Dentures or Implants: Which Do I Need?

By Tien Dang - Doctor of Dental Surgery                      

Dentures or Implants: Which Do I Need?

Over the course of our lifetime, our teeth are put under a lot of stress from everyday eating, speaking, clenching and grinding. If you consider those stressors in addition to other factors such as tooth decay, gum disease, trauma, injury, and poor oral hygiene, you will quickly realize why 120 million people in the US are missing at least one tooth. Of those people, over 36 million are missing all of their teeth! Fortunately, dentistry today can offer many solutions to missing teeth  so that you can fully enjoy your quality of life with a complete set of pearly whites. Let’s dive into the two best ways to restore missing teeth: dentures and dental implants!

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What are Dentures?

Dentures are appliances that rely on surrounding soft oral tissue, such as the gums, to support their substitute teeth.                          

There are numerous types of dentures for different situations, with each one being made specifically for you. Dentures can be fabricated out of many materials, such as resin or metal, or a combination of both.

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Complete Dentures
Complete dentures are indicated for people who are missing all of their teeth in either arch of their mouth.

Complete dentures are removable and are supported solely by soft tissue in your mouth, such as your gums. Complete dentures are removed when you sleep, and this allows you to clean them overnight in a denture cleaning solution! This feature also lets your gums to “breathe,” helping to avoid mouth fungal infections.

Many people choose complete dentures for the same reasons that they choose partial dentures: there is no surgery required and the wearer has full control of when they want to have the dentures in their mouth. Remember though, complete dentures require high maintenance and must be constantly cleaned to avoid infection and halitosis.

If you’re looking to clean your dentures, we recommend following these simple steps.

Immediate Dentures
Immediate dentures are temporary dentures that are intended to last for around 6 months.

Immediate dentures are inserted while waiting for the gums and mouth to heal before another procedure can be done for a more permanent option. Immediate dentures are usually worn by people who need to have all of their teeth removed due to infection, or severe periodontal disease.

Plus, immediate dentures help the patient to have teeth the same day they extract so that they don’t leave the office with no teeth at all. Because they are only a temporary solution while we wait for your gums to heal, immediate dentures tend not to fit perfectly well and will eventually require replacement.

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Overdentures
An Overdenture is a regular complete denture that attaches itself to dental implants.                          

Overdentures provide a much more secure, firm, and clean connection. Overdentures rely on dental implants for support and in the process prevent bone resorption (the breakdown of the bone for nutrients and minerals by the body) in the jaw.

‍Overdentures also improve sensory function because the chewing forces are transmitted to the denture, then to the implant and down into the bone. Overdentures tend to be more expensive than regular dentures because they require implants to be placed in order for them to stay in place.            

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The Denture Process  

The process of getting dentures made is relatively straight forward:                          

 
1. A 3D scan and impressions of your mouth are taken.
             
2. Your dentist will evaluate your case to help you choose the correct type of dentures that suit your specific needs.              
             
3. Dentures will be fabricated by a dental lab, and appointments will be booked every few months to make sure that the dentures are fitting comfortably.              
           

The main benefit of dentures is that they are more accessible and inexpensive than dental implants. Dentures don’t require complicated surgery in order to wear them and have a relatively quick turnaround time in comparison to other tooth replacement options.            

The main drawback of dentures is that they require more maintenance, as they have to be cared for when they are out of your mouth, and they tend to last for a shorter period of time (5-10 years) than dental implants (15-25 years) do. On top of that, the feel of dentures is not the same that dental implants have.            

Dentures rely on support from your gums and other teeth, so prolonged wear can cause bone loss and discomfort as the denture rubs inside your mouth. Since the underlying bone isn’t being stimulated any longer when you chew and speak, bone loss can happen over time.            

Dental implants are more firmly attached to the mouth and as a result, they move around less and look more natural. The stimulation from chewing and speaking is conducted down the implant, and into the bone, where it stimulates bone cells to remain and not resorb over time.            

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What are Dental Implants?

Dental Implants replace teeth permanently, and never require any removing to clean them.                          

There are numerous types of dentures for different situations, with each one being made specifically for you. Dentures can be fabricated out of many materials, such as resin or metal, or a combination of both.

There are 3 main components that make up a dental implant:                          

             
1. The dental implant itself is made out of titanium or a titanium alloy and is inserted into the jawbone. This acts similarly to the root in a natural tooth and provides a strong foundation for replacement teeth. Titanium is used since it is a biocompatible metal in the body (all areas of medicine uses titanium: hip replacements, bone splinting, titanium meshes found in heart stents, etc).              
             
2. A part called the “abutment”. The function of this piece is to connect the dental implant to the overlying crown. Abutments help to make replacement of                 worn down or damaged crowns much easier since any damage to the crown will not likely damage the underlying implant.              
             
