Knowledge, Attitudes, and Willingness to Replace Missing Teeth with Dental Implants Rather Than Traditional Prosthetic Options Among Adults in Derna City, Libya: A Cross-Sectional Study

Abstract

To assess the willingness of adults in Derna City, Libya, to replace missing teeth with dental implants rather than traditional prosthetic options, with particular emphasis on knowledge and attitudes related to implant therapy. A cross-sectional study was conducted in Derna City, Libya, from 1 June 2025 to 31 December 2025. Data were collected through face-to-face interviews using a structured Arabic questionnaire adapted from a previously published survey. Adults aged 18 years and older were recruited using convenience sampling from dental clinics and selected public areas. The questionnaire assessed sociodemographic characteristics, dental history, awareness, knowledge, attitudes, and willingness regarding dental implants. Knowledge was evaluated using five objective items, and attitude was assessed using ten items related to interest, preference, fear, expected pain, willingness to invest time, and treatment acceptance. Descriptive statistics, chi-square test, Pearson correlation, and binary logistic regression were used, and statistical significance was set at p < 0.05. A total of 458 participants were included in the final analysis. Awareness of dental implants was high, with 89.1% of participants reporting that they had heard about implant therapy. Dentists were the main source of information (33.6%). However, objective knowledge was limited, and 97.6% of participants were classified as having poor knowledge. Attitudes toward implant therapy were more favorable than knowledge, with 49.3% showing a moderate attitude and 24.5% a good attitude. More than half of the participants preferred dental implants as a treatment option (53.7%), and 88.2% indicated that they would accept implant therapy if it were offered free of charge. Willingness to accept free implant therapy was significantly associated with gender, education, occupation, attitude category, fear regarding surgery, willingness to invest time, and treatment preference, whereas age, knowledge score, and tooth extraction history were not significantly associated. A weak but significant positive correlation was found between knowledge and attitude scores (r = 0.156, p = 0.001). Adults in Derna City demonstrated high awareness but poor objective knowledge regarding dental implants. Nevertheless, attitudes toward implant therapy were generally moderate to favorable, and willingness to accept implants was high when cost was removed as a barrier. Financial considerations, fear, and treatment-related time commitment appear to be major obstacles to acceptance. Strengthening patient education and improving affordability may help increase informed acceptance of implant therapy in this population.