Are false teeth now history?

How old, dodgy dentures have given way to beautiful, permanent replacement teeth

Truly transformational: the full arch titanium/acrylic fixed implant bridge:

before treatmentafter treatment
Times (they are) a changing.  I’m actually not listening to Bob Dylan as I write this, but times are definitely changing in the world of UK dentistry, and where dentures are concerned, the change is accelerating.

20 years ago if you had lost all your teeth, false teeth or ‘falsies’ were your only option. Cheap and cheerful, available free on the NHS…and utterly hopeless as a functioning pair of teeth. Some of them looked ok and even stayed in when you were talking, sometimes!

20 years ago dental implants were in their infancy, only a few brave dentists with hugely rich patients ventured into such unchartered territory..

Fast forward 10 years and things had changed dramatically:

10 years ago if you had lost all your teeth (or a complete top or bottom set)  then it was possible to find a few dentists with the ability to replace a whole set of top or bottom teeth – but the costs, although vaguely affordable for those with serious property equity, were still somewhat eye-watering. A full set of porcelain teeth needed 10 implants to support them and each tooth was lovingly crafted – the dental technician would spend days or even weeks making them.

Some dentists realised that there must be ‘another way’ and started to use fewer implants to fix dentures in place: the implant-denture was born. The beauty of the implant denture is that instead of needing 10 implants to hold a complex custom made porcelain bridge in place, with the extra support that the implant denture gained from resting on the gums, the implant dentists could use fewer implants to hold these teeth in place:

Result! Dentures that stay put and can be used for eating most food without any fear of them falling out when discussing the latest episode of the Simpsons [Grandpa should have implant-retained dentures by now surely? -ed]

The only problem with implant retained dentures is that in patients’ eyes they are still dentures! They need to be removed for cleaning purposes every night….and no matter how well they stay in with their super-duper implant-connectors, they still have the ‘false teeth’ label.

2010

Enter the new era of ‘full arch’ implant dentistry [full arch: aka a top set, bottom set or complete set of implant-teeth].

Combining the ease of construction of implant-dentures with the satisfaction of having a set of fixed teeth that really feel like your own, without resorting to using 10 implants at a time and without the days and weeks of painstaking construction time at the dental lab…..it has become possible to completely replace a top set, bottom set or both for a rather less eyewatering fee than those huge ceramic bridges….

How?

This has been made possible by using digital scanning/CNC technology to produce titanium ‘backbones’ with micro-tolerances that are screwed into place on as little as 4 implants for a full set.

Top quality acrylic teeth are then firmly attached to the titanium backbone and the full arch titanium/acrylic fixed implant bridge is complete.

How do they look? The photographs speak for themselves.

Dental Bridges have had their day.

Did you know that dental bridges have been around for over a century?

Now I’m not one to decry something simply because its getting old – for example, I do love old cars (as friends will testify!), but how many of us would drive a 100 year old car as everyday transport? Wouldn’t that be uneconomic, wouldn’t it damage the environment?

Just like having dental bridges fitted, as it turns out.

cars

The costs add up

The problem is, a bridge relies totally on the teeth either side for its support, and those teeth have to be drilled down to pegs would you believe.

So, installing the dental bridge actually weakens the adjoining teeth, and then to add insult to injury, the bridge leans on them for the rest of its life…..the dental bridge is ‘parasitic’. Bad for its environment.

The extra loads that that bridge imparts means those teeth are much more likely to fail in the long term……a single tooth loss leads to having 2 or 3 teeth missing…the long term costs go up.

Hardly an elegant modern solution

People should also know that with a bridge, the bone and gum underneath continues to shrink slowly over time.

At best this leaves a ‘dip’ in the gum above the bridge tooth and at worst a black hole (gap) appears so that everyone you smile at knows exactly where your false tooth is!

Dental Implants are the answer

The humble dental implant solves all these issues: It stands alone without interfering with its neighbours.

Over and above that, our bone loves the titanium surface of an implant tooth – and once an implant is inserted under the gum and into the bone, then the bone will not shrink like it does with a bridge.

The aesthetic and cost implications of implant teeth are just too good to ignore.

Let us retire the bridge, and give it the rest it deserves.

Lower dentures are utterly useless

I well remember my first denture lecture as a keen young trainee: The denture-department head stood up in front of us at the top of Guy’s Tower and said:

Before I begin, don’t you lot ever forget one thing: dentures are only ever better than nothing at all!“.

And this from the head of the Prosthetics dept. (the top specialist in false teeth – ed.)

Lower full dentures are bottom of the barrell.

With the tongue muscles getting in the way the poor old lower denture hasn’t got a snowball’s chance in hell of staying put. Meanwhile the patient struggles to speak and eat while it jumps around in the mouth with a life of its own.

Patients can’t eat solid food, they can’t speak for embarrassment, and often the movement of the denture causes friction-sores on the gum. What utter misery.

What’s more, there is absolutely nothing the concerned practitioner can do about it. Try as he might, adjusting adjusting adjusting, remaking, relining and rebasing – it just won’t fix it.

Miserable patient, miserable dentist.

But aren’t the alternatives too expensive?

Not necessarily. Enter the well proven implant-retained-denture.

Essentially the patient’s own denture can be modified with special fixings which then attach to 2 or 4 implants inserted in the lower jaw. The real beauty of this method is that it keeps the cost right down. There is no expensive bridgework and only 2 or 4 implants are required to hold that denture right where it is needed.

Implants for dentures

The treatment costs a fraction of implant-bridge treatment where up to 6 implants may be required, (coupled to 10 or 12 porcelain bridge units bonded to a metal framework.)

The implant retained denture can be removed for cleaning, but when placed in the mouth it is fixed solidly. This method can also be used in the upper jaw but more implants are required – but it’s not as great a problem as these useless lower dentures.

I’m sure that patients should rather be worrying about where to go out to eat!