O.O. Dosumu, J.T. Ogunrinde and S.A. Bamigboye
Department of Restorative Dentistry, Faculty of Dentistry, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Background and Objective: Various causes of tooth loss such as caries, trauma, periodontal diseases, and cancer have been documented in the literature. In addition, factors that can modify these causes such as level of education, age and sex have been studied. There is however paucity of information on whether patients or people with missing teeth are aware of the side effects of tooth loss on them or on the remaining teeth. This study investigated the knowledge of consequences of missing teeth among partially edentulous patients in a teaching hospital. Patients and Method: Self-administered questionnaires were distributed to the patients to collect information relating to demography, cause and duration of tooth loss, awareness of the consequences of tooth loss and their sources of information. Four clinical conditions including supra-eruption, mastication, teeth drifting, and facial collapse were used to assess the level of awareness of consequences of missing teeth.
Result: Two hundred and three participants were included in the study. Their mean age was 45.5±1.8 years. There was no significant difference between the knowledge of the consequences of missing teeth and sex or on level of education (p 0.05). Dentists constituted the largest source of information to these patients (25.6%) while the media constituted the least (0.5%).
Conclusion: The result of this study showed poor knowledge of the consequences of missing teeth among partially edentulous patients and the media that should be of assistance were equally unaware, signifying urgent need for public awareness on this subject.
Key words: Tooth loss, Level of awareness, Consequence of missing teeth.
Dr. S.A. Bamigboye
Department of Restorative Dentistry,
Faculty of Dentistry,
College of Medicine,
University of Ibadan, Ibadan.
Tooth loss could result from caries, periodontal disease, trauma, infection, malignancies, or failed endodontic treatments 1,2,3,4 and can present adverse consequences on the remaining dentition and on the patients’ general wellbeing. 3, 4 Petridis et al5 reported drifting of adjacent teeth and supra-eruption of the opposing teeth to the edentulous space in their study which looked at positional changes of adjacent teeth to edentulous spaces. Also, Kini and Muliya6 observed in a case report supra-eruption of a first mandibular premolar into the space left by an upper first premolar whose coronal tissue had broken down although the whole tooth was not lost.
In addition to the drifting and supra-eruption mentioned above is a possible facial/oral asymmetry or collapse that may result following loss of teeth. Martins-Junior and Marques7 showed that premature loss of a lower right deciduous canine in an 8-year old patient resulted in deviation of the lower arch from the midline to the affected side just as Tallgren et al8 reported facial collapse in patients with teeth and alveolar bone loss.
Mastication as a consequence of tooth loss are known by many patients9 and this may be why people in this class of condition impose dietary restriction upon themselves and thereby incurring health risk.10 In addition, loss of posterior teeth has been associated with impaired chewing and inadequate nutrition, the patients having the tendency to over-prepare food in an attempt to make it soft thereby loosing important nutrients.11
Some studies recorded more than one consequence of tooth loss at a time. Rosenstiel et al12 reported that failure to replace a posterior missing tooth may disrupt balance in stomatognathic system and trigger chains of adverse reaction such as drifting, rotation or super eruption of teeth. The consequences of these loss of teeth on the patient include altered speech, ineffective mastication, loss of self confidence, concern about appearance, and feeling of bereavement,3,4 while a study13 reported higher likelihood of developing ischemic stroke among study subjects with periodontal disease and less than 24 teeth in the mouth compared with those with more than 25 teeth.
Despite the enormous adverse effects of tooth loss on functional, social and psychological wellbeing of the patients as well as on the remaining dentition, many patients in our environment do not replace their missing teeth. This could be due to poor awareness that failure to replace missing teeth may cause the remaining dentition to further deteriorate. Studies have been done on socio-psychological effects of tooth loss on patient14,15,16 but there is dearth of information on patients’ awareness of the consequences of tooth loss on the remaining dentition. The purpose of this study therefore was to determine the knowledge of consequences of tooth loss among partially edentulous patients in a teaching hospital in Nigeria.
PATIENTS AND METHOD
This study was carried out among consecutive consenting patients who presented or were referred to the prosthetic clinic of the University College Hospital, Ibadan, Nigeria for replacement of their missing teeth between 2011 and 2013. Self administered questionnaires were used to collect information from the patients. The survey questions enquired about their demography, the cause and duration of tooth loss, their knowledge of the consequences of tooth loss, four clinical conditions were used to assess patients’ level of knowledge and these were supra-eruption, mastication, tooth drifting and facial collapse.
All data from the questionnaires were entered into a computer and analyzed with statistical package for Social Sciences (SPSS) version 19. Analysis included calculation of range and mean values, Chi square test was used to compare level of awareness of consequences of tooth loss against age, sex, and education. In calculating Chi square for education and level of awareness, those who did not respond were excluded from the number. Those with no education, primary and secondary education were combined into pre-tertiary education. P-values less than 0.05 was considered statistically significant.