Assessment of dental anxiety in edentulous subjects

In this investigation an anxiety scale was constructed to measure dental anxiety in full denture patients. Furthermore, the relationship of this anxiety scale with denture history, denture satisfaction, and personality traits was investigated. A group of 125 patients who were on a waiting list to have new dentures constructed participated in this study. The coefficient alpha value of the anxiety scale was 0.81. Significant correlations were found with number of years with complete dentures (r = -0.20), with denture complaints (r = 0.18-0.19) and with some personality traits (r = 0.21-0.32). Further research into the role of dental anxiety with respect to dental behaviour and dental satisfaction in edentulous populations seems useful.     

An investigation of factors influencing patients' use of new complete dentures using structural equation modelling techniques

A review of the literature demonstrated that research had not identified a set of prognostic indicators for prospective complete denture patients, with different authors publishing contradictory results. OBJECTIVE: To investigate possible relationships between patient and clinical factors and denture wear and use of dentures for eating. METHODS: Patients attending Guy's Dental Hospital, London, for provision of complete dentures were recruited. For each patient relevant history was recorded and an examination of the edentulous mouth and existing dentures, where present, was undertaken at the beginning of treatment. At the first post-insertion appointment the edentulous mouth, previous and new dentures were examined. Three months after the review appointment patients were sent a postal questionnaire to assess patient use of dentures and patient satisfaction. Data were analysed using structural equation modelling techniques. RESULTS: 723 patients were recruited. Significant relationships were found between quality of complete dentures and patients' use of complete dentures and between quality of residual edentulous ridges and patients' use of complete dentures. These results contrast with most previous research into prognostic indicators for success in complete denture treatments. CONCLUSIONS: Quality of residual edentulous ridges and quality of new complete dentures predict patients' use of new complete dentures.     

Dental fear and anxiety in an older adult population

A random sample of 580 people aged between 50 and 89 yr completed a questionnaire containing two measures of dental fear and anxiety. One of these was Corah's Dental Anxiety Scale (DAS) and the other a scale derived from the Structured Interview for Assessing Dental Fear (SIADF). The mean score on the DAS was 7.8, and 8.4% of subjects were classified as dentally anxious. There were no differences in mean DAS scores by sex but significant differences by age, with younger individuals having higher scores (P less than 0.0001). The edentulous had significantly higher scores than the dentate (P less than 0.001). Scores on the SIADF scale were higher among younger individuals (P less than 0.0001), the edentulous (P less than 0.01) and women (P less than 0.05). Older adults who were dentally anxious were less likely to report a regular source of dental care and a dental visit in the previous year and more likely to report having avoided or delayed dental treatment. Possible explanations of higher dental anxiety scores among younger persons and the edentulous are reviewed.     

The further development and validation of the Liverpool Oral Rehabilitation Questionnaire (LORQ) version 3: a cross-sectional survey of patients referred to a dental hospital for removable prostheses replacement

STATEMENT OF PROBLEM: The Liverpool Oral Rehabilitation Questionnaire (LORQ) is a health-related quality of life instrument assessing the impact of oral rehabilitation on patients' health-related quality of life (HRQOL) following treatment for oral cancer. The small number of patients wearing prostheses in previous studies limited the validation of the denture/denture satisfaction part of the questionnaire. PURPOSE: The purpose of this study was to further validate the LORQ by obtaining HRQOL data from patients requiring replacement dentures. MATERIAL AND METHODS: The LORQv3, together with items assessing mood and anxiety, was administered with the Oral Health Impact Profile 14-item (OHIP-14) questionnaire to 104 consecutive patients, between the ages of 40 and 79, referred by their general dentists to the department of prosthodontics at the Liverpool University Dental Hospital for replacement of removable prostheses between November 2004 and June 2005. The Mann-Whitney and Kruskal-Wallis tests compared scores between patient groups. Internal consistency was measured by Cronbach's alpha. Spearman's correlation investigated associations between items on the LORQv3 and items from the OHIP-14. Test-retest was measured by the kappa coefficient, weighted by applying standard weights according to the number of categories in error. RESULTS: Patients wearing complete dentures in 1 or both arches generally scored worse for oral function and mandibular denture problems/satisfaction than patients wearing removable partial dentures. Thirty-three percent of patients were somewhat or extremely depressed, 25% were anxious or very anxious, and 15% were both depressed and anxious. CONCLUSIONS: The denture section of the LORQv3 identified expected differences among various patient subgroups in this cohort confirmed by similar findings for the OHIP-14 and the literature. Thus, this part of the LORQv3 referring to dentures and patient satisfaction demonstrated good construct and criterion validity.     

