Patient Preferences for Direct versus Indirect Dental Veneers: Associations with Durability, Socioeconomic Status, and Satisfaction.

Background: Expatriates represent a growing patient group seeking aesthetic dental treatments in cosmopolitan settings, yet limited evidence is available regarding factors associated with their choice between direct and indirect veneers. This study aimed to examine factors associated with veneer preference, assess the association of educational level and economic status with treatment interest, and evaluate the relationship between satisfaction and recommendation intent among expatriates in Erbil. Methods: A cross-sectional survey was conducted from January to June 2023 among 439 expatriates recruited from private dental clinics and cosmetic centres in Erbil using stratified convenience sampling. A validated 48-item questionnaire assessed demographics, prior dental experience, decision-making factors using 5-point Likert scales, veneer preference, satisfaction, and recommendation intent. Data were analysed using χ Results: Durability showed the strongest independent association with preference for indirect veneers compared with direct veneers (adjusted OR 2.65 per 1-point increase, 95% CI 1.78-3.95, p<0.001). Aesthetic outcome was ranked as the most important consideration overall by 44.4% of participants, but it was no longer statistically significant after adjustment. A significant education × economic status interaction was observed (p=0.03), indicating that the association between higher education and interest in veneers was more evident among participants with good or very good economic status. Among veneer recipients (n=68), 76.5% were very or somewhat satisfied; higher satisfaction was strongly associated with recommendation intent (adjusted OR 4.21 per 1-point increase, 95% CI 2.84-6.24, p<0.001). Overall, 40.3% of participants remained undecided about veneer type. Conclusion: In this cross-sectional study of expatriates in Erbil, durability was associated with preference for indirect veneers, while socioeconomic status appeared to shape treatment interest. Higher satisfaction was also associated with greater willingness to recommend veneer treatment. These findings support the use of targeted patient education, transparent discussions of expected longevity, and flexible financing strategies to facilitate informed decision-making in mobile expatriate populations. Because of the cross-sectional design, these findings should be interpreted as associations rather than causal effects.