Psychological characteristics of dissatisfied denture patients

Impact of sociodemographic factors, duration of edentulism, and medical comorbidities on the mental attitudes of individuals with complete edentulism

STATEMENT OF PROBLEM

Understanding the attitude of elderly patients is important for successful complete denture therapy. However, data regarding the impact of sociodemographic factors, impact of medical comorbidities, and duration of edentulism on the mental attitudes of such patients are lacking.

PURPOSE

The purpose of this clinical study was to explore the association of sociodemographic factors, duration of edentulism, and medical comorbidities on the attitudes of completely edentulous patients.

MATERIAL AND METHODS

The study was conducted among 125 completely edentulous patients visiting the Department of Prosthodontics, Nepal Medical College from August 2020 to October 2020. General information including age, sex, education level, medical history, and duration of edentulism were collected during a routine clinical evaluation. The mental attitudes of the participants were categorized according to M.M. House Classification into philosophical mind, exacting mind, hysterical mind, or indifferent mind. The participants were categorized into 3 age groups: 45 to 54 years, 55 to 64 years, and 65 years and above. Similarly, they were divided into 3 categories depending upon the duration of edentulism: 0 to 2 years, 2 to 5 years, and more than 5 years. Data were entered in a statistical software program for descriptive analysis using frequency distributions, and the chi-square statistical test and the Freeman-Halton extension of the Fisher exact test were used to determine the association between categorical variables.

RESULTS

The highest number of participants was in the philosophical category (34.4%) with the fewest in the hysterical group (12%). Men had more philosophical and indifferent attitudes, whereas women were more exacting (P<.001). Those with a recent history of extraction had an increased exacting attitude (P<.001). The respondents without any comorbid diseases were more philosophical, whereas a higher percentage of respondents with different comorbid conditions were assessed to be in the hysterical category (P<.001). Significant relationships were not found between mental attitude and educational status or age (P>.05).

CONCLUSIONS

Socioeconomic factors, duration of edentulism, and existing comorbidities had a significant impact on the attitudes of edentulous patients. The role of these factors should be assessed during the appraisal of the mental attitudes of edentulous patients.

Does Neuroticism Influence Oral Health-Related QOL in Patients with Removable Partial Dentures?

This prospective cohort study investigated the relationship between patient neuroticism and oral health-related quality of life (OHRQoL) before and after prosthetic treatment as well as changes in OHRQoL-namely, treatment efficacy. Sixty-three patients (23 men and 40 women; mean age 67.2 ± 8.6 years), who were scheduled to receive new removable partial dentures (RPDs), were recruited. OHRQoL was assessed using the Japanese version of the Oral Health Impact Profile (OHIP-J). The Japanese version of the NEO Five-Factor Inventory (NEO-FFI) was used to assess neuroticism. Spearman's rank correlation coefficient was calculated to determine the association between neuroticism and OHIP-J scores before and after treatment. After stratifying patients according to neuroticism score, the Wilcoxon signed-rank test was used for intragroup comparison of OHIP-J scores before and after treatment. Moreover, logistic regression analysis was used to determine the impact of covariates on treatment efficacy such as age, sex, Eichner classification, neuroticism, changes in maximal occlusal force, and OHIP-J scores before treatment. Statistical analyses showed that higher neuroticism scores were associated with higher total OHIP-J scores before treatment ( r = 0.41, P = 0.001) but were not associated with OHIP-J scores after treatment ( r = 0.07, P = 0.566). When the effect of all independent variables was analyzed in multivariate analysis, neuroticism and OHIP-J scores before treatment affected treatment efficacy. These results suggest that OHRQoL of patients with higher levels of neuroticism was low before prosthetic treatment but significantly improved by oral rehabilitation with RPDs to the same level as patients with lower levels of neuroticism. Knowledge Transfer Statement: The results of this study may change the clinical perception of the effect of prosthetic rehabilitation with removable partial dentures in patients with higher levels of neuroticism. The study concluded that prosthetic rehabilitation could contribute toward satisfaction even in neurotic patients, who are presumed to show less satisfaction with their oral status.

