title: Refusal of implant supported mandibular overdentures by elderly patients.
abstract: OBJECTIVE
  The aim of this study was to gain greater in-depth understanding of why elderly patients who are currently dissatisfied with conventional dentures decline implant treatment.
  
  
  BACKGROUND
  There is strong evidence from high-quality randomised controlled trials to support the use of implant-supported overdentures for the restoration of the edentulous mandible. However, whilst recruiting for randomised clinical trials, researchers have found that a high proportion of potential subjects decline participation, despite the removal of financial constraints.
  
  
  METHODS
  The study adopted a qualitative approach to provide a rich and deep understanding of people's reasons for refusal. Data were collected through focus group interviews in a two-centre study based in Montreal, Canada and Newcastle, UK. A semi-structured interview schedule was used and iteratively developed as analysis identified themes from previous focus groups. Transcripts of focus groups were coded and emergent themes determined.
  
  
  RESULTS
  Two main themes emerged; patients' fear and anxiety (relating to the pain of surgery, complications of the procedure and immediate post-surgical denture use), and the appropriateness of the procedure in an elderly person.
  
  
  CONCLUSIONS
  Fears of pain, complications and social embarrassment, exacerbated by age, are important factors that help explain refusal of implants by elderly patients.
authors.affiliation: School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4BW, UK. j.s.ellis@ncl.ac.uk
authors.forename: Janice S
authors.initials: JS
authors.lastname: Ellis
authors.forename: Alissa
authors.initials: A
authors.lastname: Levine
authors.forename: Christophe
authors.initials: C
authors.lastname: Bedos
authors.forename: Phillippe
authors.initials: P
authors.lastname: Mojon
authors.forename: Zeer
authors.initials: Z
authors.lastname: Rosberger
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Feine
authors.forename: J Mark
authors.initials: JM
authors.lastname: Thomason
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D016854:Dental Anxiety / Q000523:psychology; D003758:Dental Implantation, Endosseous / Q000009:adverse effects / Q000523:psychology; D019094:Dental Prosthesis, Implant-Supported; D003826:Denture, Complete, Lower; D003828:Denture, Overlay; D005239:Fear / Q000523:psychology; D005260:Female; D017144:Focus Groups; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000523:psychology; D012649:Self Concept; D016312:Treatment Refusal