What are the Alternatives to a Removable Denture?

We have seen that there are 3 choices when it comes to a partial denture: Acrylic, Cobalt chrome and Flexi-denture. These cover the removable options for replacing your missing teeth- i.e. those that will need to be taken in and out.

The alternative, (assuming you don’t want to leave the space or spaces) is a fixed option; something that will stay in your mouth permanently.

The choice here is between an dental implant and a bridge (of which there are a few different types). A combined approach maybe needed if there is not enough support available from your natural teeth i.e. a bridge supported by an implant.

If the prognosis for your remaining teeth in one jaw is very poor (usually consequence of severe gum disease) and they are all likely to be lost before long, then an immediate full denture is another consideration.

To gain a much better understanding of each of these choices, see the following questions in our missing teeth series:

• What are the other options for restoring missing teeth?

• What are the advantages and disadvantage of fixed versus removable options?

• Which is the best option for me?

• When is a removable option advisable?

• When is a fixed option advisable?

• What else must I consider?

What if you Choose to do Nothing?

You are not alone… A UK survey asked, ‘If you had several missing teeth at the back would you rather have a denture or manage without?’ Roughly half of those in their 20’s said they would rather manage with out and this percentage gradually increased to near 80% for those aged 65 and over.

Whether you have a partial denture or any other type of treatment is your call, we (the dentist) can only advise you on the possible problems if you don’t and the risks and benefits of the various options if you do.

Just because someone else says you need dentures, doesn’t necessarily make them the right choice for you. You need to be keen to wear one and care for it appropriately. Otherwise the partial denture may end up doing you more harm than good, with the extra plaque that collects around the teeth causing tooth decay and gum disease.

The potential consequences of doing nothing, are discussed in more detail in our missing teeth series. None, some or all of the consequences from having spaces may result. Whilst teeth can over erupt, it doesn’t happen all the time and many people are happy with the aesthetics and function they get without a full set of teeth. Everybody’s situation, finances, expectations, priorities and opinions are different.

People who restore their spaces, are generally very pleased they did so. The longer you leave it, the more difficult it can make things down the track, as teeth move and your bite is altered. It also helps to motivate you look after your teeth and prevent any further changes, keeping you away from the slippery slope of “Just take it out!” and ending up with a full set of dentures down the line.

If the missing tooth is the very last one at the back of your mouth, a partial denture is likely to be more trouble than it’s worth. This is because to make this stable, the denture would have to extend all the way round to the other side to stop it rocking. In this position, a missing tooth is less likely to give you any problems and the consequences in terms of looks and chewing ability may not be noticeable. See how you go after the tooth has been extracted and if you do want to replace the space, a single tooth implant is the ideal solution since there is nothing further back to support a bridge.

If the prognosis of the tooth opposite this space at the very back is not good either and eventually this is extracted too- then you would have a balanced bite and simply end up chewing on your first molars (assuming you don’t have wisdom teeth) . Now there is not going to be any over eruption and the alternative is two implants… hmmm

Everybody’s situation is different and needs to be weighed up individually in discussion with a dentist.

When would you Choose a Removable Denture over the Alternatives?

Removable partial dentures can be made for a variety of situations- and can be used to replace any number of teeth. That said, they tend to used most frequently for the following:

• Multiple missing teeth. The more missing teeth you have and the larger the spaces, (multiple missing teeth next to each other), the more complicated and expensive things start to become in terms of placing a fixed solution such as a bridge or implant. Therefore, partial dentures tend to become the preferred option in the majority of these cases unless you have tens of thousands of dollars to spend on full mouth rehabilitation.

• Finances. They are the cheapest way to replace missing teeth, so suitable where the cost of a fixed option (such as bridge or implant) is prohibitive. At least until the time, when you can afford to do this for your one or two missing teeth.
• Fixed Alternatives are unsuitable. Perhaps there isn’t sufficient good support for a bridge or you don’t have enough quality bone to place an implant without extensive grafting.
• As a temporary solution, space maintainer or to change the bite before more advanced treatment

• Where more teeth are going to be lost (generally from gum disease) or where other changes are expected in the mouth.

• Practice and preparation for a complete denture

• Healing– to allow healing after surgery or extractions before fixed options are considered.