Dentures

updated March 14, 2018

Dentures are removable dental appliances that replace missing teeth. Unlike dental implants and dental bridges, which are more or less permanently affixed to the bone, dentures are prosthetic teeth attached to a supporting structure. Dentures can be removed at night, for cleaning, or whenever desired. The most affordable dentures are those made with traditional plastic prosthetic teeth, but even more expensive porcelain cosmetic dentures usually cost less than implants.

Cost

Often more affordable than dental implants, dentures are removable dental appliances meant to look and function like natural teeth. Many patients who have experienced tooth loss and are concerned about the loss of both functionality and aesthetics turn to dentures to meet their needs. The cost of dentures varies considerably, according to geographical location, the dentist, and type of dentures.

Pricing Breakdown

Factors that influence the cost of dentures may include the area in which you live, your dentist, the type of dentures you require, and the quality of dentures you select. Full dentures are designed to replace an entire set of teeth, either the upper jaw, the lower jaw, or the entire mouth. Partial dentures, on the other hand, are for those who have lost only a few teeth and are often an affordable alternative to dental bridges.

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The quality of the dentures can determine their price to a great degree. Quality can affect the comfort and appearance as well as the cost. The old adage "You get what you pay for" often aptly applies.

• High-end dentures usually involve a great measure of dental artistry and utilize materials which simulate the natural look and color of teeth and gums to the highest degree possible. The teeth, normally made from composite acrylic resins, are designed to last a long time and often include a warranty against wear and tear, such as chipping and cracking. These life-like dentures can cost anywhere from $1,000 to $5,000 for a full set (upper and lower jaw).
• Mid-range dentures employ many of the same features as their high-end counterparts, with perhaps a lower degree of artistry and a more limited warranty. Patients should expect to pay approximately $1,000 for a full set (upper and lower jaw) of mid-range dentures.
• Low-end dentures may cost as little as $300, but the difference between low-end dentures and mid-range dentures may be great in terms of comfort, longevity, and appearance. For those seeking a temporary solution to missing teeth, however, low-end dentures may be a cost effective choice.

Financing

If you are considering dentures as a solution to missing teeth, the first step is to consult your dentist to determine the type of dentures you need and how much they will cost. Next, you may wish to ask your dentist what financing options he or she offers. In addition to offering financing plans specific to his or her office, your dentist may be affiliated with Compassionate Finance®. Compassionate Finance® operates much like a credit card. Once your application is approved, you may receive a credit line to help pay for the cost of your dental treatment. A Compassionate Finance® card offers you the freedom to select the type of dentures that suit your individual needs, and you don't have to feel restricted by what your insurance plan does and does not cover. Visit the Compassionate Finance® form or your dentist's office to learn more about Compassionate Finance® or to fill out an application.

Benefits

The benefits of dentures include increased function and an improved appearance. Additionally, because dentures are removable, many patients find that they are easier to clean than natural teeth and other dental appliances.

• Cosmetic Benefits: The cosmetic benefits of dentures are obvious. They fill in gaps left by missing teeth so patients feel more confident about their appearance. Dentures can replace missing teeth or teeth that were in poor condition, prevent further shifting of remaining teeth, support facial structure and integrity, and increase patients' self confidence.
• Functional Benefits: Dentures offer a range of functional benefits to patients. Dentures allow patients to eat the foods they want, improve speech (after patients get used to wearing dentures), and typically lasts between five and 10 years (with proper care).
• Price: Dentures tend to be the least costly solution for replacing missing teeth. Alternative treatment options such as dental bridges or implants are generally more expensive and require more extensive treatment. However, dental bridges and implants do offer a better fit, increased comfort, better chewing ability, and a more natural appearance. For these reasons, dentures-wearers may want to ask their dentists about these alternative treatment options. Your dentist can let you know if you are a good candidate for dentures, dental bridges, or implants, and let you know the cost of these options.