Dental anxiety: a comparison of dentate and edentulous subjects

Dental anxiety was measured in a representative, nationwide sample consisting of both dentate and edentulous subjects. Comparison of the mean scores of both groups shows that the edentulous sample is neither more nor less anxious about dental treatment than the dentate sample. The distribution of dental anxiety in edentulous subjects, however, differs considerably from that of the dentate group. Complete denture wearers are both more often dentally phobic and more often free from any anxiety than subjects still having at least part of their natural dentition.     

A structural equation model relating oral condition,denture quality,chewing ability,satisfaction, and oral health-related quality of life in complete denture wearers

ObjectivesTo investigate the relationship between mandibular ridge form, stability and retention of mandibular complete denture, accuracy of jaw relation recording, patients’ perception of chewing ability, satisfaction with dentures and oral health-related quality of life (OHRQoL) in complete denture wearers.MethodsA total of 183 edentulous patients, who visited the Dental Hospital of Tokyo Medical and Dental University for new complete dentures, were recruited. Oral examination was performed. Cawood and Howell's method was used to grade the mandibular ridge form. The stability and retention of the mandibular complete denture were assessed using Kapur method. Accuracy of jaw relation recording was evaluated using a newly developed jaw relation index. Patients’ perception of chewing ability was rated using a food intake questionnaire. Patients’ satisfaction with complete dentures was assessed on a 100-mm visual analogue scale. OHRQoL was measured using the Japanese version of the Oral Health Impact Profile for edentulous subjects. A structural equation model was constructed based on the hypothesis that oral condition and denture quality would be related to chewing ability, satisfaction and OHRQoL.ResultsSignificant relationships were found between mandibular ridge form, stability of mandibular complete denture, accuracy of jaw relation recording, perceived chewing ability, satisfaction and OHRQoL. Various fit indices were within acceptable limits.ConclusionsOral condition and denture quality were related to patients’ perception of chewing ability, satisfaction with dentures and OHRQoL in complete denture wearers.Clinical significanceA favourable oral condition and denture quality are important for successful complete denture therapy.     

Oral health-related quality of life and satisfaction before and after treatment with complete dentures in a Dental School in Brazil

Purpose: The aim of this study was to evaluate the impact of treatment with new complete dentures on oral health-related quality of life and satisfaction of edentulous patients attending the Prosthodontic Department in a Dental School in Brazil. Methods: A total of 70 edentulous subjects (37–86 years) treated by undergradute students at the Araçatuba Dental School, University of State of São Paulo, were accessed. A specific questionnaire for edentulous patients (EDENT) based on the Oral Health Impact Profile (OHIP-EDENT) was applied to collect information on patient oral health-related quality of life. Questions related to the personal satisfaction of the edentulous patients with their complete dentures were also included. The patients were accessed before the treatment, and 3 months after receiving the new dentures. Results: After rehabilitation with new complete dentures, all domains of OHIP-EDENT showed significant improvements. There was also a significant improvement in patient satisfaction after placement of new complete dentures. Furthermore, it was possible to observe association between upper denture satisfaction and age. Conclusion: Conventional complete dentures may have a positive impact on oral health-related quality of life and satisfaction of edentulous patients.     

