This qualitative study aimed to develop from the patient perspective in-depth understanding of the meaning and significance of tooth loss and denture wearing; how these impacted different aspects of people’s lives and sense of self; and what patients valued in terms of ‘good’ dentures.
Method:
The study was nested within a Randomised Controlled Trial comparing two impression materials for complete dentures. It comprised in-depth interviews with a purposive sample of 21 patients at two time points: following impression taking and prior to habituation of the constructed dentures; and at final assessment and trial confirmation. Patients were selected to reflect dimensions of interest with regard to experience of tooth loss and expectations of treatment based on age, gender and socio-economic circumstances. Interviews were audio-recorded and fully transcribed. A grounded theory analytic approach was employed, combining simultaneous data collection and analysis, constant comparison and search for negative cases.
Result:
Participants, in their socio-economic characteristics, mirrored the national UK profile of the edentulous population. Most were edentate for 40 years or more, encapsulating in their lived experience of tooth loss and denture wearing the inequalities in oral health status carried through life and into older age. Participation in the trial occurred at a stage in their denture wearing trajectory when they experienced considerable difficulty in getting dentures that fit and were comfortable to wear; and they had been referred by general dentists as complicated and problematic patients. Denture wearing involved distress, pain and discomfort with existing dentures, with impact on functionality, appearance and sense of self.
Conclusion:
Patients’ assessment of preference and outcomes of the new dentures was shaped by prior experience and expectations. While dimensions of oral functionality were valued, equally significant was how functionality facilitated social participation and communication; the importance of appearance was also emphasised, including for older people.