The societal impact of tooth loss and the need for restoration work such as crowns, bridges, and implants is a pressing issue. While advancements in dental care and longer lifespans have allowed more people to retain their natural teeth, a significant portion still requires these treatments. The limited availability of NHS dentists and the high cost of private care further exacerbate this need, making these treatments often inaccessible.
As a result, 10 to 15 percent of the population relies on removable dentures. A new study by the University of Sheffield highlights the emotional struggles and hidden challenges of getting dentures, mapping out the patient journey, and its impact on treatment success.
The study found that patients think about their denture journey in four stages:
- Tooth Loss: The initial stage where patients lose their teeth.
- The Emotional Tunnel: Patients face emotional challenges like self-consciousness, depression, shame, anger, fear, and also hope.
- Prosthetic Hope: Patients feel optimistic about getting dentures, hoping to regain their smile and regular eating habits.
- Prosthetic Compromise: Patients adjust to using dentures, managing expectations, and learning to talk and eat with them. They also develop strategies to feel comfortable disclosing their denture use to others.
These feelings and how dentists manage them can affect patient outcomes. A dentist’s empathy during adjustment is crucial for successful denture use.
The study found that wearing removable dentures can be a hidden disability. Many feel embarrassed or fear their dentures will fall out, leading them to avoid social situations.
Lead researcher Barry Gibson from the University of Sheffield explained that tooth loss is traumatic and that embarrassment or shame can complicate getting dentures. Poorly fitting dentures can make speaking, eating, and drinking difficult, significantly affecting their quality of life and confidence, sometimes so severely that it impacts their willingness to leave the house.
Understanding the emotional difficulties identified in the study will help dentists improve care for denture patients, leading to a better and more successful experience for everyone.
The research team collaborated with Sheffield artist Gina Allen to create an art piece reflecting the emotional journeys of denture wearers. The collage “Prosthetic Hope and Compromise” uses color to depict the varied emotional experiences of patients. It shows that each patient has a unique journey: a young woman has a successful outcome, a middle-aged man feels indifferent, and an older woman struggles with her denture.
Artist Gina Allen, with a science background, explained, “Art can help interpret data, especially around social and environmental themes.” She found the depth of individual experiences captured by the research team fascinating and aimed to convey them visually engagingly.
This collaboration led to the development of a new patient questionnaire to:
- Tailor care is based on individual needs.
- Improve communication between dentists and patients.
- Identify patients who may need additional support.
The study emphasizes the need for a clinical care pathway to improve patient support. This pathway should focus on better denture fit, educate patients about denture care, and address the shame and stigma associated with wearing dentures.
Mr Bilal El-Dhuwaib, a Clinical Teacher in Restorative Dentistry at the University of Sheffield, said: “This study is important because it goes beyond the typical numbers-driven approach to dentistry by looking at crucial aspects of patients’ emotions and lived experiences. By understanding the psychological and social impact of tooth loss and replacement, the research provides a valuable toolkit for fellow dentists and me to understand better and address the emotional rollercoaster patients navigate during this process. By equipping dentists with the tools to understand these challenges, we can create a more compassionate and effective approach to tooth replacement.”
Journal reference:
- Barry John Gibson, Sarah R Baker et al., ‘It’s like being in a tunnel’: Understanding the patient journey from tooth loss to life with removable dentures. Journal of Dentistry. DOI: 10.1016/j.jdent.2024.104964.