Did you know that approximately 30 million people in the U.S. (over 17% of the adult population) are missing all of their upper teeth? About 40% are missing at least some of their upper back teeth (bicuspids and molars). And, about 10% are missing all of their teeth, top and bottom!
A direct consequence of tooth loss is not just the resulting functional and esthetic compromise, but also a change in local oral physiology resulting in continuous bone loss in the jaw throughout a person’s lifetime. In other words, when a tooth is extracted, its supporting bone goes through a lifelong process of resorption. When multiple teeth are gone, even more bone is lost.
Since recently returning to the classroom at NYU to participate in the implant program, I have been exposed to a significant amount of literature about dental implantology and the human dentition. In addition to gaining new knowledge, I have refreshed my memory with regards to the whys and wherefores of many of the disciplines that I have been practicing lo these past 30 years as a general and cosmetic dentist in New York. In some areas of study I am reminded of facts and scientific theorem that I once learned as a student, internalized over several decades of clinical dentistry and perhaps even thought I had forgotten only to rediscover that “Oh yeah, I remember that.” Being a pupil again has been a reawakening of sorts, especially about the pros and cons of dental implants.
One of the rationales for replacing lost teeth with dental implants is to preserve the existing bone. Unlike other any other prosthetic tooth replacements (dentures and partial dentures), implants maintain a patient’s bone volume indefinitely. But implant dentistry comes with a much higher price tag than dentures. And while various treatment options can moderate the cost significantly (more about that in a future posting), the fact remains that complete and partial dentures are still very much a part of contemporary dental care.
Denture Wearers in the United States
Statistics vary regarding the number of denture wearers in the United States. I have seen statistics citing that there are as many as 30-40 million adults wearing complete dentures and 49 million adults wearing partial dentures. (FYI, a complete denture replaces all of the teeth in a given dental arch while a partial denture utilizes remaining natural teeth for stability and retention by way of metal connectors.
Well-fitting dentures, complete or partial, can and do provide a valuable service to the edentulous patient. The problem with them however, is this: the supporting bone under the denture will continue to shrink away creating the perpetual need for the denture to be refitted (relined or rebased). And this cyclic process of bone loss and refitting will continue indefinitely until a point is perhaps reached that the denture cannot gain enough support and stability from the diminished bone for comfortable function.
Bone Loss – A Serious Problem
Simply put, when natural teeth or implants are not present, the remaining bone will undergo a process of continual loss. This rate of loss dramatically slows down after the first year following tooth removal, but it doesn’t stop. As the bone shrinks, the fit of the denture loosens causing even more trauma to the supporting bone and teeth and thus accelerating the damage.
Dentures have been a part of mainstream dental care for a very long time (see my blog: The Truth About George Washington’s Teeth) and will continue to play an important role in restoring dental health. Dental implants offer a multitude of restorative options, including stabilizing dentures, all the while maintaining skeletal integrity. Sometimes an existing denture can be modified to accommodate newly placed implants providing a significant improvement in stability while containing excessive cost. Denture wearers must realize that the fit of their prosthesis must be safeguarded to ensure comfort and to help preserve the underlying bone.
In conclusion, (finally!) while implant dentistry comes with a larger price tag than conventional dentures, over the long term they can provide a healthier outcome, fewer visits to the dentist, and a much happier and more comfortable patient.
Dr. Michael Sinkin is a NYC dentist that has been in practice for over two decades. He truly cares about the experience his patients have and takes great pride in making them feel relaxed and comfortable during every visit. Come in for an appointment and experience a different kind of dental practice. To find out more about Dr. Sinkin, please click here.