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| research 10 implants 3 2016 dividualsreconsidertheirinitialtreatmentdecisions.9 As it relates to patient awareness of implant treat mentoptions,almosthalfofthepatientsinthisstudy were unaware of the nature of implant procedures and their prognosis prior to the presentation. Pragati reported that, although about one million dental im plantsareinsertedeachyearworldwide,theinforma tionavailabletothepatientsregardingtheprocedure and its success is often fragmentary.15 Chowdhary et al.10 reported that only 23.24 % of the Indian urban population had heard of dental implants as a treat ment option for replacing missing teeth. “This is the first report in dentistry showing that prisoners, whom we think we cannot educate, have the potential to do so.” Author Dr Souheil Hussaini A further issue that requires consideration is the quality and accessibility of the information available to the consumer.5 A variety of tools have been pre pared by healthcare constituencies, but they vary in quality, i.e. the clarity and organisation of the infor mation. In addition, the accessibility of these tools mayvary.Finallytheeducationandbackgroundofthe consumer may limit the opportunity to utilise these tools.4 Literacymayalsobelimitedandthustheability to read brochures and fact sheets may be lacking. While labour-intensive, personal interactions be tween healthcare personnel and the patient may be appropriate to assist many of these individuals. However, the interaction between the healthcare providerandthepatientalsorequiressomeexamina tion.4 Charlesdescribedthreedifferenttypesofmed ical decision-making. In the doctor-centred model, the healthcare provider has established credibility with the patient and makes the significant decisions. In the second type, patient-centred, the patient ac quires sufficient information to become confident in his or her decision-making abilities. The third type, a combination of the first two, is one in which the healthcare provider and the patient jointly make the medical decision. This model appears to have been effective in this study. Dentalcare,asmosthealth-relatedissues,requires patient commitment to complement the dental care provided by the clinician to be most effective. The in creased awareness demonstrated by the subjects in this study suggests that the hour-long lecture was effectiveinprovidingthesubjectswithusefulquality information that could influence the subjects’ deci sion-making process. Indeed, a number of the sub jects in the study subsequently volunteered to be treated in the prison with dental implants as part of an implant training program for dentists. However, more than half of the patients reported costtobesignificant.Thisresultiscomparabletosev eralotherstudies.VanderWijketal.observedthatthe high cost of the implants is one of the major limiting factors in the willingness of patients to undergo treatment.16 This clearly indicates the necessity for dentistsandtheimplantindustrytoreducecostsand thus create opportunities for treatment. In conclu sion, it would seem that personal interactions with health-careprofessionalsmaybeaneffectivewayto motivate individuals whose opportunities to inde pendently seek improved health are limited. While this approach is more resource-intensive, these initial contacts can motivate individuals to seek fur ther information and opportunities for improved health care._ Conclusions 1. Information delivery was helpful in the dental healthcare-decisionprocessesforaprisonpopula tion. 2. Financial factors are perceived as a significant ob stacle in the subjects’ choice of implant treatment. Editorial note: A list of references is available from thepublisher. contact Dr Souheil Hussaini, BDS, MS Director of Research, Oral Implantology Research Institute, #39 Knowledge Village PO Box 502221, Dubai, UAE Tel.: +971 4 2956595 (land line) Fax: +971 4 2958757 Mobil: +971 50 4568100 info@ID-SC.com 32016 Tel.: +97142956595 (land line) Fax: +97142958757 Mobil: +971504568100