Different types of antagonists modify the outcome of complete denture renewal.

PURPOSE: The effect of renewing removable dentures on masticatory function was evaluated according to the occlusion offered by different types of mandibular arches. MATERIALS AND METHODS: Twenty-eight patients with complete maxillary dentures were subdivided into three groups in terms of mandibular dentition type: dentate, partial denture, and complete denture. The participants were observed before and 8 weeks after maxillary denture renewal. The mandibular denture was also renewed in the partial and complete denture groups. The participants masticated carrots, peanuts, and three model foods of different hardnesses. The particle size distribution of the boluses obtained from natural foods was characterized by the median particle size (d50) in relation to the masticatory normative indicator (MNI). Chewing time (CT), number of chewing cycles (CC), and chewing frequency (CF) were video recorded. A self-assessment questionnaire for oral health-related quality of life (Geriatric Oral Health Assessment Index [GOHAI]) was used. Statistical analyses were carried out with a mixed model. RESULTS: Renewal of the dentures decreased d50 (P < .001). The number of participants with d50 values above the MNI cutoff decreased from 12 to 2 after renewal. Renewal induced an increase in mean CF while chewing model foods (P < .001). With all foods, renewal tended to affect CT, CC, and CF differently among the three groups (statistically significant renewal Å~ group interactions). The GOHAI score increased significantly for all groups. CONCLUSIONS: Denture renewal improves masticatory function. The complete denture group benefited least from renewal; the dentate group benefited most. This study confirmed the usefulness of denture renewal for improving functions and oral health- related quality of life.

Quality of life measured by OHIP-14 and GOHAI in elderly people from Bialystok, north-east Poland.

BACKGROUND: The Oral Health Impact Profile-14 (OHIP-14) and the Geriatric/General Oral Health Assessment Index (GOHAI) have never been compared for a group of the same subjects in the Polish population. The aim of the study was to compare the OHIP-14 and GOHAI measures. METHODS: 178 independently living people over the age of 55 were included in the study. The GOHAI and OHIP-14 measures were used. Other variables included age, gender, self-ratings of oral general health, education, number of missing teeth, chewing problems and dry mouth. RESULTS: The mean age of respondents was 70.8 years. The internal reliability (Cronbach's alpha) showed a high internal consistency for both measures. Spearman's rank correlation coefficient between the GOHAI and OHIP-14 scores was 0.81. Using the additive method of creating scores, 1.1% of respondents had the GOHAI score of zero, indicating no impact from oral conditions, while 13.5% of them had an OHIP-14 score of zero. Dental status, partial dentures, chewing problems, dry mouth and self-rated oral health were significantly associated with the results of the GOHAI and the OHIP-14 (Kruskal-Wallis test, Mann-Whitney U test). The numbers of preserved and missing teeth significantly correlated with the GOHAI and the OHIP-14, while DMF was significantly associated with the GOHAI only. 6 individuals with discrepant results were revealed. After the exclusion of the abovementioned patients, the internal reliability (Cronbach's alpha) still showed a high internal consistency, and the correlation between the GOHAI and OHIP-14 scores using Spearman's rank-correlation coefficient increased to 0.87. This phenomenon was identified as a "fatigue effect". CONCLUSIONS: There was a strong correlation between the GOHAI and the OHIP-14. Both instruments demonstrated good discriminant properties and helped capture the respondents' oral health problems. The questionnaires should be randomly distributed to avoid the influence of "fatigue effect" on the results of a comparison of different measures.

Psychometric Properties of the Oral Health Impact Profile and New Methodological Approach.

