The Stigma of Edentulism on Quality of Life

By Angeliki Tzortzakaki

The loss of natural teeth negatively affects people’s quality of life, as it creates both aesthetic and functional issues, while also burdening their overall health.

Introduction

Edentulism, whether partial or complete, is one of the most unpleasant challenges a person may face. It can be caused by several factors, most commonly dental caries and periodontal disease, followed by dental trauma. Its impact is significant on aesthetics—and consequently on self-confidence—as well as on functionality through impaired speech and chewing, and even on the general health of patients.

Edentulism and Self-Confidence

It is evident that the loss of natural teeth degrades an individual’s appearance. The more teeth that are missing, the more a person's facial profile is altered. Naturally, individuals in this situation often feel embarrassed and are reluctant to smile, eat, or speak in front of others. This can take a toll on their mental well-being, leading to reduced self-esteem and confidence. At the same time, fear of social stigma may limit their interpersonal and social interactions, leading to social exclusion and marginalization.

Edentulism and Functionality

Functions such as speech and chewing are directly and significantly affected by tooth loss:

  • Edentulism and Speech
    As for speech, the more teeth are missing, the more effort is required for proper articulation. As a result, communication is impaired, and social interaction is further limited.

  • Edentulism and Chewing
    Chewing is also notably impacted, as breaking down food becomes more difficult. Research shows that having fewer than 20 teeth makes mastication significantly harder. Patients report difficulties in consuming hard foods such as carrots, nuts, or apples, as highlighted in the study by Saintrain MV and de Souza EH. This difficulty is associated with the atrophy of the masseter muscle, which, although normally thick and strong, loses strength following tooth loss, requiring more effort for biting. As a result, enjoyment during meals is reduced, food taste may be altered, and key food groups may be excluded from their daily diet.

Edentulism and General Health

It is clear that complete or partial tooth loss has a negative impact not only on mental health—by lowering self-esteem and confidence—but also on physical health. As previously mentioned, edentulous patients tend to choose specific, softer foods and avoid others, leading to potential malnutrition. This is due to the decreased intake of essential nutrients resulting from inadequate consumption of fruits, vegetables, and dietary fiber. At the same time, the easier consumption of foods rich in saturated fats and carbohydrates—due to their soft texture—has been linked to an increased risk of obesity and related conditions such as insulin resistance and hyperlipidemia. In general, conditions such as cardiovascular diseases (e.g., stroke), kidney diseases (e.g., chronic kidney disease), gastrointestinal disorders (e.g., duodenal ulcers), and respiratory issues (e.g., obstructive sleep apnea) have been associated with natural tooth loss.

Conclusion

In summary, tooth loss has a negative impact on individuals’ quality of life. To prevent tooth loss and its consequences, timely and proper education should be provided by dentists regarding oral hygiene instructions. Regular dental check-ups should also be scheduled as part of prevention and treatment, to avoid the onset or progression of conditions like caries and periodontal disease, which can lead to edentulism. Finally, a good dentist-patient relationship and personal responsibility on the part of the patient are essential to achieving this goal.

References

  1. Anbarserri NM, Ismail KM, Anbarserri H, Alanazi D, AlSaffan AD, Baseer MA, Shaheen R. Impact of severity of tooth loss on oral-health-related quality of life among dental patients. J Family Med Prim Care. 2020 Jan 28;9(1):187-191. doi: 10.4103/jfmpc.jfmpc_909_19. PMID: 32110588; PMCID: PMC7014884.

  2. Emami E, de Souza RF, Kabawat M, Feine JS. The impact of edentulism on oral and general health. Int J Dent. 2013;2013:498305. doi: 10.1155/2013/498305. Epub 2013 May 8. PMID: 23737789; PMCID: PMC3664508.

  3. Saintrain MV, de Souza EH. Impact of tooth loss on the quality of life. Gerodontology. 2012 Jun;29(2):e632-6. doi: 10.1111/j.1741-2358.2011.00535.x. Epub 2011 Aug 24. PMID: 21883422.

  4. Dikicier S, Atay A, Korkmaz C. Health-related quality of life in edentulous patients. J Med Life. 2021 Sep-Oct;14(5):683-689. doi: 10.25122/jml-2021-0277. PMID: 35027971; PMCID: PMC8742902.

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