Losing Teeth—the Emotional Aspect—what happens emotionally
I just ran across this article from the British Journal (Jan. 1998). They found that these people exhibited:
1) Bereavement—the feeling of loss was often as severe as the feeling of losing a spouse or child!
2) Lowered self esteem—many people felt lower personal value as they had “gone down the socio-economic scale”!
3) Altered self confidence—this was most dramatic in people losing all the teeth or getting partial or full dentures. The loss of self confidence was evenmore pronounced one to years after.
4) Inability to discuss this “taboo” subject—This goes across the back drop of lower self esteem and fear of social situations.
5) Behaving in way that keeps the tooth loss secret—many reported holing their hand over their mouth or changing the way they smile. Some reported even refusing to smile in public.
6) Altered behavior in socializing and close relationships—again, changing their ability to smile. Not eating in public was found in many people as they reported fear of food getting between the teeth, or even worse having false teeth come lose while eating or speaking.
7) Premature aging—this feeling that they had aged “before their time” was common in the group, and was greater as the number of teeth was larger.
Wow! Losing teeth is more than the cost of extractions and replacement. Dentistry has so many ways to replace missing. Dental bridges, dental crowns, dental implants, partial dentures, and even full dentures can replace missing teeth. The advances in dental implants especially can permanently correct the tooth loss problem.
A Gorgeous Smile—What we Have and What we Want- Perception of Beauty Personal Perception vs. Desire Missing Teeth and Smile
What are the personal factors for beauty vs. the person’s perception of their “reality?” In a Nobel Biocare Quantitative Survey in Aug. 2008 of over 54,000 individuals they found the following:
Feel it is Important Are Satisfies with Own
Smile 89% 74%
Hair 78% 75%
Eyes 67% 86%
Physique 58% 47%
The biggest gap was with dissatisfaction with the smile. Question is then, with all of the advances in cosmetic dentistry, would someone settle for this gap?
See our sections on cosmetic dentistry, smile makeovers, and especially the patient smile gallery. There are now so many options with porcelain veneers, dental implants, bonding, tooth whitening, and even cosmetic dentures!
Here’s a question I’ve been asked form a patient from Wheaton looking for a sedation—“What is dental conscious sedation?” Valid question as the 2 words seem to be contradictory as if you are sedated how you could be conscious!
The dictionary defines sedation as the “reduction of anxiety, stress, irritability, or excitement by administration of a sedative agent or drug.” It does not specify the degree of reduction. In the dental setting there are a number of levels provided by the sedation dentist . Light sedation can be achieved with nitrous oxide gas (Laughing gas), or oral conscious sedation. For more information of the different levels see our blog site on sedation dentistry, or dedicated website on conscious sedation.
But why do we say conscious sedation? Done properly with conscious sedation, the patient may not be aware of what is going on in the dental office, but the patient is still able to respond to verbal commands such as to “open their mouth.” Most important, they are completely comfortable and have no memory of their dental visit (just what they were hoping for!). Done improperly they can remain alert and remember everything.
This can often be accomplished with oral conscious sedation. However very often the level of dental sedation is not predicable with oral sedation. Most states prevent the dentist from giving incremental doses of medication without the dentist having their IV sedation license. Because oral sedation medications require 30 to 60 minutes to take effect, the scheduled procedure is not often able to be completed if additional oral sedation medication is needed for patient comfort. IV medications require just minutes to take effect and patient comfort and can be adjusted maintained throughout the distist visit.
So what is the conclusion? If sedation is simply by “a reduction of anxiety…” most drug regiments will satisfy the definition. My experience is the “Patient’s definition” of sedation is that they are completely comfortable and amnesic (no memory) of the dental procedure. This can sometimes be accomplished with nitrous oxide sedation or dental oral sedation, but is much more predicable with IV dental sedation. Also, some patients want different levels of sedation depending on the procedures–for exmaple nitrous may be sufficient for one hour tooth whitening, but they want IV sedation for more difficult procedures like dental implants.
Dr. Thomas Gibbs is a dentist in Glen Ellyn, also serving the towns of Wheaton, Lombard, Naperville, Glendale Heights, Carol Stream, Lisle and the Chicago area. His office concentrates on cosmetic dentistry, dental implants, and restorative dentistry. He additionally is one of the few dentists in DuPage County and Cook County that is licensed and certified for sedation dentistry, (oral sedation and IV dental sedation).
Many of the blogs in this will cover topics on dental implant, cosmetic dentist blogs, dental health and systemic health, dental sedation, high fear dental patients, gagging dental patients, and providing care to high fear individuals searching for the best and most comfortable dentistry.
So how does it feel to have dentures. We had a lady form Carol Stream, working in Warrenville, in the position of losing all her remaining top teeth. She had many dental crowns and dental bridges some of which had failed over time.
What she hated was the prospect of having plastic on the roof of her mouth and not being able to taste food. She was equally concerned about continuing to lose bone as the teeth were lost, and wrinkles developing on her face.
Some of these problems can be particularly more common in women, who have softer bone in general than men (especially post-menopausal). All on four and Teeth in a Day were not an option due to the amount of bone and softness of the bone. She elected to have to full option of the implant supported bridge. Due to the softer bone it required 7 implants.
And what did she look forward to having when the case was completed? Bagels! We bought her a dozen at the completion of the case.
