An evaluation of the types of surgical procedures rejected by patients refusing periodontal surgical treatment: a cross-sectional study

The aim of this study was to compare patient characteristics and reported reasons for treatment refusal among patients who declined different categories of periodontal surgical procedures. This cross-sectional study included 159 patients who refused the recommended treatment despite having an indication for periodontal surgical treatment. Patients were divided into three groups according to the type of surgical procedure refused: dental implant and regenerative treatments, flap surgery/gingivectomy/frenectomy, and mucogingival surgery. Demographic and clinical data were recorded. Eleven predefined reasons for refusal were grouped into five main categories based on clinical similarities. The chi-square test, Fisher’s exact test, Kruskal–Wallis test, and multinomial logistic regression analysis were used for statistical analyses. In the overall sample, the most commonly reported reason for refusal was fear (23.9%), followed by financial reasons (22.0%) and insufficient awareness (15.7%). Fear was more frequently reported by women than by men (p=0.021). Financial reasons were the most frequently reported reason among patients who refused dental implant and regenerative treatments. Multinomial logistic regression analysis did not identify significant associations between the evaluated patient characteristics and the type of surgical procedure refused. Among patients who had already refused periodontal surgical treatment, the reported reasons for refusal differed according to the category of surgical procedure. Fear, financial reasons, and insufficient awareness were the most frequently reported reasons. These findings may support individualized patient communication and shared decision-making by highlighting concerns reported by patients who decline periodontal surgical procedures.