A comparison of patient's satisfaction between complete and partial removable denture wearers

OBJECTIVES: The aim of this study was to compare satisfaction between complete denture (CD) and Kennedy Class I removable partial denture (RPD) wearers. MATERIALS AND METHODS: A total of 156 CD and 112 RPD wearers took a part in this study. From the primary group of the examined patients, only those whose RPDs and CDs were assessed as excellent or very good by the dentist, took a part in this study. Patients graded satisfaction of their dentures by using an analogue scale from 1 to 5 (1=unsatisfactory; 5=excellent). RESULTS: Both CD and RPD wearers were mostly satisfied with their dentures (the distribution of the scores of the patients' assessments was skewed towards the highest scores; more than half of the patients scored all the examined variables to the best score category). Complete Denture wearers were significantly more satisfied with chewing, speech and retention of maxillary denture than RPD wearers (P<0.05). Removable partial denture wearers were significantly more satisfied with the retention and the comfort of wearing mandibular denture (P<0.05). There was no significant difference between CD and RPD wearers for general satisfaction with their dentures, aesthetics and comfort of wearing maxillary denture (P>0.05; N.S.). CONCLUSIONS: A majority of CD and RPD wearers were satisfied with the dentures. CD wearers were more satisfied with speech, chewing and retention of maxillary denture, while RPD wearers were more satisfied with the retention and the comfort of wearing mandibular denture. Different groups of denture wearers have to make significant, but different adjustments to wear their dentures successfully.     

义齿黏附剂和口腔湿润剂联合使用提高口干症患者全口义齿满意度的临床评价

目的：探讨义齿黏附剂和口腔湿润剂联合使用对牙槽嵴低平的口干症患者配戴全口义齿效果的影响。方法：选择10例牙槽嵴低平的无牙颌口干症患者,于义齿黏附剂使用前和使用后1个月及义齿黏附剂和口腔湿润剂联合使用后1个月、3个月及6个月对患者进行义齿满意度问卷调查, 采用SPSS17.0软件包对数据进行统计学分析。结果：义齿黏附剂与口腔湿润剂联合应用于全口义齿后6个月和使用口腔湿润剂前比较, 临床使用效果满意, 在总体满意度、咀嚼功能、舒适度以及下颌全口义齿固位效果等4个方面均显著提高)P<0.05) ; 而单独使用义齿黏附剂1个月后,患者配戴全口义齿的舒适度显著下降(P<0.05)。结论：对伴有口干症的牙槽嵴低平的无牙颌患者,联合应用义齿黏附剂和口腔湿润剂,可提高配戴全口义齿的满意度。     

Do dental anxiety questionnaires raise anxiety in dentally anxious adult patients? A two-wave panel study.

OBJECTIVE: To test whether or not dentally anxious patients attending the dentist for an appointment become more anxious when completing a dental anxiety questionnaire. BASIC RESEARCH DESIGN: Patients were initially screened to include only those who were dentally anxious. A pre- and post-test was planned with the completion of the Modified Dental Anxiety Scale (MDAS) questionnaire as the intervention. CLINICAL SETTING: Two dental access centres in the North West of England. PARTICIPANTS: Initially, 583 patients were screened. Of these, 182 (31%) were found to be dentally anxious and were recruited into the study. MAIN OUTCOME MEASURES: State-Trait Anxiety Inventory Scale Short Form. RESULTS: State anxiety did not change with the completion of the MDAS questionnaire in either designated dental phobics (MDAS >or=19) or those classified as non-phobics (MDAS <19). CONCLUSIONS: The MDAS can be used to assess dental anxiety without raising anxiety in patients with or without self-reported dental phobia.     

Psychologic response of the edentulous patient after primary surgery for oral cancer: A cross-sectional study.

