“I think anybody will tell you that tooth loss can be upsetting,” says Shirley Brown DMD, PhD, a dentist who practiced for 25 years before moving into psychology full-time. “It is incumbent upon all of us to explain to patients that even the loss of one tooth can have an impact on how they feel about themselves.”
Researchers have reported feeling of diminished feelings of masculinity, diminished femininity, impending doom; fear that other people will feel that they will be perceived as older by others, feeling that they are much older, diminished strength and vitality, and depression. When it comes to younger people, “tooth loss can be harder,” says Dr. Brow, “because they consider it to be ‘abnormal.’”
The impact of tooth loss as well as the impact of therapy based upon on the disabilities that the patient has experienced can affect the following outcomes: quality of life, patient satisfaction, and self esteem. Although it is difficult (and not in the legal “scope of practice”) for dental professionals to assess the psychological implication of tooth loss, it is part of their duly to prepare the patient for what to expect.
Most practitioners certainly explain the dental consequences of tooth loss. For instance, even the loss of a single tooth may destabilize the surrounding teeth and cause future loss of other teeth. The options of what can be done to replace any tooth loss, as well as cost and expected longevity and advantages/disadvantages of the alternatives need to be understood by the patient. Additionally, the consequence of NO treatment must be discussed.
With complete edentulism, the situation is far more complex. Not only are there statistically more health problems with toothless patients (digestive disorders, diabetes, dementia, and malnutrition to name a few), the patient must adapt to an entirely new life. Food will taste different as the patient loses taste buds from the roof of the mouth. There is diminished ability to enjoy the texture and even the thermal sensations of the food. Gagging can certainly be a problem that needs to be addressed. Chewing on both sides of the mouth may need to done with less stabile dentures.
Even the patient’s looks in the future need to be discussed. With the loss of the teeth, the bone that used to surround the teeth withers away, causing a loss in the facial height, change in the chin cress, and a “weak” look as the bones become smaller.
Even more disturbing is the sunken checks that result from edentulism. A person with a normal complement of teeth chews with 30 to 150 lbs. of force. This contrasts to a person with dentures who chews with 2 to 15 pounds of force. THIS SINKING IN OF THE CHECKS IS NOT FROM THE 
LOSS OF THE PHYSICAL MASS OF THE TEETH, BUT FROM THE ATROPHY OF THE FACIAL MUSCLES AND THE LOSS OF FACIAL HEIGHT (noted above). It is not normally reversible with the simple addition of “bulkier” dentures!
Will the replacement of the missing teeth with conventional dental bridges, partial dentures, or dental implants help stop this progression? Yes partially, but only if the replacements are earlier enough before the cycle progresses too far. Complete edentulism cannot be reversed of course, but the effects certainly diminished by implant supported dentures, or better yet, implant supported bridges. See these sections in RealTeethAgain.com for more information, Patient Feedback, and
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