Implants or Removable Partial Dentures?


I sometimes see patients who have lost a tooth or multiple teeth. I’m not talking about dentures, and I’m not talking about patients who have too many teeth for the size of their jaw when they get their teeth straightened. I’m talking about teeth that you want to keep.

The recommended way to replace missing teeth is with dental implants. The implants are placed in the bone and at the appropriate time restored with crowns. But not everyone has the funds for this treatment which costs thousands of dollars. What is a person to do? Go toothless?

The traditional way to restore the mouth when several teeth are missing is a removable partial denture. A metal framework is fabricated, and then either porcelain or acrylic teeth are placed on a pink looking acrylic which simulates gums. Modern techniques have replaced the metal with sturdy flexible materials.

So what is the downside to removable partials? There is a problem where the partial denture is anchored to the teeth. From taking the partial in and out (which is very necessary for oral hygiene) , the anchor teeth clasping the partial in place are faced with extra pressure. This can cause these teeth to lose bone, become loose, and finally they need to be taken out. It may take several years for this to occur.

Another problem is that there are tissue changes under the partial denture. If the denture is not relined food can get trapped underneath and become a problem when eating. With certain foods the denture might lift up – an embarrassing situation when in public.

Over time, the acrylic teeth can get worn down and new replacement teeth placed.

Nowadays more and more patients are opting for implants even though they are more expensive. But they chew and feel like real teeth for most patients. They have very few failures.

The newer flexible materials may not be as damaging to the teeth holding the abutments. The problem with some of these materials is that the clasp (part holding the denture to some of the teeth) may stretch and need to be replaced.   Also some of these materials can’t be relined. But my experience is that they are more comfortable for patients.