Correlation of previous experience, patient expectation and the number of post-delivery adjustments of complete dentures with patient satisfaction in a Brazilian population

A number of variables may influence the outcome of complete denture therapy. The objective of this study was to verify possible correlations between previous experience with dentures, patient expectation and the number of post-delivery adjustments with patient satisfaction after treatment. One hundred patients (mean age 61·9 ± 10·3) rated their previous experiences with complete dentures and their expectations before and satisfaction after treatment on a visual analogue scale (VAS) using scores from 0 (worst results) to 10 (best results). The number of post-delivery adjustments and other patient-related clinical variables was also noted. Patient expectation scores were higher than previous experience scores and satisfaction after treatment scores. Positive and weak correlations were found between previous chewing experiences with complete dentures, with regard to chewing expectations and comfort of use. Phonetics and comfort of use in previous experiences presented a positive correlation with expectations for chewing, aesthetics, phonetics and comfort of use. Groups of patients with different levels of education presented significant differences in expectation scores regarding comfort of use as well. A negative and weak correlation was found between phonetics satisfaction and the number of post-delivery adjustments. Patients' expectations for the therapy were higher than their satisfaction after treatment. Previous experiences with complete dentures could slightly influence patients' expectations and satisfaction, whereas lower scores for previous experience with complete dentures caused lower scores for both expectation and satisfaction. Patients' educational levels and the number of post-delivery adjustments influenced negatively the expectations about comfort of use and patient satisfaction, respectively.

Relationship between impacts of complete denture treatment on daily living, satisfaction and personality profiles

OBJECTIVES

To investigate the association between satisfaction with conventional complete denture prostheses (CDs), impacts of CDs on daily living and personality profiles.

MATERIALS AND METHODS

Fifty-six patients (28 males and 28 females; mean age 53.79 ± 7.762 years) with fitted upper and lower removable CDs were recruited for this study. Clinical success of CDs was assessed according to specific clinical criteria. The dental impact on daily living questionnaire (DIDL) was used to measure satisfaction with CDs and their impacts on daily living. NEO five factor inventory (NEO - FFI) was used to measure patients' personality profiles. Pearson correlation test and regression models were used to analyze the collected data.

RESULTS

Females were more satisfied with appearance and less satisfied with eating and scored higher on neuroticism, and lower on extraversion and openness personality domains (p < 0.05). Older patients were more satisfied with appearance and less satisfied with oral comfort and general performance (p < 0.05). Neuroticism, extraversion, openness and agreeableness personality profiles could predict and had significant relationship with CDs impacts on daily living and satisfaction with CDs.

CONCLUSION

Psychological profiles (e.g. neuroticism, extraversion, openness and agreeableness) might play a role and explain CDs impacts on daily living and patients' satisfaction with their oral status and CD treatment, therefore, might be used to predict satisfactory outcomes of CD treatment. In this regard, technical aspects of CDs are less essential when the prosthesis is clinically successful.

CLINICAL SIGNIFICANCE

Psychological factors may play a role and also provide valuable information for the prediction of satisfactory outcomes of complete denture treatment.

Patients' knowledge and understanding of the implications of wearing dentures. Report of a survey conducted at a dental institute in the south of India

AIM

The aim of this survey was to assess the knowledge and perceptions of denture treatment among a group of patients who attended the Karnataka Lingayat Education Society's (KLES) Institute of Dental Sciences, Belgaum, Karnataka State, India.

METHOD

A questionnaire with four general questions and 14 statements/questions about denture construction and wearing was developed and piloted. Ethical approval was sought and granted. After some revisions, the questionnaire was given to all patients attending KLES over a two-month period.

