Something to Chew On
Dentures vs. Implants
In recent years, there has been an explosion of options for the replacement of missing teeth. In years past, the only option for the loss of all or most teeth was dentures or partial dentures.
Full dentures are used when all of the teeth on the upper or lower jaw are missing. Partial dentures are used when some of the teeth are missing in either jaw. The term “complete dentures” usually refers to the replacement of both the upper and lower teeth with full dentures.
Partial dentures rely on the remaining teeth in the jaw for support and retention. The remaining teeth need to be stable enough so that they can support the partial denture from moving and strong enough so that they can help hold the partial denture in place.
A partial denture is removable. By that we mean that it can be removed to clean and should be removed each night before sleeping. They usually have a metal frame on the inside that supports the false teeth and have metal clasps, or hooks, that hold onto the natural teeth and support the partial denture.
A full or complete denture replaces all of the teeth. The upper complete denture relies on suction to hold it in place. The lower jaw has little to no suction and relies on a tight fit and muscle control for stability.
Dentures cover all of the palate, or roof of the mouth and all of the lower gums. As a result, an estimated 70% of the ability to taste is diminished.
Dentures and partial dentures have been used successfully throughout history and continue to be a reliable and satisfactory treatment option for tooth loss. However, there are some drawbacks to dentures. Despite their successful history and successful use, they have become a secondary option to dental implants.
As our population continues to age and our seniors are living longer, healthier and productive lives, the satisfaction with dentures has become increasingly diminished. Dentures should be removed each night before sleeping, a thought that many patients, senior or not, are not willing to do.
As we age, and if the teeth have been lost, the bones of the jaw continue to remodel and decrease in size over time. The absence of teeth leads to the “sunken in” look of patients when their dentures are removed. The loss of bone on the dental ridges increases the instability of dentures, increased irritation and decreased retention, or its ability to stay in place.
Additionally, medications, age and medical conditions can alter the quality and nature of our saliva and cause decreased muscle control. As a result, it may become increasingly more difficult to keep full dentures in place.
Another factor that I have experienced over the years working with the elderly is the difficulty in adapting to full dentures. After decades of natural teeth, I have found that many seniors, particularly those who are having medical problems or decreased cognitive function, are having difficulty adapting to the significant change. Many people are adverse to change, in general. But when impaired, to whatever extent, it may be difficult to predict whether a person may be able to adapt to complete dentures when it becomes necessary to have all of the teeth removed.
Dental implants have a strong record of predictability over the last thirty or more years, and have increasingly become the treatment of choice, when possible.
An implant is a titanium fixture, usually looking like a screw, which is surgically placed into the jaws to substitute for some or all of the missing teeth. There are many types of implants which can be properly placed by a reputable implant surgeon and dentist.
Implants heal and are directly bonded to the jaw bone. Essentially, they become part of the jaw. This helps to slow or stop bone loss in the area of the implant. The implants then act as anchors for crowns, bridges, partial or full dentures.
The number of implants required to hold a denture in place may vary, based on the type of denture that is desired. In a typical implant-denture treatment, four lower implants are placed in the lower jaw, usually more difficult to keep a denture in place than the upper. After the implants are placed, a connection is placed on them, frequently a “snap” type system. The inside of the denture has a corresponding snap and when the denture is placed, it “snaps” into place. When placed, it stays in place, is stable and food can be eaten comfortably without concern that the denture may loosen or fall out. The denture can be removed cleaned, and snapped back into place.
The retention of the denture is usually determined by the number of implants placed and the type of attachment to the denture. There are many designs and systems available and depends on what the patient requires and wants. As few as two implants can be placed to hold a lower denture in place.
Deciding What’s Right for You
Complete removable dentures are still a valuable treatment option and have satisfied patients for many years. Increasingly, it is not the treatment of choice as the implant supported dentures are more stable, preserve bone, are more predictable, don’t cover as much of the gums, decrease irritation and increase taste.
Whether or not implants are an option for you should be determined between you and your dentist. There are obviously cost, time, health and other factors which may influence your decision.
Make sure that you are seen by a reputable dentist that restores implants and works with an experienced surgeon. Make sure that you completely understand the benefits of implants as well as the exact type of implant fixture that is being recommended in your treatment plan.
While conventional dentures are and continue to be a valuable treatment option, we are fortunate to live in an era that has other options available. The ability to eat and enjoy food has become a reality for those who have been unable to wear traditional dentures successfully. Implant supported dentures should always be an option that is explored when the removal of is necessary or tooth loss has occurred.