Disadvantages

Although dentures have helped millions of people around the world in regaining the ability to eat the foods they want, there are several disadvantages associated with the dental appliance. Some of the drawbacks of dentures disappear once the patients get used to wearing the device. Other problems with dentures may become an issue for the patient and lead them to seek alternative treatments for missing teeth.

Comfort and Fit: The most common disadvantage of dentures for many patients is the fit and comfort of the dental appliance. The majority of patients feel that the dentures feel strange in their mouths when they first begin to wear them. As patients get used to their dentures, this discomfort typically fades.

Irritation: In addition to the initial awkwardness experienced by dentures-wearers, some patients may experience periodic irritation and oral sores caused by chewing, clenching, grinding, or a food particle stuck between the dental appliance and your gums.

Difficulty Chewing Certain Foods: Finally, many dentures-wearers are able to eat most of the foods that they want. However, certain crunchy or sticky foods may still present a problem when chewing. Foods that are difficult to chew could cause pain or the dentures to move out of place.

Care: Proper care of dentures is vital to preventing gum irritation and oral sores, maintaining the health of your gums, and keeping the dentures in good shape. Dentures-wearers should take the dental appliance out of their mouths for at least a few hours a day, during which time the dentures should be soaked in water and a cleaning solution.

Speech: When patients first start wearing dentures, many have difficult speaking or saying certain words. This can result in a smacking, clicking, or whistling noise. The difficulty speaking usually goes away once patients get used to wearing the dental appliance.

Alternatives to Dentures

Patients that want a more stable and comfortable denture alternative may be interested in talking to their dentists about dental implants and dental bridges. Although both of these treatments tend to be more expensive than dentures, they generally offer a more precise fit and better chewing ability than dentures. Patients can also have a tooth-colored ceramic or porcelain bridge or implant restoration placed for a more natural looking appearance.

• Dental Implants: Implants are similar to dentures, in that they are prosthetic restorations used to replace natural teeth. However, dental implants are actually attached to the jaw. Six months before the implant restoration (false tooth) can be placed in the patient's mouth, a metal anchor is permanently implanted into the jawbone. After the jawbone has grown around the anchor (a period known as osseointegration), the implant restoration can be attached to it.
• Dental Bridges: A dental bridge refers to a single false tooth or span of up to three prosthetic teeth that are attached to adjacent natural teeth with metal and plastic connectors or dental crowns. Bridges help to preserve some of the mouth's structural integrity by leaving as many natural teeth in place as possible. However, patients that are missing the majority of their teeth are typically not good candidates for dental bridges. Good candidates for dental bridges must have healthy gums and some healthy natural teeth that can act as anchors.

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Types of Dentures

Dentists can fit you with full or partial dentures, depending on whether you are missing all of your teeth or just a few of your teeth. Learn more about the different types of dentures that are currently on the market.

• Full Dentures: Full dentures are for those patients who have lost all of their natural teeth in the upper or lower jaw, or both. Full dentures restore confidence in one's appearance, and help the wearer to speak and eat normally.
• Partial Dentures: For those who have lost some teeth, but don't want to get dental implants or bridges, partial dentures are an affordable option. Removable partial dentures are held in place by natural teeth, gums, and a connective structure made of plastic and metal.
• Conventional Dentures: Conventional dentures are those that are placed once the bones and gums have healed after the removal of natural teeth. While there is a waiting period that can be frustrating, the dentures normally fit properly the first time. Conventional dentures are also the most affordable dentures option.
• Immediate Dentures: Immediate dentures, as the name implies, are placed as soon as the natural teeth are removed. With immediate dentures, the patient need not face the world without teeth, can eat normally much sooner than with conventional dentures, and does not have the speech problems associated with the normal denture process. However, since healing of the gums and jaw will change the fit of immediate dentures, the patient will typically need a new set in about six months.
• Natural Looking Cosmetic Dentures: Instead of traditional plastic prosthetic teeth, natural looking cosmetic dentures are made with modern ceramic porcelain teeth. The dentures are usually individually crafted, and look more like real teeth than the plastic variety. Cosmetic dentures also have a more natural looking support structure, and though they may cost a bit more than conventional dentures, they are truly difficult to distinguish from real teeth.