3. The crown, which is similar to the visible part of the tooth. The crown is what does all of the chewing. It is connected to the abutment, which is connected to the implant and is custom made from resin or ceramic, which mimics the color and feel of real teeth.              
           

Implants: Benefits and Drawbacks

At a glance:            

             
• Implants do not result in bone loss because it keeps your jaw engaged and working.              
             
• Dental implants are more stable than dentures and last longer without the need for cleaning every night.              
             
• Dental implants cannot be removed at will and must be installed or removed surgically.              
             
• The implant installation process is more invasive and has a greater likelihood of infection.              
           

Some of the biggest reasons why many people opt for dental implants are because they are permanent, look like real teeth, and feel incredibly natural!            

Implants tend to last much longer than dentures and typically match the color of your natural teeth better than dentures will. Plus, dental implants are fused with the bone, so they are more firm in your mouth and do not move around as dentures do. This makes implants look and feel more natural! Dental implants also have the added benefit of helping keep the jaw bone from deteriorating, because the implants are attached to your jaw and you’ll exercise it when you chew.            

However, dental implants do have some drawbacks. Typically, implants are more expensive than dentures, and they also have a longer process of completion. There will be a 2-6 month healing period where the implant will need time to “osseointegrate”, which means that the bone and implant have become fused together. During that time, however, you can opt for temporary dentures to replace your missing teeth while you wait for your implant to fuse to the bone.   

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The Implant Process

The implant process takes a few months and can span many appointments.

         
1. 3D scans are used to locate the best position for the dental implants and to visualize what it will look like.          
         
2. The implant is placed and allowed to osseointegrate for 2-6 months.          
         
3. A healing cover is then placed on top of the implant to mold the gum to the final shape that the crown will need.          
         
4. Temporary dentures will be given for cosmetic purposes if the patient desires.          
         
5. Once it is confirmed that the root has integrated properly, the custom made crowns are placed on the root and the healing cover is removed. You are now ready to enjoy your new teeth!          
       

Are Dentures or Implants Right For Me?

When do I need Dentures?

         
1. If you need to have many missing teeth replaced at the same time.          
         
2. If you cannot afford multiple implants or other restorative options.          
         
3. When you are undergoing a transition period of extracting hopeless teeth, and need something to replace your missing teeth in the interim.          
       

When Do I Need Dental Implants?

         
1. When you wish to replace missing teeth, without having to worry about taking them out to clean and apply adhesives every day.          
         
2. If you want to have a permanent replacement that is anatomically and functionally similar to a normal tooth.          
         
3. When you want a more natural look when talking and chewing and that is more stable and firm in your mouth.          
         
4. If you want to prevent bone loss dental implants are likely for you. Dental implants engage the jaw and have been shown to help preserve your jaw bone.          
       

Dentures and Implants Example Scenarios:

I am 80 years old and I am missing my entire bottom row of teeth        

In this case, complete dentures are preferable to implants for a few reasons. First, your age means that the tissue might not be healthy enough for implants, and the added possibility of complications when inserting implants isn’t a risk that is worth taking. Financially, it is also a cheaper option since one denture can replace an entire row of teeth, while many implants are required to place an entire row.        

I am 21 years old and I lost one of my front teeth in an accident        

A dental implant would be the best option. The tissues in your mouth and jaw bone are likely healthy enough for dental implants. The fact that only one tooth is missing makes also makes it easy to insert the implants. Finally, because of your young age, having implants means that they will last for most of the patient’s life. You won’t have to go through the hassle of removing dentures every day!        

I’m in my 60’s and I lost most of my natural teeth in the bottom row except for a few.        

In this case, the patient has numerous options to choose from, with each having their own unique set of benefits and cons.        

Assuming that the few teeth leftover are all still healthy, they can choose the partial denture route. A partial denture will sit on top of the areas where the teeth are missing, utilizing the strength of the remaining teeth and gums to hold them in place. This option is the least expensive since no surgery is required before or after placing them. The major con of this option is that the remaining teeth will also be lost over time since extra forces are being put on the remaining teeth to help hold the partial denture in place.        

If the remaining teeth are unhealthy, the doctor may recommend extracting the remaining teeth to have a complete denture placed instead. A complete denture will replace the entire row of teeth, and can be customized to have any appearance desired. Some cons of this option include: requirement for adhesives will be required to hold the denture in place, loss of sensory feeling when chewing, adaptation period to speak and chew, and bone loss over time due to lack of stimulation at the bone level.

An over denture is simply the complete denture, only with a few implants placed underneath that help to hold the overlaying denture in place. This option is more beneficial than the conventional denture because no adhesives are required to hold it in place, bone loss will lessen significantly, and less healing time is required to speak and chew.