Journal of Indian Association of Public Health Dentistry

ORIGINAL ARTICLE
Year
: 2019  |  Volume : 17  |  Issue : 1  |  Page : 54--57

Self-reported oral health and denture satisfaction in partially and completely edentulous patients


Kirti Raina, Bhuvan Deep Gupta, Rahul Gupta, Abhinav Sharma, Priyanka Kotia, Insha Nissar 
 Department of Public Health Dentistry, I.T.S Dental College, Greater Noida, Uttar Pradesh, India

Correspondence Address:
Dr. Kirti Raina
R/O - H. No-2, P/0 - Miran Sahib, Tehsil- R. S Pura, Jammu, Jammu and Kashmir
India

Abstract

Context: Edentulism is a handicap that affects the quality of life and nutrition. Tooth loss leads to functional impairment at the level of the orofacial system, significantly interfering with chewing, swallowing and speech, as well as to temporomandibular joint dysfunction, disorders of intermaxillary relation, and facial physiognomy. Aim: The aim of the study was to explore variables that influence self-reported oral health and denture satisfaction in partially and completely edentulous patients using oral health impact profile for edentulous (OHIP-EDENT). Materials and Methods: A hospital-based study was carried out on the patient's age ranged from 30 to 70 years in the dental college who had been treated with complete dentures and removable partial denture using convenience sampling method. Prevalidated questionnaire consisting of OHIP-EDENT was self-administered to all the study participants. The information about the appetite, perceived general and oral health, and satisfaction from the dentures was recorded using a 4-point Likert scale. Data were collected, entered, and analyzed using SPSS version 20.0. One-way ANOVA was performed to test for comparison between different denture groups. P < 0.05 shows statistically significant difference. Results: When the mean of denture satisfaction level was calculated between different denture group and different domains of OHIP-EDENT, there was no difference found in level of denture satisfaction between different denture groups, i.e., overall denture satisfaction mean in Group 1 was 2.18 ± 0.32, Group 2 has 2.23 ± 0.36, Group 3 has the mean of 2.18 ± 0.42, Group 4 has 2.23 ± 0.67, and P value was 0.810 which shows nonsignificant difference. Conclusion: The results of the present study suggest that the poor self-perceived satisfaction among denture wearers affect their quality of life.



How to cite this article:
Raina K, Gupta BD, Gupta R, Sharma A, Kotia P, Nissar I. Self-reported oral health and denture satisfaction in partially and completely edentulous patients.J Indian Assoc Public Health Dent 2019;17:54-57


How to cite this URL:
Raina K, Gupta BD, Gupta R, Sharma A, Kotia P, Nissar I. Self-reported oral health and denture satisfaction in partially and completely edentulous patients. J Indian Assoc Public Health Dent [serial online] 2019 [cited 2019 Apr 18 ];17:54-57
Available from: http://www.jiaphd.org/text.asp?2019/17/1/54/254338


Full Text

 Introduction



Oral health is a multidimensional concept that reflects the oral as well as general health status of an individual at any point in time. It is influenced by numerous factors, such as the existing pathology, experiencing dental problems, tooth loss, prosthesis wear,[1],[2] and age, as well as additional cultural, psychologic, social, educational, dietary, and financial considerations.[3]

Edentulism is a handicap that affects the quality of life and nutrition.[4] Tooth loss leads to functional impairment at the level of the orofacial system, significantly interfering with chewing, swallowing, and speech, as well as to temporomandibular joint dysfunction, disorders of intermaxillary relation, and facial physiognomy.[5],[6] In addition, a less attractive facial appearance, difficulty with speech, and avoidance of social contacts may result in psychosocial problems. Well-designed denture may improve the oral health of patients and consequently their quality of life.[7]

The complete dentures (CDs) replace the entire dentition and restore the functions of mastication, speech, and esthetics. This is the only option after the entire tooth or implant-supported options are exhausted. It is the most commonly used treatment after complete loss of dentition and its use is not going to decline in among population with limited economic resources.[8]

Removable prosthodontics treatment is associated with oral complaints such as speech, mastication, pain, and aesthetics. Oral complaints vary among removable partial denture (RPD) and CD wearers.[9] Pain due to an unsatisfactory denture sometimes causes insomnia and some negative changes in eating behaviors. The psychological effects of these problems are common in the elderly which affects their oral health and quality of life.[10]

Oral health-related quality of life (OHRQL) is a multidimensional construct that includes a subjective evaluation of the individual's oral health, functional well-being, emotional well-being, expectations and satisfaction with care, and sense of self. It has wide-reaching applications in the survey and clinical research. It is an integral part of general health and well-being. In fact, it is recognized by the WHO as an important segment of the Global Oral Health Program (2003).[11]

OHRQL measurement scales, such as the oral health impact profile (OHIP), have been developed based on perceived oral health problems and attempt to assess their impact on an individual's quality of life. The OHIP for edentulous (OHIP-EDENT) is an OHIP-49 adapted version indicated to use for OHRQL evaluation of the elderly or after replacing the missing teeth.[12] OHIP-EDENT subscales are functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap. Self-reported oral health and satisfaction with CDs may also be influenced by the nature of the dentition in the opposing arch.[13]

It has been suggested that the influence of the opposing dentition on self-reported oral health and satisfaction in patients with CDs is not completely understood and warrants further investigation.

The aim of the present study, therefore, was to explore a wide range of variables that might influence self-reported oral health and denture satisfaction in partially and completely edentulous patients and to know about the satisfaction of patients with dentures and various aspects of wearing dentures using OHIP-EDENT questionnaire.