STATEMENT OF PROBLEM: Edentulous patients can have difficulty in tolerating dentures and this may lead to psychologic disturbance. The problem is potentially more severe for edentulous patients after primary surgery for oral cancer, where treatment can include composite resection and reconstruction, followed by adjuvant radiotherapy. PURPOSE: This study investigated the psychologic response and oral satisfaction of edentulous patients treated by surgery for oral squamous cell carcinoma, and to make a comparison to edentulous noncancer counterparts. METHODS AND MATERIAL: The cross-sectional study included patients who were alive and disease-free 2 to 3 years after primary surgery. Seventy patients underwent surgery at the Regional Maxillofacial Unit, Liverpool, in 1993 and 1994. Twenty-eight patients were disease-free; 26 completed questionnaires that included a general health questionnaire (GHQ), a body satisfaction scale, a self-esteem scale, an oral symptom checklist, and a denture satisfaction questionnaire. Comparison was made with 98 noncancer edentulous patients from the same unit. RESULTS: There were similarities in psychologic and oral satisfaction scores between the noncancer and cancer edentulous patients. Cancer patients reported lower self-esteem (P <.02). Cancer patients who were not rehabilitated with either conventional or implant-retained prostheses had significant psychologic morbidity as measured by the GHQ, self-esteem, and body satisfaction scales. Cancer patients with implant-retained overdentures reported greater satisfaction with their dentures compared with their counterparts who wore conventional dentures (P <.05). CONCLUSION: Edentulous cancer patients who do not achieve oral rehabilitation after surgery for oral cancer exhibited significant psychologic morbidity. Patients with implant-retained overdentures exhibited a tendency to adopt the same psychologic response with improved denture satisfaction as edentulous patients with conventional dentures, despite the former having more extensive disease that would otherwise make the provision of dentures much more difficult if implants were not used.     

Effectiveness of three treatment modalities for the edentulous mandible. A five-year randomized clinical trial

Currently, 3 treatment options are available for patients with denture complaints and an edentulous mandible with a height of at least 15 mm: meticulous construction of a new set of dentures (CD), construction of a new set of dentures following preprosthetic surgery to enlarge the denture-bearing area (PPS), and construction of an implant-retained mandibular overdenture (IRO). The aim of this study was to evaluate patient satisfaction and subjective chewing ability of edentulous patients treated with one of these treatment modalities. Ninety edentulous patients (Cawood class IV and V, mean mandibular height 20.7 mm) were randomly assigned to receive 1 of these 3 groups. Denture satisfaction and chewing ability were assessed using questionnaires focusing on denture-related complaints and problems chewing different types of food were assessed before treatment, and 1- and 5-years after treatment. At the 1-year evaluation, significantly better scores were observed in the 2 surgical groups (IRO, PPS) than in the CD group. At 5-year evaluation the "complaints of the lower denture" showed a significantly better score in the IRO group when compared to the PPS and CD groups. No significant differences were observed between the PPS and CD group. From this study it is concluded that both in the short and long term denture satisfaction appears most favourable in the IRO group when compared to the PPS and CD groups. Implant-retained overdentures are therefore a satisfactory treatment modality for edentulous patients with problems with their lower denture, even in cases of not severely resorbed mandibles.     

Dental anxiety before removal of a third molar and association with general trait anxiety.

PURPOSE: The aim of the present study was to evaluate dental anxiety in patients consulting for third molar removal, and to assess possible relationships with general trait anxiety. MATERIALS AND METHODS: Dental anxiety was measured using Corah's Anxiety Scale (DAS), the Dental Fear Survey (DFS), and the state anxiety scale of the State-Trait Anxiety Inventory (STAI). Trait anxiety was measured with the trait anxiety scale of the STAI. RESULTS: Trait anxiety showed significant positive correlations with both DAS score and DFS score. The 3 measures of dental anxiety all showed significant positive correlations with each other. The difference between men and women was only statistically significant in the case of trait anxiety. CONCLUSION: These results suggest that trait anxiety may be a useful predictor of a patient's predisposition to dental anxiety.     

An investigation of factors influencing patients' satisfaction with new complete dentures using structural equation modelling

OBJECTIVE: To investigate possible relationships between patient and clinical factors and patient satisfaction with new complete dentures. METHODS: Patients attending King's College London Dental Institute, Guy's Hospital, London, for new complete dentures were recruited. Relevant history was recorded and the edentulous mouth and existing dentures, where present, were examined at the beginning of treatment. The edentulous mouth, the previous and new dentures were re-examined at the first post-insertion visit. Three months after this visit, patients were sent a postal questionnaire to assess patient satisfaction. Data were analysed using structural equation modelling techniques. RESULTS: 723 patients were recruited. Significant relationships were found between quality of complete dentures, quality of residual alveolar, adaptability factors and patients' satisfaction with complete dentures. CONCLUSIONS: Quality of the mandibular residual alveolar ridges, retention and stability of the mandibular dentures, accuracy of reproduction of retruded jaw relationship and patient adaptability were powerful determinants of patients' satisfaction with new complete dentures.     

