is a removable replacement for missing
teeth and nearby gum tissue. Usually made of
acrylic, dentures can replace all of a patient’s
teeth (complete dentures) or only some missing
teeth (partial dentures).
design and technology has improved, and it is
now possible to have aesthetic, functional and
Consequence of missing teeth
many reasons why you might be missing teeth; it
is a common complaint at the dental office.
|Complete dentures have
greatly increased the vertical facial
height of this patient, as seen in the
before and after photos.
you get the missing tooth or teeth replaced
though? The most popular reason is appearance. A
smile that shows off missing teeth often sends
an uncomplimentary message to others. If a
considerable number of teeth are missing, your
mouth might be over-closing, resulting in a face
that appears short. From a dentist's
standpoint though, there are greater concerns
than just appearance.
are missing, the above teeth might begin
erupting (coming out of their socket) into the
empty space. A missing tooth can also result in
nearby teeth drifting, or tipping, into the open
space. Problems in occlusion (bite) can arise,
making it difficult to close the mouth or chew.
Speech sounds can also be altered if prominent
teeth are missing.
such consequences, not all teeth require
replacement. In the case of older patients,
most can lead functional lives while missing
their second and third molars. Always question
your dentist's reasons for wanting to replace a
missing tooth that is not affecting your
Options For Replacing Teeth/Tooth
have several options for replacing missing teeth
- not all options apply to every patient though.
The following are viable options for replacing
one or more teeth:
Partial or Full Dentures
Bridges (Fixed, Resin-bonded, or Cantilever)
various factors that dentists consider in
choosing the best option. Some include:
of teeth missing: When only 1 or 2 teeth are
missing, implants are the best option.
Alternatively, bridges can be placed. Partial
dentures are good for cases when more than 3-4
teeth are missing, and complete dentures are for
when all teeth are missing.
Dental implants are very costly, and are not
covered by most dental insurance programs.
Bridges are usually second in cost, followed by
partial or full dentures.
Time: Bridges are usually completed by
two appointments in the course of a week.
Dentures are made as quickly, but need
adjustments over the course of months. Implants
involve surgery, and require several months for
health: The biggest dental concern is the
condition within the mouth. Few dentists will
place implants in patients who are avid smokers,
as they are prone to failure. Similarly, bridges
need to be supported by nearby teeth, so those
teeth need to be of sound health. Dentures have
the highest success rate in those with poor oral
Dental implants are the gold standard for
replacing missing teeth, and many patients can
hardly tell them apart from real teeth. Bridges
are also highly aesthetic and fixed in the
mouth, but keeping them clean can be difficult.
Dentures can appear natural, but can slip out
while eating certain foods, so most patients
need to learn to adapt.
your dentist why they chose a particular
treatment in replacing missing teeth. They
should be more than willing to explain their
reasoning to you.
(above) and partial dentures (below).
of dentures are available – complete and
partial. Complete dentures are used when
all teeth are missing in an arch (upper
or lower) and partial dentures are for when some
natural teeth remain. If your few remaining
natural teeth are mobile, heavily decayed or
worn down, your dentist may suggest extracting
them and opting for complete dentures – always
consider the consequence of tooth extractions
dentures are either of the “conventional” or
“immediate” type, depending on when they are
made. Immediate complete dentures are made in
advance so that they can be placed right after
your teeth have been extracted. This saves you
the embarrassment of being seen without teeth as
your gums heal from the extractions. During the
healing process though, your bones and gums
shrink, so your immediate dentures will require
regular adjustments to ensure proper fit –
therefore, immediate dentures are a temporary
solution. Conventional dentures are made 2 to 3
months after your teeth have been removed and
healing is complete. They are better fitting and
only need occasional adjustments.
type of denture is a partial denture. A
removable partial denture consists of
replacement teeth attached to a pink or
gum-colored plastic base, which is connected by
metal framework that holds the denture in place
in the mouth. Partial dentures are used when one
or more natural teeth remain in the upper or
|Clasps built within the
partial denture framework circle and
hold onto natural teeth for increased
retention. They are usually placed
around back teeth to keep them hidden.
dentures are designed to adapt perfectly to the
mouth contour. Adaptation to the bone and gums,
as well as the patient’s unconscious
neuromuscular control, helps retain complete
dentures in the mouth. Because of the tongue,
lower complete dentures are more difficult to
keep in the mouth than their upper counterpart.
dentures are removable but have internal
attachments, such as clasps, that attach to
adjacent teeth, helping to keep them in the
mouth. Partial dentures are therefore
considerably more retentive than complete
|Example of lower
relatively recent development has been the use
of implants alongside traditional complete
dentures. Complete dentures are aesthetic,
cheap, but do not retain well in the mouth
(especially lower dentures). Implants are
permanently fixed in the mouth, but are too
costly to replace all the teeth in a dental
arch. Clinicians have combined the best features
of both by developing implant-supported
three to four implants are placed in the
jawbone. Then, instead of placing artificial
porcelain teeth, small “male” abutments are
attached on top. The complete denture is
separate and has “female” parts underneath that
bind and “lock” onto the implant abutments.
