Psychosocial Implications of Tooth Loss and Dental Rehabilitation in Vulnerable Edentulous Older Adults in Chile: A Qualitative Study

BACKGROUND: Complete tooth loss remains highly prevalent among older adults and disproportionately affects the most disadvantaged. Although the functional consequences of edentulism and subsequent rehabilitation are well documented, its psychological and emotional implications, particularly in vulnerable older populations, are less explored. OBJECTIVE: This study aimed to explore the psychological and emotional impact of tooth loss and complete denture rehabilitation among a sample of vulnerable edentulous older adults in Chile. MATERIALS AND METHODS: A qualitative narrative study with a hermeneutic orientation was conducted. In-depth semi-structured interviews were carried out with 10 completely edentulous adults aged 70-80 years who had received free comprehensive dental rehabilitation (conventional complete dentures or implant-retained mandibular overdentures) through a publicly funded program in a highly deprived urban area. Interviews were audio-recorded, transcribed verbatim, and analyzed inductively using thematic narrative analysis. RESULTS: Two overarching categories emerged: psychological suffering and impact of dental rehabilitation on psychological well-being. Psychological suffering was characterised by shame related to appearance, erosion of identity and self-esteem, fear of social judgement leading to social withdrawal, and the aggravating role of economic deprivation. Tooth loss generated profound emotional distress extending beyond functional impairment, often remaining hidden yet substantially affecting social participation and sense of self. In contrast, dental rehabilitation was perceived as transformative, restoring not only oral function but also confidence, dignity, social engagement and emotional well-being. CONCLUSIONS: Tooth loss is a significant source of psychological suffering in later life, particularly among socioeconomically vulnerable older adults, with adverse effects on social participation and well-being that may be mitigated through timely access to adequate dental rehabilitation.