How to Choose Dentures or Implants — and Why
When you need to replace one or more missing teeth, you have a few options, including dentures and implants.
Choosing the right solution depends on several factors, such as price, preference, and the health of your jawbone and remaining teeth.
Dentures and implants each have their own advantages and disadvantages, so it’s important to discuss your options in detail with your dentist. It’s also worth exploring other alternatives to dentures and implants, such as dental bridges.
Dentures and implants ultimately serve the same purposes. They:
help you chew foods you might otherwise not be able to eat
support facial muscles
improve speech
increase self-esteem and reduce self-consciousness by giving you a nice smile
However, there are also significant differences between the two dental solutions. Here are some pros and cons for each approach that should be considered before you make a decision.
Procedure for dentures vs. implants
Implants
Implants require enough bone in which to place screw-like implants that are capped with crowns. They have become increasingly popular in recent years, especially among adults ages 55 to 64, according to a 2018 study.
A dental implant is made by first extracting a damaged root. Once the root is gone, or if the root had been removed previously, a hole is drilled into the jawbone.
A metal prosthetic root, called a post, is implanted deep into the bone. The top of the post will be fitted with a crown, but not until bone has started to grow around the post, securing it in place.
It can take a couple of months until the post is ready to receive an abutment, the piece to which the crown will be fitted. Sometimes the abutment is placed when the post is implanted.
The final step is to have a crown — an artificial tooth made to match surrounding teeth — attached to the abutment.
Dentures
Dentures are removable, prosthetic teeth that can be fitted for your mouth regardless of how much bone is present.
Dentures can be complete sets to replace all the teeth on the upper or lower jaws or be made to replace a few missing teeth. These are called partial dentures.
Dentures are made by first taking an impression of the upper or lower gums or both if dentures are needed to replace all of teeth.
Before the dentures are made, your dentist will also study your bite and the alignment of your upper and lower jaws to make sure the length of the dentures will allow for optimal chewing and speech.
A preliminary set of dentures are then made in a lab and sent to your dentist. The dentures will be placed in your mouth and any needed adjustments to the alignment or length of the teeth are made before a final set of dentures is produced.
Dentures are made to look like natural teeth and gums, and are held in place with a special type of adhesive that bonds them to your gums.
Cost of dentures vs. implants
Dental implants are more expensive than dentures and other treatments, such as bridges.
Though prices vary based on the location of the dentist’s practice and other factors, the American Dental Association (ADA) reports that an implant may cost between $1,600 and $2,200 per tooth.
The ADA suggests that the average cost of a complete set of upper dentures is a little more than $1,600, and complete dentures for the lower jaw are about the same.
Maintenance of dentures vs. implants
Care for dental implants is similar to standard dental hygiene for natural teeth. That means brushing at least twice a day with a soft-bristle brush, flossing, and having regular checkups.
For dentures to remain viable for the long term, however, greater daily maintenance is required. You shouldn’t wear them overnight, for example. They should soak in water or a special cleaning solution during that time.
To clean dentures (which should be done daily), remove them after eating and brush them. You may also need to brush away any bits of adhesive that linger on your gums.
Because your bite changes over time, dentures will need to be refitted from time to time. Dental implants, on the other hand, are permanent fixtures that may require replacement crowns if original crowns become cracked or broken.
Complications from dentures vs. implants
Dental implants are usually safe and effective solutions to missing teeth but can present a range of complications, such as infection and mechanical problems (loose posts, cracked crowns). Dental implant failures occur about 5 to 10 percent of the time.
The most common complications with dentures are:
the dentures not staying in place
sores (ulcerations) forming on the gums
Making a decision on dentures vs. implants
When you’re ready to make a decision about your dental future, consider the following factors:
Age
Because dental implants are more permanent solutions, those in their 60s or younger may want to choose implants, as they can expect to enjoy a few decades of use out of their prosthetic teeth.
Older adults, especially those who don’t wish to go through the more time-consuming and invasive procedures involved with implants, may prefer dentures.
Bone density
Implants require a certain amount of jawbone material in order to support the posts. If you have lost bone material, either through injury, age, gum disease, or tooth loss, you may not be a good candidate for implants.
Dental bone grafting can be done to bolster jawbone density, but it’s a more expensive and involved process.
Function and feel
Dental implants may provide a preferable comfort level and better chewing than dentures.
However, a 2019 study found that people who had implant-supported over dentures — a hybrid of dentures and implants — reported more satisfaction with the comfort and chewing efficiency compared to having conventional dentures.
Hygiene
If you’re unable or unlikely to take the time to care for your dentures effectively, you should consider implants, which are more low maintenance, though more expensive.
It’s important that you be honest about your willingness and ability to provide daily care for your dentures.
Alternatives to dentures and implants
Dentures and implants are only two options for replacing missing teeth. Other alternative treatments to discuss with your dentist include:
Dental bridge
If you’re missing one or more teeth, a dental bridge can be a convenient approach to filling that gap. Also known as a fixed partial denture, a bridge attaches to surrounding teeth for support.
Research suggests that a high percentage of individuals with dental bridges are satisfied with them, though there needs to be greater patient education related to proper care and maintenance of these devices.
Temporary partial denture
Often referred to as a flipper, a temporary partial denture is a removable, retainer-like device that contains one or more teeth. The prosthetic teeth can give the appearance of a full smile but can be removed for easy cleaning.
Flippers are among the least expensive solutions to missing teeth, but they are also the least durable.
These devices are typically used by people waiting for implants or a fixed bridge, but they can be long-term solutions for individuals who understand that replacement flippers will likely be necessary over time.
Snap-in denture
Something of a cross between dentures and implants, snap-in dentures don’t rely on an adhesive to remain in place. Instead, snap-in dentures — also called overdentures — rely on implants to secure their position in the mouth.
Instead of having a post and abutment for each missing tooth, snap-in dentures may be fitted with a few snaps on the bottom that attach to two to four posts in each jaw. Snap-in dentures can be permanent fixtures or removable for cleaning.
Snap-in dentures are more stable than conventional dentures, but they’re also more expensive. They also come with similar potential complications as regular dental implants and do require regular maintenance
Takeaway
You should make the choice between dentures or implants carefully and in consultation with your dentist.
Though implants are more expensive, they could provide 20 or more years of service compared with dentures, which may require occasional adjustments or replacements through the years.
If you look carefully at all of your options to replace your missing teeth and consider your priorities and what you want the prosthetics to accomplish, you should be able to make a final decision with confidence.
