20th Century vs 21st Century
Question:
Dear Dr. Crapo: I’m coming to the end of a long career. In the next two years, god willing, things will wind down nicely giving me time for family and hobbies. As I come to this point, I know that my dental health is not what it should be. On my lower, I’ve got eight teeth. I’ve lost my molars basically to neglect and decay. My dentist said I could get a partial or maybe some implants. I hate to say it, but during my working life I just haven’t taken time for myself and have spent as little on dentistry as I could because it seemed inconvenient and expensive. I’ve had great health otherwise so it’s never been a priority. I do have a partial on top for appearance sake. I have three gaps up there that wouldn’t look good without teeth, so I had a partial made up. It’s working, but of late I’ve been wondering what to do. I’ve got some large fillings that the partial fits onto and my front teeth look, well, let’s just say weather-beaten. I’m wondering if I should get new partials or if I need some bridging with crowns or if implants are the way to go. Money is not a great barrier, though, I want to be careful. I’m seventy next month and have great health as I said.
Answer:
While partial dentures are still used, they are not mainstream anymore. This is especially true where they are not supported by teeth on each side of a “gap.” In your lower jaw the partial would be supported by your front teeth, but because you have no back teeth, it would just sit on your gums. Proper engineering can make this acceptable, but it’s not good value for your dollar. It is far better to place implants in the molar area, fixed with crowns for a permanent “function and clean-like-your-own-teeth” solution. You will also love the biting power when chewing your food – there is no comparison between the two options. In your upper jaw, you may well use permanently fixed bridges to “fill your gaps.” If your teeth have good root size and the bone and gums are healthy, this could act as a very good solution. It sometimes has a double benefit in that the teeth anchoring the bridgework have large fillings and may need crowning anyway. Partial dentures would be less expensive, but you have to take them in and out to clean them and partial dentures hold “bacteria-laden” saliva and plaque in and around your own teeth which promotes decay. If you have adequate bone for implants in your upper jaw, the reason to consider them is that they are easier to maintain than bridgework or partials. And decay – which you’ve suffered from – will never be a problem.
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