The outcomes of mandibular third molar removal and non-removal: a study ofpatients' preferences using a multi-attribute method

The aim was to study patients' preferences about outcomes of mandibular thi rd molar removal and non-removal using multi-attribute utility (MAU) method ology. The study comprised three stages. Stage 1: Elicitation of domains, i .e. main areas of patients' lives which could be affected by third molar re moval and non-removal. Stage 2a: Interdomain weighting was obtained by rela tive weighting of the domains elicited in Stage 1. Stage 2b: Intradomain we ighting obtained by patients' designation of values for different health sl ates of each domain. Stage 3: Rating of outcomes. The patients were asked t o imagine experiencing a variety of outcomes of mandibular third molar remo val and non-removal, described in 19 short vignettes. The numbers of patien ts interviewed for the three stages were 30, 78, and 55, respectively. Five domains were identified. The mean relative weightings were approximately e qual for the domains "Home and social life" and "General health and well-be ing", followed in order of importance by "Job and studies" and "Health and comfort of mouth, teeth and gums". "Your appearance" received the lowest me an relative weighting. The vignette, which described the presence of a flui d-filled sac and suggested that this tooth must be removed, received the hi ghest mean preference (least effect on patients' lives). The lowest mean pr eference (most effect on patients' lives) was generated by the vignette, wh ich stated that the jaw was broken and that the teeth must be wired togethe r for 6 weeks. We conclude that, from the patient's perspective, outcomes o f non-removal were preferable to outcomes of mandibular third molar removal .