Know options if you have lost, or will lose, all your teeth

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Just about everyone knows the word "dentures." Historically, these are full replacements of the teeth, and they rely totally on suction or adhesives to stay in place.

These were once the primary option for someone who had lost all his or her teeth.

The underside of dentures, known as the base or plate, is made to conform to the remaining tissue like a second skin. Oftentimes, pressure spots can occur that, when adjusted, affect this intimate contact.

Also, the shape, size and width of the remaining ridge all play a part in supporting denture.

Now, there are many other options.

The next step up would be implant retained dentures. Dental implants come in a variety of shapes and sizes. The ability of dentures to be implant retained has everything to do with the remaining bone under the surface of the tissue.

When teeth are removed, the bone the supporting the teeth dissolves away over time. The most successful cases of implant retention occur soon after tooth removal.

The amount of bone and the proposed implant sizes are evaluated with a 3D scan of the dental arches involved. Implants can be placed "in the bone" virtually, on the computer.

It is then possible to transfer this information to a lab for surgical guide fabrication, which greatly facilitates the time necessary and accuracy of placing the implant(s).

Another factor that must be considered is bite force. An implant supported denture against natural teeth will need to withstand considerable more force, thus affecting the options for implant retention.

Patients with extremely strong bite muscles, and grinders, also need much more additional stabilization.

The connection can be as simple as a housing fitted into the denture that attaches to the head of the implant. This is the most common today.

Another type of attachment consists of a lab fabricated "bar" that is permanently screwed to the implant and the removable prosthesis sits atop the bar, using "clips" that hug the bar.

This type does help to prevent the posterior lifting that some patients experience with the housings only.

The next step up would be a hybrid, or fixed tooth replacement. These also use implants; however, whatever prosthesis is chosen cannot be removed by the patient. It can be removed by the dental professional which is convenient for dental cleanings and if any repairs were necessary.

These types of replacements are usually retained by no fewer than four implants. Sometimes this is referred to "teeth in a day," although this is a temporary fix and will need to be replaced with a final prosthesis, usually in about six months.

In this modern time, this is considered the ultimate in tooth replacement. Prior to this technology, the best that could be done was a number of implants supporting fixed bridges. Not only was this a problem for any repairs, it was extremely expensive.

Somewhere among the options, there is usually one that seems to fit the patient and the situation. Bottom line: There are much better choices for total tooth replacement than even a few years ago.

James G. Jenkins, D.M.D. is the owner of Bluffton Dental Care in Bluffton.

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