Dentures at 34????

Over the years I have heard advice almost exactly the same as yours from every dentist I have spoken to. “Everyone of my patients who have lost all their teeth have regretted it” or words to that effect.

The only problem is that this advice has not accorded with my own experience.

I come from a background that probably did not place much importance on dental health or regular check-ups. Both my parents have worn dentures for as long as I can remember. They used to warn us children that unless we brushed our teeth at night we would face the same outcome as they and have to wear dentures. On the other had when friends or family encountered dental problems they were the first to advise that they should have their teeth out so they seemed to confirm, despite their warnings to us, a satisfaction with dentures and a preferenec for early extractions. Certainly from a child onwards I always thought my experience would be like theirs and I would lose all my teeth in due course as they had done. The prospect held no terrors for me. It was normal.

I never bothered to go to a dentist regularly which did not seem to matter much until my mid-thirties when decay and gum diseases started to be a problem. It was then that I asked to have my teeth taken out: a requested that was denied immediately for the reasons you have given. However, I did not really respond well to treatment, perhaps because my heart was not in it. So the inevitable happened and I had all my remaining teeth extracted shortly after my fortieth birthday.

I agree that the transition to dentures is not that easy or that quick. It takes months for your gums to really heal and stabilise and until then proficient use of dentures is compromised. All I can say, unlike all your patients, is that I do not regret losing my teeth. I have now been wearing complete dentures for about twenty two years and my present set about six years, which were relined about two years ago and continue to fit well. Over the years my dentures have simply become part of me. My dentures have certainly improved my appearance and are easy to maintain. I have had very little trouble with them unlike my natural teeth. Eating with dentures is different than with natural teeth but I can manage most things and enjoy my food. My dentures are reasonably stable andcontrolling them in my mouth is second nature to me.

All in all I am satisfied with my dentures and do not regret the loss of my teeth. I think my experience is much more usual than you would suppose which is why many denture wearers when surveyed have a positive response to their dentures and the loss of their teeth was both expected and often came as a relief. In fact in my view if people knew what well-fitting dentures were really like they would be more insistent on being offered them as an alternative to often painful, lengthy and expensive dental treatments.

Lastly I have no doubt that my general health improved immediately my teeth were extracted. That alone would have supported the decision to extract.

Thanks so much for all the input, I am just really torn with the cost between the two. Of course, I would rather have the implants, but I can't afford to have them and it is very hard to find a dentist that is willing to work with payments. And as we all know Dental Insurance Sucks! It doesn't cover anything! I will try and keep searching for one that will help...just not sure how much longer I can go on.

It helps to know that it's not the worst thing that could happen, as most do learn to adjust.

Thank you for taking the trouble to reply to my post.

I think the issue is more complex than the blanket condemnation of dentures by dentists would suggest.

It does seem that you would agree that my satisfactory experience of dentures is quite typical in that I have successfully adapted to denture wear, I use them proficiently for eating and speaking and have done so for over twenty years. I am happier with my condition now than I was in the last years of having teeth. I would suspect that is a typical and completely truthful reaction too.

My point is that a judgement should be made sooner rather than later whether a patient is sufficiently motivated to retain teeth and the likelihood of extensive or total extractions in the foreseeable future. In my case I am sure that I should have had extractions earlier, probably in my mid-thirties, as this would have avoided expensive and sometimes painful treatments which were ultimately of little value. Prolonging the life of teeth for the sake of it seems to me to be pointless.

When the time came I was not a suitable patient for partial dentures, even a lower partial. I do not think this is unusual. I would also suspect that many complete denture wearers reached that point after a period of partial denture wear. Again an assessment could have been made whether the resultant delay of the inevitable was worth it.

The two unknowns are the small percentage of patients who will not adapt well to dentures, if at all and bone resorption. Of the group that cannot adapt there may be a number who are too old or ill to do so or who have already have lost considerable bone around their teeth which makes functional dentures difficult. In these cases an earlier decision to extract may have greatly helped.

