Implant surgeon and co-partner of Ten Dental, Nikhil Sisodia, shares his insight into cosmetic and implant dentistry, and the impact it can have on patients' confidence.
Issues in the aesthetic zone can be particularly upsetting and worrisome to patients. Whilst compromised teeth in any area of the mouth can be painful and affect daily life, the appearance or absence of teeth in the aesthetic zone can have an outsized effect on how a patient is perceived – both by themselves and others. Poor dental aesthetics have been found to negatively impact patients’ psycho-social wellbeing and quality of life, particularly affecting their self-confidence and self-esteem, with potential knock-on effects on their social lives.[i]
Dental implants are predominantly thought of in the context of older patients, owing to the strong correlation between aging and edentulism. The aesthetic changes wrought by edentulism, particularly alveolar bone resorption, cause a characteristic shortening and reshaping of the jaw that has become deeply interwoven with cultural images of the elderly. Despite the close association, tooth loss is not an inevitable consequence of age, it can be prevented through good oral hygiene and care. Where it does still occur, early dental implant treatment can help prevent dramatic jaw alterations from developing. However, whilst aging and edentulism remain hand-in-hand in the popular imagination, younger patients face a double blow aesthetically as it can leave them looking prematurely aged. Though fewer younger patients have need for dental implants, among those who do, it can be a truly transformative solution.
Research has found that patients are generally more satisfied with their face following aesthetic dental treatments, and that this raises their overall satisfaction with their body. However, this can be modified by the personality of the individual. Patients who scored higher for neuroticism were found to experience lower satisfaction with their body, both before and after cosmetic treatments. The study also found that the more pleased patients were with their body generally prior to treatment, the higher their reported satisfaction following treatment.[ii] This makes sense if we consider that a defect in the aesthetic zone can have a marring effect, which can be quite noticeable and have an outsized impact for its relatively small scale on aesthetic judgements. More broadly, the full success of any aesthetic treatment – no matter how well executed – will always be in the eye of the patient. It is therefore imperative to understand the patient, what they expect from treatment, and to give them a realistic prognosis.
Whilst the circumstances of the pandemic have been anxiety-inducing, the return to normalcy brings its own challenges. Though lockdown was generally stressful, the relative isolation did provide, in some cases, a welcome reprieve from aesthetic judgements (especially for those who did not partake in regular video calls). As people return from remote working and resume socialising, concerns over personal appearance will return in force. For instance, many people feel very conscious of weight that they put on during the pandemic, and are now anxious to lose it. Others have gotten used to presenting a distorted vision of themselves electronically, for example using filters on video calls and social media photos, many of which subtly alter the structure and colouration of the face. Over time, this may increase their own dissatisfaction with their appearance.[iii] This technological trend was already being linked to rising dysmorphia, self-image issues and increased demand for cosmetic procedures prior to the pandemic, and it seems likely that a rise in electronic communication and socialisation with a corresponding decrease in in-person contact would exacerbate such trends.[iv] For individuals concerned about the appearance of their teeth, the widespread adoption of face masks had the ancillary benefit of hiding this area of concern. As mask wearing diminishes, they must again confront people judging the appearance of their teeth, or at least their perception that people are doing so.
Patients have faced unprecedented disruption accessing dental treatment during the pandemic, and many have chosen to avoid or postpone treatment during this challenging time. In some cases, this lapse will have seen patients’ oral health condition deteriorate, leaving them more urgently needing treatment now. This, coupled with an uptick in demand for complex treatments and technically demanding cosmetic procedures, is creating a lot of pressure on practices. Many patients will benefit from being referred, but you want to make sure that your patients are always in the best of hands.
If you have a patient interested in dental implants, and are looking to refer them, Ten Dental+Facial is a well-established clinic with excellent facilities and experienced, friendly staff. Adhering to stringent infection control measures, you can be assured that your patient will receive the best care in the safest conditions. The multi award-winning team accepts referrals ranging from simple to advanced implant cases, including those where existing implants are in danger of failing. We make sure patients have a realistic view of what is achievable through treatment, and ensure that patients know how to maintain their implants before they are returned to you for on-going review and follow-up treatment.
Cosmetic concerns should not be trivialised. The aesthetics of a patient’s smile can have a powerful effect on how they see themselves and how they are treated by others. In a period of heightened social anxiety, it is especially valuable to help patients receive treatment that achieves aesthetic excellence not just functional success.
[i] Zaidi A., Karim A., Mohiuddin S., Rehman K. Effects of dental aesthetics on psycho-social wellbeing among students of health sciences. Journal of the Pakistan Medical Association. 2020; 70(6): 1002-1005. https://pubmed.ncbi.nlm.nih.gov/32810096/ July 20, 2021.
[ii] Sarin S., Gilbert D., Asimakopoulou K. Why simple aesthetic dental treatment in general practice does not make all patients happy. British Dental Journal. 2014; 216: 681-685. https://www.nature.com/articles/sj.bdj.2014.524 July 20, 2021.
[iii] Himanshu, Kaur A., Kaur A., Singla G. Rising dysmorphia among adolescents: a cause for concern. Journal of Family Medicine and Primary Care. 2020; 9(2): 567-570. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7114025/ July 20, 2021.
[iv] Chen J., Ishii M., Bater K., Darrach H., Liao D., Huynh P., Reh I., Nellis J., Kumar A., Ishii L. Association between the use of social media and photograph editing applications, self-esteem, and cosmetic surgery acceptance. JAMA Facial Plastic Surgery. 2019; 21(5): 361-366. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6604085/ July 20, 2021.