The Path Toward Preserving the Tooth Between Knowledge and Fear: Patient Perceptions of Root Canal Treatment

Purpose: To assess patients’ knowledge, awareness, experiences, and attitudes toward root canal treatment (RCT) and to explore how education level and prior treatment experience are associated with treatment preferences.
Methods: A descriptive cross-sectional survey was administered to 689 adults presenting to Uşak University Faculty of Dentistry. The two-section questionnaire captured demographics and 16 items on sources of information, past experiences, fear, awareness, and preferences. Data were analysed using descriptive statistics, the Pearson chi-square test or Fisher’s exact test, and binary logistic regression (α=0.05).
Results: A total of 689 participants were included in the study. Of these, 79.7% reported having previously undergone RCT, and 88.2% of those individuals evaluated their treatment experience positively. Overall, 79.7% perceived RCT as a successful treatment modality, and 78.2% reported that they would prefer RCT over extraction or implant placement for an infected tooth. Pain related concerns were identified as the most common source of fear by 46.2% of participants. Educational level was significantly associated with self-reported knowledge regarding RCT (p<0.001), and higher knowledge levels were associated with perceiving RCT as successful (p=0.002) and preferring RCT as a treatment option (p<0.001). However, in multivariable analysis, treatment preference was associated primarily with the
perception that RCT weakens the tooth rather than with knowledge level itself (p<0.001). The vast majority of participants (96.2%) indicated that the public should be more thoroughly informed about RCT.
Conclusion: This study demonstrates that patients’ attitudes and treatment preferences regarding root canal treatment are shaped by perceptions and expectations rather than by knowledge level alone. Expectations related to pain and assumptions about tooth durability play a notable role in the decision-making process. In particular, the widespread belief that root canal treatment weakens the tooth may negatively influence patients’ attitudes toward conservative treatment options. These findings indicate that patient education should extend beyond the provision of factual information and be supported by patient centered and evidence-based communication strategies that address misconceptions and expectations. Clear and accessible public information may help promote appropriate treatment choices.

Keywords: Root canal treatment, knowledge, dental anxiety, survey