Relevant Degree Programs
Graduate Student Supervision
Doctoral Student Supervision (Jan 2008 - Nov 2020)
Complete tooth loss is a leading cause of oral disability, and is among the mostdifficult treatment challenges in dentistry. Tooth loss, like the loss of other body parts,can generate profound emotional and social responses, but there is no comprehensivetheory to explain how people psychologically manage loss of a part of their body. Giventhe complexity of the phenomena surrounding these issues, the purpose of thisdissertation was to conduct a systematic review of the literature to search for andsynthesize the psychosocial theories commonly related to the loss of anatomical parts,such as breasts, limb, or teeth, and to explain the beliefs and behaviours of peopleresponding to such losses. The methodological challenges encountered whenconducting the systematic search and qualitative synthesis of theories are alsopresented with proposed solutions and considerations to overcome such challenges.Finally, I explore how theories from this qualitative synthesis explain the beliefs,concerns, and responses of people who experience complete tooth loss. The findings ofthe search yielded 2,540 citations that referenced 288 articles referring to 89 primarytheories containing 586 constructs. Through the synthesis of seven constructcategories, a metatheory with essential contributions from theories related tocommunications, developmental regulation, emotions, resources, and social cognitionwas integrated to explain responses to loss. Different approaches of searching werenecessary, for example, both electronic and manual searches were used, includingsearching of the reference list of selected articles to better understand the sources ofrelevant theories. Inclusion criteria were refined using iterative and inductive processesto ensure the inclusion of all relevant literature. The qualitative synthesis presented inthis study was a useful approach for developing a metatheory that provided aconceptual foundation, which was used to explain how people manage the loss ofanatomical parts. A metatheory synthesized from five dominant theories addressingcommunication, personal background, emotions, resources, and social awarenessoffers a comprehensive and plausible explanation of how people respondpsychologically and socially to the loss of their teeth, and it expands the scope ofinformation needed to help people manage their loss and subsequent treatment.
Master's Student Supervision (2010 - 2018)
Aim: To study the effect of implant overdenture maintenance events on psychosocial outcomes using existing Visual Analogue Scale (VAS) and Oral Health Impact Profile (OHIP-49) measures, and to assess the association between VAS overall satisfaction and OHIP scores. Materials and methods:The data for this study were obtained from the charts of 86 edentulous patients who began implant overdenture treatment in a randomized clinical trial at the University of British Colombia between 2003 and 2006, and were followed for 5 years. Participants had been randomly assigned to receive either one or two implants to retain their mandibular dentures. Each participant had completed two patient-based outcome questionnaires at baseline before implant treatment, two months, one, three and five years after treatment. The questionnaires were the OHIP-49 and VAS assessing the following denture related variables for mandibular and maxillary dentures separately (pain, comfort, appearance, function, stability, speech, hygiene, and overall satisfaction). All maintenance events related to implants, attachments and overdentures bases were recorded. Results:After 5 years, completed data were available for 62 participants. No significant differences in the mean value of VAS scores for all mandibular denture outcome variables and OHIP-49 scores between participants who received one and two implants allowed for pooling of all the participant data into one group to study the effects of mandibular overdenture maintenance on patient-based outcomes without specifying the number of implants they had received. Participants were divided into three maintenance groups, low, medium and high, based on the number of maintenance events they experienced during the five years. No significant differences were found in the 5-year VAS scores or in total OHIP-49 scores between the three groups of patients (ANOVA and Kruskal Wallis, p>.05). Except for the one year time point, there was a significant association at the baseline, 2 months and 5 years between the VAS overall satisfaction and total OHIP-49 scores.Conclusions:The number of maintenance events did not tend to affect patient-based outcomes. The lack of significant correlation between VAS overall satisfaction and OHIP-49 cores at the one-year interval suggests that these two questionnaires are not necessarily measuring the same outcomes.