A permanent denture is a great way to replace missing teeth. Many people hear the word “denture” and think of sticky denture paste and soaking teeth overnight but a permanent denture is a much more stable and natural-looking way to restore your smile. A permanent denture is an implant-supported dental prosthesis that is much more comfortable and easier to care for. Most often, implant-supported dentures use between four and eight implants per arch to secure the denture in place. A traditional denture relies on adhesion, suction, and retention to stay in place. Without the security of an implant, a traditional denture is much more likely to become ill-fitting and to slip around in the patient's mouth when they speak or eat.
What are the advantages of a permanent denture?
A permanent denture is significantly more comfortable than a traditional denture. Since they are screwed down onto implants, the denture cannot slip around and remains stable. The roots of our teeth provide constant stimulation within the jaw bone, encouraging continual bone regeneration. When the natural teeth are missing, the jaw bone is not stimulated to create new growth so the cells within the bone take their energy elsewhere and the jaw begins to deteriorate.
Dental implants are essentially artificial tooth roots and work the same way to stimulate bone regeneration. This alone gives permanent dentures a big advantage in supporting overall health. Since a traditional denture sits on top of the gum tissue, the structure of the jaw bone will change. This bone loss can lead to an ill-fitting denture that is not only uncomfortable to wear, but can cause irritation and mouth sores on the gums beneath the denture, making it incredibly uncomfortable and possibly even painful to wear. It is not uncommon for a patient to simply stop wearing an uncomfortable denture at which point they are no longer able to enjoy their favorite foods and their quality of life may begin to decline.
Along with the benefits of comfort, stability, and bone health, the aesthetics achieved by a permanent denture and the longevity of the denture are much higher than that of any other dental prosthesis. An implant-supported denture is much more expensive than other traditional options but in the long run, may be the more cost-effective choice for some patients because they rarely need to be replaced. At some point, the denture itself may need to be repaired or replaced due to natural wear but the better the denture is clean and maintained, the longer it will last.
How is a permanent denture placed?
When a patient needs to have a permanent denture placed, the dentist will work in conjunction with an implant specialist. To begin, your dentist will refer you to an oral surgeon or periodontist for an evaluation to see if you are a candidate for dental implants. A number of things will come into play during their evaluation of your mouth including your medical history, lifestyle habits, and any medication that you are currently taking or have been on in the past.
Patients who have endured chemotherapy may need preparatory surgeries to make sure their implants are successful. It is important for the patient to have sufficient and healthy gum tissue and bone structure for the implant to integrate and maintain support. If necessary, a bone and/or gum graft can be performed before the implant is placed. This may add a couple months of healing time but sometimes, the bone graft can be done at the same time the implant is placed.
Implant placement surgery is performed under local anesthesia, administered via injection to the areas receiving an implant. A small incision is made in the gum tissue to give the doctor clear access to the jaw bone. They will then drill a small hole directly into the bone and insert the implant. The gum tissue is then stitched up around the implant, leaving a small portion protruding through the gum tissue. A healing cap, or temporary abutment, is placed over the implants to protect them from damage and infection while you heal.
The implants are left to heal and integrate with the jaw bone for up to 6 months, during which you will wear a temporary denture. The temporary will help you become accustomed to your new smile and bite before your permanent denture is placed. It is normal to experience mild discomfort for a few days after implant surgery but it should subside within a week or two. You may also notice slight bruising and swelling of your face and gum tissue, even minor bleeding or soreness at the implant sites. These are all common after implant surgery and should begin to subside within a few days. Any symptoms that persist or do not improve after a few days, or become unbearable should be addressed by your doctor as soon as possible to make sure that you are not developing an infection, which could lead to implant failure.
Am I a candidate for a permanent denture?
Not everyone is a candidate for dental implants and a traditional denture is still a great option to restore your smile. For those who are otherwise healthy and can endure implant placement surgery and the extensive healing time, a permanent denture is the best choice. Patients with pre-existing conditions such as uncontrolled diabetes or osteoporosis may need to consider other options but that does not necessarily mean that these patients cannot have dental implants.
Since traditional replacement restorations, such as bridges or traditional dentures, contribute to bone deterioration, they do not last as long as implant-supported restorations and need to be replaced every 10 years or so. As the bone shrinks, it changes the way everything fits and can even change the appearance of your face. Dental implants are considered a permanent restoration and can last 20 years to a lifetime. To protect your investment, it is important to clean and maintain your dental implants properly and visit your dentist for professional cleanings more frequently than twice a year. Most implant patients benefit from a professional cleaning every three months.
As with any dental treatment, it is important to discuss any concerns as well as your goals for your smile with your dentist and implant specialist. With help from your doctors, you will be able to make an informed decision and choose the treatment path that will be suit your individual needs and lifestyle.