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Psychiatric Implications for Implant Dentistry

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A beautiful smile doesn’t just look great, but it also makes you feel confident. The advancement in dentistry has made it possible for anyone who can afford it to have beautiful teeth in less than a day if they wished to. Implants have become one of the more requested treatments to combat tooth decay or loss of teeth. There are also adverse side effects to advanced medical procedures like all on 4 dental implants that can affect many people who were not prepared for some side effects. 

What are all-on-4 implants?

This type of implant is for patients who have had all their teeth removed and have no desire to reinsert a denture constantly. A denture is placed onto the entire top or bottom jaw and is secured onto four implants that hold it in place. They have the same function as your natural teeth would and could be cleaned the same way. Unlike certain other implants, these are not removed daily. 


There is a degree of pain involved in having a procedure like this done. Local anaesthetic is used during the procedure, but once the drug has worn off, the patient can experience a significant amount of pain. Much of this experience has been linked to chronic inflammation due to metal hypersensitivity from titanium implants. Medical scientists are working on alternative Zirconium replacement metals to use for all-on-4 dental implants. Often the alveolar nerve gets penetrated when drilling in the lower jaw is done too deeply, and it can affect the sensations that patients will have in the future. Some patients have experienced slight discomfort with cleaning and chewing, but the percentage is too low to add as a significant adverse side effect. 

Psychological effects

For patients suffering from bad dental health, an implant like the all-on-4 dental implants can significantly improve their mental state. It can induce feelings of confidence because they smile more, eat better, and live their lives with less focus on their physical appearance. A boost in anyone’s confidence, especially those with compromised mental health, can lead to the patient living a happier lifestyle. However, for patients who have a severe mental illness, the all-on-4 dental implant could reverse this confidence. The patient’s mental health would need to be considered as their lifestyle could affect the implant negatively. A psychiatric evaluation is usually done before the procedure to assess whether the candidate would be suitable for the implant. Even if the warning signs are low, the patient should still go through a screening to determine if they will cope with the implant’s permanency. You cannot reverse the process. If any psychological screening has been omitted before the implant was inserted, it can lead to expensive treatments later on in the patient’s life.

Posttraumatic stress disorder, body dysmorphic disease, and obsessive-compulsive disorder are three of the most concerning mental health issues that negatively affect the implant’s result. The patient’s reactions could also have a very negative and financially damaging effect on the doctor and the practice or hospital where the operation was done. It could be viewed as negligence if an unfit candidate was given an implant that they were not mentally suited for.  Therefore dentists need to follow through with strict precaution to ensure that all candidates are well prepared and aware of the results before booking their operation. 

Elena Deeley did her degree in psychology at the University of Edinburgh. She has an ongoing interest in mental health and well-being.

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