OBJECTIVE: Evaluate the validity, reliability, and factorial invariance of the complete Portuguese version of the Oral Health Impact Profile (OHIP) and its short version (OHIP-14). METHODS: A total of 1,162 adults enrolled in the Faculty of Dentistry of Araraquara/UNESP participated in the study; 73.1% were women; and the mean age was 40.7 ± 16.3 yr. We conducted a confirmatory factor analysis, where χ(2)/df, comparative fit index, goodness of fit index, and root mean square error of approximation were used as indices of goodness of fit. The convergent validity was judged from the average variance extracted and the composite reliability, and the internal consistency was estimated by Cronbach standardized alpha. The stability of the models was evaluated by multigroup analysis in independent samples (test and validation) and between users and nonusers of dental prosthesis. RESULTS: We found best-fitting models for the OHIP-14 and among dental prosthesis users. The convergent validity was below adequate values for the factors "functional limitation" and "physical pain" for the complete version and for the factors "functional limitation" and "psychological discomfort" for the OHIP-14. Values of composite reliability and internal consistency were below adequate in the OHIP-14 for the factors "functional limitation" and "psychological discomfort." We detected strong invariance between test and validation samples of the full version and weak invariance for OHIP-14. The models for users and nonusers of dental prosthesis were not invariant for both versions. CONCLUSION: The reduced version of the OHIP was parsimonious, reliable, and valid to capture the construct "impact of oral health on quality of life," which was more pronounced in prosthesis users.

Development of a Maltese version of oral health-associated questionnaires: OHIP-14, GOHAI, and the Denture Satisfaction Questionnaire.

PURPOSE: To show the reliability of the Maltese translations of OHIP-14, GOHAI, and the Denture Satisfaction Questionnaire, define the reliability of the responses, and determine the correlation between OHIP-14 and GOHAI. MATERIALS AND METHODS: The items of the three questionnaires (OHIP-14, GOHAI, and Denture Satisfaction) were translated into Maltese and back into English to compare with the original version. Specific sampling of a population well versed in Maltese and English was carried out to obtain a sample of respondents for each questionnaire. Data were gathered through self-administered questionnaires: first administering the Maltese version and following with the English version 1 week later. RESULTS: Participation rates were high (98%). Cronbach's alpha for all three questionnaires was high (> 0.7), indicating satisfactory test-retest reliability of the instruments. Similarly, the Spearman correlation coefficients for both the English and Maltese versions of OHIP-14 and GOHAI were good (> 0.6). CONCLUSION: The Maltese versions of OHIP-14, GOHAI, and the Denture Satisfaction Questionnaire can be safely used as a valid alternative to the English versions in studies of patients who are limited in linguistic proficiency.

Oral health-related quality of life and periodontal and dental health status in Iranian hemodialysis patients.

AIM: The aim of this study was to evaluate oral health status and oral health related quality of life (OHRQoL) in Iranian patients undergoing hemodialysis. MATERIALS AND METHODS: In this cross-sectional study 145 (95 dentate and 50 edentulous) patients undergoing hemodialysis participated. Demographic information, laboratory findings and dental health status was recorded by a standard form. Oral hygiene status was obtained by simplifed oral hygiene index (OHI-S) and oral health was evaluated by decay missing flling teeth (DMFT) index, plaque index (PLI) and periodontal disease index. Oral health related quality of life was determined by means of short form oral health impact profle (OHIP-14) and general oral health assessment index (GOHAI). RESULTS: The mean (± SD) DMFT, PLI and PDI were 15.47 ± 7.85, 2.03 ± 0.95, 4.09 ± 1.31 respectively. OHI-S was good in 7 (7.4%), fair 25 (26.6%) and poor in 38 (26.6%) of patients. The mean OHIP-14 and GOHAI scores were 31.32 ± 12.53 and 29.07 ± 8.5 respectively. The self-perceived oral health of 58 (40%) was good, 49(33.8%) was fair and 38 (26.2%) was poor. Patients with higher scores for the questionnaires had significantly worst self-rated oral health. Besides, there was a significant positive correlation between dental and periodontal variables with OHIP-14 and GOHAI scores. CONCLUSION: Hemodialysis patients had a poor oral hygiene and periodontal status, weak attitudes and negligence toward oral health but they were satisfed of their oral health condition and their OHRQoL was approximately good. Therefor it should be communications between nephrologists and oral health care professionals for promoting the oral health status of the patients. CLINICAL SIGNIFICANCE: The findings high light the need of comprehensive oral examinations including periodontal therapy, restorative treatment, preventive dental treatment and follow-up care in the hemodialysis patients.

