PSYCHOLOGICAL EFFECTS OF PERMANENTLY IMPLANTED FALSE TEETH - A 2-YEAR FOLLOW-UP AND COMPARISON WITH DENTATE PATIENTS

The treatment of patients who have suffered total tooth loss (edentulism) has always posed many problems in dental care, since removable dentures cannot restore function completely and can often result in pain and mouth ulcers. An important recent advance is the development of ''osseointegrated implants.'' This technique involves the insertion of titanium screws into the jawbone and the denture is then attached to this fixed bridge. A previous controlled study (Kent and Johns, 1991) has shown that in the short term this technique is associated with a reduction in psychological distress and the number of dentally disabling symptoms, but no change in self-esteem. The aims of the current study were to (a) conduct a longer-term follow-up of these patients (the implant group) and (b) compare their adjustment with patients who possess their natural teeth (the dentate group). Twenty implant patients completed the General Health Questionnaire (GHQ), Rosenberg's self-esteem scale (Rosenberg, 1965) and a check-list of disabling symptoms on three occasions: before treatment, six months and 24 months post-treatment. Sixty-one dentate patients from four general dental practices completed the same questionnaires on a single occasion. In the implant group at 24 months, the number of psychological symptoms (GHQ) had returned to the pre-treatment level, even though the reduction in the number of disabling symptoms was maintained. Self-esteem remained unchanged. There was considerable individual variation in changes in GHQ scores, although, on average, the implant group's level of well-being at 24 months was similar to the dentate patients' on all measures.