Choosing Between Dental Implants and Dentures to Replace Missing Teeth

Tooth loss is a common medical condition. Even with modern advances in dental care, adults from the age of 20 to 64 have an average of 25.5 teeth remaining out of the initial 32, and 2.2% of adults in the same age bracket have no teeth remaining. 

No matter your age or how many teeth you are missing, there are solutions available to you. 

Two popular options are dental implants and dentures. Let’s look at both options – considering cost, appearance, upkeep and more – and discuss some of the pros and cons of each to help you decide which solution might be the better option for you.

What Are Dental Implants?

A dental implant consists of a small metal post (usually made out of titanium or zirconium, or other safe metals) and an artificial replacement tooth, connected to each other by a piece called an abutment. The post is implanted in the jaw bone, taking the place of the original root. The artificial tooth – fabricated to match your natural teeth – is then connected to the post via the abutment. 

Implants generally replace individual teeth, with each post taking the place of each individual root. However, there are implant solutions, such as All-on-4®, where a smaller number of implants are used to support an entire arch of replacement teeth.

What Are Dentures?

Dentures are oral appliances used for replacing teeth. Unlike dental implants, dentures are removable. They can be either full or partial – full dentures replacing an entire arch of teeth, partial dentures replacing multiple missing teeth but where some natural teeth remain. They are typically made of acrylic, porcelain, or metal.

Unlike dental implants, dentures require no surgery.

Candidacy

Almost anyone of any age can be a candidate for dentures, provided you are missing at least some of your teeth. Since there is no surgery involved, there are little-to-no risk factors.

Implants have more qualifying conditions than dentures. They are available to anyone 18 years or older, including adults in their 80s and 90s. However the ideal candidates are non-smokers with healthy gums. A healthy jawbone is also a plus, though a bone graft can be an option if there isn’t enough jawbone to attach the implant to.

Cost

Comparing the cost of dentures and implants is a matter of upfront costs versus upkeep costs.

Dental implants tend to be more expensive upfront, due to the higher quality of materials involved, as well as the necessity of surgery. However, they can last anywhere from 10 years to multiple decades.

Dentures on the other hand are less expensive up front, and require no surgery costs. They often need replacing more often though, every 5 to 7 years on average.

Aesthetics and Function

The look and feel of dentures versus implants can be quite different.

Implants tend to feel more like a real tooth. They don’t typically impact your speech, and once they are healed you will be able to eat normally. On top of that, you don’t have to worry about implants falling out.

Dentures can take some time to get used to, sometimes as much as a few months. It may take some time to adjust to how they feel, and can affect speech and chewing abilities. These are things that lessen over time as you adapt to eating and speaking with them in.

Procedure

The procedure for dental implants happens in 6 steps:

• Consultation: The dentist conducts a comprehensive evaluation of your mouth and teeth to determine whether you are a good candidate for dental implants, or if another treatment method would work better for you. They will explain the treatment, timeline, and recovery process, and answer any questions you have. 
• Bone Graft: This stage is only necessary for those patients with insufficient healthy bone for the implants to be placed into. If needed, the bone graft procedure will be performed, after which you will need to let it heal for six months or longer before your dentist can proceed with the implants.  
• Implantation: ​​Before placing the implant in your jaw, you will receive either local anesthetic (in the case of a single tooth replacement) or more extensive anesthesia (for multiple teeth). The placement of the post is done by making a small incision in the gum where the prosthesis will go, drilling the post into the bone, and stitching the cut closed. This takes up to two hours per tooth. 
• Implantation Recovery: Your mouth will need up to six months to heal. During this time, the bone grows around the implant, creating the ultra-stability that dental implants are known for. 
• Placing the Abutment and Crown: The abutment is the small piece that screws into the implant and will support a restorative crown (the “tooth” part). After attaching it to the implant, the dentist makes an impression of your mouth so that the porcelain crown can be matched perfectly to the size, shape, and color of your natural teeth. When it’s ready, you will come back to have the crown installed. In the interim, a temporary crown is placed over the abutment. 
• Crown Recovery: The recovery time after placing the crown is much shorter than the other recovery times. The crowns may be sensitive for a few days, but this should dissipate relatively quickly. 

