Would dentures or dental implants be better for my 65-year old dad?Dental Dental Implants
It is indeed wonderful to know that Daddy is still relatively young and is in a position to consider enhancing his smile and overall dental health.
Given that there is some research to suggest that loss of teeth is associated with an increased risk of early mortality and that prosthetic reconstruction and replacement of teeth improves quality of life, we congratulate your dad on wanting to take the step forward to improve his overall dental health.
The decision making process of choosing dentures vs implants is not straightforward, and MUST involve many factors. We can broadly discuss this using a TRIPOD of Treatment Planning, just like how a camera tripod can stand sturdily on three solid legs.
1) What does Daddy want?
Does Daddy desire a set of fixed teeth so that he no longer needs to have the inconvenience of having to put on and take off his dentures daily, or even sometimes forgetting to wear his dentures? If this is the case, then implants to support a set of fixed replacement teeth should be strongly considered. Another factor to consider here is whether he feels that a removable denture is good enough for him to chew and enjoy his food. There is also some compromise in esthetics with a denture if the clasps (metal hooks) are visible he smiles. With current technologies, the fear of surgery can be more manageable with in-office sedation, working with an anesthetist.
2) What does Daddy present with?
This aspect is crucial. Many factors need to be considered, which means both Daddy and the dental surgeons treating him need to be aligned.
a) Medical history: Daddy has to be in stable health to undergo the dental implant procedure.
b) State of the surrounding teeth and gums: dental implants need to have a strong bony and gum foundation to last. The new implant-supported teeth replacements also need to harmonise with the surrounding teeth and gums in terms of colour, shape, position and size. Many times, we realise that we need to perform adjunctive procedures with the surrounding teeth and gums to create an appropriate foundation before the actual implant procedure is carried out. Most of the time, bone grafting procedures to rebuilt the underlying bone foundation is needed to ensure a strong anchor for the implants.
c) Willingness to undergo surgery: Dental implant procedures involve surgery and often MULTIPLE SURGICAL PROCEDURES. If Daddy for any reason refuses surgery, then either the denture or teeth-anchored fixed bridge would be more appropriate.
3) What can Daddy afford? (Both TIME and FINANCES)
Dental implant procedures usually cost a lot more financially compared to dentures. If adjunctive procedures such as bone grafting, sedation, temporary implant teeth placement, are needed, the cost goes up rather substantially.
There is also a dimension of time. Dental implants require a certain time for healing and integration with the jaw bone. This usually takes 4 to 6 months. If adjunctive procedures are required, the entire reconstruction process may take up to 2 years. Hence if Daddy is unwilling to accept that time is required for the body to heal, then dentures may still be the treatment of choice.
As seen from the above 3 "legs" of treatment planning, there is a need for comprehensive data collection involving careful diagnosis, high-quality X-rays and scans, before the final decision can be made as to dentures or implants will be the treatment of choice.
The answer to the question truly depends on a number of factors. The most important thing is about what your dad wants. For example, if he does not want any form of surgery at all, then a denture or perhaps a dental bridge may be instead a better option for him.
Whilst a denture would be suitable for him to regain confidence and smiling, there is a difference in terms of bite strength a dental implant has over a denture.
It would be possible to bite into an apple with a denture, however it would be far much easier if he had dental implants to eat harder food. Of course it is important to consider his diet and lifestyle to make this decision. What would be wrong is for him or the family to say that he only eats soft food or that he is old and hence why he should only have a denture.
This is a choice that the patient has to make. If he is unable to enjoy eating what he enjoys the most with a denture then perhaps he may have to transition to dental implants later. There are naturally some factors which might prevent dental implants from being an option.
In addition if it is front teeth, he is likely to need xrays or even a CT scan to assess remaining bone levels. The dentist will also ask him about his general health and asks if he smokes to see if there are any potential absolute or relative contraindications for dental implants.
Of course cost is another important factor. Singaporeans and PRs are very lucky to be able to use some Medisave towards the costs of dental implants. But all being said, I would love for my dad to be able to eat normally as possible so that he can enjoy his later years and especially smile at his grandchildren. sincerely Dr Samintharaj Kumar
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