Decision‐Making Process for Treatment of Mandibular Fractures among Minority Groups

Objectives: While patients' preferences for medical care are widely studied, only a small number of studies have looked at the decision-making process for dental treatment of mandibular fracture. This study examines the decision-making process for treatment of mandibular fractures among minority groups. Study participants were asked to consider Maxillomandibular Fixation (MMF - a non-surgical approach of wiring the teeth for 4–8 weeks) or Rigid Internal Fixation (RIF - surgical placement of bone plate). Methods: A qualitative study of patients receiving care at an inner-city hospital for either 3rd molar extraction under general anesthesia or a mandibular fracture were recruited to participate in an hour-long focus group to discuss their preferences. The 3rd molar group was selected as a comparison group exemplifying experience with oral surgery and recovery from general anesthesia. Results: Seven decision-making factors affecting choice of treatment were discussed by both jaw fracture and 3rd molar groups, including: side effects, effectiveness of each treatment, trusting doctor's recommendation, what to expect from each procedure, use of pictures from previous case studies, surgery location of scar/ incision, and size of scar. Rigid Internal Fixation (RIF) participants discussed a different set of concerns compared to Maxillomandibular Fixation (MMF) participants. Conclusions: Regardless of gender, the treatment of choice for both 3rd molar and jaw fracture participants was the non-surgical method of wiring of the teeth for 4–8 weeks. The Phase II part of this study will systematically examine patient preferences among a larger sample of 3rd molar and jaw fracture patients by incorporating the patient-reported concerns about treatment of jaw fracture found in this inductive, phenomenological study.