 Materials and Methods



This hospital-based study was carried out on the patients who had been treated with CDs and RPDs at the Dental College in Delhi NCR from January 01, 2016 to January 31, 2016. Ethical clearance was obtained from the Institutional Review Board (ITSCDSR/L/2017/079/12-9-17) before starting the study. A pilot study was conducted on five patients to test the validity of Hindi translated version of prevalidated OHIP-EDENT questionnaire in which first forward translation was done followed by expert panel, back translation then pretesting, and cognitive interviewing and then final version was made.

The patients were selected by convenience sampling method who met the following criteria:

Inclusion criteria

Patients who received CD prostheses from the Department of Prosthodontics from January 01, 2016 to January 31, 2016, were included in the study.

Exclusion criteria

Patients with implant-supported CD prostheses. Patients with CD prostheses made elsewhere. The total of 150 patients was contacted by telephone, of which 80 respondents who were willing for the examination were given appointment, and clinical examination was conducted. The informed consent was obtained from all patients. On the appointed date, patients were examined clinically and they were given a prevalidated 19-item questionnaire consisting of OHIP-EDNT to be filled by them.

The questionnaire included questions regarding demographics, denture status, and appetite; avoiding food items as a consequence of wearing dentures, perceived general and oral health, satisfaction with dentures; and various aspects of wearing dentures using a 4-point Likert scale with the response categories never and seldom to always.

The study patients were classified into following groups: Group 1 – CD in both arches, Group 2 – Complete maxillary denture opposing natural teeth, Group 3 – Complete mandibular denture opposing natural teeth, Group 4 – Kennedy Class I-II-RPD, and Group 5 – Kennedy Class III–IV-RPD.

Data were entered in Excel sheet and SPSS version 20.0 (IBM Corp, Armonk, NY, USA) was used. One-way ANOVA was performed to make a comparison between different groups and P < 0.05 was considered as statistically significant.

 Results



When demographic distribution was seen, it was found that 48.75% of the study participants were >60 years of age, whereas only 12.5% were in the age group of 30–45 years and the gender-wise distribution of the study patients which showed that there were 76.2% males and 23.8% females in the study population.

The study population was also divided according to the denture status of an individual, and it was seen that 27.5% of them belonged to Group 1 (CD), whereas there was only 16.2% in Group 2 and Group 3 (Complete mandibular denture opposing natural teeth and Kennedy Class I–II-RPD, respectively) [Table 1].{Table 1}

When the mean was compared between all the groups, there was no statistically significant difference found in level of denture satisfaction between different denture groups, i.e., overall denture satisfaction mean in Group 1 was 2.18 ± 0.32, Group 2 has 2.23 ± 0.36, Group 3 has the mean of 2.18 ± 0.42, Group 4 has 2.23 ± 0.67, and P value was 0.810 [Table 2].{Table 2}

In functional limitation domain, 63% of the patients indicated that they had difficulty in chewing foods sometimes; in physical pain, 59% of patients experienced painful aching in the mouth for sometimes. In psychological discomfort, 45% of patients indicated being worried by dental problems often. In physical disability, 56% of patients indicated that they avoided eating some foods often because of problems with their dentures, in psychological disability, 44% of patients unable to eat often, in social disability, 31% of patients avoid going out often, and in handicap, 59% of patients unable to enjoy company and unsatisfied often.

 Discussion



In recent decades, and despite the attention paid by health professionals in promotion of oral health, efforts for the elderly population have been inadequate or nonexistent. It is, therefore, essential to understand their concepts, values, and levels of satisfaction regarding oral health so as to adapt interventions to how they experience them.[14] For most patients, the loss of all teeth represents, first of all, difficulty in chewing and eating.

The wearing of a new CD may be associated with some complaints, especially shortly after the insertion of the denture. The complaints may be lack of retention and stability, pain or discomfort, accumulation of food under the denture, altered speech, difficulty in chewing, unsatisfactory appearance, and wretching.[15]

In the present study, the questionnaire used was in accordance with Dervis[16] which contained all the necessary parameters related to functionality of dentures, possible occurrence of pain, and the psychological and social aspect of their use. The answers to these questions are a clear indication of how patients feel about their dentures. The obtained results clearly showed that patients were not satisfied with CD and partial denture.

In this study, males are highly unsatisfied than females regarding denture wearing, another study done by Pan et al. studied sex differences in denture satisfaction. They concluded that female patients were less satisfied which is in contrast to this study, this might be due to higher percentage of males in the study population as compared to females.[17]

When OHIP-EDENT was used to see the denture satisfaction, our results are in accordance with the study done by Shah et al. However, in their study, patients were less satisfied with mandibular denture, whereas in this study, patients were dissatisfied with both the dentures.[18]

In the present study, patients have more problems with CDs and RPDs, another study done by Celebić and Knezović-Zlatarić compared satisfaction between CD and Kennedy Class I RPD wearers. They concluded that CD and RPD wearers were mostly satisfied with their dentures which in contrast to our study, it might be due to the reason; the quality of denture given to the patients was not up to the mark. A further study can be conducted to elicit different reasons for such a low rate of denture satisfaction.[19]

Limitations

Convenient sampling method was taken in this study. Using stratified sampling method, more accurate results can be obtained and the bigger sample size would increase the efficacy and also the generalizability of the study.

 Conclusion



As we know that, the dentures are a favored treatment option for edentulous and partially edentulous patients and are commonly accepted as they provide a pleasing appearance and maintain normal speech, as well as supply occlusal support and adequate means for mastication, but the results of the present study showed that the poor self-perceived satisfaction among denture wearers affect their quality of life and there was no statistically significant difference found between different types of denture wearers. Dentists should provide good satisfactory denture to the patients so that they enjoy their good quality of life.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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