A survey of patients' preferences for the treatment of teeth with apical periodontitis.

INTRODUCTION: This research aimed to investigate the preference of patients in Toronto, Canada for management of a tooth affected by painful apical periodontitis when considering its retention via root canal treatment (RCT) and its extraction followed by no replacement, replacement with an implant-supported crown, fixed, or removable partial prostheses. METHODS: Data were collected through a mail-out survey of the University of Toronto Faculty of Dentistry patients, which was complemented by a convenience sample of patients in 10 community practices in Toronto (n = 1000, response rate = 43%). Participants were asked to select their general preference for anterior and posterior teeth with apical periodontitis between saving the tooth or extraction and their specific preference for tooth retention via RCT or extraction. By using bivariate and logistic regression analyses, we applied the Gelberg-Andersen Behavioral Model for Vulnerable Populations to the preference questions to understand the influential factors (P ≤ .05). RESULTS: Participants' specific preference for tooth retention via RCT was slightly but significantly lower than their general preference (anterior tooth, 93.7% versus 97.2%; posterior tooth, 83.8% versus 89.6%; P < .005). Higher annual income, previous RCT, functional dentition, good/excellent self-rated oral health, and regular dental visits were associated with higher preferences for tooth retention in response to different questions. CONCLUSIONS: The high preference for retaining a tooth in general was moderated by the specific consideration of RCT to retain the tooth. When RCT and extraction are viable options, patients should be advised about the treatment options in an impartial manner and encouraged to communicate their preferences.

Impact of various screwed implant prostheses on oral health-related quality of life as measured with the QoLIP-10 and OHIP-14 scales: a cross-sectional study.

OBJECTIVES: This study aimed to validate the Quality of Life with Implant-Prostheses (QoLIP-10) questionnaire for assessing the impact of screwed implant-supported rehabilitations on oral health-related quality of life (OHRQoL). METHODS: 131 patients wearing screw-retained implant restorations were assigned to the following groups: Group 1 (HP; n=50): fixed-detachable hybrid prostheses (control), Group 2 (S-PD; n=43): metal-ceramic screwed partial dentures, and Group 3 (S-CD; n=38): metal-ceramic screwed complete dentures. Impacts on OHRQoL were evaluated using the QoLIP-10 and Oral Health Impact Profile (OHIP-14sp) scales. Data on global oral satisfaction, socio-demographics, health-behaviours, and prosthetics were gathered. Reliability and validity of the QoLIP-10 were investigated for screwed prosthesis wearers. The Spearman's rank test was applied to determine the correlation between both indices. Descriptive and non-parametric probes were run to evaluate the influence of the study variables on OHRQoL. RESULTS: The QoLIP-10 confirmed its psychometric capacity for screwed prosthesis wearers. Both tests were inversely correlated. HP wearers reported the worst dental-facial aesthetics, performance, and functional limitation outcomes. Gender, education level, complaints about the mouth, perception of treatment needs, and prosthetic status modulated the OHRQoL. CONCLUSIONS: Screwed implants restorations provide better OHRQoL than do fixed-detachable hybrid prostheses.

A new, short, specific questionnaire (QoLIP-10) for evaluating the oral health-related quality of life of implant-retained overdenture and hybrid prosthesis wearers.

