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Why Do Dentist Want Me to Have Dentures?

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I have a disaster of a smile. I always need a ton of work on my teeth. I am willing to invest in them and fix them, but it seems like all my dentist ever recommends is the most aggressive treatment possible. I have two teeth he just wants to pull and put in partial dentures. I’m only 32 and I feel like my life is over if I’m already getting dentures. Is there another option for me?

Patty

Dear Patty,

woman smiling with dentist behind her

The Best Dentists Try to Save Your Teeth

I’m going to tell you right off the bat that this is not going to be the best dentist for you. Some smiles are high maintenance. You can do everything right with your oral hygiene but they still end up needing a lot of work. Just as teeth vary, so do dentists. You have some that will just not want to put in the effort to deal with your smile. Others will make every effort to save as many teeth as possible.

My first recommendation for you is to get a second opinion on whether or not these two teeth can be saved. It may be you will not even need to worry about a tooth replacement. For argument’s sake, though, let’s say the teeth cannot be saved. Your dentist was under an ethical obligation to give you all the options available to you — not just the easiest for him.

There Are Other Tooth Replacement Options

Removable partial dentures are probably the worst option for you. If we want to go to the other end of the spectrum and tell you the best option, I would recommend dental implants. These are like having a healthy natural tooth in your mouth again. Though, they are pricey and surgery is required because they place a prosthetic root in your jaw to mimic your natural tooth. You’ll also want to find a dentist with post-doctoral training in dental implants because it is quite an advanced procedure.

If you decide that is out of range for you, the next best option is a dental bridge. This will suspend a false tooth between two dental crowns. Of course, that means the two adjacent teeth will have to be crowned, but if they happen to need work anyway, they may be a great option for you.

Find a dentist willing to put in the work and give you all your options.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Should I Keep My Last Two Upper Teeth?

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I have two upper partial dentures. The only thing left on my upper teeth are the top two front ones. I can’t decide if I should keep them or extract them and get a full upper denture or keep the last two good teeth. I don’t know anyone else in this situation that I can ask. Is there a clinical opinion on this?

Marc

Dear Marc,

I am going to have to preface this by saying my advice is given based on general principles drawn from what you’ve said. I haven’t examined you or seen x-rays so there is no way for me to give you a definitive response.

In most cases, it is better to save your natural teeth whenever possible. Whenever you extract a tooth and replace it with a removable device, there is always some shifting and movement. If you replace it with a dental implant, that is closer to having a healthy natural tooth.

The Danger of Facial Collapse

There is usually an even bigger issue with having all your teeth removed, which is known as facial collapse. When your teeth are extracted, your body recognizes there are no longer teeth there. In order to use its resources well, your body begins to resorb the minerals in your jawbone in order to use them elsewhere where it perceives they’ll be more useful. After ten to twenty years, depending on the individual body’s response, you will no longer have enough jawbone left to retain your dentures, a condition dentists call facial collapse. This doesn’t affect upper dentures nearly as much because that is held in by suction. However, if you were wearing a lower denture, it would be disastrous. These just rest on the ridge of your jawbone, which will disappear.

Your case is different. Yes, you have two teeth left, but with the eating/biting stresses put on them as your only natural teeth I don’t expect them to last long. The teeth for a complete denture will be much easier on your natural teeth on your bottom arch. In a situation such as yours, the best solution would be to remove those two upper teeth and place an implant overdenture there. This places four to six dental implants and anchors a denture to them.

Not everyone can afford that. However, even the least secure option of completely removable dentures will be better than what you have going on now. You’ll be more comfortable and it will look more natural.

This blog is brought to you by Duluth, GA Dentist Dr. David P. Marion.