Permanent Dentures
Traditional removable dentures have long been used as a way of replacing missing teeth but many who wear them feel they place limitations on their social, romantic, and professional lives. Sticky and messy adhesives are typically used to hold them in place which is not the most stable of ways to hold them in position. Because conventional dentures have a tendency to shift out of place, they can be uncomfortable, create functionality issues, and could cause the wearer to avoid certain foods. The jawbone can also shrink when removable dentures are worn for prolonged periods of time which could have a negative effect on the patient’s facial structures and appearance.
Given the volume of people that need dentures, it is unfortunate that many of them are unhappy and feel the condition of their teeth hold them back. Fortunately, permanent dentures offer a solution for edentulous patients that have been dissatisfied with conventional removable dentures.
Permanent Dentures: An Overview
Permanent dentures, or denture implants, are replacement teeth that are affixed directly to the jawbone. Unlike conventional dentures, implant dentures cannot be removed meaning they feel and function the way natural teeth do. As such, patients do not run the risk of their dentures moving or falling out and they cannot be misplaced accidentally.
Permanent Denture Procedure
The procedure to place permanent dentures typically begins with the dentist or oral surgeon conducting an oral examination on the patient. Impressions of the teeth will be taken in addition to X-rays and scans of the jawbone to determine precisely where the implants will be placed. Any damaged teeth will also be removed prior to placing the implants.
Surgery to place the dental implants then follows and involves opening the gums and implanting the small metal posts into the jawbone. The implants serve as replacement tooth roots upon which, the dentures will be mounted. The procedure is done under anesthesia, so the patient feels no pain during surgery. Some months of recovery is then typically needed during which, the implant and jawbone fuse together through a process known as osseointegration. Once fully healed, the permanent denture can be secured to the implant creating a permanent restoration that allows the patient to chew, eat, smile, and talk confidently.
Post-Surgery Aftercare & Recovery
Following dental implant surgery (or surgeries if multi-stage), patients may experience bruising and swelling of the face and gums. Minor bleeding may also occur and the area around the implant may be sore or painful. Discomfort and swelling are generally manageable with over-the-counter pain relievers (acetaminophen) or placing a cold compress on the area. Saltwater rinses or antibiotics could also be recommended to avoid infection.
Post-surgery symptoms generally resolve after a few days or a week. Patients should plan to stick to a diet of soft foods while the mouth is healing so as not to irritate the wounds. Typically, the dentist will use dissolving stitches but if not, a follow up visit will be needed to remove them. Should post-surgery symptoms linger or worsen, patients should consult their dentist for a checkup.
Permanent Denture Advantages
- When compared to conventional dental implants, the procedure for permanent dentures is less invasive, shorter, requires less time to heal, and results in less post-op discomfort.
- Fixed denture patients can eat food without limitation and more comfortably speak compared to wearers of removable dentures.
- Unlike removable dentures that cover the palate (roof of the mouth), permanent dentures leave this area exposed allowing the patient to better taste food.
- Bite force is more evenly distributed compared to conventional dentures.
- Permanent dentures are more robust, sturdy, and can last 30 or more years with proper care whereas removable dentures tend to wear out and require replacement every 3-5 years.
- Oral hygiene routines are generally unaffected as permanent dentures can be cleaned the same way natural teeth are and do not have to be removed. Failure to properly clean removable dentures can result in halitosis (bad breath).
- A fewer number of implants are required to support removable dentures.
- Provides better support to facial features and avoid the “sunken-in” look commonly associated with removable dentures.
- Customized to precisely fit the patient’s mouth providing a better fit and level of comfort.
- Some patients may be sensitive or allergic to the materials or adhesives used for removable dentures. This can cause irritation, swelling, redness, or discomfort. These pitfalls are avoided with permanent dentures as they do not require adhesives and their materials are biocompatible.
Permanent Denture Considerations
Despite being relatively safe, surgery is involved when getting permanent dentures. As such, complications, inflammation, and infection are possible, though rare. With proper care, cleaning, and regular dental checkups, most permanent denture patients will not experience any dental issues.
Cost is another consideration when evaluating if permanent dentures are appropriate. Traditional removable dentures are generally less costly than permanent dentures because surgery is not involved. The cost for a full set of implant dentures can run from $15,000 to $24,000 whereas removable dentures can be had for $600 to $5000 depending on their quality. While purchasing inexpensive (cheap) dentures is possible, patients will likely find that they get what they paid for as these devices will not be as durable or long-lasting.
Cost can also be greatly influenced if additional procedures are necessary prior to placing permanent dentures. For example, should the patient have bone loss or insufficient jawbone density, a bone grafting procedure may be needed before implant surgery. Depending on the extent of graphing needed and the type of graft used, cost can range between $200 to $1200 per graft. However, if the graft uses autograft bone (bone taken from another area of the patient’s body), will be significantly higher due to multiple surgeries being necessary.
Permanent dentures may not be suitable for certain patients and removable dentures may be a better alternative. Patients that are averse to surgery, have underlying medical conditions that increase implant failure risk, have compromised immune systems, clench or grind their teeth (bruxism), or use tobacco, are generally not suitable candidates for permanent dentures.