Fixed and Removable Dentures
If you have lost an entire arch of teeth (top and/or bottom), or are soon to have your remaining teeth removed because they are too unhealthy to save, you may be able to replace them with fixed dentures supported by dental implants. Doctors and patients alike prefer fixed over removable dentures because they:
- Look, feel and function just like natural teeth
- Don't slip when you eat or talk
- Prevent bone loss in the jaw
- Last a lifetime
How It Works
Dental implants serve the same purpose as the roots of natural teeth: anchoring the replacement teeth to your jawbone. Just like natural tooth roots, they lie under the gum line and therefore are not visible in the mouth. Only the lifelike prosthetic teeth attached to them (the fixed denture) can be seen by you or anyone else. Because dental implants are made of titanium, a metal that has the unique ability to fuse to living bone, they are extremely stable and reliable. How many implants are needed? The number varies because each individual has unique conditions: Depending on the volume and density of the bone in your jaw, you will need as few as four implants or as many as six for your new teeth to function as well as a set of healthy, natural teeth.
What to Expect
The surgery to place dental implants that support a fixed denture is a simple, routine procedure carried out in an office setting, under local anesthesia in most cases. (If you need to have failing teeth removed, that will be done first, often the same day your implants are placed). After numbing the area, the appropriate number of implants will be placed in your jaw at precisely planned angles and positions to maximize support and avoid anatomical structures such as nerves and sinuses. Depending on how many implants are needed, the surgery can take anywhere from one to three hours. Most people who have dental implants placed find that any post-operative discomfort can be managed with over-the-counter anti-inflammatory medication such as ibuprofen or acetaminophen. Some don't even need to take that.
What happens immediately after surgery will depend on what's best to promote healing in your individual situation. Sometimes a set of temporary teeth can be attached immediately, so that you can leave the office with new teeth. A few months later, your permanent replacement teeth with be installed. In other cases, the implants will be left to heal for several months before any teeth are attached. Sometimes that is the best way to insure that the implants remain undisturbed as they go through the process of fusing to your jawbone, which is known as osseointegration.
In either case, you will need to go easy on your newly placed implants during the crucial healing phase following surgery. You will be advised to eat a softer diet and avoid hard, chewy foods until the process of osseointegration is complete — about three months. While this may seem like a long time, keep in mind that people who wear removable dentures often avoid these foods permanently. The good news is that once your implants have fused to your jawbone and your new permanent teeth are attached, you will be able to eat anything you want. In fact, you are likely to forget you even have dental implants!
Full or partial tooth loss, if left untreated, doesn't just affect a person's self-image — it can also increase the risk of developing nutritional problems and other systemic health disorders. Fortunately, there's a reliable and time-tested method for treating this condition: full or partial dentures.
Dentures are just one option for replacing missing teeth; some of the others include fixed bridgework and dental implants. Each method has its particular pluses and minuses, which should be carefully considered. There are also several varieties of dentures available to address specific issues, from partial dentures to implant-supported overdentures. The best option for you will depend on your individual situation.
How Do Removable Dentures Work?
Full or partial dentures consist of a gum-colored base made of plastic resin, which fits over the remaining alveolar (bone) ridge that formerly held the teeth. The prosthetic teeth projecting from the base are designed to look and function just like your natural teeth. Dentures are held in place primarily by the suctioning effect of their close fit against the alveolar ridges — that's why it's so important that they are fitted properly. The upper denture also gets extra support from the large surface area of the roof of the mouth (palate), which generally makes it extremely stable.
At first, wearing dentures may require some getting used to in terms of talking and eating, as the dentures become “balanced” in the space formerly occupied by the teeth. But over time, the muscles, nerves and ligaments of the mouth learn to work in new ways, which allows these functions to occur normally. Dentures also help support the facial skeleton and the soft tissues of the lips and cheeks, which can help create a more youthful appearance.
Types of Full Dentures
Immediate Dentures: These are usually a temporary means of helping you transition to successful denture wearing. Because of the muscular readjustment required, as well as the natural shrinkage of gums, the dentures which are placed immediately after tooth extraction won't fit as well as permanent dentures made when the healing is complete. They do, however, provide you with new teeth right away, and give you time to adjust.
Conventional Full Dentures: After a period of time, permanent dentures that conform to your mouth with near-perfect accuracy can be fabricated. These are carefully crafted to look as much like your own natural teeth as possible, and are able to function properly in your mouth for a long time.
Implant-Supported Overdentures: To increase the stability of a lower or upper denture, it's possible for it to be securely anchored using two or more dental implants. The upper jaw requires more implants (generally three or more) than the lower jaw due to a lesser bone density. Many people find this option offers a great balance of comfort, functionality and value.
Types of Partial Dentures
Transitional Partial Dentures: These relatively inexpensive removable plastic dentures serve as a temporary tooth replacement and space maintainer as you wait for your mouth to heal from tooth extraction, for example. Once the healing process is complete, dental implants can be placed.
Removable Partial Dentures (RPDs): Usually made of cast vitallium, these well-constructed, metal-based removable partial dentures are much lighter and less obtrusive than those made of plastic. They are a little more expensive than plastic dentures but will fit better. They are, however, much less expensive than implants or fixed bridgework.
How Dentures Are Made and Fitted
Making quality dentures is a blend of science and art. First, an accurate impression (mold) is made of the alveolar ridges on the top and bottom of your mouth. The base of the denture is made from this mold in a dental laboratory. Working together, the dentist and lab technician choose from among many different sizes and shapes of prosthetic teeth to re-create a natural-looking smile. When everyone is satisfied with the result, the temporary dentures are made in permanent form.
To enable normal speech and eating, it's crucial to balance your bite. This means that the upper and lower dentures come together and properly stabilize each other. The form and function of the dentures are carefully checked to ensure that they are working and fitting properly.
What to Expect After You Get Dentures
If you've recently lost your teeth and received an immediate denture, it's normal to find some tissue shrinkage and bone loss occurring. Therefore, in several months you may find that your immediate dentures no longer fit well. You will have two choices at this point: You can have your immediate (temporary) dentures re-lined. This means that material is added under the denture's base to better conform to the new contours of your alveolar ridge. A better option is to move to a set of conventional full dentures, which will last longer and fit better. With proper care, dentures offer a functional, aesthetic and economical solution to the problem of tooth loss.
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