Tooth loss is something we see daily in our dental offices. For us it’s a matter of fact, a straightforward physical process. But for patients, losing a tooth can be much more than that; it can be very emotional. Whether it’s the loss of a single tooth or becoming completely edentulous, this can trigger unexpected emotions, including grief.
This grief can go beyond the functional aspect of tooth loss and touch on someone’s sense of aging, self-worth, self-identity, and self-confidence. Being aware of someone’s grief about tooth loss and its impact on the person can help us be more empathetic with these patients.
For many people, losing a tooth feels like losing a part of themselves. A patient just this week told me she felt like she’d lost a part of herself when her teeth were extracted. That is a very emotional feeling. Losing a part of oneself is grief-inducing.
I personally experienced this grief. As a dental professional, I’m aware of what it takes to care for my oral health, and I’ve taken good care of my mouth. I have very little restorative work except for one tooth, which started with a crack and has been a problem for more than 20 years. When it finally reached the point of no return, the thought of losing my tooth was very difficult for me. I didn’t think it would be so hard!
I see tooth loss and discuss extractions with patients every day. But when it happened to me, it brought unexpected waves of emotion. I felt like I’d failed, that I hadn’t done everything I could have, that maybe there was still a way to save it. In reality, I’d done more than most people to be able to keep my tooth. I’d had endo, retreat endo, and a total of six crowns placed on the tooth; I’d really tried. This made me stop and think of the grief that patients can experience with tooth loss.
Why losing a single tooth feels so significant
The loss of one tooth (partial edentulism) might not seem life-changing, but for a patient it can feel huge. Our teeth are part of our self-image. They’re not just our smiles; they shape our faces and contribute to the youthfulness or aging of our faces. A person’s smile is often the first thing people see, and it contributes to someone’s self-confidence. When a single tooth is lost, it may leave a visible space, which can cause anxiety about appearance. Having a gap in one’s smile may lead to embarrassment in social settings, making the person self-conscious and hesitant to fully smile.
Beyond esthetics, losing a tooth can influence a person’s view of their overall health and age. Young patients may feel discouraged, as tooth loss is often associated with something that occurs in older people. They may have worries about this being the beginning of a trend and potentially leading to more oral health problems.
The emotional toll of total tooth loss
When a patient experiences total tooth loss (full edentulism), the emotional impact can be even more extreme. This can significantly change the way someone interacts with society. The loss affects their appearance, speech, eating habits, and diet. It influences their self-confidence, daily life, and overall quality of life. Edentulism is usually perceived as an indicator of aging, making some people feel that they’ve lost part of their youth.
Social isolation can accompany edentulism. People may avoid social outings, eating meals in public, or speaking in public for fear others may notice their dental condition or they’ll be judged for the loss. Such concerns can lead to withdrawal from family gatherings, going out with friends, and attending public events. This isolation can take a toll on a person’s mental health and contribute to depression or low self-worth.
Stages of grief in tooth loss
When they lose teeth, patients will go often through the normal stages of grief.
1.Denial and shock: They react with initial disbelief, especially patients who didn’t anticipate the tooth loss. They may feel frustrated or be in disbelief, wondering how this happened or what they did wrong.
2. Anger and frustration: They have frustration over the causes, whether dental neglect, aging, illness, or accident. Anger often occurs if the loss was preventable or the result of an accident.
3. Bargaining and regret: They have regret over not taking the necessary preventive steps. The patient may wonder what they could have done to prevent the loss.
4. Sadness and grief: They feel sad about the loss of their smile as well as the functional loss. Patients experience changes in their appearance and perhaps their ability to chew and speak.
5. Acceptance and adaptation: Moving toward acceptance, patients often explore restorative options such as implants, bridges, and dentures. This stage takes time to accept the differences and gain back their lost confidence.
Support patients through the grieving process
Understanding that patients with tooth loss go through the grieving process can help clinicians be more empathetic and compassionate. Experiencing my own tooth loss enabled me to better comprehend the impact on someone’s confidence and self-identity. Acknowledge their grief and offer validation that this grief is real and a common reaction to tooth loss. This is important, especially for full edentulism. Presenting restorative options to the patient can help them regain confidence.
Reassure patients and reinforce that losing a tooth is sometimes an unavoidable part of life and grief is normal. Encourage them to have self-compassion and remind them to be gentle with themselves and learn from the experience. Tooth loss does not define someone.
