Prior Periodontal Treatment Experience and Autonomy Preference in Stage III/IV Periodontitis: A Cross-Sectional, Questionnaire-Based Observational Study

INTRODUCTION AND AIMS: In this study, we aimed to evaluate whether prior periodontal treatment experience was associated with patients' autonomy preference (AP) in clinical decision-making among individuals with stage III/IV periodontitis. METHODS: This cross-sectional, questionnaire-based observational study included 146 patients with stage III/IV periodontitis who were categorised into treatment-naive and -experienced groups according to prior periodontal treatment history. Participants completed structured surveys assessing sociodemographic, medical, and oral health factors. AP was measured using a standardised scenario-based score featuring mild, moderate, and severe periodontal vignettes. Data were analysed using multivariable linear regression and propensity score weighting. RESULTS: In multivariable linear regression, prior periodontal treatment experience was significantly associated with a higher AP scenario score (P = .042), and this finding was supported by propensity score weighting. Higher AP in the treatment-experienced group was most evident in the mild scenarios, particularly for clinical scheduling (P = .026) and adjunctive care decisions (P = .002). However, as disease severity increased, AP diminished, with both groups universally relying on clinician-led decisions in severe cases. CONCLUSION: Prior periodontal treatment experience was independently associated with higher AP, with the association being most evident in mild periodontal scenarios. CLINICAL RELEVANCE: Prior periodontal treatment experience may enhance patient participation in periodontal decision-making, supporting more individualised shared decision-making in clinical practice.