Implant-supported Dentures - The Treatment Process

The implant-supported dentures treatment process is tailored to the restorative needs of the individual patient. Some will need to undergo dental therapy and healing before the implants can be placed, extending the amount of time before the final dentures prosthetic can be placed.

Preparing for Dental Implants

The following are some common treatments that are performed before the placement of dental implants.

1. Tooth extraction and restoration: If tooth decay or gum disease is so severe that a tooth can't be saved, it will need to be extracted. Your dentist will examine the remaining teeth in your mouth and determine if they should be removed or restored with tooth-colored fillings, inlays, onlays, or dental crowns. After the teeth have been extracted, the gums need at least two to three months to heal before an implant can be placed or an impression taken.
2. Gum grafts: To ensure the security and longevity of dental implants, there must be adequate gum tissue above and around them. If patients have lost healthy gum tissue due to gum disease or tooth loss, a gum graft may be required before implant placement. The gums require a healing period of at least a month or two after gum grafting surgery.
3. Bone grafts: If the jawbone is not thick or solid enough, bone-grafting surgery is performed to support the implant and help withstand the forces caused by biting and chewing. The healing period from a bone graft can take a month or two.

The Dental Implant Procedure

Once the gums and jawbone are healthy enough to accommodate dental implants, they can be placed. 

1. Implant placement: The dental implants, which resemble small screws made of titanium, are surgically placed in the jawbone. In effect, a dental implant replaces the tooth's natural root. Each implant is inserted into the gums and jawbone through a small incision. One of the advantages of implant-supported dentures is that fewer implants can be placed than teeth. For complete upper dentures, between six and eight implants are placed. For complete lower dentures, four to five implants are placed. After the implants have been placed, the gums and bone will take three to six months to grown in around the implant, a process called osseointegration.
2. Hardware attachment: Once the gums have healed, the snap, bar, or abutment is attached to the titanium implant. This is accomplished by reopening the gum tissue to expose the dental implant. The hardware is then attached to the dental implant, and the gums are allowed two weeks to heal around the abutment.
3. Tooth restoration: The tooth restoration phase is the most exciting part of the implant-supported dentures treatment process. At this time, the custom-made dentures are secured to the hardware that is attached to the implant.

The Dentures Fabrication Process

While you are undergoing the dental implant placement process, your dentist's lab will begin to fabricate your dentures. The dentures fabrication process involves:

1. Impressions: When the gums have sufficiently healed and are determined to be in healthy condition, your dentist can take impressions of your teeth using digital technology or dental putty.
2. Creation of model prosthetics: Before your final dentures are crafted, your dentist may have a wax model made so he or she can check the fit and appearance of the dentures. This allows for some modifications to the design.
3. Fabrication of final dentures: When you and your dentist are satisfied with the fit and look of the dentures, a dental lab technician or prosthodontist will create the prosthetic out of durable and natural looking dental materials.
4. Adjustments: After your final dentures are made and attached to the dental implants, the fit or look of the dentures may be adjusted.

After Treatment

After implant-supported dentures are in place, patients should properly care for their teeth and gums. The dentures, gums, and tongue should be brushed twice a day. Patients should also floss daily to remove debris between the teeth; though false teeth won't become damaged by decay, plaque build-up can still cause gum disease and bad breath. Patients with dentures should also schedule dental visits every six months so their dentists can check the fit of the dentures and look for signs of dental problems. 

Costs

The cost of implant-supported dentures depends on the health of your teeth and gums, the number of teeth that need replacement, and the quality of the dental restoration.

• Custom, porcelain dentures (full upper and lower set): $1,500-$4,000
• Oral surgery with traditional dental implants: $1,000-$3,000 per implant (six to eight implants are required for the upper jaw, while four to five implants are required for the lower jaw.)
• Oral surgery with mini dental implants: $500-$1,500 per implant 

Benefits

Implant-supported dentures offer a number of benefits over traditional dentures. Patients with implant-supported dentures can eat, speak, and smile with confidence, knowing that their dentures are securely in place. Further, implant-supported dentures can actually improve a patient's oral health. Read on to learn more about the benefits of implant-supported dentures.