RESULTS

All 423 patients who attended KLES in the two-month period completed the questionnaire. Five questionnaires were not analysed because of ambiguity in the answers. The final patient sample was 418 (207 females and 211 males, mean age 40 +/- 15.3 years) of whom 140 (33.5%) were dentate and 278 (66.5%) edentulous in either one or both jaws. Among the 278 edentulous patients, 143 (51.4%) had not worn any kind of denture and 135 (48.6%) wore dentures. There was a wide variation in the accuracy of the patients' knowledge of denture treatment. In particular, more than 20% did not know that complete denture treatment requires five or more visits, that denture wearers may experience oral pain, whether or not dentures may cause more problems than natural teeth, or that dentures may make audible clicks and cause problems when speaking.

CONCLUSION

Patient education is an essential element in successful denture treatment. It should begin prior to the treatment, to ensure that the technical capability of the clinician matches the expectations of the patient. The initial appointment needs to be used as an educational tool to raise patients' level of understanding of prosthetic rehabilitation and how the proposed treatment will meet their needs.

A treatment trial of an information package to help patients accept new dentures

Intolerance of dentures can be very distressing and difficult to treat. Therefore, 44 patients, having had partial or total dental clearance, completed the Brief Symptom (Psychiatric) Inventory, the Hospital Anxiety and Depression Scale and the Satisfaction with Life Scale. Allocated alternately, each patient had treatment as usual or watched a video containing information, recapitulated in a leaflet, based on the Self Regulatory Model of health beliefs explaining the experiences of wearing dentures and how to tolerate them. They were then fitted with dentures. Two and six weeks later, although both groups expressed favourable expectations of their dentures, the control group deteriorated continually on all measures, correlated with a decline in self-reported dental functioning. The video group improved on all measures except Satisfaction with Life. Therefore, our study is unique in showing that appropriate management of patients can arrest (1) clinically significant distress which can be occasioned by the replacement of teeth by dentures and (2) the development of complaints which may be seen as spurious. Experimental procedures are suggested to determine the influences which have brought this about in our study.

Determining 'need' for a Removable Partial Denture: a qualitative study of factors that influence dentist provision and patient use

OBJECTIVE

To identify factors that influence Removable Partial Denture (RPD) provision, and patient use of RPDs in the UK.

DESIGN

Exploratory qualitative interview study.

SUBJECTS AND METHODS

SUBJECTS

There were two sample groups. A purposive sample of 16 male and female dentists was categorised in terms of level of RPD provision, experience, and practice characteristics. A purposive sample of 17 male and female partially dentate patients was categorised in terms of RPD use and demographic characteristics.

DATA COLLECTION

Semi-structured in-depth interviews.

RESULTS

For dentists, RPD provision was indicated by patient demand and physical function of the remaining teeth, but was mediated by NHS fee structures and professional satisfaction. For patients, RPD use was influenced by the trade-off between improved appearance and the unpalatable presence of an RPD in their mouth. The location of the gap(s) was important, but other issues were relevant such as ability to "manage" without the RPD.

CONCLUSION

When defining "need" for an RPD, dentists focused on physical function of the teeth whereas patients focused on social meanings of the mouth. These differing priorities may improve understandings of patient non-compliance in RPD use. Further research on the relationship between denture use and social identity could be beneficial.

Influence of psychological factors on the acceptance of complete dentures

OBJECTIVES

To assess the influence of psychological factors on the acceptance of complete dentures in a population wearing dentures judged to be clinically satisfactory.

DESIGN

Subjects were asked to complete personality profiles and also to rate their dentures using a denture satisfaction questionnaire.

SETTING

The survey was conducted in the prosthetics clinic of a teaching hospital.

SUBJECTS

Patients were selected from those who had new complete dentures constructed in the department within the previous two years.

INTERVENTION AND MAIN OUTCOME MEASURES

The personality inventory was a self-administered questionnaire comprising 240 items covering the five domains of personality. Denture satisfaction was scored on a nine item scale with four Likert type responses to each.

