Patient Understanding and Recall of Risks and Complications of Dental Implant Treatment Following Informed Consent

Introduction: A study undertaken to determine the risks and complications of dental implant treatment recalled by patients following a written and verbal informed consent process.
Method: A piloted questionnaire consisting of open and directed questions completed by 25 patients in a general practice setting.
Results: Complications recalled most readily with open questioning were nerve damage (80%) and bruising (80%), followed by implant fracture/loss (68%), infection (64%), bleeding (60%), and pain (56%). Directed questioning highlighted that 24% of patients believed that implants always integrate. 12% were unaware of possible additional charges. Patients failed to recall adjacent tooth complications or allergic reactions (16%), long-term sinus complications (20%), peri-implant gingival recession, peri-implantitis, implant fracture or permanent nerve damage (12%). 20% failed to recall periodontitis as an implant survival risk factor and 9% did not recall possible implant-crown fracture. Risks and complications recalled most readily were: complications experienced previously, risks with high perceived impact such as nerve damage, and ‘absolute’ risks, such as failed implant integration or implant fracture/loss. Males, older patients and those with a higher socio-economic status had greater understanding and recall.
Conclusions: Although patient recall of risks and complications was good, improvements in the consent process may create more realistic expectations, greater patient satisfaction, higher commitment to treatment and less likelihood of litigation.