Treatment Preferences for Toothache among Working Poor Canadians

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Working poor (WP) Canadians are those who work ≥20 hours/week, are not full-time students, and have annual family incomes <$34,300. They have unique vulnerabilities and face significant barriers to accessing dental care because they rarely receive employment-based dental benefits and are ineligible for publicly funded dental programs. This research aimed to understand whether WP Canadians would prefer extraction rather than tooth restoration and preservation when they have toothache.


A cross-sectional stratified sampling study design and telephone survey methodology was used to collect data from a nationally representative sample of 1049 WP individuals aged 18–64 years. A pretested questionnaire included sociodemographic and self-reported oral health questions and asked participants to select their preference for maintaining versus extracting an aching tooth. By using bivariate and logistic regression analyses, we applied the Gelberg-Andersen Behavioral Model for Vulnerable Populations to understand what influences treatment preferences among this population (P ≤ .05).


The majority of participants (86%) preferred to save and fill an aching tooth rather than take it out. Those who were older, partially dentate, reported a history of oral pain, had their last dental visit more than 3 years ago, or who only visited the dentist when in pain were significantly more likely to opt for tooth extraction.


The majority of WP Canadians value preserving their natural dentition. Effective dental care service delivery in both private and public settings requires an understanding of the possible factors that influence WP persons' preferences for essential treatment modalities in dentistry.

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