Edentulousness and oral rehabilitation: experiences from the patients' perspective

The psychological effects of tooth loss in the permanent dentition are relatively unknown. Complete edentulousness is a serious life event in terms of readjustment. The aim of the study was to describe the process patients with deteriorating dental status had gone through before treatment with a fixed prosthesis (Brånemark System, Novum), and to describe what living with a fixed prosthesis means to the patients themselves. In-depth interviews were carried out with 18 patients, and the interviews were transcribed verbatim and analysed in open, axial and selective coding processes according to Grounded Theory. In the analysis, four categories were developed and labelled: 'alterations in self-image', 'becoming a deviating person', 'becoming an uncertain person' and 'becoming the person I once was'. 'Alterations in self-image' was identified as the core category and was related to the other three categories. The core category describes the changes in self-image starting with the subjects' increasingly worsened dental status, followed by a period of them having to live and cope with a denture and, finally, their living with a fixed prosthesis. The motive power for the decision to undergo treatment with a fixed prosthesis seems to be a desire to restore dental status and also to recapture attractiveness, self-esteem and a positive self-image.