Improves Ability to Eat

Although traditional dentures will provide more biting force than a mouthful of missing teeth, it is still far less than can be achieved with real teeth - or implant-supported dentures. Dentures that are anchored by dental implants will triple the patient's biting force, when compared to traditional dentures, making it easier to eat crunchy, tough, and chewy foods. In addition, implant-supported dentures will not move out of place, even when pressure is applied to the prosthetic when eating.

Improves Ability to Speak

It is common for patients with traditional dentures to mumble, slur their speech, or make clicking noises when speaking. This is caused by tense facial muscles that are struggling to keep poorly fitting dentures in their proper position. With implant-supported dentures, these problems can be a thing of the past. When the dentures are secured to dental implants that have become fully integrated with your jaw bone, they will not move around or become displaced. This greatly improves a patient's ability to speak clearly.

Better Fit

The prosthetic that is attached to the dental implants is custom made to fit over the patient's gums. After you have undergone dental implant surgery and your gums have fully healed, an impression is taken of the gums (and any remaining teeth) so the dentures can be fabricated for an optimal fit.

More Comfortable

Implant-supported dentures are more comfortable for two reasons. First, the dental technician or prosthodontist will craft dentures that offer a good fit. Second, the dentures will stay in their ideal position, permanently, because they are securely attached to the dental implants that have been surgically embedded into the jaw bone.

Looks and Feels More Natural

Custom-made porcelain dentures are crafted to look like your natural teeth (or an improved version of your natural teeth). Great care is taken to design and fabricate a set of teeth that not only look natural, but also complement the size and shape of your mouth. Dentists may first create wax versions of the dentures so patients can try on their new teeth on before the final dentures are made; this process allows for design modifications and fit adjustments that can be applied to the final set of dentures.
Once the dentures have been fabricated, the dentist will attach them to the implants using a ball or stud attachment. Securing the dentures to implants will ensure that they stay in place even when pressure and biting force is applied, making the dentures feel more like natural teeth than replacement teeth.

Don't Require Dental Adhesives

Implant-supported dentures do not require the use of sticky, messy, foul-tasting dental adhesives. Patients can finally stop buying these products and no longer have to spend time trying to keep their dentures in place. Instead, patients can focus on caring for their dentures in the same manner that they would care for real teeth; patients should brush twice a day, floss daily, and visit the dentist every six months.

Stops Dissolution of the Jaw Bone

When a patient loses their teeth, the jaw bone recognizes that it is no longer serving its purpose of supporting the tooth. As a result, the jaw bone begins to degenerate. The only way to stop this process is to replace some of the missing teeth's roots with dental implants. Once an implant has been placed, the jaw bone will begin to regenerate, thereby improving the patient's overall oral health.

Doesn't Wear Down the Gums

Traditional dentures rest on the gums, which provide the support for these dental appliances. Unfortunately, the dentures eventually wear down the gum tissue, resulting in "shrinking gums". As the gums recede, the dentures become loose and require additional adjustments to improve their fit.
Because implant-supported dentures are supported by dental implants rather than the gums, patients do not experience this degeneration of gum tissue.

Increases Confidence

Implant-supported dentures can increase a patient's confidence level by improving the ability to eat and speak, as well as the appearance of the smile. Patients no longer have to worry about the embarrassment that is caused when dentures slip out of place while in the middle of a conversation or out to eat with friends.

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Risks

Dental implant-supported dentures have become the best treatment option for patients who are missing all or most of their teeth. The treatment boasts a high success rate, particularly when the patient makes a commitment to the maintenance of good oral health and a qualified dentist performs treatment. However, complications may occur. Here is an overview of the complications that may affect the implants, abutments, and dentures.