OBJECTIVES: This study aimed to validate a new questionnaire for assessing the oral health-related quality of life (OHRQoL) of implant-prosthesis wearers. METHODS: A group of specialists designed the 10-item scale: 'Quality of Life with Implant-Prostheses' (QoLIP-10). After completing a pilot trial, 150 subjects wearing implant-prostheses or complete dentures who were not requesting dental treatment participated in the main investigation. They were divided into three groups (n=50 each) depending on the type of dental restoration. Group 1 (CD): complete denture wearers (control); Group 2 (IO): implant-retained overdenture wearers and Group 3 (HP): subjects with fixed implant hybrid prostheses. Participants answered the QoLIP-10 and the Oral Health Impact Profile (OHIP-20sp) questionnaires. Information on global oral satisfaction, socio-demographic, health-behavioural, clinical and prosthetic-related data were gathered. The psychometric characteristics of the QoLIP-10 were investigated. The Spearman's rank correlation test was used to determine the association between the total scores of the QoLIP-10 and OHIP-20sp. Descriptive and non-parametric probes were run to evaluate the impact scores obtained depending on the study variables. RESULTS: The QoLIP-10 scale is reliable and valid. The factor analysis confirmed the existence of three dimensions and meaningful inter-correlations among the 10 items. HP wearers demonstrated better biopsychosocial QoL, as indicated by their answers to Item 1 (oral pain) and Item 3 (chewing difficulty). CONCLUSIONS: The QoLIP-10 index confirmed its psychometric capacity for assessing the OHRQoL of implant overdenture and hybrid prosthesis wearers. Overall, the participants were satisfied with their mouth and implant-restorations. CLINICAL SIGNIFICANCE: The QoLIP-10 may be recommended for determining the influence of implant-retained overdentures and hybrid prostheses on the well-being of future patients. Hybrid prostheses are the most predictable treatment option for improving patient satisfaction in terms of oral pain and chewing functionality when compared to implant overdentures and complete dentures.

Denture wearer's perception of ambient care. Part 2. Analyses of data.

OBJECTIVE: The aim was to investigate to what extent denture wearers were satisfied with the ambient care (care) received. MATERIALS AND METHODS: A study sample of 117 completely edentulous and 56 partially edentulous patients, who had received their dentures in the period 1997-2005 at Bergen School of Dentistry, completed a questionnaire containing eight specific items regarding different aspects of care, each with two positive (a and b) and two negative (c and d) categories, and four global items. The care items, including confidence in the dental team, information, waiting time and cost, constitute the Ambient Care Scale; the global items were concerned with overall care, satisfaction with dentures, self-reported oral and general health. RESULTS: Between 91-100% of Ambient Care Scale responses were in the two positive categories. The completely edentulous group was significantly more satisfied than the partially edentulous group regarding several Ambient Care Scale items and oral health. Also, ratios between categories b and a showed systematic higher degrees of satisfaction for the completely edentulous group than the partially edentulous group. Fifty-six per cent in the completely edentulous group and 36% in the partially edentulous group were very satisfied, i.e. with ≥ 6 of 8 possible responses in category a. Analysis of the very satisfied showed that the highest degrees of satisfaction for both groups were found regarding students and staff, the lowest regarding cost and waiting times. CONCLUSIONS: Patient satisfaction with care was very high. Completely edentulous patients were systematically more satisfied than partially edentulous ones.

Oral complaints of denture-wearing elderly people living in two nursing homes in Istanbul, Turkey.

AIM: The aim of this study was to observe and determine oral complaints of people aged 55 years or older, living in two nursing homes in Istanbul, Turkey, and their satisfaction with their complete or partial dentures by means of a simple questionnaire. METHODS: Two old people's homes (one public and one private) in the district of Uskudar in Istanbul agreed to take part in this study. All residents who were available were invited to answer a piloted nine-point questionnaire with questions on age, gender, physical problems, eating, and communication, aesthetic denture wearing and psychological problems. The questions were asked in person by one investigator. The resulting data were entered into SPSS version 15. RESULTS: Out of a total of 210 residents, 130 (61.9%) took part in the study, of whom 53% (n=71) of residents were living in the private nursing home and 60% (n=81) were female. One hundred and five (80%) were denture wearers. More than half of the residents (59%, n=79) were over 75 years old. Problems were mostly seen in older ages, especially those over 75 years old, over 60% of whom reported problems for all the variables listed in the questionnaire. Women were more aware of halitosis than men. CONCLUSIONS: The results of this study confirm those of previous studies and suggest that elderly people with dentures, and particularly complete dentures, frequently complain of a wide range of problems including: eating, social interaction and communication and these problems have a detrimental influence on their quality of life.

