Refusal of implant supported mandibular overdentures by elderly patients.
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.
Ellis
Janice S
JS
School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4BW, UK. j.s.ellis@ncl.ac.uk
Levine
Alissa
A
Bedos
Christophe
C
Mojon
Phillippe
P
Rosberger
Zeer
Z
Feine
Jocelyne
J
Thomason
J Mark
JM
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