I have advanced tooth decay and gum disease. My two center front teeth are healthy, and after a visit with the periodontist, he says that those two teeth are likely the only ones he can save. I have a cheap bulky partial, and I have an underbite. My dentist thinks that removing the two teeth and getting a complete denture would be healthier than partial dentures. I got a second opinion, and the dentist said that he could do either option, and it’s up to me. I guess that a full denture would look better than a partial. I’m asking a couple of dentists online for their help. My budget is limited, and I’m concerned about that too. But I’ve learned my lesson about neglecting my teeth, so although I’m not too fond of debt, if I need a loan to correct the situation, I’ll apply for financing.  Is it best to have my center front teeth removed or to get partial dentures around them? Thanks. Timothy from Huntsville, AL

Timothy,

For an accurate diagnosis and treatment options, Dr. Brooksher would need to examine your teeth personally and do x-rays.  We’ll give some principles based on your description of your oral health. But we can give you some principles that might help.

Save Your Teeth or Extract Them for Dentures?

The factors below and talking with your dentist can help you decide if you want to keep your teeth or get full dentures.

1. It’s usually best to save healthy natural teeth

When your natural teeth are healthy and won’t compromise your oral health, it’s usually best to save them. Replacing teeth with a removable appliance—a partial or full denture—has many disadvantages. The denture can move or slide if it’s not anchored, and it won’t be comfortable.

2. When few teeth remain, they are under stress

If you only have two upper teeth that are healthy, the force from your lower teeth when you bite and chew puts stress on the upper teeth. Pressure on the teeth can weaken them internally, even if they appear healthy on the outside.

3. A full upper denture increases comfort

Suction keeps a full upper denture in place, and it moves less than a lower denture. It’s more comfortable than a partial denture, and it’s easier to eat and chew with it.

4. A well-made upper denture is healthy for other teeth

A well-made upper removable denture is gentle on lower teeth. If you have a severe underbite, the force or impact of chewing can put stress on lower teeth.

5. When all your teeth are missing, your jawbone is affected

Teeth stimulate the jawbone, so when all your teeth are missing, the stimulation stops, and your body resorbs the bone. After 10 to 20 years, you’ll lack enough jawbone to support your facial muscles, and your face will sag and make you look older. The missing bone will make it difficult—if not impossible—to keep a lower denture in place. But you will still have some suction for an upper denture.

6. Implant-supported dentures increase function and comfort

Your dentist can tell you if you’re a candidate for an implant-supported partial denture or an implant-supported denture. Either option might exceed your budget, but implants stimulate your jawbone to prevent further shrinkage. Your denture won’t slip around, and it will be comfortable to eat and speak with it.

Again, Dr. Brooksher hasn’t completed your oral exam or seen your x-rays, so you’ll have to rely on a local dentist for accurate diagnosis and treatment options.

Steven Brooksher, DDS of Baton Rouge sponsors this post. Dr. Brooksher is an accredited cosmetic dentist and a fellow of the International Congress of Oral Implantologists.