The only certainty is that we know that the underlying bone of the jaw will recede, albeit usually very slowly after the first year following extractions. Again I believe I am in the majority of those that should have sufficient support for a life time of denture wear. Certainly my parents did. That would be the general expectation. Obviously the delay in extractions can exacerbate matters due to extensive bone loss caused by gum disease. Subsequent illness may cause accelerated bone loss. However, even after extractions much can be done to address this, if it is perceived to be a likely problem and, in particular, through the provision of implants.

Further, a consideration you did not address is the overall health of the patient. I thought that it was an old wives’ tale that the retention of teeth can have adverse health consequences. But I know this to be the case. My general health certainly improved markedly after the clearance of my teeth.

In summary, I think the dental professions hostility to dentures is over done; just as its propensity to extract in response to almost any serious problem fifty years ago was over done. There needs to be a balance. Not everyone has good teeth and gums and is destined to retain their teeth and for many in this group the early provision of dentures may be the best choice. It would have been for me. Dentures are not perfect but they are quiet satisfactory. They are not the end of all dental problems, although they eliminate a great many of them, and they are certainly better than the teeth I lost at the time I lost them and several years before that. That must be the comparison that should be made. I think that, if people knew how well properly fitting dentures worked, they would like the alternative of acquiring them to be fully examined and discussed; both the pros and the cons, not just the cons. In my view more would chose dentures if they knew and at an earlier age. So they are not necessarily a last resort but the treatment of choice in a number of circumstances.

Again thank you for your time.

A friend of mine said she had her dentures when she was still in her teens - I guess implants were not an option for her back then? Anyway, she has learned how to deal with the dentures (front teeth) and I think she had them changed (improved?) once or twice already. The quality of her dentures is good, because I didn't really notice until recently, when she mentioned having them. She told me that one good thing that came from having dentures, is that she is more careful with practicing proper oral hygiene - because she doesn't want to lose more teeth and have a more extensive denture.

According to the This is Dentistry website (the post about Missing Teeth), you can have these options for missing teeth - full dentures, partial dentures, dental bridges, or dental implants. If dental implants aren't an option because of the cost, maybe you can ask your dentist about a dental bridge (or dental crowns?) instead?

There seems to be a large discrepancy between the dental profession's attitude towards full dentures (avoid at all costs) and those of the wearers themselves, who are generally accepting of both the loss of theri teeth and their dentures.

In a major survey of adult dental health in the United Kingdom, of the respondents who had lost their remaining teeth in the preceeding ten years (about 1% in the age group 35 to 54 and 3% of those aged 55 and over) 65% expected to lose their teeth when they did and over half were not upset by their tooth loss, compared to 18% who were very upset. Generally men were less likely to find total tooth loss upsetting. More respondents said that teeth should be removed if they caused problems or that there was nothing to worry about dentures than said that teeth should be retained for as long as possible.

Of full denture wearers in general, some 75% were satisfied with the appearance of their dentures. 60% had no problems with their dentures with the incidence of problems surprisingly declining with the years of both denture wear and the age of dentures. No reason was given for this but it could be that, notwithstanding progressive bone loss, the familiarity with denture wear and the dentures themselves overcomes this. The principal problem with dentures was with eating with 26% reporting some problems. The greatest problem being food getting under the plates, nearly half of the complaints, with only 5% having difficulty chewing or biting. A much smaller percentage of denture wearers had problems speaking or other problems, such as looseness, discomfort or ulcers. Few thought their problems were sufficient to warrant a visit to a dentist. An overwhelming majority had no difficulty in wearing their dentures throughout the day, although some took tehm out when at home, which I would not have thought was necessarily indicative of unsatisfactory dentures. I do myself.

Overall, it would appear to be a much greater level of satisfaction with dentures than many would have expected. Given that the identity of respondents was kept secret, there would seem to have been no particular motivation to minimise the discomfort or handicap of dentures. The survey also accords with my experience of wearing full dentures for over twenty years. I have been satisfied with my dentures and experienced very few probelms with them. I see no reason why this should change in the future. It would seem that for those with poor teeth and gums, dentures may be a more sensible option than is generally believed.