Removable dentures have long been used to replace missing teeth but because of their design, wearers often find they place restrictions on their social, romantic, and professional lives. When not properly fitted, removable dentures are prone to loosening or shifting which can be uncomfortable and lead to issues when eating and speaking. Wearing removable dentures for prolonged periods can also lead to jawbone shrinkage affecting the wearer’s appearance.
Fortunately, permanent dentures are an alternative that avoid many of the pitfalls associated with removable dentures. To better educate patients evaluating options for replacing missing teeth, this article will examine everything that needs to be known about permanent dentures.
Permanent Dentures Overview
A permanent denture is a set of false teeth mounted to dental implants placed directly into the jawbone. They can be used to replace a single lost tooth or an entire upper or lower jaw. Unlike conventional dentures, implant dentures cannot be removed by the wearer. As such, they look, feel, and function just like natural teeth and have no risk of moving or falling out. Additionally, there is no risk of accidentally misplacing permanent dentures.
The procedure for placing permanent dentures typically begins with an oral examination of the patient’s teeth. Jawbone scans will also be performed to determine the exact locations where implants will be placed (two in the front of the jawbone and two in the back). Any damaged teeth will be extracted and the jawbone prepared for surgery.
The dental implants are then surgically placed in the applicable areas of the jawbone while the patient is under local or general anesthesia. The small metal implants serve as replacement tooth roots embedded into the jaw. Then, the oral surgeon will mount the replacement teeth onto the posts.
After the implants are placed, a recovery period is needed. During the healing period, a biological fusion process, called osseointegration, occurs between the implant and jawbone. Proper fusion is critical to the long-term effectiveness of the system and can take several months to complete based on how quickly the patient heals. Depending on the implant used and the condition of the patient’s jawbone, multiple procedures may be required to complete the process.
Preparing for the Procedure
Prior to getting dental implants, the patient will need to undergo a full dental exam. X-rays and molds of the teeth will also be taken prior to surgery. Patients should make their surgeon aware of their health history, any medical conditions or prior orthopedic implants they have, and any medications they take.
The surgical team will provide instructions on how long to fast prior to surgery. If general anesthesia will be used during the procedure, the patient will need to make arrangements for someone to drive them home following surgery.
What to Expect Following Surgery
Following the dental implant surgery, or surgeries if done in multiple stages, some discomfort is normal. Bruising or swelling of the face or gums are also common side effects following implant surgery. Some minor bleeding in the mouth may occur and there could be soreness and pain surrounding the implants.
Pain and swelling are generally manageable in the initial days following surgery by taking over-the-counter pain relievers and applying ice packs or cold compresses. Rinsing with salt-water or using antibiotics can also help avoid infections from developing. Should any symptoms progress or linger, patients should contact their dentist promptly for evaluation.
While recovering from surgery, plan to stick to a diet of soft, bland foods while the wounds heal. Avoid hard or crunchy foods as these could damage the wound and prolong healing. Typically, self-dissolving stitches are used but if not, the patient will need to return to their doctor’s office to have them removed.
Who is a Candidate for Permanent Dentures?
Implant dentures are typically suitable solutions for anyone with one or more missing or damaged teeth. While age is not a factor when considering permanent dentures, certain underlying health conditions can impact a person’s candidacy for the procedure. For example, dental implants require sufficient jawbone to support the device. Patients without enough jawbone density, may not be able to undergo implant surgery or could require a bone grafting procedure prior to placing implants.
Given that surgery is required to obtain permanent dentures, patients must be willing to navigate the various pre- and post-surgery instructions needed to ensure the procedure is successful. This includes practicing sound oral hygiene and avoiding any items or activities during recovery that could affect the surgical site. Should a patient not be willing to adhere to these requirements, they should likely seek alternative treatment options.
Advantages of Permanent Dentures
- The surgical procedure for permanent dentures is less invasive, shorter, takes less time to heal from, and results in less post-surgery discomfort compared to conventional dental implants;
- Unlike removable denture users, wearers of permanent dentures can speak and eat more comfortably;
- Do not require messy adhesives to hold the device in the mouth;
- Distributes bite forces more evenly;
- Robust and long-lasting;
- Easier to maintain – does not require removal when cleaning;
- Requires fewer dental implants;
- Provides better support to facial features helping the patient maintain a natural look;
- Better fitting and more comfortable than removable dentures
Disadvantages of Permanent Dentures
While relatively safe, obtaining permanent dentures does involve surgery. This can open the door to infections, inflammation, or other dental issues that could jeopardize the effectiveness of the restoration. However, these complications can be minimized with adequate cleaning and maintaining regular dental checkups.
Cost is another potential drawback when evaluating permanent dentures vs other restoration options. This is especially true if additional procedures, like bone or gum grafting, are required prior to placing the implants. While the upfront cost for surgery and replacing the crown may be higher than with removable dentures, the long-term benefits greatly exceed the price.
A final drawback associated with permanent dentures is the fact that underlying health conditions could exclude a patient from being a candidate for the procedure. Health issues like cancer, diabetes, or the aforementioned lack of sufficient jawbone, could all eliminate a patient from candidacy for permanent dentures.