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OR36 - Race, Bias, and Root Canals: Investigating the Treatment of Post-Endodontic Pain

Thursday, May 4, 2023

10:30 AM – 10:45 AM CT

Location: E353B (Level 3)

Presenter(s)

Morgan Celistan, D.MD

Resident
Harvard School of Dental Medicine
Boston, Massachusetts

Disclosure information not submitted.

Co-Author(s)

Crystal Song, N/A

DMD Candidate
Harvard School of Dental Medicine
Boston, Massachusetts

Disclosure information not submitted.
JS

Jacqueline Starr, Ph.D.

Lecturer on Oral Health Policy and Epidemiology
Harvard School of Dental Medicine
Boston, Massachusetts

Disclosure information not submitted.
Jennifer Gibbs, D.D.S., Ph.D., M.A.

Head of the Division of Endodontics
Harvard School of Dental Medicine
Boston, Massachusetts

Disclosure information not submitted.
Christine Riedy, Ph.D., M.A., M.P.H.

Chair and Associate Professor of Oral Health Policy and Epidemiology
Harvard School of Dental Medicine
Boston, Massachusetts

Disclosure information not submitted.
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Shenam Ticku, B.D.S., M.P.H.

Instructor in Oral Health Policy and Epidemiology
Harvard School of Dental Medicine
Boston, Massachusetts

Disclosure information not submitted.

Racial biases have played a significant role in the delivery of healthcare in the U.S. Medical literature has consistently shown significant differences in patient care delivery based on race, especially concerning pain management. This study investigates the role of racial biases in post-operative pain management treatment in endodontic residents. Endodontic residents attending US programs were invited via email to participate in this Qualtrics-delivered study. Participants were presented with four standardized patient video vignettes and reported their likelihood of rendering a number of treatment options to manage the patient’s reported pain on a Likert-type scale. Additionally, participants completed a recall of vignette characteristics and the Color-Blind Racial Attitude Scale (CoBRAS). The response rate was over 30%. There was significant consensus in likelihood of each action to be taken when treating a patient with post-operative pain (NSAID counseling, emergency appointment, phone follow-up, prescribing a steroid, prescribing an antibiotic, and prescribing an opioid, respectively; F=498.14, P< 0.01). Interim results reveal that there were no significant differences in treatment option selected with respect to race of the standardized patients (p >0.05 all groups). CoBRAS scores differed significantly based on participant race (F=3.41, p< 0.05). Finalized data analysis, which will be conducted at the survey’s conclusion, will be presented. This study shows that, while colorblind racial attitudes differ, these attitudes do not appear to influence treatment decisions when addressing pain following endodontic treatment. Further studies are needed to determine what other internal or external factors may influence treatment protocols.