You may remember the ill-fitting and obviously unrealistic removable dentures that your parents or grandparents wore, and you may not be aware that there are multiple options for replacing teeth. Many of the alternatives to removable dentures are more expensive, so it’s important for these options to be durable and resilient. Currently, permanent dentures are the gold standard for dental restorations. Permanent dentures, also known as fixed dentures, are replacement teeth that attach to a dental implant that has been surgically placed in the jaw. Permanent dentures can replace one missing tooth or multiple teeth, and in some cases, multiple teeth can be supported by just a few dental implants. Dental implants also provide a medical benefit: when the implants are placed into the jaw, they stimulate the growth of bone, increasing the strength and restoring the shape of the jaw. Not everyone is an ideal candidate for permanent dentures, but a consultation with a dentist can help you determine the best restoration option for you.
Removable dentures, while affordable, are known for growing looser and slipping over time, becoming uncomfortable and adversely affecting the wearer’s ability to speak properly and to chew multiple types of food. Of course, messy denture adhesives are so annoying that some people just decide to stop chewing altogether -- and where’s the fun in that? Denture adhesives are also likely to contain zinc, which can lead to an unhealthy buildup of zinc in the body and cause nerve damage in the extremities. Gradually, the weight of removable dentures on the alveolar bone is likely to induce shrinkage of the bone, which in turn continues to affect the fit and comfort of the denture. Removable dentures were first observed as early as 700 BCE, and affordability just can’t make up for technology that’s thousands of years old -- especially when the cost comes with an inability to eat and enjoy food and to smile with pride.
Permanent dentures allow patients to chew and enjoy a wide variety of food with confidence, as they function just like healthy natural teeth. They never slip when talking or smiling; they’re permanent. Permanent dentures are prosthetic teeth that are attached to the tip of a dental implant that is placed in the jaw. The procedure always begins with a complete dental examination that includes an x-ray and molds of the teeth. Be sure to tell your dentist about any other medical procedures you may have had and if you have any health conditions, especially heart conditions. Also be prepared to provide a list of every medication that you take, as some of these can influence the treatment plan and prolong healing time. Based on the state of the bone and the needs of the patient, the dentist will determine the exact location of the dental implants. For some patients who need a full row of teeth replaced, or all of their teeth, it may be possible to design a prosthetic bridge of teeth that can attach an entire row of teeth to as few as two implants. Some implants must be placed at an angle in the jaw, either to optimize available bone or because of the location and placement of the roots of adjacent teeth and the angle of the patient’s bite. Once the location and angle of the implant or implants has been determined and the restoration plan is established, the procedures can be scheduled. At this time, your dentist will discuss the type of anesthesia they will use and provide instructions if you opt for general anesthesia; patients who do so will receive preoperative instructions including a required fasting time and will also need to be sure to arrange for a ride home from the procedure.
Multiple procedures may be necessary, depending on specific clinical needs. The patient may need to have teeth extracted before implants can be placed. When there is not a sufficient amount of natural bone remaining in the jaw to support the necessary number of implants, bone grafts may be necessary. Depending on the extent of the bone graft, this procedure could require several months to heal before the bone can adequately support an implant.
When it is time to place the implants, the patient is anesthetized with either a local or general anesthetic. Local anesthetic may be administered more than once throughout the procedure, depending on its duration. Then, the periodontist makes a small incision in the gum tissue and places the cylindrical implant into the bone, essentially replacing the root of the missing tooth. The surgical site is cleaned and the gum tissue is sutured in place, protecting the bone as it heals, and the implant is left alone to heal into the bone. During this time, the implant fuses to the bone, creating a strong and stable support for the permanent denture. The process of the implant and bone connecting with each other is called osseointegration. Once the bone has fully healed, the implant is once again exposed and the permanent denture is bonded to the implant.
Every surgical procedure comes with some risks and possible side effects. Common side effects of implant surgery include swelling and bruising, and the gums may bleed slightly. The implant area may also feel sore. Patients may prefer to use pain medications or cold compresses to manage these uncomfortable side effects, and salt-water rinses can help keep the surgical site clean and free of infection. If your oral surgeon used dissolvable stitches, these rinses can help free the stitches when they are ready to come out. If symptoms do not improve, or if they worsen, see your dentist; if infection is present, you may receive a prescription for oral antibiotics. You may also need to visit the dentist for a follow-up visit if you need to get your stitches taken out. You won’t want to eat hard or crunchy foods while your mouth is sore and healing, which could last up to a week following each surgical procedure. Once the implants have fully healed and the dentures are in place, take care of them just as you would care for natural teeth, brushing away debris and bacteria and cleaning around the gumline and in any interdental spaces. It won’t take long before you’re smiling with confidence and eating with gusto.