% <0.001*
31–50 67.2% 47.2% 28.0% 44.1% 41.2%
31–50 21.9% 33.6% 49.5% 38.2% 17.6%
Employment status Freelancer 14.1% 21.6% 9.7% 14.7% 45.1% <0.001*
Housewife 1.6% 17.6% 7.5% 33.8% 15.7%
Student 60.9% 30.4% 22.6% 33.8% 23.5%
Unemployed 20.3% 24.0% 58.1% 16.2% 15.7%
Educational level Illiterate 18.8% 1.6% 7.5% 0.0% 11.8% <0.001*
Secondary education 3.1% 29.6% 16.1% 29.4% 17.6%
University degree 45.3% 50.4% 19.4% 61.8% 25.5%
Postgraduate study 18.8% 8.0% 7.5% 5.9% 31.4%
Graduate 1.6% .8% 0.0% 0.0% 0.0%
Gender Female 32.8% 47.2% 64.5% 57.4% 49.0% 0.007*
Male 64.1% 52.8% 34.4% 42.6% 51.0%

*p-value at the level of significance< 0.05.


Discussion

Oral rehabilitation is the discipline within dentistry that deals with the diagnosis, treatment planning, and restoration of more significant tooth defects, acquired or congenitally missing teeth, and any other oral tissues. The treatment of missing teeth can be composed of restoration of teeth with crowns or replacement of teeth with implants, fixed partial dentures, or removable dentures [8].

The leading role of prosthodontics is the rehabilitation of patients after the loss of teeth and oral function. However, there are generally no standard rules about how to estimate need, demand, or utilization of prosthodontic services in most situations, since the financial condition and patients’ preferences play a vital role [9].

The present study evaluated the perception and awareness of Saudi patients in Riyadh, Saudi Arabia, about dental implants as replacement therapy for missing teeth. It is revealed that there was a significant difference between the perception of the participants over different age groups (p-value < 0.001), where participants aging between 31 and 50 years old had the highest level of knowledge (67.2%). Furthermore, students showed a significantly higher level of knowledge (p-value < 0.001) compared to other employment status variables.

In addition, responders with a university degree showed a significantly higher level of knowledge (p-value < 0.001) compared to other educational levels (45.3%). Finally, males showed a significantly higher level of knowledge (p-value = 0.007) compared to females (64.1%).

The perception of patients toward dental implants has been evaluated in different settings. Satpathy et al. [1] performed a cross-sectional study to assess the patients’ acceptance, awareness, and perceived cost of dental implants as a treatment for the replacement of missing teeth in Bhubaneswar and Cuttack. Satpathy et al. [1] indicated that only 15.91% of the patients knew about dental implants. The patients’ local dentist was their primary source of information related to the dental implant treatment modality, followed by electronic media and print.

In addition, about 71.23% of subjects disproved the removable prosthesis as a replacement for missing teeth. Most of them (60.44%) expressed that treatment was unaffordable. The cost and associated surgery were significant disadvantage and obstacle to this modality. However, they were willing to know more about the dental implant treatment modality [1].

These findings came in compliance with the present work. Among the participants, 44.6% of the responders chose dental implants as an option for missing teeth; furthermore, 36.7% of the participants got their information from the dentist, followed by 35.2% through the internet. Turning to knowledge about implants, 30.8% of the participants evaluated their level of knowledge as very good. However, the cost was a major barrier, where 34% of the responders mentioned that they would not choose dental implants due to its high cost. Arora et al. [15] also supported these findings.

Also, Saha et al. [16] performed a cross-sectional study that was carried out among 483 patients. Around 41.7% of the subjects were aware of dental implants, but, still, few (4.1%) had undergone this procedure. Dental professionals were the primary source of information followed by media about implants, and the level of awareness increased with education. The high cost of the procedure was the main factor for not undergoing treatment (35.2%).

Similarly, the present study also revealed that dentists are the major source of information about dental implants. Furthermore, the level of knowledge of the patients was considered satisfactory, with high acceptance for undergoing dental implant treatment. The high cost was the major disadvantage of dental implants.

In addition, the present study had some limitations; the level of knowledge was mainly evaluated by responders, which could be a subject for bias. Furthermore, a little number of questions could decrease the reliability of the results. To the best of our knowledge, this is the first study to evaluate the acceptance and perception of patients for dental implants as a treatment for the replacement of missing teeth.


