European Journal of Cardiovascular Medicine

Total tooth loss or edentulism is a severe oral disorder, most common in the aged, and impacts general quality of life by disturbing chewing, speech, and appearance [1]. Complete dentures remain the most sought-after prosthetic treatment among totally edentulous individuals and provide functional and psychological rehabilitation [2]. Complete denture adaptation is often inadequate as primary wearers experience discomfort, mastication difficulty, excess salivary flow, speech disturbance, and psychological morbidity [3]. Individual adaptation is a dynamic process and is influenced by the age, gender, oral anatomy, neuromuscular coordination, and previous experience of the individual with dentures [4].

The comfort and satisfaction of complete denture wearers are determined by a variety of factors like the fit, occlusion, and retention of the prosthesis, as well as patient-related factors including pain tolerance, motivation, and adaptability [5]. Studies have shown that initial discomfort is normal, but adaptation tends to be progressive after a few weeks to months [2, 6]. Chewing efficiency and intelligible speech improve with time, and overall comfort and satisfaction are achieved [7]. Despite advancements in prosthodontics, a large number of patients who are wearing dentures for the first time have trouble adapting, and this causes frustration and even abandonment of the prosthesis [8]. It is critical that prosthodontists have an understanding of the adaptation process to improve their ability to educate their patients, develop better treatment planning, and produce superior long-term results [9].

High levels of older persons require complete dentures due to untreated oral infections, periodontal disease, and the scarcity of dental treatment in Bangladesh [10]. However, limited studies exist assessing the adaptation and comfort of novice complete denture wearers in the Bangladeshi population [11]. Cultural and dietary lifestyles, oral hygiene behavior, and access to healthcare contribute to the acceptance and success of dentures, and thus it is important to investigate patient experiences in this regard [12, 13].

The current study aimed to evaluate first-time complete denture wearers' adaptation process and comfort levels over a six-month period. By measuring patient-reported difficulties, adaptation time, and satisfaction, the study seeks to have an understanding of denture wearers' current difficulties and factors for successful adaptation. Findings can be used to improve prosthetic rehabilitation strategies and patient counseling, which will enhance the quality of edentulous patients' lives in Bangladesh.

This prospective observational study was conducted in the Department of Prosthodontics at Bangabandhu Sheikh Mujib Medical University (BSMMU) and beau-dent, Dhaka, Bangladesh, over one year from January 2010 to December 2010. A total of 50 first-time complete denture wearers were included. Patients who had never worn dentures before and required complete maxillary and mandibular dentures due to edentulism were selected. Those with systemic diseases affecting oral health, neuromuscular disorders, or prior denture experience were excluded.

Comprehensive clinical evaluation was conducted, and impressions were taken on a regular basis. Conventional heat-cured acrylic resin dentures were fabricated so that they occluded and fitted properly. Instruction regarding usage, cleaning, and dietary changes following insertion was taught to patients. Follow-ups were conducted at one week, one month, three months, and six months in order to measure adaptation and comfort ratings.

A structured questionnaire provided demographic data, primary complaints, adjustment time, comfort levels, and general satisfaction. Comfort and satisfaction were rated on a five-point Likert scale ranging from "very dissatisfied" to "very satisfied." Descriptive statistics such as frequencies and percentages were used in analyzing data with windows software SPSS version 12. Informed consent from participants were attained. Statistical significance was set at p < 0.05.

Table 1: Demographic Characteristics of Participants

Table 1 presents the demographic characteristics of the 50 participants. The majority (36%) were aged 60-69 years, followed by 30% in the 50-59 age group. Participants aged ≥70 years accounted for 18%, while those aged 40-49 years were the least (16%). Males comprised 54% of the study population, while females made up 46%.

Table 2: Primary Complaints during Adaptation Period

Table 2 highlights the primary complaints experienced by first-time complete denture wearers during the adaptation period. Pain or discomfort was the most common issue, reported by 44% of participants, followed by difficulty in chewing 36%. Speech problems affected 20%, while excessive salivation was noted in 16%. A gag reflex was experienced by 10% of patients, whereas 14% reported no complaints.

Table 3: Adaptation Time for Denture Usage

Table 3 illustrates the adaptation time among first-time complete denture wearers. The majority (36%) adapted within 1-2 weeks, while 34% required 3-4 weeks. A smaller proportion (20%) took more than a month to adjust, whereas 10% adapted within the first week.

Table 4: Comfort Level of Participants over Time

Table 4 shows the progression of comfort levels among first-time complete denture wearers over six months. At the first week, only 10% felt comfortable, while 56% experienced some discomfort and 34% were uncomfortable. By one month, comfort increased to 32%, with 50% still experiencing some discomfort. At three months, 64% were comfortable, 28% had mild discomfort, and only 8% remained uncomfortable. By six months, the majority 84% reported comfort, with minimal discomfort 12% and only 4% remaining uncomfortable, indicating a gradual improvement in adaptation over time.

