Formerly Nancy Tomkins and Associates

Dental Implants Versus Dentures What is There to Compare?

The media abounds with articles about dental implants and dentures. The internet also contributes to the volume of information accessible to consumers. However, the vast amount of material available can result in information overload and sometimes lead to confusion. Comparisons commonly made about dental implants and dentures may add to the confusion.

In fact, there is no comparison between dental implants and dentures. It is like comparing apples to oranges. With dental implants and dentures, one does not include or exclude the other. Perhaps describing what they are and their purpose in the oral cavity will help to shed some light on the subject.

Dentures are the replacement of one, multiple or all teeth and their supporting structures i.e. the soft tissue (gums) and hard bone. This could be in one arch (jaw) or both arches (upper and lower). A tooth or teeth can be missing for a variety of reasons: decay (cavities), periodontal (gum) disease, injury (sports and other accidents), or congenitally missing (born without). There are different types of dentures fabricated from different materials: dental plastics (acrylics) and/or dental metals. Dentures are further classified into partial (some teeth missing) to complete (all teeth missing) on that arch. Dentures are designed to be removed by the wearer after each meal for cleaning. They are easily removed as they rest on soft tissue with no anchor or they clip to remaining healthy natural teeth as anchors. Dentures ‘sit’ on the soft and hard tissue of the jaw bone.

Dental Implants
Dental implants are artificial tooth roots that are placed into the jawbone usually with minor oral surgery. New cells then grow and fix (integrate) the implant into the jawbone. Dental implants serve as anchors to secure an oral prosthesis such as a crown, bridge, or denture. A natural tooth consists of the root (the part below the surface of the gums) and the crown (the part above the gums). A dental implant replaces the root but it does not include the crown. A dental implant by itself does not replace a tooth or teeth. It is an anchor to which a crown or denture can be made and attached to. A simplistic analogy for dental implants would be to think of them as a house foundation. Houses can be built on the ground when there is solid ground underneath such as bedrock. However, if the ground is soft, then a house is likely to settle and have problems if it isn’t supported by a foundation. The same is true for dentures, especially complete lower dentures. A foundation is a part of a house; it is not a house on its own. A foundation is the anchor/support for the house that is built on top of it. A dental implant is not a complete replacement for a missing tooth. It is an artificial root; it is not a tooth on its own. A dental implant serves as an anchor or foundation for the tooth or teeth that will be fabricated and attached on top of it.

Replacing Missing Teeth
Are you or someone that you know missing a tooth, several or all of the teeth? There are a number of treatment options including dental implants for different situations. Here are three common scenarios.

1. Single Tooth Missing
A simple solution to replace a missing tooth is an acrylic partial denture that is removable by the patient. A fixed bridge is another solution. The teeth adjacent to the missing tooth are prepared to hold the bridge permanently in place. A fixed bridge cannot be removed by the patient. And then there is the implant alternative. A dental implant (artificial root) is placed in the jaw where the tooth is missing. A period of time is allowed for healing and integration of the implant. Afterwards, a single crown the shape, size and colour of the missing tooth is fabricated and fixed to the dental implant. The crown cannot be removed by the patient.

2. Multiple Teeth Missing
Removable partial dentures, an acrylic partial or cast metal partial with wire clasps to retain the denture, are options to replace multiple missing teeth on an arch. Depending on the number of missing teeth and their location, dental implants can be used in different ways to assist tooth replacement. One approach involves the placement of multiple implants and a fixed restoration that is not removable by the patient. Partials on implants that can be removed by the patient are another alternative. These dentures are fabricated to fit over and attach onto dental implants. One or two implants can hold a partial prosthesis securely in place, the denture can be made without clasps.

3. All Teeth Missing
When all the natural teeth are missing a number of options are available.
A conventional acrylic complete denture can be fabricated. The denture sits directly on the gum tissue. However, holding complete dentures in place (retention) can be very challenging for some patients, especially complete lower denture wearers who have lost a lot of bone. Denture adhesive is a common but unfavourable solution. There are different approaches to replacing all the teeth that utilize dental implants. The minimum placement of 2 implants on the lower arch can help to retain a lower denture. The placement of multiple implants (minimum of 3 to 4) allows a more secure and stable approach to retain and support the denture. It is also possible to replace all of the missing teeth with a prosthesis that is fixed onto dental implants and is not removable by the patient. There are pro and cons to all the alternatives for each individual. It is important to seek different opinions in order to decide which option is best for you. With advancements in materials, design and techniques, dental implants have come a long way since their introduction in the late sixties. Dental implants allow the closest possible replacement for natural teeth and the best way to restore your natural smile. Ask your Dental Professional about how dental implants might be the right solution for you.

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