MOST people do not realise the problems that arise after dentures are placed. Would you rather have an artificial leg than your natural one? I feel on very safe ground in assuming that you would emphatically answer: “Definitely not!” So, replacing your natural teeth with either a full or partial denture is about as desirable as having an artificial leg.
The name immediate dentures sounds like something produced by a fast-food version of a dental office. However, in this context, immediate means the denture is placed immediately after the dentist assesses the mouth’s condition, and there is a distinct possibility of a prosthesis.
Dentures allow you to chew; an artificial leg allows you to walk. The problem in both instances is the performance quality of the artificial replacement in comparison to what nature originally provided. Quite simply, the artificial replacement will never function as well as your natural teeth, no matter how good it looks.
Dentures are not maintenance-free; they need adjustments. It is not that the denture changes; it is the tissues under the dentures that change. A denture adjustment is necessary when denture material must be removed to relieve pressure at pressure spots that occur when bone and tissue shrink. Since tissue shrinks as it heals, dentures placed immediately after tooth extraction may need to be relined once the tissue has healed. All dentures need relining periodically to adjust for normal tissue changes. So, a denture is not a one-shot cure. It is very important to see your dentist once a year so the tissue under the denture can be monitored.
With this overview, let me offer a word of caution. Your dentist may offer you options on the types of tooth replacements possible in your case. Offering you treatment options is part of your dentist’s obligation. This is where you need to become a wise, informed dental consumer so you can discuss the best decision for your situation with him.
As a rule of thumb, fixed prosthodontics (crowns and bridges) are more expensive than removable prosthodontics (full or partial dentures). However, fixed prosthodontics is usually a more desirable replacement. Dentures also vary in cost depending on the type of teeth, the material used to make the denture base, and the number of steps involved in constructing the prosthetic device. If you find a place that claims to be able to make your denture in one day for much less than the fee being charged in the area by most other dentists, you will probably get exactly what you pay for. Let the buyer beware! There are no bargains in healthcare!
Here is a typical example of what happens in preparation for an immediate denture. The first phase is the removal of all teeth posterior to (behind) the cuspid teeth. These ridges are then allowed to heal and act as a stable base for the future denture. After healing, the denture is constructed. Then, the natural teeth are extracted, and the dentures are immediately placed in the mouth. This keeps the patient from being without his or her anterior (front) teeth at any time.
There are many advantages to immediate dentures, besides the immediate aesthetic considerations. They protect sensitive extraction sites, help control bleeding from the tooth sockets, and cover the surgical area, keeping food and debris out of the extraction sockets.
An additional advantage that you might consider worth the extra expense of the immediate denture is that your dentist knows how your “natural” teeth appeared. Thus, he is likely to be able to construct a denture that more closely resembles your natural teeth. This makes the transition easier when you see your friends and family because your appearance is minimally changed. The other option is that you can change your appearance with new dentures, if you want.
Finally, an immediate denture gives the dentist a better idea of how your natural teeth were biting. He can construct a denture that better stimulates the bite you had before extractions.
Aesthetically, immediate dentures are a better option than having dentures made after a period of toothlessness. However, they do not present more problems.
More denture adjustments are needed when immediate dentures are placed, and these dentures may need to be relined shortly after they are seated. The reason is that the tissue, including the bone in the area, shrinks during the healing process after the teeth are removed. The healing process lasts about six months. This shrinkage causes the denture to become loose and alters its fit. Relining is not needed immediately for conventional dentures fitted on ridges, even if time has elapsed since the teeth were extracted.
Usually, the immediate dentures themselves are not any more expensive than conventional dentures. However, since immediate dentures must often be relined once the ridges have healed, the reline is usually an additional charge.