1. Department of Health, Behavior & Society
Department of Health, Behavior & Society David Holtgrave, PhD, Professor & Chair
© 2005, Johns Hopkins University. All rights reserved.

2. Overview of Presentation (Session 4156.0 Abstract 165494)
“Translating Evidence Into Practice: A Patient Perspective on Third Molar Extraction”
First-person, consumer perspective
How I came to be on this panel
Life course experiences with dentists regarding third molars
Scope of extant literature (a patient perspective)
Research / practice suggestions from a first person perspective

3. Clinical Case Male patient Mid 40s Generally good health
Generally good oral health
Small number fillings
One root canal with cap
Tetracycline staining from childhood
Four partially erupted third molars; good condition

4. A health literacy conference story
Invited speaker at Pfizer Health Literacy Conference
Speaking on HIV prevention
During discussion needed another example of patient empowerment (my third molars)
Participant after participant revealed they too had third molars

5. Dentist #1: Shared Decision Making (Patient brings up options)
Dentist saw third molars and recommended potential removal
Patient examined clinical decision making literature
Patient and dentist discussed literature in detail
Benefits
Side effects
Probabilistic concepts
Other-cause mortality / context
Decision trees
Shared decision made for watchful waiting

6. Dentist #2: Prescriptive Directions
Dentist recommended third molar removal
Prescription fashion
Patient mentioned clinical decision making literature on third molar extraction, and began discussion
Dentist response was surprise and then silence
Conversation ended “before it began”

7. Dentist #3: Shared Decision Making (Dentist brings up options)
Dentist noted option of third molar extraction
Dentist also noted pros and cons of extraction
Patient mentioned reading of the literature and engaged in discussion of pros and cons
Dentist welcomed the discussion
Dental team included in discussion
Shared decision made for watchful waiting

8. Scope of Extant Literature
Key Word
Crossed With
PubMed Hits
Third Molar
No cross terms
3974
Decision Analysis 30
Cost-effectiveness 22
Health Literacy 3
Patient Perspective
All terms above
53 unduplicated hits

9. Suggestions From a Consumer
Research on health literacy and third molars needs expansion
Research on decision aids for shared decision making needs expansion
At least one consumer wants the best scientific information presented, uncertainties acknowledged, and decisions truly shared

10. Department of Health, Behavior & Society
Department of Health, Behavior & Society David Holtgrave, PhD, Professor & Chair
© 2005, Johns Hopkins University. All rights reserved.