Key Points
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Existing research suggests that 30-50% of patients who are prescribed an RPD never or only occasionally wear the prosthesis.
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This study has identified key factors that influence professional provision and patient use of RPDs.
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For patients, wearing an RPD is not simply a matter of aesthetics, but of avoiding the social stigma associated with tooth loss.
Abstract
Objective To identify factors that influence Removable Partial Denture (RPD) provision, and patient use of RPDs in the UK.
Design Exploratory qualitative interview study.
Subjects and methods Subjects There were two sample groups. A purposive sample of 16 male and female dentists was categorised in terms of level of RPD provision, experience, and practice characteristics. A purposive sample of 17 male and female partially dentate patients was categorised in terms of RPD use and demographic characteristics. Data collection Semi-structured in-depth interviews.
Results For dentists, RPD provision was indicated by patient demand and physical function of the remaining teeth, but was mediated by NHS fee structures and professional satisfaction. For patients, RPD use was influenced by the trade-off between improved appearance and the unpalatable presence of an RPD in their mouth. The location of the gap(s) was important, but other issues were relevant such as ability to 'manage' without the RPD.
Conclusion When defining 'need' for an RPD, dentists focused on physical function of the teeth whereas patients focused on social meanings of the mouth. These differing priorities may improve understandings of patient non-compliance in RPD use. Further research on the relationship between denture use and social identity could be beneficial.
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Acknowledgements
This study was funded by the NHS Executive Regional R&D with assistance from the Dental Practice Board for England and Wales. Many thanks to the dentists and patients who participated in the study, and also to Dr Julie Birch for assistance in project development.
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Graham, R., Mihaylov, S., Jepson, N. et al. Determining 'need' for a Removable Partial Denture: a qualitative study of factors that influence dentist provision and patient use. Br Dent J 200, 155–158 (2006). https://doi.org/10.1038/sj.bdj.4813193
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DOI: https://doi.org/10.1038/sj.bdj.4813193
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