Plain English Summary
Background and study aims
Bias is an inclination for or against a person or a group, as it allows for one's personal opinions to influence judgement. It is defined in the Oxford dictionary as an ‘inclination or prejudice, for or against one person or group, especially in a way considered unfair.’ There are many forms of bias, which are generally one sided and have the ability to affect everyday social interactions. The aims of this study are to determine whether explicit and implicit racial bias predicts the recommendation of root canal therapy or extraction for White and Black patients suffering from irreversible pulpitis (inflammation of dental pulp tissue), and to determine whether different treatment decisions are made for Black vs White patients and to determine whether such differences (if any) are related to the presence of explicit or implicit racial bias.
Who can participate?
What does the study involve?
Participating dentists are given a clinical scenario in combination with a patient’s relevant clinical photographs and radiographs depicting either a Black or White patient presenting with a decayed tooth and the associated symptoms of irreversible pulpitis. Explicit bias is measured through a questionnaire, which evaluates the recommended course of treatment, the strength of the recommendation and their perception of the patient’s dental cooperativeness. Implicit bias is evaluated through brief implicit association tests.
What are the possible benefits and risks of participating?
The possible benefits are to create early awareness and active prevention. Although it might not be likely to completely eliminate the effects impact biases can have upon decision making, a reduction in the occurrence is a worthy result. Ultimately by creating awareness, bias can be recognised and reduced. The risks of participation are that during the tests participants may feel uncomfortable and may not want to continue further.
Where is the study run from?
The University of Cagliari (Italy)
When is the study starting and how long is it expected to run for?
January 2017 to November 2017
Who is funding the study?
Investigator initiated and funded
Who is the main contact?
Dr Neha Patel
Unconscious racial bias may affect dentists’ clinical decision on tooth restorability
The race of a patient does not affect dental clinicians recommendation for root canal treatment.
Azienda Ospedaliero Universitaria Di Cagliari, 12/12/2017, ref: PG/2017/7126
Single-center cross sectional survey
Primary study design
Secondary study design
Cross sectional study
Patient information sheet
Not available in web format, please use the contact details to request a patient information sheet
Implicit and explicit bias and its influence on clinical treatment planning decisions
Dentists were given a clinical scenario in combination with a patient’s relevant clinical photographs and radiographs depicting either a Black or White patient presenting with a decayed tooth and associated symptoms of irreversible pulpitis.
Explicit bias was measured through a questionnaire, which evaluated participants’ course of treatment, strength of recommendation and their perception of patient’s dental cooperativeness.
Implicit bias was evaluated through brief implicit association tests.
Primary outcome measure
Recommendation for root canal treatment (RCT) is measured using a dichotomous scale (yes or no)
Secondary outcome measures
Recommendation for extraction is measured using a dichotomous scale (yes or no)
Overall trial start date
Overall trial end date
Reason abandoned (if study stopped)
Participant inclusion criteria
Target number of participants
Total final enrolment
Participant exclusion criteria
1. Dental student or nurse
2. Any health professional without a BDS
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
The University of Cagliari
Investigator initiated and funded
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
The trialists intend to publish the results of the study in a high-impact peer reviewed journal, and intend on publishing around 6 months to 1 year after the overall trial end date.
IPD sharing statement
The datasets generated during and/or analysed during the current study are/will be available upon request from Dr Neha Patel. Type of data - questionnaire responses and IAT results (raw, tabulated), accessed over email (.doc).
Consent was provided by each individual participant, and all data was anonymised
Intention to publish date
Participant level data
Available on request
Basic results (scientific)
See additional file (ISRCTN25639427_BasicResults_13Nov18.pdf)
2019 results in https://pubmed.ncbi.nlm.nih.gov/30931761/ (added 25/09/2020)
- ISRCTN25639427_BasicResults_13Nov18.pdf Uploaded 13/11/2018