The shortened dental arch - an assessment of patients' dental health state utility values

Objectives: The aim of this study was to determine how patients value the potential outcomes from different treatments for the shortened dental arch (SDA). Methods: 110 partially dentate patients were interviewed and presented with illustrative models as well as a description of the process and likely outcome of six possible treatments for the shortened dental arch. The patients were asked to indicate on a standardised visual analogue scale how they would value the health of their mouth if they had received each of the treatments described. Results: With a utility value of 0.0 representing the worst possible health state for a mouth and 1.0 representing the best, the mean utility value for 'no treatment' for a SDA was 0.28 (sd=0.29). For a cobalt-chromium based removable partial denture, an acrylic-resin based removable partial denture, implant treatment, a resin-bonded cantilevered bridge and a conventional cantilevered fixed bridge the utility values were 0.42 (sd=0.3), 0.49 (sd=0.31), 0.53 (sd=0.35), 0.63 (sd=0.26) and 0.64 (sd=0.28) respectively. Conclusions: The treatment outcome from a cantilevered bridge attracted the highest mean utility value. Participants did not value implant treatment as highly as fixed bridgework, but they did rate the utility of implants more highly than the utility value of removable dentures. However, the patients placed a very low value on the outcome from 'no' treatment. Thus, the appropriateness of the shortened dental arch as an oral health goal can be questioned.