The procedures for dentures are more simple, but can vary depending on the situation:

• Removable Versus Attached: There are two different types of dentures – removable and attached. Removable dentures (both partial and full) are taken out nightly and cleaned. However your dentist may recommend attaching denture implants, which are fixed dentures.
• Extraction: After you and your dentist decide on a treatment, they may need to extract some teeth if there is decay present. The dentist will give you an appropriate anesthetic and then perform the procedure. If you are getting full dentures and need all your teeth removed, this will likely happen in stages.
• Immediate Dentures: Immediate dentures can be made for you to wear while waiting on your permanent dentures to be fabricated. The benefits of these are protection for the sockets where teeth have been extracted, preventing jaw atrophy, as well as removing the need to spend weeks or months with no teeth. Though they’re called “immediate dentures” because you can wear them out of the dentist’s office on the same day you have teeth extracted, you will need to have them fitted in advance.
• Making Impressions: Your gums will be given time to heal from any extractions before you’re fitted for your permanent dentures. This can take anywhere from four weeks to six months. To create the final dentures, the dentist first makes impressions of your jaw and mouth. These are then sent to a lab where a technician uses the impressions to make a wax or stone model of your mouth. The model is then used to customize your dentures out of a variety of materials such as resin or polymer for the base, and acrylic, resin, or porcelain for the artificial teeth. If it’s a partial denture there will also be a metal framework for securing it to remaining natural teeth.
• Color Selection: If you’re getting partial dentures, the artificial teeth will need to be color-matched to your existing teeth. If you’re getting full dentures, you can discuss with the dentist what color you want your new teeth to be (natural teeth are not actually pure white). Your complexion can help determine what shade looks best on you. Matching the whites of your eyes is also a good practice. The dentist will guide you through the color chart and help you decide which shade is right for you.
• Fitting Permanent Dentures: Roughly two to three months after your extractions, the dentist will have you try out your new dentures to check the fit. They will be looking for any areas of excess pressure on the gums and will make adjustments as needed. It may take several office visits before you get the optimal fit.

Aftercare and Maintenance

Immediately after the implant surgery you will need to take any prescribed medications as directed by your provider, and any over-the-counter pain relievers you may need. Eat a diet of soft foods for a few days and brush diligently but carefully so as to avoid disturbing the incisions.

After you have fully recovered from surgery and crown placement, maintenance of implants is essentially the care needed for natural teeth:

• brushing and flossing daily
• scheduling regular dental checkups
• avoiding an excess of sweet food and drink, as well as sticky foods
• avoiding tobacco products
• abstaining from chewing on ice and non-food items like pencils

After receiving both your immediate and final dentures, your dentist will give you instructions on how to treat them during the healing process.

Once you take your permanent set of removable dentures home, you will need to:

• clean them daily, as tartar and plaque can build up just as they do on natural teeth
• remove the dentures each night to allow your gums time to rest and restore from the day

Effectiveness

Dental implants are generally very effective, though complications can arise from such things as loose posts or cracked crowns. Good maintenance habits and regular dental checkups will help implants to be as effective as possible. 

Dentures, while a more affordable solution, are not as effective as implants. Common issues include them slipping out of place and sores that form on the gums. Careful maintenance can help alleviate these complications.

How Long Do They Last?

While dental implants are a permanent solution, it doesn’t mean every implant will last forever. However, the success rates are very high. A healthy patient with good hygiene habits is likely to enjoy dental implants for a lifetime without complications. 

Typically, you can expect dentures to last between 5 and 7 years before you need to consider replacing them. 

Over time, they may wear down or become stained, and your mouth may change, causing the dentures to not fit as well. You will need periodic dental appointments to check your oral health and ensure a good fit. You can also extend the lifespan of your dentures by avoiding certain kinds of food, such as sticky, hard, or tough types of food like popcorn, gummy candy, and tough meat.

Can You Get Implants After Dentures?

It is possible to get implants after having worn dentures (either full or partial), but the main consideration is the bone density in your jaw. 

Implants need sufficient bone density to hold a post in place. After wearing dentures for a long time, the jawbone may begin to collapse. It’s also possible that your jaw may have lacked the necessary density to begin with, thus leaving dentures as the most simple option at the time. If either of these are the case, a bone graft may be able to restore enough bone for an implant to be possible.

Bunker Hill Dentistry Offers Multiple Solutions for Missing Teeth in Houston

If you are suffering from tooth loss, Bunker Hill Dentistry can help. If you are in the Houston area, contact us to set up an appointment today.

Learn more about your options for replacing missing teeth