Influence of the patient's race on the dentist's decision to extract or retain a decayed tooth.

Objectives: The aim of this study was to investigate the influence of the patient's race on the dentist's decision to extract or retain a decayed tooth.

Methods: A probabilistic random sample of 297 dentists from Recife, Brazil, was used. Two case scenarios were presented to the dentists. Both scenarios showed a molar that was extensively decayed, but indicated for conservative treatment. The scenarios included a description of the patient and eight photographs of the clinical case, including a photograph of the patient's face. The dentists were asked to regard the patient as poor and then to decide whether to extract or retain the molar. However, although the scenarios were based on the same clinical case, the photographs of the patient's face were different. One scenario showed the photograph of a white patient whereas the other showed the photograph of a black patient. The first scenario was presented 2 months before the second so that the dentists would not remember the former.

Results: The dentist's decision varied significantly according to the patient's race, with dentists deciding to extract more frequently for the black patient than for the white patient (25.6% vs. 16.2%; P < 0.001). This racial variation occurred regardless of the demographic and socioeconomic variables of the dentists. It did, however, occur as a function of the setting of the dentist's practice.

Conclusion: The patient's race may influence a dentist's decision whether to extract or retain a decayed tooth.