Dentures made in this manner are held firmly in
place and can only be removed in one direction.
implants are involved, the cost goes up
considerably, and other issues need to be
considered. The dental implant portion of the
site outlines all major concerns.
dentures takes anywhere from 2 weeks to 2 months
depending on the number of adjustments required.
first dental visit, your dentist will examine
your gums, supporting bone, and remaining teeth
to make a recommendation. In some rare cases,
oral surgery is performed to correct bony ridges
that may interfere with the stability of the
denture. Your dentist may suggest extracting
remaining teeth and using complete dentures, in
which case, further oral surgery is required.
Once your dentist has decided that dentures are
right for you, he or she will make an impression
of the gums to identify every ridge and crevice
to ensure the best denture fit possible. This is
a crucial step that determines the comfort of
the final product. If you are receiving a
partial denture, your dentist may drill the
surface of certain teeth to create “rests”. The
final metal framework of your partial denture
will fit into these rests and provide support to
the denture through your natural teeth.
dentist will then take further impressions of
your mouth and take measurements on how your
jaws relate to each other. For the following
appointment, your dentist will have models, wax
forms, and plastic patterns of your future
denture ready. You will try them in, and the
denture will be assessed for color, shape, and
fit before the final denture is cast. You will
be given the chance to select the shape, size
and color of your denture teeth at this stage.
By the next
appointment, your dentist will have the final
denture ready. You will try it in, and any major
adjustments will be made then and there. Over
the next few weeks, you will note small
alterations that need to be made, and your
dentist will comply in follow-up appointments.
dentures will feel awkward and loose for a few
weeks, especially if they are complete dentures.
Over that time, your check muscles and tongue
learn to keep them in place, and you become
comfortable inserting and removing them. This is
a unconscious learned process – your body simply
learns to adapt without you placing any effort.
time, it is not unusual to have minor
irritations or soreness. You may find your
saliva flow increases, but these should all
disappear in a few weeks time. If there is an
obvious problem, where the dentures do not sit
properly or impinge on tissue, inform your
dentist right away. Frequently, the problems
listed above do not resolve on their own and
minor adjustments to the denture are required –
see your dentist.
|Denture solutions or
tablets help keep dentures clean
over-night. Proper denture care is
essential to ensure they last long.
Even if you
wear full dentures, you still must take good
care of your mouth. Too often patients assume
that not having any natural teeth means they can
forgo good oral healthcare – this is simply not
true. Everything from periodontal disease (gum
disease) to fungal infection of the mouth is
probable with patients who have poor oral
gums, tongue and palate every morning with a
soft-bristled brush before you insert your
dentures to stimulate circulation in your
tissues and help remove plaque. When removing
dentures at night, brush the dentures carefully
to remove any loose debris and plaque then soak
them in a cleansing solution. Some people keep
their dentures in an ultrasonic cleaner, but
this does not replace manual brushing.
patients may need teeth extractions, implant
placement, or surgery for removing bony
protrusions (tori) – these are all additional
costs. Fortunately, since dentures are the
cheaper alternative for dental bridges and
implants, most insurance programs will cover a
portion of the costs.
dentures can range from $500 to $2000 per arch
(upper or lower) if done by a dental specialist
such as a prosthodontist. You can save money by
finding a capable general dentist, as they
charge from $300 to $1200 per arch, on average.
on how many teeth require replacement, the
complexity of the design, and the metal
framework material used, the cost of partial
dentures can greatly vary. We suggest you shop
around, but be aware that poorly constructed
dentures mean hours of adjustment down the road
and a great deal of added aggravation.
your dentures last depends on many factors
including how you take care of them and also how
much you use them in terms of general wear and
tear. Over time dentures become loose as your
gums shrink and your bite changes. When this
happens you may need a new set of dentures or in
some cases a simple modification of your
existing dentures may solve the problem.
recommend getting new dentures every 6-8 years
since simple adjustments to old dentures are not
enough by that time.
Advantages & disadvantages
care, dentures can last long – up to a decade.
Compared to other treatments, dentures are
non-invasive and cheap. Dentures can replace
missing teeth and gum tissue (bridges and
implants only replace the tooth, not the tissue)
and appear natural to most. They are functional
and allow for chewing and speech.
some clear disadvantages with dentures though.
They take time getting adjusted to, and chewing
function will never be as it was with natural
teeth. Mouth irritation and sores develop over
the years, but are quickly resolved with denture
adjustments made during regular checkups. Many
patients have trouble keeping lower dentures in
place, and since upper dentures cover the
palate, taste sensation is somewhat reduced.