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Beverly Hills Institute of Dental Esthetics
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Brian LeSage, DDS, FAGD, FAACD

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Is an Implant Denture My Only Option?

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My dentist recommends removing all my lower teeth removed and replacing them with an implant denture. Although I am 42, I am concerned about the risks because of my health. I have high blood pressure, pre-diabetic weight, and a chronic skin condition treated with cortisone cream.  I recently had a cancerous growth removed from my face. I also take several prescription medications. Given my health history, I worry that this surgery could cause complications or infection that might put my overall health at risk. Why would an implant denture be my only option? Thanks. Salome from UT

Salome,

Without an exam and X-rays, it’s not possible to provide treatment recommendations. What we can say is that when it comes to replacing missing teeth, there are always several approaches—not just one.

From your description, it doesn’t sound like the dentist fully considered your medical challenges. Instead, you were given a somewhat aggressive treatment plan. A removable denture is a reasonable option in cases like this, yet it wasn’t mentioned. This raises the concern that the recommendation to remove all your lower teeth to place an implant denture may have been driven by financial motives rather than by your well-being.

What Defines Quality Dental Care?

Two key elements to quality dental care are competence and compassion. While both matter, in your situation compassion matters even more essential than clinical skill.

Do All Your Lower Teeth Really Need to Be Removed?

Lower implant denture

Implant overdenture

It seems unlikely that all your lower teeth suddenly became unsalvageable. If some remain healthy or functional, they can often be used to support a removable denture. The main questions are:

  • Are any teeth still stable and usable?
  • Do they play a role in chewing and eating?
  • Could keeping some teeth give you better function and comfort?

Get a Second Opinion

A second opinion from an accredited cosmetic dentist can provide clarity and reassurance. Be careful not to share your expectations with the new dentist. Just listen to their recommendations. If they only recommend an implant denture with no mention of a removable appliance, consider getting a third opinion.

 

Brian LeSage, DDS, an accredited fellow of cosmetic dentistry in Beverly Hills, sponsors this post.

 

What Are the Types of Dental Implant Bone Graft Materials?

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Dental implant crown, abutment, and root formSuccessful dental implants require healthy jawbone as their foundation. According to an American Academy of Implant Dentistry article, when you lose a tooth, the bone shrinks 25 percent in the first three months and up to 50 percent in the first six months. If you have missing teeth, your body begins to resorb the bone because tooth roots are no longer present to stimulate the bone.

Before you get dental implants, a skilled surgeon will ensure you have enough bone to support them. If you do not have enough bone, your surgeon will include grafting in your treatment plan. Your oral surgeon or periodontist can obtain bone graft materials from different sources.

What Are the Types of Dental Implant Bone Graft Materials?

Types of dental implant bone graft materials include:

  • Your bone (autograft) – This is the safest and most effective means of obtaining grafting material. Using your bone requires surgery at both the grafting and surgical sites. A surgeon or periodontist (gum specialist) can take bone from the chin, jaw, tibia, or hip. A specialist may harvest bone from the tibia in the office, but the procedure requires IV sedation. Bone taken from your hip requires hospitalization.
  • Tissue bank human bone (allograft) – A surgeon may obtain human cadaver bone from a reputable tissue bank. It is more affordable than using your bone. The main concern of this graft type is the risk of disease, an immune reaction, or rejection.
  • Animal bone (xenograft) – Sterilized and processed bone, commonly cow bone, can minimize infection. Over time, your body absorbs the bone and replaces it with your bone.
  • Mineral bone substitute (alloplast) – This synthetic tissue is second in safety to using your bone. In time your body will resorb and replace it with your tissue.
  • Recombinant gene technology-derived protein – This dental product has specific uses in the sinuses and jawbone.

What Happens After Bone Grafting?

Depending on the extent of the graft and the type of material used, it can take four to nine months for the bone to heal, after which your oral surgeon can place your implants. After the implants fuse with your jawbone, your oral surgeon or periodontist will prepare the implant sites for your replacement teeth. A cosmetic dentist can take impressions of your mouth for natural-looking dental crowns or an implant denture.

Dr. Brian LeSage, an accredited Fellow of cosmetic dentistry, sponsors this post.

Is it too late for an implant denture?

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I have worn upper and lower removable dentures since 1998. Is it too late for an implant denture even if I have bone shrinkage? Thank you. Teri

Teri – Thank you for your inquiry. Regardless of how long you have been wearing dentures, you can still receive implant dentures. But we will explain some factors that may affect your treatment plan.

Is It Too Late for an Implant Denture?

You can get an implant denture even if you have worn removable dentures for decades. But the condition of your jawbone can affect your treatment plan.

Long-term denture wearing

Tooth roots stimulate and preserve jawbone, so when all your teeth are missing, your body uses the minerals from your jawbone and uses them elsewhere. Your jawbone will begin to shrink, and within ten to fifteen years without bone support, your facial muscles will sag. It will become challenging and uncomfortable to wear a denture.

Dental implants and bone shrinkage

An implant dentist embeds dental implants in your jawbone for support. But if your bone volume is low due to shrinkage, dental implants will not be stable. Before you receive implants, your dentist or surgeon must build up the bone or use a technique that does not require grafting if you are eligible for it.

Bone grafting for dental implants

Options for bone grafting for dental implants include harvesting bone from your body, possibly from your hip. Artificial and sterilized bone products are also available. Your implant dentist or surgeon will explain your options.

Implant overdenture

Lower implant denture

Implant denture

An implant overdenture is another name for an implant denture. The denture base snaps, clips, or screws onto dental implants. If you receive a traditional overdenture and have bone loss, you will need a graft before implant placement.

All-on-4 implants

All-on-4 uses four to six dental implants and places them at angles so that more of the implant root is in contact with the bone to increase resistance to displacement. This technique can eliminate the need for bone grafting.

Look for a dentist who is experienced in dental implant restoration or implant placement and restoration. Dentists who restore implants only work with an oral surgeon or periodontist to place your implants.

Dr. Brian LeSage, a Fellow of the Academy of General Dentistry, sponsors this post.

Is it too late for an implant denture?

“Because of your smile, you make life more beautiful.”
– Thích Nhất Hạnh

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