Researchers may have developed a better understanding of the stages in a patient’s journey from tooth loss to the use of dental prosthetics, according to a recent study.
Advancements in oral health care have led many patients residing in middle- and high-income countries to live to older ages with total or partial intact dentition. Nonetheless, over 60% and 33% of older individuals may experience periodontal disease and xerostomia, respectively.
Previous studies have found that 20% to 50% of patients with less than 21 teeth who receive partial dental prosthetics may not use them, and a large proportion of these patients admit to not being prepared to live with dentures as a result of social and emotional factors. These studies have indicated that the use of dental prosthetics may impact a patient’s self-worth, appearance, and confidence.
In a new multi-method qualitative study, an interdisciplinary team of researchers—comprised of clinical academic dentists; social scientists with expertise in psychology, geography, and sociology; and staff working in the dental industry—used narrative interviews and direct observation to assess the experiences of 20 patients who received dentures within the past 5 years and 13 patients who were receiving treatment for new or replacement dentures. They also led a focus group to examine the patients’ journeys.
After performing a phenomenological analysis informed by grounded theory methods, the researchers found that 35.7% (n = 5/14) of the patients who completed treatment had positive outcomes—defined as the use of dentures with minimal disruption to daily life—50% (n = 7) of the patients achieved a solution in which they better understood how to use their dentures, and 14.3% (n = 2) of them no longer used dentures, according to study results published in the Journal of Dentistry
Many of the patients who participated in the study related the experience of tooth loss to being in an “emotional tunnel” in which they were tasked with taking control and managing disclosure of their dentures.
The researchers identified four phases from tooth loss to recovery on the basis of patient conceptualization: “tooth loss,” “emotional tunnel,” “prosthetic hope,” and “prosthetic compromise.”
They also noted that there were five appointments that occurred throughout the patients’ journeys—including “extractions,” “first impressions,” “second impressions,” “the try in,” and “the handover.”
The researchers found that the try-in stage may present physicians with opportunities to communicate information about dentures and continued care plans.
They suggested that an integrated framework may help detail the patients’ journey from tooth loss to dental prosthetics as well as aid physicians in treating patients. They concluded that tending to patients’ emotional needs may help drive positive clinical outcomes.
A full list of disclosures can be found in the original study.
