Tooth loss, or edentulism, is a significant global health issue, particularly affecting the elderly. It has a profound impact on an individual's quality of life, affecting their nutrition, speech, and overall well-being. Despite a decline in recent years, edentulism remains a permanent and debilitating condition, with a high prevalence in certain regions. For instance, Latin America and the Caribbean have the highest rates, while countries like Bangladesh and Nepal have lower occurrences. Even in high-income countries, such as New Zealand, edentulism is a concern.
The preferred treatment for edentulous patients is removable complete dentures (RCDs). However, the successful adaptation of RCDs is a challenge for both patients and dental professionals. While initial fitting and fabrication receive much attention, the post-insertion phase is equally crucial for patient satisfaction and long-term success. Edentulous patients often have higher expectations about their denture treatment, which can lead to dissatisfaction if not managed properly.
Dental practitioners face the challenge of managing complete denture patients who frequently encounter difficulties with their prostheses. Adaptation to RCDs is critical, but many patients, especially the elderly, struggle to adapt physically or psychologically. This can result in post-insertion complaints, such as discomfort, pain, difficulty chewing, slurred speech, and aesthetic concerns.
It is essential for dental practitioners to provide detailed explanations about the limitations and possibilities of complete denture therapy. This includes fostering a positive patient-prosthodontist relationship and early identification of potential issues. Dentists should follow up with patients after delivering and fitting dentures, offering guidance and adjustments as needed.
This study explores the post-insertion challenges presented to dental practitioners at Makerere University Dental Hospital in Uganda. There is a lack of published literature on this topic, making this research crucial for understanding and improving the post-insertion care of edentulous patients in Uganda.
The study employed a qualitative method, using key informant interviews with dental practitioners. The participants included dental technologists and surgeons, who shared their experiences and insights. The study revealed several challenges faced by patients after receiving RCDs. These included difficulties with speech, eating, and saliva control, as well as issues with denture stability and pain caused by poorly polished dentures.
Poor oral hygiene was also a significant challenge, leading to potential infections and complications. Patients often felt disappointed with the appearance of their dentures, which affected their confidence and self-esteem. Some patients also struggled with the cost of RCDs and the alternative option of implants, which was even more expensive.
Dental practitioners provided various post-insertion advice to patients, including routine cleaning care and guidance on maintaining oral hygiene. They emphasized the importance of proper denture care to prevent tissue injuries and infections. Patients were also advised to persevere and continue wearing their dentures, assuring them that they would adapt and become comfortable over time.
The study's findings highlight the need for better education and guidance on oral hygiene practices, as well as thorough counseling and support for patients undergoing RCD treatment. Dental practitioners should focus on ensuring proper fitting and polishing of RCDs to minimize discomfort and pain.
In conclusion, this study identifies several post-insertion challenges faced by patients with RCDs, including speech difficulties, eating problems, and poor oral hygiene. Patients' confidence and self-esteem are impacted by their dissatisfaction with the appearance of their dentures. Denture instability is also a common issue. Integrated support for patients and dental practitioners is crucial to enhance the effectiveness of RCD therapy, improve stability and affordability, and provide guidance on denture cleaning and adaptation.