Conclusion

Dental implants are widely acceptable by patients in Riyadh, Saudi Arabia. Patients depend mainly on dentists as their major source of information. The knowledge of patients toward dental implants is satisfactory, yet efforts to improve this level are highly recommended. Further studies in other areas of Saudi Arabia are mandatory to draw the figures of patients’ perception of dental implants all over the kingdom.


Conflict of interest

The authors declare that there is no conflict of interest regarding the publication of this article.


Funding

None.


Consent for publication

Informed consent was obtained from all the participants.


Ethical approval

Online survey was distributed after the signing the consent form from the participants.


Author details

Abdulrahman Ayidh Alharbi1, Aziz Mohammed Aloufi1, Jarah Saleh Almutairi1, Thamer Rashed Alharbi1, Turki Khalid Alharbi1

  1. Arass Dentistry College, Qassim University, Qassim, Saudi Arabia

References

  1. Satpathy A, Porwal A, Bhattacharya A, Sahu PK. Patient awareness, acceptance, and perceived cost of Dental Implants as a treatment modality for replacement of missing teeth: a survey in Bhubaneswar and Cuttack. Int J Public Health Dent. 2011;2(1):1–7.
  2. Naert I, Koutsikakis G, Duyck J, Quirynen M, Jacobs R, Van Steenberghe D. The biologic outcome of implant-supported restorations in the treatment of partial edentulism: Part 1: a longitudinal clinical evaluation. Clin Oral Implan Res. 2002;13(4):381–9. https://doi.org/10.1034/j.1600-0501.2002.130407.x; https://doi.org/10.1034/j.1600-0501.2002.130406.x
  3. Zitzmann NU, Sendi P, Marinello CP. An economic evaluation of implant treatment in edentulous patients—preliminary results. Int J Prosthodont. 2005;18(1).
  4. Guyatt GH, Cook DJ. Health status, quality of life, and the individual. JAMA. 1994;272(8):630–1. https://doi.org/10.1001/jama.272.8.630; https://doi.org/10.1001/jama.1994.03520080072047
  5. Tepper G, Haas R, Mailath G, Teller C, Bernhart T, Monov G, Watzek G. Representative marketing-oriented study on implants in the Austrian population. II. Implant acceptance, patient-perceived cost, and patient satisfaction. Clin Oral Implan Res. 2003;14(5):634–42. https://doi.org/10.1034/j.1600-0501.2003.00917.x
  6. Tepper G, Haas R, Mailath G, Teller C, Zechner W, Watzak G, Watzek G. Representative marketing-oriented study on implants in the Austrian population. I. Level of information, sources of information, and need for patient information. Clin Oral Implan Res. 2003;14(5):621–33. https://doi.org/10.1034/j.1600-0501.2003.00916.x
  7. Zimmer CM, Zimmer WM, Williams J, Liesener J. Public awareness and acceptance of dental implants. Int J Oral Maxillofac Implants. 1992;7(2). https://doi.org/10.1097/00008505-199304000-00017
  8. Allen PF, McMillan AS, Walshaw D. A patient-based assessment of implant-stabilized and conventional complete dentures. J Prosthet Dent. 2001;85(2):141–7. https://doi.org/10.1067/mpr.2001.113214
  9. Bhat AM, Prasad KD, Sharma D, Hegde R. Attitude toward desire for implant treatment in South Coastal Kranataka population: a short-term epidemiological survey. Int J Oral Implantol Clin Res. 2012;3(2):63–6. https://doi.org/10.5005/jp-journals-10012-1068
  10. Balshi TJ, Wolfinger GJ, Hernandez RE. Patient attitudes before and after dental implant rehabilitation. Implant Dent. 1994;3(2):117. https://doi.org/10.1097/00008505-199405000-00019
  11. Gbadebo OS, Lawal FB, Sulaiman AO, Ajayi DM. Dental implant as an option for tooth replacement: the awareness of patients at a tertiary hospital in a developing country. Contemp Clin Dent. 2014;5(3):302. https://doi.org/10.4103/0976-237X.137914
  12. Gaviria L, Salcido JP, Guda T, Ong JL. Current trends in dental implants. J Korean Assoc Oral and Maxillofac Surg. 2014;40(2):50–60. https://doi.org/10.5125/jkaoms.2014.40.2.50
  13. Brennan M, Houston F, O’Sullivan M, O’Connell B. Patient satisfaction and oral health-related quality of life outcomes of implant overdentures and fixed complete dentures. Int J Oral Maxillofac Implants. 2010;25(4).
  14. Hultin M, Davidson T, Gynther G, Helgesson G, Jemt T, Lekholm U, et al. Oral rehabilitation of tooth loss: a systematic review of quantitative studies of OHRQoL. Int J Prosthodont. 2012;25(6).
  15. Arora et al. Patient awareness and acceptance of dental implants as a treatment modality for the replacement of missing teeth. Int J Sci Res. 2018;2277–817.
  16. Saha A, Dutta S, Vijaya V, Rajnikant N. Awareness among patients regarding Implants as a treatment option for replacement of missing teeth in Chattisgarh. J Int Oral Health. 2013;5(5):48.


