The definition of young has been moving up at the same rate as the baby boomer population ages. Most of this population group is highly interested in staying young, which includes a complete or mostly complete dentition. The impact of implants and fixed prostheses affirms this need to remain viable and healthy in all ways. Tooth loss at any age can be difficult since these days it is considered “abnormal.” A study of patients aged 65 years and older revealed that keeping natural teeth was “critically important.” Patients in this study who had 25 or more natural teeth rated their oral health and quality of life better. Clinicians who treat patients with missing teeth should evaluate feelings on quality of life issues such as self-consciousness or fear of going out to elicit these and other subjective concerns. A second study indicated that successful treatment of these patients needs to begin with an evaluation of their motivation for dentures and their emotional attitude toward dentures. Patients will need to understand how dentures will affect speech, mastication, and neuromuscular control. By staying positive, clinicians will help patients solve future problems. These 2 studies indicate there is an emotional and psychological impact of tooth loss which cannot be overestimated. Communication needs to be clear on patient expectations in order to achieve a satisfactory outcome, and it is vital that patients come to their own conclusions, not forced from a psychological position of their clinician. For many patients, treatment can proceed in stages, giving them time to adjust and completing their need for an attractive, complete smile. Patients also need to be reassured that they will be treated as they present today, going forward, not discussing the past, and helping empower them to move ahead. Many patients are embarrassed at their situation and fear they will be thought less intelligent or from a lower economic class than patients will complete dentition. Many avoid going to the dentist due to fear and shame. Edentulism is a powerful emotion, making patients feel vulnerable. J. Fraser McCord, DDS, BDS, at the University Dental Hospital of Manchester, says that perhaps the teaching paradigm should shift to “teaching how to treat a patient who has no teeth, rather than how to provide dentures for an edentulous mouth.”
(Source: AGD Impact, June 2008, Volume 36, Issue 6)
