A smile on the face of tooth loss

A smile on the face of tooth loss

Sylvain-Jacques Desjardins | Apples, carrots and nuts are foods most of us chew on for granted. But for Bernadette Lessard, 69, crunching on such foods wasn't possible for the past four decades that she wore conventional dentures. Not anymore.

Dr. Jocelyne Feine PHOTO: Owen Egan

"Now I can easily bite into a juicy apple with a large smile on my face," says Lessard, who received two dental implants at McGill as part of a clinical trial headed by Jocelyne Feine, director of McGill's Graduate Studies in Dental Sciences (Faculty of Dentistry).

Lessard was one of about 160 toothless people who volunteered for two studies on dental prosthetics and implants that were overseen by Feine between 1996 and 2002. Both trials, which focused on middle-aged and senior patients, were launched to compare the use of conventional dentures to two-implant overdentures, the latter being dental prostheses that are attached to a person's mouth via two implants that are drilled into the upper or lower jawbones.

Last week, Feine released the results of her studies during a two-day conference that she co-organized at McGill. Attended by about 175 dentists, dental students and technicians, the conference featured Feine and 13 other speakers, who presented the latest facts on tooth loss, its impacts on health and nutrition, and the use of two-implant overdentures versus conventional dentures.

The primary goal of the event was for dental professionals to share information and to develop a consensus statement on two-implant overdentures. This consensus will eventually be presented to the provincial and federal governments, as well as to practicing clinicians across Quebec. Another objective of the conference was to develop a textbook on two-implant overdentures, which will be published next year.

Ultimately, conference attendees agreed two-implant overdentures should become the standard of care for toothless Canadians. "Two-implant overdentures are by far superior to conventional dentures and can help a patient's ability to chew by up to 50 percent," Feine stressed, noting they are already the usual treatment in Sweden and the Netherlands.

Feine explained that tooth loss, which is clinically labelled as edentulism, particularly affects low-income seniors and is a huge problem across the country. Indeed, according to the latest statistics available, over half of Canadians over 65 were toothless in 1988.

While the situation has since improved, 58 percent of Quebecers over 65 still have no teeth. Worse, Quebecers in the lowest socio-economic brackets are six times more likely to be toothless than high-income earners. "Because Canada's population is aging," warned Feine, "clearly, the high demand for treatment of edentulism will continue for many decades."

What's more, losing teeth doesn't just affect seniors. Twenty-five percent of young Quebecers with annual incomes below $24,000 have no teeth at all. Regardless of age, Feine said, "tooth loss has a substantially negative impact on diet and health."

Other highlights of Feine's research determined that:

• People with conventional dentures avoid hard-to-chew foods.

• Diminished mastication prevents people with conventional dentures from consuming the necessary amount of fruits, vegetables, meats and breads.

• Edentulous individuals have a higher consumption of fat and cholesterol.

• Studies have linked tooth loss to systemic disease in the elderly.

• Individuals with low-cost implant dentures have significantly fewer gastrointestinal disorders and better nutrition than those wearing conventional dentures.

• Lack of teeth can lead to the deterioration of general health and premature death.

Having just two implant overdentures is better than receiving conventional dentures, Feine said, because implants improve prosthetic stability, comfort, appearance, as well as the ability to chew and speak. "Patients can cope with conventional dentures," she said. "The question is, should they have to?"

Jeanne Dumont, 76, wholeheartedly agrees conventional dentures don't cut it. Alas, she was randomly selected to take part in the conventional dentures segment of Feine's trial and didn't receive implant overdentures.

"Having conventional dentures has caused so many ulcers in my mouth that I'm on medication 365 days per year," she says. "Not to mention I've never been able to chew on raw vegetables or a piece of steak for years. I'm very limited in what I can eat."

Compare that to Bernadette Lessard. "Getting implant overdentures has changed my life," she says. "I now eat with absolute pleasure."