How to Cite this Article
Pubmed Style

Alharbi AA, Aloufi AM, Almutairi JS, Alharbi TR, Alharbi TK. Patient acceptance, awareness, and perceived cost of dental implants as a treatment modality for replacement of missing teeth: a survey in Riyadh. IJMDC. 2020; 4(2): 448-453. doi:10.24911/IJMDC.51-1577137308


Web Style

Alharbi AA, Aloufi AM, Almutairi JS, Alharbi TR, Alharbi TK. Patient acceptance, awareness, and perceived cost of dental implants as a treatment modality for replacement of missing teeth: a survey in Riyadh. https://www.ijmdc.com/?mno=79158 [Access: October 15, 2021]. doi:10.24911/IJMDC.51-1577137308


AMA (American Medical Association) Style

Alharbi AA, Aloufi AM, Almutairi JS, Alharbi TR, Alharbi TK. Patient acceptance, awareness, and perceived cost of dental implants as a treatment modality for replacement of missing teeth: a survey in Riyadh. IJMDC. 2020; 4(2): 448-453. doi:10.24911/IJMDC.51-1577137308



Vancouver/ICMJE Style

Alharbi AA, Aloufi AM, Almutairi JS, Alharbi TR, Alharbi TK. Patient acceptance, awareness, and perceived cost of dental implants as a treatment modality for replacement of missing teeth: a survey in Riyadh. IJMDC. (2020), [cited October 15, 2021]; 4(2): 448-453. doi:10.24911/IJMDC.51-1577137308



Harvard Style

Alharbi, A. A., Aloufi, . A. M., Almutairi, . J. S., Alharbi, . T. R. & Alharbi, . T. K. (2020) Patient acceptance, awareness, and perceived cost of dental implants as a treatment modality for replacement of missing teeth: a survey in Riyadh. IJMDC, 4 (2), 448-453. doi:10.24911/IJMDC.51-1577137308



Turabian Style

Alharbi, Abdulrahman Ayidh, Aziz Mohammed Aloufi, Jarah Saleh Almutairi, Thamer Rashed Alharbi, and Turki Khalid Alharbi. 2020. Patient acceptance, awareness, and perceived cost of dental implants as a treatment modality for replacement of missing teeth: a survey in Riyadh. International Journal of Medicine in Developing Countries, 4 (2), 448-453. doi:10.24911/IJMDC.51-1577137308



Chicago Style

Alharbi, Abdulrahman Ayidh, Aziz Mohammed Aloufi, Jarah Saleh Almutairi, Thamer Rashed Alharbi, and Turki Khalid Alharbi. "Patient acceptance, awareness, and perceived cost of dental implants as a treatment modality for replacement of missing teeth: a survey in Riyadh." International Journal of Medicine in Developing Countries 4 (2020), 448-453. doi:10.24911/IJMDC.51-1577137308



MLA (The Modern Language Association) Style

Alharbi, Abdulrahman Ayidh, Aziz Mohammed Aloufi, Jarah Saleh Almutairi, Thamer Rashed Alharbi, and Turki Khalid Alharbi. "Patient acceptance, awareness, and perceived cost of dental implants as a treatment modality for replacement of missing teeth: a survey in Riyadh." International Journal of Medicine in Developing Countries 4.2 (2020), 448-453. Print. doi:10.24911/IJMDC.51-1577137308



APA (American Psychological Association) Style

Alharbi, A. A., Aloufi, . A. M., Almutairi, . J. S., Alharbi, . T. R. & Alharbi, . T. K. (2020) Patient acceptance, awareness, and perceived cost of dental implants as a treatment modality for replacement of missing teeth: a survey in Riyadh. International Journal of Medicine in Developing Countries, 4 (2), 448-453. doi:10.24911/IJMDC.51-1577137308