Correlates of Anxiety and Depression in Turkish Complete Denture Patients

Article excerpt

Denture wearing is a stressful life event which can cause anxiety and depression. Patients' adaptation to dentures may be hindered by their emotional reactions. The present study examined the variables related to anxiety and depression symptoms among 158 adult complete dental prosthesis patients. The results showed that the participants had mild to moderate depression and moderate state anxiety symptoms. The results of the regression analyses showed that treatment duration, perceived burden due to teeth loss and expected benefits of new dentures were related to anxiety. Age, burden of teeth loss and perceived social support from the dentist were related to depression symptoms. Therefore, these variables need to be considered in the management of prosthesis patients.

Keywords: denture patients, anxiety, depression, sociodemographic variables, social support.

Dental treatment is a stressful life event, creating many psychological reactions which may hinder adjustment to denture wearing. Studies with denture patients have shown that they experience emotional problems such as fear, anxiety, depression, and problems in social situations (Branchi, Boddi, Corti, & Hardoy, 2001; Chamberlain & Chamberlain, 1985). Dental anxiety, which is defined as the fear of dental treatment, including fear of discomfort, pain, dysfunction and esthetic complaints (Ter Horst & De Wit, 1993), is a problem which is often encountered.

Psychological responses to dental treatment vary among patients (Chamberlain & Chamberlain, 1985; Friedman, Landesman, & Wexler, 1988). These differences are related to some individual characteristics and the psychological state of denture patients. Dental anxiety is found to be related to increased levels of general anxiety, fear of pain, mutilation, and some personality factors (Hagglin, Hakeberg et al., 2001; Ter Horst & De Wit, 1993). Certain sociodemographic characteristics, such as gender and age, have been noted to be related to anxiety experienced by dental patients. Women tend to experience more anxiety than do men (Bergdahl & Bergdahl, 2003; Enkling, Marwinski, & Jöhren, 2006; Milgrom, Fiset, Melnick, & Weinstein, 1988). There seems to be an inconsistency with respect to the effect of age on dental anxiety. Although some researchers have reported that younger patients were more anxious than older ones, (Hagglin, Berggren, Hakeberg, Hallström, & Bengtsson, 1999; Humphris, Freeman, Campbell, Tuutti, & D'Souza, 2000) in some other studies the opposite trend was found (Milgrom et al., 1988; Stouthard & Hoogstraten, 1990). Rahman and Arntz (1991) examined cognitive aspects of dental anxiety. They reported that dentally anxious patients tended to expect some aversive events during their dental care, which led to even higher levels of anxiety and to avoidance behavior. Thus, expectations of patients about a dental prosthesis and their perception of burden due to wearing it may increase their symptoms of anxiety and depression. The cognitive perspective proposes that it is not the event, but the view the person takes of the event, that determines how stressful the situation is. Therefore, in order to examine distress we need to investigate how patients perceive dental loss and prosthesis.

Depression experienced by dental patients is related to real or perceived loss. Denture patients experience some symptoms of anxiety and depression due to loss of their teeth and the consequent aesthetic changes in their body (Friedman et al., 1988; Persson et al., 2003). Persson et al. have recently shown that, among older people, those who have lost more teeth experience higher levels of depression than do those who have lost fewer teeth. Chamberlain and Chamberlain (1985) argue that symptoms of depression are also related to the gender of the denture patient. They found that, among the elderly, women had more depressive symptoms than did men. Furthermore, several studies revealed that depression tended to increase with age (Blazer & Williams, 1980; Murrel, Himmelfarb, & Wright, 1983). …