Dentures or implants: What's the best choice?
AIMING to keep your own teeth for life is the best outcome for everyone, but if we are unlucky, neglectful or a smoker, and some teeth are lost, there are options for their replacement.
Everyone should know
Australian Dental Association Oral Health Committee consultant Dr Peter Alldritt noted, "Most medications have a side-effect in the mouth, called xerostomia, which means dry mouth. You then have less saliva flow which means you start losing suction for your dentures which rely on saliva.
"If you have your own teeth, without adequate saliva your risk of tooth decay goes up because in the saliva there is a lot of proteins, calcium, phosphates, iron and enzymes which neutralises the acidity in your mouth and help to protect your teeth against decay."
Seniors should also be aware that after stopping work, they often experience a decline in their dental health as their eating habits change. "When you retire you may have some morning tea with a biscuit, or a bit of afternoon with a slice of cake," Dr Alldritt said. "Every time you eat, you get an acid attack on your teeth. Now you are eating five times a day instead of three times a day, you have now doubled the number of acid attacks and that can put you at higher risk of decay especially if you already have a dry mouth because you are taking a few medications."
There are two common options for teeth replacement - implants and dentures. Dr Alldritt said most dentists will consider all these options for every missing tooth.
Implants are increasing in popularity as they are the closest device which looks, feels and acts like our own teeth.
Their technology is getting better all the time, but the price hasn't. "They are still the most expensive treatment option," Dr Alldritt said.
They are screwed in permanently to the jaw bone. And, as long as nothing goes wrong with the fusion to the bone, they may last a lifetime.
It also takes some time to get the desired result as there are a number of steps to be completed in the process of having them settle into your jaw bone.
"It can several months because the implant has to be inserted into bone and then you let it fuse with the bone, which can take a few months," Dr Alldritt said. "Then the implant is uncovered and the tooth put on top. Then if you need bone grafting because you don't have enough bone, then it's even more months. It's not an instant fix."
If you have a whole jaw of teeth replaced, you need to be prepared to allow time for the muscles of your jaw, cheeks and tongue to get used to the new device in your mouth.
When you have replaced your teeth due to gum disease, for example, that disease could return around the implants so optimal oral hygiene is important as well as six or 12 visits to the dentist for a complete clean.
This removable prothesis is much cheaper than implants. It can be made and placed within about a month.
"When a person ends up with no teeth in their mouth, that condition is called edentulism," Dr Alldritt said. "The rate of people becoming edentuliast is decreasing because we have better control of disease and better oral hygiene, we would like to think our diet is improving, although, let's be honest; sugar is a massive problem." As a result, the demand for dentures is decreasing.
When there is no longer teeth and as we age, the jaw bone shrinks so the denture gets looser and looser which makes it harder for a "successful" set to be made. "We find a lot of people up relying on denture adhesive.," Dr Alldritt said.
Another reason for their decline is the increase in people deciding that wearing dentures - the loose, gum irritating, eating and smiling inhibitor - is just all too much to put up with anymore.
They do often rub and cause sore spots, and that trauma can be a pre-disposition to oral cancer. "It affects more than a 1000 people a year in Australia and it is often diagnosed quite late in its disease progression and therefore the progress is very poor," Dr Alldritt said.
His strong advice is that people with dentures should visit their dentist once a year.
Dr Alldritt said there is little that can be one to improve the design of dentures. What can help is retaining as much bone as possible to help hold the denture in place.