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Making edentulous patients heard

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  Posted by: The Probe      9th February 2020

With Phillip Silver, UK Country Manager and Consultant at Solvay Dental 360

 

Everyone wants to feel understood, and yet so many people feel they are not – this can be an isolating and confidence destroying experience. Expressing ourselves is a core part of the human condition, so it should come as little surprise that when communication becomes difficult, people’s social relationships are impacted and can break down. Difficulties communicating can spiral into social isolation, withdrawal and loneliness, and can raise an individual’s risk for developing physical and mental health problems.[1]

Various illnesses and health circumstances can have an impact on our ability to articulate, edentulism being one of the more commonly occurring. Edentulism can profoundly affect patients’ lives, often more so than many patients anticipate. Permanently losing teeth can impair basic oral function, making it difficult to eat and speak. It can cause physical discomfort, embarrassment and have aesthetic ramifications, which often carry negative cultural associations. The condition can lead to further sequela including supra eruption and temporomandibular disorders (TMD), which further impact the patient’s wellbeing and can complicate treatment.[2]

Beyond the purely functional aspects, there is considerable stigma attached to tooth loss. The loss of teeth is generally seen as having an aging effect, particularly where resorption results in the patient’s profile receding inwards, giving a “gummy” appearance. For younger patients, losing teeth can be even more stigmatising. Because tooth loss is less common among younger people, and associated with aging, younger people with tooth loss are sometimes seen as more “at fault” for their condition. People may assume that a younger person who has lost teeth: lives in poverty, leads a particularly unhealthy/unhygienic lifestyle, abuses drugs or gets involved in fights. These are unfair assumptions, but many members of the public do make snap judgements based on appearance, and these attitudes can negatively impact patients’ lives.

Patients that have lost teeth, or have undergone another change that affects their speech, can benefit from retraining themselves. However, tooth loss can cause mechanical issues that negatively impact the patient’s speech in ways that are difficult or impossible to fully compensate for without intervention.

An inability to enunciate can provoke prejudice, with some people assuming that not being able to speak clearly correlates with a lack of intelligence or mental acuity. In reality there are many different factors that can affect one’s speech, but the above attitude can result in people being talked down to or regarded with contempt.

Dentures can help, but where they are ill-fitting, the denture can move and shift unpredictably in the mouth. Not only can this interfere with speech directly, it can also accelerate bone resorption and potentially cause injury, resulting in oral lesions.[3], [4], [5]

Individuals with edentulism may also slip into avoidant behaviours to draw attention away from missing teeth or ill-fitting dentures. Examples of this include: covering the mouth while eating or talking, avoiding opening their mouth as much as they previously would during speech, and isolating themselves during social activities or meals. While such practices are intended to mask the problem and reduce negative responses from others, these behaviours are generally maladaptive, and can further increase social isolation.

Temporomandibular disorders

Partial edentulism is a risk factor for developing a TMD, with more than half of partially edentulous patients presenting at least one TMD. TMDs can cause orofacial pain and discomfort, and restrict mouth opening.[6] Consequently, a TMD can cause or exacerbate difficulties with verbal communication.

Multiple factors influence the development of TMD including muscular, occlusal and psychological. Partial edentulism appears to influence the severity of TMD, with greater numbers of lost teeth correlating to increased loads on the temporomandibular joint and corresponding structural changes.[7] Not wearing a denture, or wearing an ill-fitting one have been observed to contribute to developing TMD symptoms. Where a prothesis fits poorly, patients may constantly need to compensate for its movement with muscular contractions. Compensating for the instability of the appliance in this way can result in muscle strain, dysfunction and pain.[8] An individual’s emotional state, particularly psychological stress and mental health conditions are also understood to contribute to the development of a TMD.[9], [10]

Ill-fitting partial dentures can cause and exacerbate a variety of issues, so much so that many patients avoid them or stop using them altogether.[11] The material composition of the device can make a real difference to patient comfort. Ultaire® AKP from Solvay Dental 360® is an innovative non-corrosive polymer that is totally metal-free, yet comparably strong. Removable partial dentures made from Ultaire® AKP are aesthetically pleasing, non-irritating, lightweight and very comfortable – enabling patients to speak and eat with confidence.

