Pathways to full mouth extraction

Abstract

The process of not attending the dentist is a vicious cycle in which anxiety plays a crucial role. A research project concerning the disease and non-disease reasons for full mouth extraction provided an opportunity to describe the dental histories in terms of dental attendance pattern and related factors which resulted in full dentures. Three profiles of dental histories could be outlined: 1) The regular attenders (19%). Because of their age (means = 47 yr), their positive attitude towards dentistry together with their positive attitude towards full dentures, it is suggested that the possibilities of keeping the natural dentition were exhausted so that full mouth extraction was an acceptable solution. 2) The symptomatic attenders (38%). Because anxiety, which was widespread in this group, was not based on negative experiences, it is suggested that anxiety is caused by social learning. Together with their positive attitude towards full dentures, the high prevalence of full dentures in their social environment and their low socioeconomic status, the conclusion is drawn that these patients lived in a culture which supports behavior that leads to total tooth loss. 3) Once regular attenders (43%). In this group anxiety leads to a negative perception of dental visits and to a negative attitude towards dentists. As a consequence dental visits are deferred, which results in deterioration of the dentition. Experiences with dentists are distorted in a negative way, which increases dental anxiety. Facilitated by a positive attitude towards full dentures, their bad dental condition finally urges them to take full dentures at early age.

The vicious cycle of dental fear: exploring the interplay between oral health, service utilization and dental fear

“…However, it is also possible that the increased number of teeth extracted might be as a result of differences in the progression of carious lesions between people with high and low fear when they finally seek treatment. This fits well with the belief of Bouma et al that if the vicious cycle of fear, treatment need and negative treatment experience is not broken the eventual consequence is full mouth extraction [14]. …”

“…Some researchers posit a role for psychological variables such as embarrassment, with dental fear and anxiety leading to avoidance, a deterioration in dental health, and feelings of shame and embarrassment culminating in reinforced avoidance [17,18]. In contrast, Bouma et al [14] propose that anxiety plays a crucial role in avoidance behaviour by causing a deterioration in oral health and an increase in the perceived likelihood of pain and restorative treatments resulting in further negative dental visiting experiences. Similarly, Thomson et al [5] have argued that dental fear may be a component in a cycle of dental disadvantage, with dentally anxious individuals avoiding dental care and thereby worsening their problems and increasing the likelihood that subsequent dental visits will be for emergency reasons.…”

Edentulism and Comorbid Factors

“…According to World Health Organization criteria, 24 people with no teeth are considered physically impaired. Edentulous patients could also be considered disabled , due to their inability to eat and speak effectively, which are two of the essential tasks of life; they could be considered handicapped , as they tend to avoid eating and speaking in public 25…”

The Use of a Respiratory Rate Biofeedback Device to Reduce Dental Anxiety: An Exploratory Investigation

“…The sequelae of severe dental anxiety are obvious: the patient may avoid dental care, may demonstrate irregular attendance, and/or may only seek treatment in an emergency (Liddell and May 1984;Milgrom et al 1988). This pattern of behavior creates a cumulative causation effect whereby the subsequent painful emergency treatments continue to generate more dental anxiety (Nuttall 1984;Moore and Birn 1990;Milgrom and Weinstein 1993;Abrahamsson et al 2002), subsequently resulting in further negative dental visit experiences (Bouma et al 1987).…”