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Dentures, Bridges or Dental Implants – you’ve got plenty of options to replace teeth. But which do you choose? Which option is best for you? While that may be for you to decide, this blog post will go over all 3 options: Dentures, Bridges and Dental Implants – and give you all the information you need to make the right decision.
Dentures are used to replace the teeth of people who have lost their teeth due to poor oral health or an accident. They are probably one of the oldest forms of replacement teeth, but they are far from the best as far as fit, comfort, function and often times esthetics.
When we lose our teeth the bone in the areas atrophies-it shrinks in both width and height. This happens very rapidly within the first six months but then continues throughout our lives. The bone in the jaw is much like our muscles-if we exercise we maintain muscle mass. As soon as we stop we lose it. The bone in the jaws are maintained as long as there is some function being placed by teeth (or implants) but if there are not teeth there is no function and the bone atrophies.
This becomes very significant in later years, because when the bone shrinks the changes that occur makes having a comfortable and secure denture very difficult. For this reason, people who have recently begun wearing dentures have much fewer problems than those that have worn them for ten years or more. One american study done ~1990 found that approximately 20% of the population who have had full dentures for a long time (~20 years or more) find it more comfortable to eat without the dentures than to keep them in!
There are 2 types of dentures: partial and complete. Complete dentures are much like the picture shown where there are no teeth in one or both jaws. Partial dentures are used when there are still some natural teeth present in one of the arches. Full or partial dentures are designed to sit on the gums and are removable by the patient. Fitting dentures requires your dentist taking impressions or molds of your teeth and gums that will be used to make the custom fitting denture teeth.
Full dentures are held in place by suction to the gum tissue, although the amount of suction can be very poor, hence many patients are forced to “glue” them in using a denture adhesive. Denture adhesives become messy, can affect taste and in over 25 years I have never met a patient who has said they really enjoy using adhesives. Usually it has just become an unfortunate necessity. Partial dentures are usually held in place by the teeth. Although they are much more secure than full dentures, they sometimes still put pressure on the gums and can be uncomfortable especially when food gets underneath. They can also create cavities or gum problems with the remaining teeth if not cleaned really well after every meal and snack.
Today’s dentures are made from acrylic which is a type of plastic-this is what the pink portion of the denture is made of. The teeth are either acrylic or porcelain. In the past porcelain was preferred because it was more esthetic however todays acrylics are equal if not superior in many ways.
Dentures are cleaned the same way you would clean your own teeth. Hygiene is extremely important to prevent bad breath, plaque, tartar and gum disease. Dentures should always be removed at night and cleaned by rinsing under water.
Alternatives – Bridges and Dental Implants:
To be comprehensive there are two other ways dentists can replace missing teeth: bridges which are attached to the adjacent teeth (usually by placing crowns on the teeth) and these are permanent; and by the use of implants. Implants are essentially artificial tooth roots and these can be made to support permanent teeth, or they can be used to retain/support a removable denture.
In the case of bridges attached to teeth, it is imperative that the teeth supporting the bridge are healthy and strong enough to last. If not then the entire bridge will be at risk of failing. If your teeth are too weak to hold a bridge your dentist may recommend partial dentures for your mouth that will be held in place with a clasp.
Implants today are without question the best way to replace missing teeth. The long term success (>10 years) with implants is over 98% if it is treatment planned according to sound scientific and clinical protocol and principles. This success rate is far greater than tooth supported bridges and far more functional and comfortable than traditional dentures.
The volume of information is really too large to discuss in this blog but please visit our site map for further information on these treatment options.
Dental Implant Materials
The most common dental implant today is an endosseous implant-which simply means it is placed into the bone. Dental implants are usually made from titanium or titanium alloy, although ceramic implants are now available in a material called zirconium oxide. This lightweight strong metal does not react adversely in the human body making rejection a non factor. The term for healing or fusing of the dental implant to the jaw bone is known as osseointegration. There are some other implant materials which have been used: stainless steel, cobalt chromium molybdenum alloy and vitallium. These are used for a different style and process of implants compared to the endosseous implants and although probably not well knowncan be very successful and be a viable alternative for some patients.
Dental Implant Procedure
Good candidates for dental implant surgery are evaluated for possible surgery if they have enough bone and gum tissue and to determine if there are any medical/health issues which may complicate the procedure. X-rays will be required to evaluate the implant sites for bone volume, density and overall dental health.
- The first stage, the implant surgeon will place a dental implant into the upper or lower jawbone beneath the gum tissue. The healing time varies depending on the general health of the patient but is usually a minimum of three months.
- A second stage of the surgery may be necessary to uncover the implant after it is healed. The dentist will attach an abutment to the implant. The abutment is the post which protrudes above the gums and allows the dentist to attach teeth
- The artificial tooth made by your dentist that is attached to the tooth may take 2 or 3 visits to properly fit in the oral cavity.
- In some cases implants can be placed the same day that a tooth is extracted
- In some cases permanent teeth (“teeth in a day”) can be placed and attached to the implants the very same day that the implant is placed.
Dental Implant Care
You do need to care for your implant teeth much the same way you did with your natural teeth. Regular maintenance includes daily brushing to prevent gum disease from developing. Post-operative patients should have teeth cleaning appointments setup with their dentists on a regular basis.
Benefits and Negatives of Dental Implants
In my opinion the biggest benefit of dental implants is their ability to restore comfort, function and esthetics to a person who has lost one or more teeth. Secondly they have a huge success rate compared to practically any other alternative and other services we provide as dentists.
The top 3 reasons we lose our natural teeth is due to decay, gum disease and fracture of our teeth. Implants do not decay and we rarely see a fracture of an implant, especially if it is treatment planned properly. Although implants can experience bone loss they do not have the same attachment mechanism as natural teeth (ligaments), and the bone loss can once again be minimized with ideal treatment planning and engineering of the implants and teeth.
Another major benefit of dental implants is you can have permanent teeth again- you do not have to take them out at night and put them back in the morning. Dental implants look just like real teeth and sometimes better, the surface of the artificial teeth are resistant to stains compared to natural teeth enamel that can become discolored.
About Dr. Peter Balogh:
Dr. Peter Balogh (B.Sc. D.D.S. D.A.B.O.I) is a dentist at Vancouver Centre for Cosmetic Implant Dentistry. He focuses on cosmetic and implant dentistry and has been practicing since 1992.