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Abstract
It has been claimed that permanent dental implants improve the well-being of patients distressed by their removable dentures. Research appears to suggest that this improvement is temporary but the findings have been obscured by the use of inappropriate measures of distress, failure to control for Type II and (in ubiquitous use of repeated pair-wise testing) Type I statistical error, poor measures of dental functioning, inadequate descriptions of sampling, failure to include moderating variables such as the impact of dentures on daily living and failure to allow for causal effects of distress. Individual variation has been overlooked: only some patients may be significantly distressed by their dentures. It has been difficult to find control groups of patients to exclude the effect of confounding influences. The crucial assumption, that psychological distress reduces as dental functioning improves, has not been examined. Statistical modelling, using suitable measures of chronic distress, controlling for the effects of moderating variables and examining causal relationships, would help to clarify this, Psychological distress, according to statistical analysis designed to avoid Type I and Type II error, should be less, long after the fitting of implants than before.