Response shift in oral health-related quality of life measurement in patients with partial edentulism.

The purposes of this study were to determine whether a response shift was observable after partial denture treatment and to identify the predictors that influenced the response shift magnitude and direction. A total of 173 consecutive patients with no more than eight missing teeth who received implant-supported, fixed or removable partial dentures at Okayama University Dental Hospital were asked to complete a full-version Oral Health-Related Quality of Life (OHRQoL) questionnaire before (pre-test) and after treatment (post-test). Additionally, a short form (then-test) consisting of seven questions selected from the full version had its reliability verified and was utilised to retrospectively assess the pre-treatment OHRQoL status. The difference between the summary scores of the then-test and the pre-test determined the response shift magnitude and direction. The then-test mean score (22·9 ± 6·6) was significantly lower (worse OHRQoL) than that of the pre-test (26·4 ± 5·2). The response shift effect size was of moderate magnitude and negative direction (d = -0·78). A multiple regression analysis showed that age (younger patients) (P < 0·01), number of replaced teeth (fewer) (P < 0·01) and pre-test scores (lower) (P < 0·01) were the significant predictors for response shift. In conclusion, a response shift phenomenon with negative and moderate effect size was observed after partial denture treatment. The significant predictor variables were young age, fewer numbers of replaced teeth and lower pre-test scores.

Factors explaining desire for dental implant therapy: analysis of the results from a longitudinal study.

PURPOSE: The aim of this research was to investigate possible factors behind the desire for and changes in attitude toward implant treatment in a population of middle-aged and older individuals in Sweden. MATERIALS AND METHODS: In 1989 and 1999, questionnaires were sent to 3,000 residents in Orebro County, Sweden. Response rates were 79% and 68%, respectively. Those responding to both questionnaires yielded a longitudinal study panel. Logistic regression models were done with "desire of implant treatment" and "changes in desire of implant treatment" as dependent variables. RESULTS: Older people, non-city residents, and those with one or several missing and unreplaced teeth changed their desire for implant treatment between study years. Effects of age, residence, and better dental status disappeared during the 10-year study period. Those who were edentulous and those with removable dentures (pseudo R2: 0.17) expressed lower desire for treatment than those with all teeth remaining or only one or a few teeth missing (pseudo R2: 0.24) in 1989. High income significantly increased the probability to desire implant treatment for the study panel at both study occasions (P = .016 and P = .034 for 1989 and 1999, respectively). CONCLUSIONS: Factors influencing desire for implant treatment were primarily income and dental status. The influence of young age, urban living, and dental status regarding the subgroup with one or several teeth missing in relation to those with all their teeth disappeared during the 10-year study period.

Is the shortened dental arch an underused treatment strategy in the Republic of Ireland?

OBJECTIVES: To determine the proportion of Republic of Ireland 35-44 and 65+ year-olds currently satisfying the criteria for a classic shortened dental arch (SDA) of 20 anterior teeth. RESEARCH DESIGN: Secondary analysis of data collected in the 2000/02 epidemiological survey of the oral health of Irish adults. CLINICAL SETTING: Participants underwent a clinical oral examination in health board dental clinics and completed a detailed interview pertaining to dental and general health. PARTICIPANTS: The analysis is based on a random sample of adults, aged 35 to 44 years (n = 978), and 65 years and older (n = 714). MAIN OUTCOME MEASURES: The SDA was measured as 20 teeth in the mouth in the positions normally described as from the left second premolar to the right second premolar in each arch. RESULTS: Only one of the 35-44 year-olds and none of the 65+ year-olds had teeth in their mouths in positions normally described as a classic SDA. However, of the 35-44 year old age group only five patients who had at least a premolar dentition of 20 contiguous teeth had been provided with a removable denture compared to one patient from the 65+ years group. CONCLUSIONS: Very few older patients in the Republic of Ireland have a SDA based on the measure used. However, very few have been provided with removable dentures where they already possess at least a premolar dentition of 20 contiguous teeth. Suggested reasons for this may include limitations of the data recorded, patient preferences and economic factors.