If you would like more information on dental implant alternatives to dentures, give our office a call at 630-858-8800. You may also go to our dental implant website and request additional Free Reports and LiveWithoutDentures.com
I.V. sedation is the most advanced sedative technique for the comprehensive control of pain and anxiety in dentistry. In this technique, drugs that produce the sedative effect are placed into an I.V. line, which is placed into a vein. Less than 2% of general dentist in Illinois have the special training, permit, and licensing issued by the Board of Dental Examiners to perform this advanced sedative technique.
Intraveneous IV sedation produces a profound state of relaxation. Dr. Gibbs is not only able to carefully control the amount of sedation required, but adjust the level quickly to make certain the patient is always comfortable. In most cases, amnesia is profound–patients typically will not remember the procedures performed. The intravenous sedation method is superior pain control.
With the technique that Dr. Gibbs uses most frequently, an oral pill is first used to relax the patient prior to giving the IV medication. This way the patient is completely relaxed before the IV is started. This is particularly good when the patient is needle phobic, as there often little memory of the IV being started.
Most states (Illinois included) do not allow dentists without to titrate, or adjust, the amount of medication orally to ascertain patient comfort. Because so few dentists are licensed to perform this level of sedation and comfort, we do have to limit the number of procedures we are able to perform each week. It is a common occurrence to have patients drive over 100 miles for IV sedation procedures. For truly apprehensive patients, we would encourage you to verify the level of comfort that your dentist “promises” to deliver!
P.S.–Why is this post in a website usually devoted to dental implants? Because the very high fear group typically does have greater restorative needs. It also allows Dr. Gibbs to do surgical procedures comfortably, and be far more experienced in complex dental restorations! (Be especially wary of those who offer sedation pill dentistry without the IV “‘what-if” mode).
Here’s a case that shows how dental implants can eliminate the need for a partial denture, and even replace a failed dental bridge. One of the big problems with a conventional dental bridge is if any of the teeth fail either with new decay of gum disease, the entire bridge needs to be replaced.
With a partial denture, there are not only the unsightly metal clasps and the bulk of the metal structure in the mouth, but there is the prospect that the teeth being clasped will be further compromised and lost over time.
So what is it like to have a dental implant placed? This short video shows a man from Wheaton describing how it was to have the implant surgically placed, ant the subsequent crown placed.
Many patients have asked about heavily marketed dental implant options such as Teeth-in-an Hour, All-on-Four, or Teeth-in-a- Day. This a procedure where a person with a denture is able to have four dental implants placed and walk away wearing an implant retained denture replacement. Dr. Gibbs recently attended an update seminar on these concepts, so let me share my assessment:
1) Most marketing efforts on these concepts show a person chewing an apple right away. In the vast majority of cases they are using a temporary restoration with the permanent restoration being made in 3 to 4 months.
2) Placing an dental implant supported restoration immediately is great, and I can do this in many cases, however, it adds considerably to cost, with no additional long term benefits.
3) All though there is a high success rate once the permanent restoration is finished. For the very high price of All-on-Four (one large “chain” of dental implants charges about $30,000 per arch), I personally like additional stability with more support than four implants (think table legs).
4) Avoiding bone grafts by placing implants at an angle is appropriate, in instances where implants are long enough and cross-splinted for mutual support.
5) Immediate placement restorations cannot be placed in areas where tooth have just been extracted. Temporary restoration and bone healing must occur first.
6) Special caution should be exercised before thinking that complex implant problems can be solved in “cookie-cutter” solutions such as All-on Four.” The number of implants required is HEAVILY dependent on other factors such as parafunction (clenching, grinding), shape of the jawbones, nature of opposing teeth (dentures vs. natural teeth, individual facial aesthetic, bone density, systemic disease, and many other factors. Both patient and practitioners should use caution not to over-simplify.
7) The most important aspect of these restorations is the use of sophisticated software that uses CT bone scans to image the bone in 3D. This allows more accurate placement, less healing time, and more comfort for the patient. For you “techies” out there go to my website and look at how we do this for complex cases under the implant or advanced technology sections!
All technology has uses, abuses, and limitations. I do use this technology, but I do believe some mass advertising of this is misleading-ask us if you questions!
I am constantly amazed that most dentists (apparently) do not tell their patients what can and will happen when they lose teeth. I was asked to produce a educational series on dental implants, and felt compelled to start with a section of the problems that patients are not aware of—and probably were not informed about. Personally, I think that all dentists have the LEGAL and MORAL obligation to tell people about these problems!
Issues such as
1) The vast amount of bone loss that follows tooth loss and progresses over time
2) Facial wrinkles resulting from the atrophy of the facial muscles
3) Social embarrassment and fear of social situations
4) Inability to chew food properly contributing to nutritional problems, obesity, and diabetes
5) Perpetual and progressive inability to use full and partial dentures (also pain!)
6) Bone loss beneath convention bridges resulting in food impaction and increases gum disease on additional tooth loss
7) Decrease mobility
8) Increased incidence of neurological disorders from denture adhesives
9) Increased incidence of heart disease, stroke, and diabetes. Even pancreatic cancer!
10) Bite collapse of the back teeth resulting in more tooth loss, inability to chew food, and a “flaring out” or loss of the front teeth!
And the list goes on-and on with more problems being discovered almost every day. Watch this enlightening video!
