Influence of Demographics on Patients’ Receipt of Endodontic Therapy or Implant Placement – Updated

Ryan Reese, DMD, MSD, Anita Aminoshariae, DDS, Thomas Montagnese, DDS, MS, Andre Mickel, DDS, MSD

In the April 2015 issue of the Journal of Endodontics Reese et al published what they feel is the first article discussing the role of demographics and socioeconomic status in endodontic or implant treatments. Their findings are significant for all practitioners for as the authors state: “Clinicians need to be aware that patient demographics and/or dental insurance status play a role in treatment decisions.”

More specifically the “results of this study showed that patient demographics including age, sex, race, and insurance as well as SES significantly affected the choice between endodontic and implant therapy.” (emphasis added)

The published abstract is below followed by a two question, non-scientific, survey to gauge whether those in private practice are finding similar results as compared to the university setting from which these statistics were drawn. This posting will be updated once the first 100 responses to the survey have been received.



In your experience do demographic attributes and insurance status significantly affect whether your patients choose Root Canal Therapy or Implants?


Are you finding more of your patients asking about the possibility of implants when you have recommended endodontic treatment as your treatment option of choice?




With the recent advancement in dental treatment modalities, patients are increasingly faced with the dilemma of selecting between root canal treatment (RCT) and implant placement (IP). Data on the influence of demographics on the aforementioned choice appear to be limited. The purpose of this retrospective cohort study was to investigate any association between demographic attributes and patients’ receipt of RCT or IP.


The study sample for this computerized retrospective cohort study included 4084 dental school patients who received RCT and/or IP between 2006 and 2011. The following data were abstracted for each patient: age, sex, ethnicity, insurance status, and zip codes; the last variable was the proxy for socioeconomic status (SES). Statistical analysis included descriptive, chi-square test, and computation of odds ratios.


Patient age, sex, race, insurance status, and SES were significantly associated with the choice of endodontic or implant therapy. Older patients were 6 times more likely as younger ones to receive IP. Males were 1.3 times more likely as females to have received IP; whites were twice as likely as blacks for the same treatment. Insured patients were 1.6 times more likely to have received RCT compared with uninsured patients The odds of patients from high SES receiving IP was 2.4 times greater than those from low SES.


Demographic attributes and insurance status significantly affected the receipt of RCT or IP. Clinicians need to be aware that patient demographics and/or dental insurance status play a role in treatment decisions.

Please complete the short 2 question survey below:

Dr. Barry H. Korzen

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