RESULTS

A group of 16% consistently complained about their dentures. Statistical analysis showed that personality factors especially Neuroticism had a significant relationship with denture satisfaction.

CONCLUSION

Psychological factors significantly influence denture satisfaction and profiles may provide useful in predicting potential difficult denture wearers.

Gender differences in oral health behavior and general health habits in an adult population

This study aimed to evaluate gender differences in oral health behavior and general health habits in adults. The subjects were 207 males and 196 females aged 20-64 yrs who were public officials in the city or town administrations in Chiba Prefecture, Japan. The questionnaire survey included three items: (1) self assessment of oral health status, (2) oral health behavior and (3) general health habits. Statistical analysis was performed using the chi-square test for differences of responses between males and females. The proportion of subjects with cognition of symptoms of oral disease ranged from 14.3 to 23.0%. The percentage of those who had not visited a dentist in the last year were 52.7% for males and 36.7% for females (p < 0.01). Subjects who brushed their teeth almost every day at bed time were 60.9% of males and 88.8% of females (p < 0.01). A comparison of the numbers of positive responses regarding general health habits found no differences in the distribution of general health habits score between males and females. Examining the relationship between oral health behavior and general health habits revealed that males with general habit high scores tended to have positive oral hygiene behavior. These results support the thesis that gender specificities in oral health depend on individual attitudes to oral health and dental utilization. In addition, understanding the cognitive factors of males and females would accelerate dental approaches to modifying oral health behavior of both groups, thus contributing to lifelong health maintenance.

Patient management and decision making in complete denture fabrication using a duplicate denture procedure: a clinical report

A patient may have difficulty adapting to a new prosthesis for either physical or psychological reasons. This article describes a procedure for duplicating an existing denture and gives the practitioner an alternative to the traditional denture fabrication techniques. The duplicated denture fabrication technique minimizes the changes to the new denture, making it easier for the patient to adapt to new dentures. However, in-depth communication with the patient is necessary for successful denture therapy.

Optimized therapy for the edentulous predicament: cost-effectiveness considerations

After proof of the clinical effectiveness of prosthodontic interventions, comparative economic analyses (cost-effectiveness, cost benefit, cost utility) should be undertaken to establish the relative value of each intervention in terms of its costs and consequences. Over time, these analyses must consider the balance between each intervention's initial and maintenance costs versus a broad array of clinician and patient-based multidimensional benefits or outcomes. The findings of current research will enhance increased economic analysis in prosthodontics, which, in turn, may help both dentists' and patients' decision-making. Even implant-supported prostheses that are clinically effective have yet to be proven societally effective because they are inaccessible economically to some who need them. Long-term, multidimensional comparative economic analyses of overdenture and conventional denture use may lead to the expansion of implant-supported dentures to selected patients who, to date, have not had access to this treatment modality.

"Prosthetic condition" and patients' judgment of complete dentures

PURPOSE

This study introduces the concept "prosthetic condition", which combines the quality of complete dentures and residual alveolar ridges.

MATERIAL AND METHODS

A pilot study was performed to select quality criteria with an acceptable interobserver agreement. With these criteria, a clinical examination was performed to assess the quality of the existing complete dentures and the residual alveolar ridges of 397 complete denture wearers. During clinical examination, the interobserver agreement of the selected criteria was retested. The "prosthetic condition" was assessed by combining the scores for denture quality and quality of the residual alveolar ridges. Subsequently, participants' satisfaction with and complaints about their dentures were scored according to their answers to specific questions.

RESULTS

Logistic regression analysis demonstrated that no variable of the "prosthetic condition" proved to explain the denture satisfaction. Some variables of the "prosthetic condition" had a significant but not relevant correlation with some denture complaints.

CONCLUSIONS

More research is necessary to substantiate the concept "prosthetic condition" as an acceptable measure of professionally quality assessment of dentures and denture-bearing surfaces. However, in determining the treatment need of community-dwelling groups, this concept seems a more realistic measure than denture quality only.