The effect of personality type on denture satisfaction

PURPOSE: The aim of this study was to determine the correlation between personality type and denture satisfaction of totally and partially edentulous patients. MATERIALS AND METHODS: Two hundred thirty-nine patients (107 women and 132 men) aged 31 to 78 years (mean, 51.87) using removable dentures (165 maxillary and mandibular partial, 51 maxillary and mandibular complete, and 23 maxillary complete and mandibular partial) were asked to fill out a questionnaire on their satisfaction with their dentures with regard to esthetics, speaking ability, and masticatory function. Personality types were evaluated using both the responses to this questionnaire and the Type A Behavior Pattern Test. Chi-square test and logistic regression analysis were used to compare the denture satisfaction scores of the groups (Type A, Type B, and Type AB). The level of statistical significance was set at P = .05. RESULTS: Denture satisfaction of the patients with regard to esthetics, speaking ability, and masticatory function was affected by personality type. Statistically significant differences were found between Type A and types B and AB, as well as between types B and AB. CONCLUSION: The personality type of the patients had an effect on their satisfaction with dentures. The lowest denture satisfaction values were observed in the Type A patients.     

Patient satisfaction and preference with magnet, bar-clip, and ball-socket retained mandibular implant overdentures: a cross-over clinical trial

PURPOSE: The purposes of this study were to: (1) determine patient satisfaction with implant-supported mandibular overdentures using magnet, bar-clip, and ball-socket attachments; and (2) assess the relation between maximum bite force and patient satisfaction. MATERIALS AND METHODS: In a cross-over clinical trial, 18 edentulous patients with mandibular denture complaints received two mandibular implants and new mandibular and maxillary dentures. The mandibular denture was initially without any kind of attachment system, but it was fitted with one of the attachment types after 3 months. The attachments were changed 3 months thereafter, in random order. A questionnaire on denture complaints was administered at baseline (with the old denture), after 3 months of function with the new denture without attachments, and after 3 months of function with each of the attachments (within-subject comparison). In addition, patients were asked to express their overall appreciation of their dentures on a VAS. Patients' preferences were determined at the end of the experiment. Maximum bite forces were obtained from a previous study with the same population. Five scales of denture complaints were constructed. Mean scale and VAS scores at the five evaluation points were compared among the groups. Pearson correlation was calculated between maximum bite force and scale and VAS scores. RESULTS AND CONCLUSION: Mandibular implant-supported overdenture treatment reduced various denture complaints. The VAS score better reflected patients' preferences than did scale score. Patients strongly preferred bar-clip (10/18 subjects) and ball-socket attachments (7/18 subjects) over magnet attachments (1/18 subjects). Patients' preferences could not be predicted on the basis of baseline observations. Maximum bite force was not correlated to scale or VAS score. Hence, patients with higher maximum bite forces were not necessarily more satisfied.     