Fears and concerns of individuals contemplating esthetic restorative dentistry.

Questionnaires that focus on the fear of dental treatment typically include a narrow list of previous treatment-related factors. By omitting items concerned with psychologic, emotional, and interpersonal traits that impact treatment, practitioners often fail to gain additional valuable information on related anxiety issues. This study was undertaken to identify previously unrecognized or poorly discussed sources of fear and anxiety in patients seeking esthetic dental treatment. The Esthetic Clinic at Tufts University School of Dental Medicine recruited 62 participants who were asked to score their level of anxieties and concerns based on 24 different items on a 0 to 5 Likert scale. In addition, age, gender, and type of procedure in consideration were the only other variables recorded. The item that elicited the highest level of anxiety was "not feeling happy with my new smile." Thirty-eight respondents (61.3%) said they feel "markedly anxious"or "severely anxious" or answered "avoid completely." Concerns "that the outcome might look false and unnatural" or "that the dentist might not redo it if I am not satisfied with the outcome" both received 37 out of 62 (59.7%) similar responses. These results suggest obstacles to treatment exist not only in areas typically investigated but also in factors rarely discussed during the patient-practitioner encounter. The practitioner needs to consider a broader range of issues when addressing the patient's concerns.

Subjective values of different treatments for missing molars in older Japanese.

The purpose of this study was to determine how elderly Japanese people subjectively value treatment options for missing molars. Subjects were 528 independently community-dwelling elderly people. They were presented with photographs and descriptions of the process and expected outcomes of five possible treatment options: cantilever fixed dental prosthesis (FDP); resin or metal removable partial denture prosthesis (RPDP); implant-supported fixed prosthesis; and no replacement (shortened dental arch: SDA) for missing lower bilateral first and second molars. The participants filled in the questionnaire on subjective importance for treatment and indicated on a visual analogue scale how they valued the treatment (utility value: UV). Values were analysed by Mann-Whitney U-tests and multiple logistic regression analyses. Overall, the UVs for the FDP and the metal RPDP were the highest, and the UV for the SDA was the lowest. With respect to subjective importance, 'chewing ability' and 'no pain during function' were significantly selected more frequently. Multiple logistic regression analyses showed that the UV for the resin RPDP had significant positive associations with denture wearers and low treatment cost, whereas the implant had significant negative associations with denture wearers and older age. The SDA had significant positive associations with men and low treatment cost and a negative association with appearance. In conclusion, these elderly Japanese preferred cantilever FDPs and metal RPDPs to implants and 'no replacement.' It suggests that the SDA as an oral health goal can be questionable from the patients' point of view, even if it is biologically correct.

Discriminant analysis of patients' reasons for choosing or refusing treatments for partial edentulism.

The aim of the study was to explore partially edentulous patients' reasons for choosing or refusing prosthodontic treatment with removable partial dentures (RPD), fixed partial dentures (FPD) and implant partial dentures (IPD). Clinical and oral health-related quality of life measures were collected from 165 partially edentulous patients undergoing treatment. Patients' preferences were recorded and reasons for choosing or refusing treatments were measured with 32 questions using a five-point Likert scale. Descriptive statistics, chi-square and multiple logistic regression were used to compare patients' preferences according to clinical variables. Discriminant analysis was used to examine the impact of each reason for a patient's decision to choose or refuse treatment options. Results showed that older patients (P < 0.001) and with greater oral-related quality of life impacts (P < 0.05) were more likely to choose RPD. IPD were preferred by patients with higher education levels (P < 0.01). Discriminant functions revealed that the desire to have a fixed or removable denture had great impact on preferences. Removal of tooth structure was the main reason for refusing FPD and financial cost had a great impact on refusing IPD. Overall agreement between observed patients' decisions and those predicted by the discriminant function was >90% for all treatments. Reasons vary greatly among patients, and the role of individual perception of potential reasons for treatment selection was the most important determinants of patients' decisions. The main reasons for choosing or refusing treatments focused in this study can be used to guide shared decision-making, providing treatments that better match patients' expectations and desires.

