Introduction
Conventionally, complete denture prosthesis has been applied for replacing lost teeth. Despite advancements in denture fabrication and techniques, the psychological impact on patient’s post-treatment has received limited attention.1 Psychological factors, along with elements such as mastication and speech, are crucial for predicting the outcome of complete denture treatments. In addition to predicting patient satisfaction, the standard of new complete dentures can be used to investigate possible connections between clinical parameters, patient characteristics, and overall satisfaction with the new dentures.
Materials and Methods
A survey was planned to evaluate patient satisfaction following the insertion of complete denture prostheses. About 118 patients who received complete denture prosthesis were selected randomly from Department of Prosthodontics & Crown, and Bridge Seema Dental College Rishikesh.
A validated questionnaire on complete denture on required questions was prepared for the survey. Around 118 patients were taken for survey. All the 118 patients responded to the questionnaire. An informed consent was provided to all the patients and were assured that the information will be kept confidential.
These patients were asked to return for a follow-up two weeks after receiving their prostheses.
Methodology
Patients selected for the study were seated comfortably on a dental chair. After receiving the written consent to participate in the study, a validated questionnaire was filled by all the participants. Details regarding the newly fabricated prosthesis were recorded as reported by each praticipant. They were encouraged to provide honest feedback about their new dentures, with assurance that their identities would remain confidential. The questions were asked in the patient's native language.
Once the questionnaires were completed for 118 patients, the responses were grouped based on a satisfaction scale: very happy, happy, average, not happy, and not at all happy. The parameters evaluated included:
Results
Among the total population (118) chosen for the study 69 were males and 49 were females. (Figure 1)
Retention
Out of 118 patients (Figure 2)
63 (53%) were very happy with the fit of their upper denture.
27 (23%) were happy with the fit of their upper denture.
23 (20%) had average satisfaction with the fit of their upper denture.
4 (3%) were not happy with the fit of their upper denture.
1 (1%) was not at all happy with the fit of their upper denture.
Patient satisfaction regarding the fit of the lower denture
Out of 118 patients (Figure 3)
47 (40%) were very happy with the fit of their lower denture.
41 (35%) were happy with the fit of their lower denture.
22 (18%) had average satisfaction with the fit of their lower denture.
6 (5%) were not happy with the fit of their lower denture.
2 (2%) were not at all happy with the fit of their lower denture.
Patient satisfaction regarding the colour of the denture
Out of 118 patients:
Patient satisfaction regarding the colour of the teeth
Out of 118 patients:
Patient satisfaction regarding the appearance of the face after receiving the denture
Out of 118 patients:(Figure 6)
Patient satisfaction regarding pronunciation
Out of 118 patients: (Figure 7)
Patient satisfaction regarding chewing
Out of 118 patients:
Patient satisfaction regarding denture finishing
Out of 118 patients (Figure 9)
Overall satisfaction
Out of 118 patients:(Figure 10)
Discussion
Patient contentment has always been the primary objective in dental treatments. When it comes to patients obtaining complete denture fabrication, several factors play a crucial role in ensuring their satisfaction. Dentists prioritize efficient chewing ability, pleasing aesthetics, clear pronunciation, and overall comfort for the patient. Achieving harmony in the patient-dentist relationship and treatment outcomes often involves a psychological assessment focused on satisfaction.2
The relationship between the patient and the dentist was assessed after treatment in a study headed by Marinus A. J et al.3 A standardised questionnaire was used to collect the patients' ideas, attitudes, and expectations about the new dentures as well as their feedback on their treatment experience.3, 4
For treatment to be considered successful, it is essential to fulfil not only the objectives set by the operators but, more importantly, to ensure patient satisfaction.5 However, the patient's personality is also a significant factor that influences the criteria for their satisfaction.
The results of another study by Marinus A. J. on the causes of denture dissatisfaction showed that most patients' satisfaction levels differ from one another, making it frequently unpredictable for both the patient and the dentist.6
Michael Robert Fenlon et al. emphasized that the quality of mandibular residual alveolar ridges, the retention and stability of mandibular dentures, the accuracy in reproducing the retruded jaw relationship, and patient adaptability significantly influence patients' satisfaction with new complete dentures.7
This study was carried out at SDCH with a cohort of 118 patients who had recently been fitted with complete denture prostheses. Satisfaction with the dentures was assessed based on criteria such as retention, aesthetics (including tooth color, denture appearance), pronunciation, chewing, denture finishing, and overall satisfaction. Patients rated their satisfaction using a scale that ranged from "very happy" to "not at all happy."
According to the findings, 53% of the patients expressed high satisfaction with the fit of their upper denture, whereas 40% were similarly satisfied with the fit of their lower denture. This difference in satisfaction levels is likely influenced by the fact that the effectiveness of adhesion and retention is directly related to the surface area covered by the denture. Mandibular dentures, which cover less surface area compared to maxillary prosthesis, typically experience lower levels of adhesive and retentive forces.8
In this study, 46% of patients expressed being very happy with the denture colour, 50% were very happy with the tooth colour, and 52% were very happy with the overall appearance of their facial features. Ellis J et al., in a pilot study, noted increased patient happiness with improved appearance, highlighting the direct impact of aesthetics on initial patient happiness.9, 10 The colour of the denture base and artificial teeth is crucial in achieving a satisfactory appearance for denture patients.
Pronouncing different sounds with a prosthesis on has always been a posed challenge. Even well-adapted denture prostheses experience slight movement on such a base, which can affect speech satisfaction, especially initially. In this study, only 36% of patients felt comfortable with their pronunciation. E Berg, in an assessment of 74 denture patients, also identified speech as a major prosthodontic challenge during the adaptation period.11 However, with continued wear and practice, all patients typically adjust to speaking comfortably with their dentures.12
Mastication, is another crucial function performed by teeth. Natural teeth, with their roots embedded in bone, execute this task effortlessly. However, for patients with new prostheses that rest on unstable mucosa, chewing becomes a challenging task. Patients transitioning from having teeth to being edentulous struggle with the movement of prostheses on a shifting foundation. Edentulous individuals are significantly impaired in their ability to chew, and even clinically satisfactory complete dentures are considered a poor substitute for natural teeth.8, 13
In this study, it was noted that only 29% of patients were satisfied with their ability to chew. However, this aspect heavily depends on the condition of the oral tissues, and the patient's motivation also plays a crucial role in improving chewing efficiency.
Smoothness is closely associated with the comfort of wearing a prosthesis. 44% of patients expressed being very happy with the smoothness of their dentures, indicating comfort in wearing them.
The denture wearer's overall level of pleasure is greatly influenced by how comfortable the denture is to wear. Sixty-one percent of the patients said they were very happy with their dentures. The majority of patients in Alfadda et al.'s study reported being between "somewhat satisfied" and "very satisfied," with the majority citing things like using dentures in both the upper and lower jaws and having stability and sufficient retention of the lower jaw denture as the main causes of their pleasure.14 The majority of patient’s issues in another study by Celebiu et al. assessing patient satisfaction with complete dentures were speaking and chewing solid and hard foods.15
Conclusion
The study highlights the crucial role of complete denture prostheses in enhancing patient satisfaction across various aspects. While satisfaction levels with denture fit, aesthetics, and overall experience are notably high, opportunities for improvement exist in speech clarity and mastication effectiveness. These findings underscore the importance of continual refinement in prosthetic techniques to better meet patient expectations and enhance quality of life. Future efforts should focus on integrating these insights to advance prosthetic care and improve patient-centred outcomes in dental practice.
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