Comparison of denture stomatitis prevalence in 2 population groups

PURPOSE: The aim of this cross-sectional study was to profile complete denture wearers in 2 different unmatched and nonrandomized population groups and compare any possible relationships between the prevalence of denture stomatitis and other factors involved in wearing complete dentures. MATERIALS AND METHODS: Denture wearers who attended the clinics of the Dental School and Hospital, University of Bristol, United Kingdom (group A), and the Dental School, University of Athens, Greece (group B), were examined. The examination included a record of gender, age, years wearing a complete denture, number of dentures used, duration of current denture's usage, daily time period of denture wearing, and clinical examination of the maxillary denture-bearing mucosa. Data were analyzed using the chi-square test. RESULTS: Denture wearers of group A were older, more experienced in wearing complete dentures, and had used more sets of dentures. The majority of patients used dentures exhibiting decreased vertical dimension of occlusion and wore their dentures only in the daytime. Denture stomatitis prevalence was statistically significantly different between groups A and B (27% and 39.7%, respectively). In both groups, the denture stomatitis prevalence was greater in women. There was no statistically significant difference between the groups regarding the age of denture wearers, the number of dentures used, or the vertical dimension of occlusion. In group B, the denture stomatitis prevalence was significantly related to the years of denture-wearing experience and the current denture's usage. In both groups, continuous denture wearing was highly related to denture stomatitis prevalence. CONCLUSIONS: This cross-sectional study showed that 2 different population groups of denture wearers presented different complete denture wearing habits and denture stomatitis prevalence. Comparisons indicate that proper denture wearing habits decrease the prevalence of denture stomatitis.     

The relationship between various parameters of complete denture quality and patients’ satisfaction

BackgroundPatients’ appreciation of their conventional complete dentures might be affected by the quality of the dentures.MethodsA random sample of 33 edentulous patients who were rehabilitated by means of conventional complete dentures participated in the study. Three independent investigators who underwent technique calibration evaluated the dentures on the basis of seven clinical criteria by using a validated examination form. The patients filled out a validated denture satisfaction scale. The author used Pearson product-moment correlation and analysis of covariance to identify possible correlations.ResultsThe study results showed that most patients were between “reasonably satisfied” and “very satisfied” with their dentures. The author found nominally higher satisfaction among those receiving both mandibular and maxillary dentures and significant positive correlations between the overall denture satisfaction score and the stability of the mandibular denture (P = .039) and retention of the mandibular denture (P = .005). In contrast, esthetic lip support and lower lip line, occlusion, and maxillary stability and retention were not correlated with participants’ overall satisfaction level (P > .064).ConclusionsThe results of this study show that a clinically stable mandibular denture was the most important determinant of patients’ satisfaction.Practical ImplicationsThe study findings highlight the most important denture quality parameters that can aid clinicians in meeting their patients’ expectations.     

Dental caries and changes in dental anxiety in late adolescence

Little is known about changes in dental anxiety with ageing and their association with changes in oral health. This study examined the relationship between changes in dental caries experience and dental anxiety from 15 to 18 years of age among adolescent participants in the Dunedin Multidisciplinary Health and Development Study. Dental anxiety was estimated using the Corah Dental Anxiety Scale (DAS), and individuals with a DAS score of 13 + were identied as being dentally anxious. Dental examinations were performed on 649 individuals at ages 15 and 18, and a DMFS score was computed for each. Caries prevalence among those who were dentally anxious at both 15 and 18 years was signicantly higher than for those who were not at either age. Regression analysis revealed that dental anxiety predicted caries incidence between ages 15 and 18 years. Dental anxiety is likely to be a signicant predictor of dental caries experience, and may be a risk factor for dental caries incidence.     

Relationship between dental anxiety and pain perception during scaling

Dental pain, anxiety and fear are important factors that prevent patients from seeking dental care. In this study, we aimed to evaluate the pain perception of patients during scaling and its relationship with dental anxiety. One hundred dental patients participated in the study. Pain levels after scaling were assessed with a Visual Analog Scale (VAS) and an Anxiety Questionnaire consisting of seven questions. The mean VAS score for the entire study group was 17.3 ± 13.8 with no statistically significant differences between gender and different age groups. The mean anxiety score was 11.66 ± 4.17. This was significantly higher in women (P = 0.005), but there were no statistically significant differences between different age groups. There was a statistically significant correlation between VAS and total anxiety score (P < 0.001) as well as each question, except for questions number 3 and 4 in men. Patients were found to experience only limited pain during scaling. They were anxious because they expected pain, women being more anxious than men. Hence, dentists should seek to alleviate or reduce pain and anxiety related to treatment not only to successfully complete the treatment, but also to sustain and carry the patients into successful maintenance and patient recall.