Right now it’s estimated that around 35 million Americans don’t have any remaining natural teeth—including almost one-quarter of the population over age 65. The vast majority of these people—some 90 percent, according to the American College of Prosthodontists—wear dentures. While there are several different types of dentures available, we will concentrate here on full dentures, which may be fixed or removable. Full dentures are undeniably popular, but they do have some drawbacks that potential wearers should be aware of. Let’s look more closely at the pluses and minuses.
Removable full dentures
These time-tested devices replace an entire arch (top or bottom set) of teeth; an individual may need two sets. Each one is custom-made to fit perfectly on the bony ridge of the jaw, where the teeth used to be, and is primarily held in place by suction. Removable dentures should be taken out at night for cleaning, and to give the tissues in the mouth a chance to rest; they are the kind of “false teeth” you may picture sitting on a bedside table.
- Removable full dentures are (at least initially) the least expensive method of tooth replacement
- When well made, they can look quite natural and function adequately
- In time, most people can learn to use them effectively for eating and speaking
- Most people require an adjustment period to learn to wear dentures properly
- Many report that they have trouble eating “challenging” foods, like vegetables and meat
- Dentures don’t stop bone loss in the jaw, which starts when teeth are lost – in fact, the pressure they place on the bony ridge of the jaw tends to accelerate bone loss
- Bone loss in the jaw causes the facial features to lose support, which can create the appearance of premature aging often seen in edentulous (toothless) people
- Bone loss also means that dentures will lose their fit over time, and will need to be re-made periodically
- Dentures must be kept clean; if not, they sometimes develop bad odors or tastes
Fixed full dentures
Instead of being removable, full dentures may be held firmly in place by four to six dental implants. These are tiny screw-like posts of titanium metal, which are placed into the jawbone in a minor surgical procedure. Over time the osseophilic (bone-loving) metal implants become fused with the natural bone, and offer a solid anchorage for replacement teeth. This tooth-replacement system has pluses and minuses of its own:
- Fixed full dentures eliminate many of the problems (such as looseness and poor fit) that are associated with removable dentures
- Most people experience little trouble eating and speaking, as fixed dentures are stable
- Dental implants used with fixed dentures help prevent further bone loss by providing stimulus to the bone tissue, which keeps it from eroding
- You don’t need to remove fixed dentures removed, but they can be taken off easily by your dentist
- The implant system is initially more costly (but over time, it may actually provide a savings, because it can last a long time)
- Not everyone is a good candidate for dental implants; while most can safely have the procedure, some individuals need to avoid even minor surgery, or have other serious medical issues
- The implant process takes some time to complete – usually a few months. Temporary replacement teeth may be needed in this period.