Implant Failure Complications

Although dental implant success rates are high, there are cases in which the implant will fail. Most cases of implant failure can be prevented if the patient maintains his or her oral health and chooses a qualified implant dentist to plan and perform the procedure. Dental implants are more likely to fail in the maxilla (upper jaw) than in the mandible (lower jaw). Possible reasons for implant failure include:

Loosening of the screws: The dental implant is attached to the abutment via a screw. Loose screws should be replaced immediately to prevent damage to the implant.

Screw fracture: Screw fractures may occur if there is a defect present, or when the hardware can't sustain the force that is exerted upon it.

Implant fracture: The dental implant can fracture or break into pieces when the implant is overloaded. This may be caused by placement of the wrong size, length, or type of implant; by placing too many implants; or by improper positioning of the implant.

Loose implants: An implant may become loose when the abutment and replacement teeth have been placed prematurely, there is an insufficient amount of bone to support the implant, or a poor quality implant was placed.

Inadequate bone support: During the planning stages of the dental implant process, the dentist should determine if there is sufficient bone to cover and support the dental implants. If not, bone graft surgery can be performed in preparation for dental implant surgery.

Bone loss around the implant: Once the implant is placed, bone loss can still occur. Bone loss may occur from too much bite pressure being applied to the implants or as a result of poor dental hygiene.

Infection: Patients are at an increased risk of developing an infection anytime surgery is performed. An infection can also develop if the patient is not maintaining good oral hygiene habits. Infection of the tissues, ligaments, and bone surrounding the implant can result in implant failure.

Osseointegration problems: Osseointegration is the process in which the bone reforms around the implant, integrating the titanium post within the jaw bone. Osseointegration problems are more likely to occur if there is not sufficient jaw bone, or if the patient smokes, takes certain medications, or does not maintain good dental health habits.

Abutment Complications

Three to six months after the dental implants have been placed, the abutment is attached to the implant with a screw. As the abutment becomes worn, complications may occur, resulting in the need for abutment repairs. Patients have reported the following types of abutment complications.

Attachment fractures: If the screw or abutment becomes cracked, it can cause the implants to become overloaded, thereby damaging the implants. Fractured screws and abutment pieces should be replaced as soon as possible.

Retention loss of the clips: The clips that attach the dentures to the abutments may lose their grip and require replacement.

Clip fractures: The clips may become cracked or broken and require replacement.

Attachments becoming dislodged: Due to the high degree of force that is exerted on the attachments, they may move out of place. If the hardware becomes dislodged, visit your dentist so it can be repaired or replaced.

Failure of the abutment screw: If the improper size, length, or type screw was used to attach the implant to the abutment, the screw should be replaced.

Abutment defects: It is possible that defects affect abutment pieces. Defective abutment hardware can increase the risk of attachment fractures, displacement, and retention loss.

Overdentures Complications

The following complications may affect the dentures themselves.

Malformation of the ball sockets: Ball abutments fit into precisely placed and sized sockets on the overdentures. With time, the sockets may become deformed, and the abutment will no longer fit in the socket.

Fractures or cracks in the porcelain prosthetic: Over time, the artificial teeth may crack, resulting in the need for replacement or repairs.

Retention problems: Due to excessive wear, the attachment pieces on the dentures may become less effective and require repair.

Poor stability: Poor stability is typically the result of defects or damage to the attachment pieces. The dentist can check the dentures and abutment pieces to determine the cause of the instability.

Occlusion: If the dentures are not occlusally balanced, it can result in pain, instability, and an overload of pressure. The dentist should check the patient's bite to ensure that the dentures will feel comfortable and stay in place.

Oral Health Complications

In addition to the complications that are specific to the implant, abutments, and dentures, there are various oral health problems that can occur in patients with dentures. Patients should keep their teeth and gums clean, and visit the dentist every six months so problems, if they exist, can be identified and treated. The types of oral health problems that commonly affect patients with dentures include:

• Gingival hyperplasia
• Hyperplastic tissue
• Mucosal inflammation
• Mucosal proliferation
• Peri-implant mucosal hyperplasia
• Peri-implant mucositis
• Proliferative gingivitis

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