March 2021 - Dr. Rick Lane

Unfortunately, I am missing several teeth from a couple different issues. I was in an accident a few years ago and had a couple teeth get knocked out. Then, I have another tooth that ended up getting decay underneath an old crown. There wasn’t enough of the natural tooth left to support the crown any longer. So, I ended up losing that tooth too.

I want to start improving my smile by getting the missing teeth replaced. So I have started researching information about dental implants. But, they seem to be very expensive. My dentist recommends them of course. Are they the best option to replace missing teeth, or is my dentist trying to make an extra buck? Please let me know what my options are for this kind of a situation.

-Bart in Indiana

Bart,

Thank you for reaching out with your questions about options to replace missing teeth. As your dentist recommended, dental implants truly are the best solution to replace several missing teeth for many reasons. Yes, they are more expensive than other alternatives. But, when compared to other treatment plans, they do act just like your natural teeth. Not only will they look just like a natural tooth, but they will function just like them.

You didn’t mention how old you are in your inquiry. But, it is important to realize that as time goes on (10-20 years) you will experience bone loss where you no longer have teeth present. This can create a whole host of problems down the road. However, dental implants prevent the shifting of teeth into those empty spaces, as well as any bone loss. This is because the implant post is surgically implanted into the jawbone which will prevent the bone loss. When people experience bone loss, their chewing efficiency declines and they appear much older than they really are.

There are some cases when you may not be a dental implant candidate. For example, if you are a smoker or in poor general health, they may not work well for you. You also didn’t mention if your missing teeth are all together or if they are spaced throughout your mouth. Depending on the location of the missing teeth, you may be able to use a dental bridge, which is anchored in place by your surrounding teeth. But this doesn’t prevent the bone loss from taking place in those empty spaces, and it also requires shaving down the surrounding healthy teeth to prepare them for crowns because that is how the fake tooth that fills the gap is supported. A dental bridge is indeed less expensive. But, it may not be best in the long term.

If budget is a determining factor, it is possible that you could get a partial denture, which is removable. Or you could learn more to see if a bridge will work for the location of your missing teeth. As far as price goes, a partial denture is the least expensive option to replace missing teeth. And it should be disclosed that most denture patients aren’t happy with the end result. Patients can experience an uncomfortable fit with any kind of denture, and it may cause sore areas in your mouth. Some people also complain of having issues with chewing and eating. All that said, a partial will look OK. But, your quality of life will be much more improved if you choose dental implants to replace your missing teeth.

Thank you for your question. Hopefully, this will give you some more information to help you determine the right fit for you. Lastly, it is always a good idea to get a second opinion by a reputable implant dentist in your area. Then, you will be able to compare treatment plans. But don’t use price as the final factor when selecting your dentist. Not every dentist has the training and high level of skill to successfully place dental implants.

This post is sponsored by Petaluma dentist Rick Lane, DDS.

Hello,

I have had dentures for over 30 years and I’m only 60 years old. At this point, I’m miserable. My denture won’t stay in even when I use dental adhesive. The last time I met with my dentist, he told me that I don’t really have much of any ridge left. And he even said it could continue to get so bad that I cannot keep a denture in at all. What am I supposed to do?

I am so embarrassed to smile and I cannot get my head around living the rest of my life worrying about if my denture will fall out. Please tell me you have some other options for someone in my situation.

Thank you for your time,

Denise in Kansas

Denise,

diagram of jaw bones to compare facial collapse

This diagram demonstrates facial collapse and shows how the bone deteriorates over time. The top image shows a healthy jaw. The images shown below and toward the bottom show significant bone loss.

I’m so sorry to hear that you are going through this situation. Unfortunately, you are not in an ideal situation to explore other options to replace missing teeth. In fact, your options are somewhat limited due to a condition known as facial collapse. As you have explained, what happens when you lose your teeth is that your body doesn’t think there is any reason to support them anymore. So the bone deteriorates because the minerals are used elsewhere in your body because your body resorbs them. This kind of condition will not improve. In fact, as your dentist mentioned, it will only get worse. Denture wearers who are experiencing facial collapse complain of them being very uncomfortable, falling out at embarrassing times and eventually if it gets bad enough the denture won’t stay in at all.

When it gets to the point where you are at, the only thing that can be done is to build that bone back up. This may take some research and patience to find a dentist that has the skill and experience to do the bone grafting. There are many oral surgeons who won’t even attempt to do the procedure at this point. But, with some perseverance you should be able to find someone to help you. It would be good if you were open to traveling if needed.

When the bone grafting is complete and the body has healed, there are several options to get your teeth back and get you smiling again. Your options are pretty dependent on what your budget is and how much treatment you are willing to do. The first option is to have a new removable denture made that will fit on your new arch. This is an affordable option, however as time goes on you will be in the same situation you are in now. When the tooth isn’t there, the body will begin the resorption process again. So, you will experience the same denture problems again. But, it will be essentially like starting over.

Dental implants are an option, but they do cost more than other alternatives. The implant is surgically implanted into your jawbone. The more dental implants that are used to secure your dentures, the more stable and secure they will be. But, the most important factor here is that the post signals to the body that the minerals are required to support it and to keep it in place. So, in the area immediately around the implant site, the bone will be stimulated and you won’t experience bone loss. When there are even just two dental implants on the top arch and two on the bottom, it is called an overdenture. Or sometimes this procedure is referred to as a snap-on denture. The more dental implants you can afford, the better off you will be regarding bone loss and a stable denture.

There are other dental implant hybrid restorations. In these cases, the dentures are fastened to the implants. This tends to be a little more expensive. Also, mini implants work similarly but they are smaller and less expensive. They won’t give you the same stability as multiple traditional dental implants.

The best thing you can do at this point is to find a couple implant dentists who are willing to help you and then talk through your options. Then, you will be able to determine which one is best for you. Remember, at this point it’s not about price shopping. You need to research the dentist’s credentials, ask about cases similar to yours, and ultimately make the decision on the dentist you feel like you can trust the most.

Thank you for sharing your story. Hopefully, it will be helpful to others who are so young and considering dentures, or anyone considering dentures for that matter. Over time, bone loss will occur and can present several difficulties. Your story will help others when they are faced with having to remove all their teeth. Or it may help others who aren’t that far down the road with dentures to consider getting dental implants to improve their longevity and performance.

Hopefully, you are encouraged in that you do have options. We wish you all the best.

This post is sponsored by Petaluma dentist Rick Lane, DDS.

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