The subsequent effects of tooth loss and ensuing communication difficulties can be considerable, and are not to be underestimated. A properly fitting, comfortable partial denture can improve speech, increase comfort and confidence and help prevent further complications from developing. Helping your patient find the optimal treatment for tooth loss can have a transformative impact on their wellbeing.

 

To book a Solvay Dental 360® Professional Lunch and Learn or to find more information about Ultaire® AKP and Dentivera® milling discs,
please visit 
www.solvaydental360.com

 

[1] Palmer A., Newsom J., Rook K. How does difficulty communicating affect the social relationships of older adults? An exploration using data from a national survey. Journal of Communication Disorders. 2016; 62: 131-146. https://doi.org/10.1016/j.jcomdis.2016.06.002 November 8, 2019.

[2] Rana S., Acharya B., Bhochhibhoya A., Sharma R., Acharya J., Mainali A. Patterns of partial edentulism based on Kennedy’s classification among patients reporting to Nepal Medical College and Teaching Hospital. Journal of Kathmandu Medical College. 2018; 7(4); 153-157. https://doi.org/10.3126/jkmc.v7i4.23313 November 8, 2019.

[3] Andrei O., Märgärit R., Tänäsescu L., Däguci L., Däguci C., Prosthetic rehabilitation of complete edentulous patients with morphological changes induced by age and old ill fitted dentures. Romanian Journal of Morphology & Embryology. 2016; 57(Suppl 2): 861-864. https://www.ncbi.nlm.nih.gov/pubmed/27833983 November 8, 2019.

[4] Mubarak S. Hmud A., Chandrasekharan S., Ali A. Prevalence of denture-related oral lesions among patients attending College of Dentistry, University of Dammam: a clinico-pathological study. Journal of International Society of Preventive & Community Dentistry. 2015; 5(6): 506-512. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4697237/ November 8, 2019.

[5] Tiwari K., Ahmad N., Verma A., Ali M., Krishna D., Pandey K. Residual ridge resorption: the unstoppable. International Journal of Applied Research. 2016; 2(2): 169-171. http://www.allresearchjournal.com/archives/?year=2016&vol=2&issue=2&part=C&ArticleId=1499 November 8, 2019.

[6] Amin M., Khan A., Khan M. Frequency of common signs of temporomandibular disorders in patients with reduced occlusal support due to partial edentulism. Pakistan Oral & Dental Journal. 2019; 39(2): 206-211https://www.podj.com.pk/index.php/podj/article/view/407 November 8, 2019.

[7] Fallahi H., Alikazaemi M., Javidi P., Kazemi P., Behbudi A., Zanganeh T. Evaluation of the relationship between partial edentulism and TMJ disorders. Biosciences Biotechnology Research Asia. 2016; 13(3): 1725-1729. http://dx.doi.org/10.13005/bbra/2323 November 8, 2019.

[8] Bordin T., Conci R., Pezzini M., Pezzini R., Mendonça M. Prevalence of signs and symptoms of temporomandibular disorders (TMD) in patients wearing bimaxillary complete dentures, removable partial dentures and in students with natural dentition. Acta Odontológica Latinoamericana. 2013; 26(3): 173-180. https://www.ncbi.nlm.nih.gov/pubmed/25335371 November 8, 2019.

[9] Saeed T., Riaz N. Level of depression in temporomandibular disorder patients. Journal of the Pakistan Dental Association. 2018; 27(3): 100-105. https://doi.org/10.25301/JPDA.273.100 November 8, 2019.

[10] Chisnoiu A., Picos AM., Popa S., Chisnoiu P., Lascu L., Picos A., Chisnoiu R. Factors involved in the etiology of temporomandibular disorders – a literature review. Clujul Medical. 2015; 88(4): 473-478. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4689239/ November 8, 2019.

[11] Campbell S., Cooper L., Craddock H., Hyde T., Nattress B., Pavitt S., Seymour D. Removable partial dentures: the clinical need for innovation. The Journal of Prosthetic Dentistry. 2017; 118(3): 273-280. https://www.sciencedirect.com/science/article/pii/S0022391317300732 November 8, 2019.


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