Abstract
Studies on self-perception have demonstrated that tooth loss is associated with esthetic, functional, psychological and social impacts for individuals. However, not all subjects seek treatment immediately after tooth loss, even when desire for replacement is strongly expressed. The aim of this study was to evaluate the perception of patients submitted to tooth extraction about factors associated with tooth loss and prosthodontic treatment, at the time and after extraction. A convenience sample of 211 consecutive patients were clinically evaluated and answered to a questionnaire about perceived impacts and prosthodontic treatment needs. Data were collected at the time of extraction and after a 3-month time interval. Perceived impacts were high (21 to 76% at the time and 35 to 87% after extraction). From 72.5% patients who expressed intention of immediate replacement of edentulous spaces, only 8.1% had actually been treated. Financial limitation was considered the most important factor that restricted access to treatment. Bivariate statistical analysis showed association between immediate dental replacement and anterior tooth loss (p=0.00) and extension of edentulous space (p=0.01). Position of lost teeth was associated to perceived functional limitation (p=0.03). Worsened appearance was associated to tooth loss in the maxillary arch (p=0.02), and desire of prosthodontic treatment was associated to the extension of edentulous space (p=0.05). Perceived impacts were more frequent in women than men. It was concluded that although patients usually expressed prosthodontic treatment needs, clinical and financial issues are determinant factors for tooth replacement.
Highlights
Self-perceived prosthodontic needs are determined by a sort of functional, esthetic, psychological and social impacts due to tooth loss [1,2]
These impacts have detrimental effects on oral health related to quality of life (OHRQoL) measures [3,4] and different levels of prosthodontic intervention are needed as a standard of care to improve condition of edentulous patients [5]
At the time of extraction self-perception of impacts ranged from 20.9% to 75.8% and great part of patients expressed desire for immediate reposition (72.5%)
Summary
Self-perceived prosthodontic needs are determined by a sort of functional, esthetic, psychological and social impacts due to tooth loss [1,2]. Like number and location of absent teeth, age, gender, impaired function, discomfort and dissatisfaction with appearance, and other sociodemographic, cultural and financial determinants are known as important ingredients of perceived treatment needs and, as consequence, essential aspects of clinical decision making [7,8,9,10]. Another issue that influences demand for prosthodontic treatment is the time between tooth loss and seek for treatment. Need-demand relation will be dependent on perceived extension of impacts, feasibility and availability of health care services [1]
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