To Have or Not to Have: Dentures versus Prosthodontic Services

by Gerald Schneiderman, MD,FRCP(C)

Prosthodontic services have been rapidly growing in dental offices. I have had a long history of gum disease which led to restorative dentistry, and after progressive deterioration, I had to confront the issue of whether I was going to have some kind of plate, partial, total, or prosthodontics.

When I started on this journey as a patient, I was rather naïve about the complexity of the whole process. It began with bone taken from my hip and ultimately ended with dental implants as the final product. This was a long and laborious effort undertaken by my prosthodontist. It was complicated by the loss of an implant, followed by an infection that led me to ear, nose, and throat specialists to have the infection surgically remedied.

The journey was protracted, starting with such things as: “move your lower jaw left”, “to the right”, “up”, “down”, “in”, “out”, and before long, the entire process seemed like it would never end. However, the final result was exceptional. It fulfilled a wish of mine that I was not going to reach the end of my life with a bridge or partial plate. Over my parents’ lives, I observed them struggle – prior to the advent of prosthodontics – in the mainstream, with dentists and dental specialists.

I find now that I have become a strong supporter of prosthodontia, and urge all dentists to consider the same wherever possible. Certainly for me, it has reinforced the fact that a patient’s body image, including dental health, is critical in one’s personal sense of aesthetic well-being. This fact is also promoted by contemporary trends in what is considered socially and aesthetically respectable.

I would also like to recommend that, based on my own experience, and that of many others, anxiety levels in relation to treatment, which are tied into the long and complicated process of prosthodontia, must be contained during the patient’s journey. All professionals should consider in addition to the patient’s anxiety levels the patient’s degree of knowledge, understanding, and misconceptions. Finally with an increasing geriatric population, it is my wish that older patients wherever possible are considered for implants.

As a final thought for all professionals, including myself as a psychiatrist, we always hope for a cure, that all problems will resolve favourably. However, this may not always be possible, and the hard part for all of us is not to personalize the limitations of what we do and have done, and consider ourselves as failures. For me, this has been a journey that has taught me patience. The value and the importance of teeth in the plethora of health issues, combined with the dental professionals’ ability and dexterity, is truly admirable and worthy of commendation. OH

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