Table 5: Satisfaction Level after 6 Months of Denture Use

Table 5 presents the satisfaction levels of participants after six months of denture use. The majority 44% were satisfied, while 30% were very satisfied. A neutral response was given by 14% of participants. Dissatisfaction was reported by 8%, and 4% were very dissatisfied, indicating that most first-time denture wearers had a positive experience over time.

The adaptation process for new complete denture wearers is normally challenging, involving both functional and psychological adaptation. Our study measured adaptation and levels of comfort among 50 Bangladeshi patients for six months, reflecting considerable trends in discomfort, time to adaptation, and general satisfaction.

Age and sex are confirmed factors in denture adaptation. Our study's most frequent age category (66%) was 50-69 years, as might be expected on the global scale for edentulism among older individuals [14]. Males were slightly more than females (54%), as expected of general health-seeking behavior, rather than by a gender disparity in denture adaptation [15].

Wearers commonly report a number of discomforts during the initial adaptation process, as evident from our findings. Discomfort and pain (44%) were the most commonly reported, followed by masticatory (36%) and speech (20%) difficulties. The findings are consistent with Trulsson et al., who indicated that first-time denture wearers experience significant functional and psychological discomfort from the altered oral environment [16]. Excessive salivation (16%) and gag reflex (10%) were also prominent complaints. Oral stereognostic ability has been reported by Eitner et al., to play a part in what patients think about their prostheses and are therefore responsible for their comfort levels [17]. Our results support the argument that discomfort at the beginning is a natural response to foreign objects within the oral cavity, which slowly decreases with time.

Adaptation to dentures varies in individuals. In the current study, most participants (70%) adapted within a month, 36% adapting between 1-2 weeks and 34% adapting between 3-4 weeks. Nonetheless, 20% of the participants adapted after over a month. The results were consistent with those of Müller et al., who opined that the adaptation period relies on patient motivation, experience, and psychological acceptance of dentures [18]. Patients who adjusted more quickly had fewer initial grievances, underlining the significance of patient education prior to denture placement. Carr & Brown emphasized that pre-treatment counseling greatly enhances acceptance and diminishes perceived distress [15].

Comfort levels showed remarkable improvement over six months. In week one, only 10% of participants felt comfortable, 56% experienced some discomfort, and 34% felt totally uncomfortable. These figures improved in step with time, with 84% feeling comfortable at six months. This gradual improvement is consistent with evidence by Kawai et al., who found that adaptation was an ongoing process of increasing tolerance over time [19]. Levin & Richardson also noted the importance of frequent follow-ups and minor adjustments to maximize comfort levels [20]. The decrease in discomfort supports the concept that neuroplasticity in oral sensory perception enables patients to functionally adapt to new prostheses [21].

Satisfaction is the best predictor of denture adaptation success. 74% were very satisfied or satisfied, and 14% were neutral at six months. Only 12% reported dissatisfaction, consistent with findings of Petričević & Rener-Sitar, who argued that denture fit, esthetics, and speech function are factors in overall satisfaction [14]. Psychosocial issues are also highly significant in denture satisfaction. Greenland & Margrain found a link between anxiety and patient satisfaction, with strong stress on reassurance and ongoing support during the adaptation period [22]. In our study, those who were not satisfied in the early stages were more likely to have more than one complaint to start with, highlighting the merits of early education and intervention.

Education of patients on the adaptation process can lower expectation levels and maximize long-term satisfaction [15]. Intermittent follow-ups facilitate required adjustments, lowering pain levels and increasing comfort levels as time passes [20]. Treatment of psychological issues discussed can increase adaptation, as it is evident from the reports by patients having decreased anxiety who noted increased comfort and satisfaction [20].

Limitations of the study

Despite its valuable insights, our study has some limitations. The small sample size (n=50) may not fully represent the broader population, and the study focused solely on conventional dentures without considering implant-supported prostheses. Future research should explore long-term adaptation beyond six months and assess the impact of different prosthetic techniques on patient comfort and satisfaction.

Our study confirms that first-time complete denture wearers experience significant adaptation challenges, particularly in the initial weeks. However, comfort levels improve over time, and most patients achieve satisfactory adaptation within six months. Pain, chewing difficulties, and speech issues are common early complaints, but regular follow-ups and patient education can enhance the adaptation process. These findings emphasize the need for comprehensive patient support to improve the overall experience of denture wearers.

Financial support and sponsorship

No funding sources.

Conflicts of interest

There are no conflicts of interest

Our study confirms that first-time complete denture wearers experience significant adaptation challenges, particularly in the initial weeks. However, comfort levels improve over time, and most patients achieve satisfactory adaptation within six months. Pain, chewing difficulties, and speech issues are common early complaints, but regular follow-ups and patient education can enhance the adaptation process. These findings emphasize the need for comprehensive patient support to improve the overall experience of denture wearers.

Financial support and sponsorship

No funding sources.

Conflicts of interest

There are no conflicts of interest