Japanese version of the Oral Health Impact Profile (OHIP-J).

The objective of the study was to develop a Japanese version of the Oral Health Impact Profile (OHIP). The original 49 items were translated using a forward-backward method following accepted cultural adaptation guidelines. A de novo development of Japanese items was conducted to establish content validity. The associations between the OHIP summary score and self-reported oral health (n = 220) and self-reported denture quality (n = 155) were investigated for construct validity. The association between the OHIP summary score and six oral conditions (n = 227) were also tested. The responsiveness of the instrument was established by comparing the score before and after using newly fabricated removable partial dentures (n = 30). The test-retest reliability (n = 37) and internal consistency (n = 251) were also calculated. After the de novo development, five new items were added to the OHIP. The priori hypothesized associations between the OHIP score and oral health conditions were confirmed (P < 0.001). The change in the OHIP scores from 63.6 to 40.6 (P < 0.001) supports the responsiveness of the instrument. Intra-class correlation coefficients of 0.81 and Cronbach's alpha of 0.98 indicate high test-retest reliability and internal consistency of the instrument's summary score. Sufficient discriminative and evaluative psychometric properties of the currently developed Japanese version of the OHIP in typical target populations make the instrument suitable for assessing the oral health-related quality of life in cross-sectional as well as longitudinal studies.

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.

General well-being as an important co-factor of self-assessment of dental appearance.

PURPOSE: This study aimed to correlate the general well-being of patients and their judgment about their dental appearance. MATERIALS AND METHODS: Based on internationally accepted guidelines regarding dental esthetics, a questionnaire was developed to measure subjective assessments of dental appearance. Fourteen items defined an esthetic sum score (0 = satisfied; 56 = dissatisfied). Further, general well-being was evaluated with a long-established and highly reliable test. Eighty participants were included (47 women, 33 men). Participants were.drawn from 4 different groups (n = 20): natural dentition (group N), fixed partial dentures (group F), removable partial dentures (group R), and patients who had an esthetic problem with their teeth (group P). RESULTS: Seventy-five participants showed a normal well-being. Five participants showed a depressive state and formed a new group (group D). The medians of the sum scores (25th, 75th percentile) were: group N: 12 (10, 14); group F: 14 (8, 29); group R: 14 (9, 27); group P: 23 (18, 35); group D: 30 (26, 35). Significant differences were found between groups N and P, as well as between group D and groups N, F, and R. CONCLUSION: Because of the significant difference between groups N and P, basis validation of the sum score was achieved. Further, self-assessments of dental appearance appeared to be more negative for participants with a depressive state compared with the other groups. In clinical studies, selection bias can be prevented by using a test that measures well-being to verify if a study sample includes a normal number of depressive subjects and therefore represents the general population.

Patients' experiences with partial dentures: a qualitative study.

OBJECTIVE: The aim of the study was to gain insight into people's experiences of being given and using partial dentures. METHODS: In-depth semi-structured interviews were carried out with 23 people of varied age, social background and denture wearing experience in Tayside, Scotland. Participants were encouraged to discuss how they came to have partial dentures, their day-to-day denture use and their interactions with dentists. The interview data were systematically coded using key theme headings, and summary charts were constructed to facilitate analysis. RESULTS: The initial decision that a partial denture was needed was generally difficult to accept. People perceived the main benefits of partial dentures to be improved appearance and confidence, but experienced a variety of difficulties with their dentures and often coped with these by only wearing them on social occasions. Participants had not always told their dentists about the difficulties they experienced. Barriers to seeking help with denture problems included financial constraints, previous experience of rushed appointments or poor communication from dentists and a perceived lack of entitlement to help when partial dentures were issued free. CONCLUSIONS: Partial dentures can be difficult to cope with. People experience a range of difficulties in wearing them, not all of which have been discussed with dentists. Informative and supportive communication when partial dentures are first needed, and subsequently, can improve the quality of patients' experiences and may help promote effective use and appropriate help-seeking by partial denture wearers.