Patients’ experience of partial tooth loss and expectations to treatment: a qualitative study in Danish and Swedish patients

Abstract

Knowledge of impairments, wishes and expectations is essential to make correct decisions regarding oral rehabilitation. The purpose of this study was to investigate discomforts, wishes and expectations in patients' with partial edentulism before entering oral rehabilitation. In Copenhagen, Denmark, and Malmö, Sweden, respectively, 20 patients with partial edentulism seeking rehabilitation were interviewed in a semistructured qualitative manner. The interviews were transcribed and analysed yielding overall domains. Six themes appeared as overall domains: (i) experienced impairments, (ii) experienced social awareness, (iii) expectation to treatment, (iv) expectation to durability/survival, (v) coping strategies dealing with the tooth loss including explanations of the tooth loss and (vi) modifications to experienced impairment. The impairments were mostly experienced as problems in social settings. Most participants expressed a simple wish to function normally; a fixed solution was preferred. Many Danish participants accepted a removable solution whereas only few Swedish participants did so. The domains 'coping strategies' and 'modifications' were not part of the chosen topics of interest, indicating a high wish of the participants to explain their tooth loss and how they coped with it. In conclusion, a large degree of social impairment was found in the patient group along with several coping strategies. The impairments were modified by a number of factors indicating that highly individualised care and treatment is needed. A state of normality was described as the primary treatment wish with a higher acceptance of removable solutions in Denmark than in Sweden. For final decision-making, surrounding factors seemed to influence the patients' choices.

Impairments due to tooth loss and prosthetic expectations in patients from an urban area and a rural area in Sweden. A qualitative study

“…To focus on the topic of interest in our study and limiting the amount of data, we used semi‐structured interviews with focus on tooth loss and treatment hereof. The content in the interview guide was based on a prior study, which led to a theoretical framework with the inclusion of the following topics: Patient's explanation of own tooth loss Coping strategies with impairment due to tooth loss Modifying factors influencing impairment due to tooth loss Expectation of treatment Expectation of longevity/survival of the reconstructions …”

“…In qualitative studies, tooth loss is often shown to be associated with social stigma . Furthermore, patients are often so dissatisfied with their removable dental prostheses (RDPs) that their acceptance is difficult and becoming “an uncertain person” with low self esteem .…”

“…A previous study investigated the impact of tooth loss and expectations of prosthetic rehabilitation in patients with partial edentulism recruited from the Schools of Dentistry in Copenhagen, Denmark and Malmö, Sweden . A range of different impairments due to tooth loss and strategies to accommodate them was found.…”

Em Conduta Clínica Conservadora Ainda Há Aplicação para os Pinos Intradentinários?

“…2 Perder um ou mais dentes muitas vezes leva a um declínio da qualidade de vida, incluindo o comprometimento da função mastigatória e da estética, perda de status social, diminuição da autoestima ao enfrentar e ter que gerenciar a ausência do dente. 3,4 Para muitos pacientes, reabilitação oral significa um retorno a um estilo de vida normal, que melhora consideravelmente a qualidade de vida. 3 Essa é a melhor escolha, não em termos de substituição dos dentes perdidos, mas, num sentido mais amplo, de experimentar a restauração da função oral e tudo o que estiver associada a esta.…”

“…3 Preservar estruturas dentais em pacientes parcialmente endêntulos é de fundamental importância, sejam estas associadas ou não ao tratamento endodôntico. 4 Reabilitar associando com endodontia ou implantodontia tem ficado, muitas vezes, restrito ao debate de porcentagens de sucesso e longevidade, mas apesar de terem características muito diferentes, partilham o objetivo comum de servirem de pilar a uma reabilitação. 5 Nesse sentido, esforços constantes têm sido realizados buscando por melhores estratégias restauradoras, para prolongar a permanência da estrutura dental na cavidade bucal, incluindo técnicas de proteção dentinopulpar, que levam em consideração a preservação da vitalidade pulpar.…”