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.