As people live longer and retain their natural teeth, the dental profession faces new challenges. We hear why dentures could be the answer.
Although tooth retention may be higher as we age, 73% of people have one or more missing back teeth and 7.6% have one or more missing front teeth, the digitalisation of dentistry has raised the bar in the oral rehabilitation of edentulous and partially dentate patients.
Dental implants are now widely considered the gold standard for replacement. But there are always barriers to treatment. The patient perception of benefits versus price is a big consideration – particularly amid a cost-of-living crisis.
Socioeconomic inequalities can often mean the less financially able suffer the most tooth loss but often are those who rely on the affordability of dentures.
Others might wish to avoid more invasive surgery or prefer the removable nature of dentures, allowing them to follow less challenging cleaning protocols whilst reducing the number of follow-up appointments.
Better choice for patients
Flexibility and affordability, it seems, can trump aesthetics if it makes for a simpler life, accessibility to tooth replacement and a more straightforward oral care regime.
And, of course there are the clinical challenges that restrict patient suitability. Dentures can be a better choice for patients with poor bone density or those with medical conditions or medications that affect the healing process.
The Oral Health Foundation published the results of a study, conducted across 19 countries, that revealed an average of 19% of the population wear some form of denture. So, whilst we have seen fewer people experiencing tooth loss, there remains an onus on the profession to help these patients manage partial edentulism.
Another recent study also gives weight to the belief that dentures can have a negative impact on overall nutrition. The research study found that people with dentures had a significant decline in nutrition markers, whilst people who did not wear dentures did not experience this decline.
Loss of teeth and placement of dentures can have a significant emotional and psychological impact, especially if patients struggle to adapt to their wear, which means dentures can negatively impact overall wellbeing.
Irregular movement and separation of the denture from the mandible during eating also has potential for discomfort and tissue trauma.
What this has traditionally meant for dental professionals tasked with creating and fitting patients with dentures is a plethora of challenges.
However, manufacturers continue to innovate, improve and enhance the patient experience as the market develops and grows.
Pandemic’s legacy
So whilst there remains a cohort of patients for whom implant placement is not an option, it is important to respect choices and utilise the best practices and tools that help restrict any negative physical and psychological impact.
Ricky Price is a clinical dental technician working with his father, James, across their family-run clinics – Herne Bay Dentures and Dover Dentures. Qualified for eight years, he has seen a recent spike in the number of patients requiring dentures – the pandemic’s legacy continuing to deliver.
‘The year of 2020 was a terrible year. We had to shut for a lot of it, so patients were without access. The pandemic subsequently caused horrendous delays in appointments. By the time we could see patients again, some had grown scared of attendance, or were unable to get an appointment.
‘What we are now seeing is the result of this. Since 2021, we’ve been really busy. Dentists are catching up on examinations and we are now seeing patients who require extractions and need tooth replacement treatment.’
Mostly they receive referrals from local dentists in Kent – and it’s easy to underestimate the variety of patients who come through their doors. Each patient comes to dentures with a different story, perspective and their own unique challenges. Some, Ricky says, have hidden the fact that they wear prosthodontics.
Communication at the core
‘As well as older patients, we also manufacture dentures for younger people. These patients may have lost teeth due to eating disorders, neglected their oral hygiene during Covid-19, or lost teeth in a sports accident.
‘Some patients will disregard implant placement to avoid the quarterly routine maintenance and cleaning visits. Others don’t want surgery. But, whatever the circumstances, we always tailor our conversations to engage fully with every patient.
‘We must build good rapport to ascertain their needs and understand what is important to them. Without good communication, we cannot give them the service expected.’
He adds: ‘Some patients tell us that they have kept it a secret from loved ones that they wear dentures so whilst it’s important to ensure that their new teeth look as natural and are as comfortable as possible, it is also key that we give them the best advice for discreet and secure wear and allay fears of embarrassment.
‘We always adopt different approaches and strategies – from the 90-something patient without bone and unsuited to implant placement to somebody younger who cannot afford implants. They are all looking to replace teeth quickly in a way they can afford – denture fitting still has appeal so it is key we respect their choices and support them accordingly.’
And whilst it falls on the dental profession to remove any stigma for patients around denture wear, recommending the best products to ensure comfort and confidence is key to their endeavours.
Enormous boon
For Ricky, Fixodent has been an enormous boon for his patients.
‘I generally recommend Fixodent Professional due to the firm hold and antibacterial aspect. The adhesives have an anti-bacterial property, it helps keep them clean too by creating a food seal that helps prevent food particles from getting beneath the dentures and protects from gum irritation. The thin nozzle also makes for an accurate, mess-free application.’
Ricky adds: ‘Dentures have developed hugely in the last decade and the higher end are so natural looking. I have been recommending Fixodent since 2015 and it is great for patient confidence – especially for younger patients who generally don’t want people to know they wear them.
‘A good denture adhesive can make a huge difference by ensuring stability and boosting patient perception of fit and comfort. It helps retention, of course, but a lot of it is psychological, so patients feel more secure and can laugh without covering their smile.’
‘We always take the time to show patients how to use the fixative properly and get the seal. Giving patients that time is essential. We want patients to feel confident and enjoy the simplest things without self-consciousness. If they sometimes forget they are wearing dentures, then even better.’
For more information or to order samples, visit www.oralbprofessional.co.uk/s.
