Fixed vs. Removable Dentures: Which Option is Best for You?

Fixed or removable dentures?

Hello, Doctor.
I have a question: I have a fixed dental prosthesis on the upper right side (consisting of four teeth starting from the right central incisor), which has been in place for over ten years.
Currently, it is becoming loose and bleeding, and my gums are also red and swollen.
I recently visited a dental clinic, and the dentist suggested that I should have the old prosthesis removed and replaced.
However, I am confused about one thing: the dentist mentioned that since I am still young, if I were to get a prosthesis, a "fixed dental prosthesis" would be more suitable; otherwise, I would need implants, which are currently more expensive.
The dentist also advised against "removable dentures" for younger patients, as they may be harder to adapt to.

If I choose to get a "fixed dental prosthesis," in addition to the original four teeth, I would need to include one tooth from the back and two front incisors, totaling seven teeth.
This means that my front teeth would need to be reduced in size, which I really do not want to do as it would damage my natural teeth.
Moreover, if these seven teeth have issues in the future, would I then need to get even more fixed prostheses?
So I would like to ask:
1.
If I opt for a "fixed dental prosthesis," do I really need to get that many (seven teeth)? Are there other options available?
2.
Will getting "removable dentures" affect any other healthy teeth besides removing the old prosthesis?
3.
What types of "removable dentures" are there? What is their approximate lifespan? Are they less convenient for eating, or do they have reduced chewing functionality?
4.
If I choose to get "removable dentures" now, would I still be able to get "fixed dental prostheses" or implants in the future?
I would appreciate your guidance or suggestions on what I should do.
Thank you for your help!

vivan, 30~39 year old female. Ask Date: 2008/09/15

Dr. Huang Zhicheng reply Dentistry

Dear Vivan,
If all four of your dentures need to be extracted, it is possible that, according to the principles of occlusal mechanics, you may require a bridge consisting of seven teeth as you mentioned.
Removable dentures do indeed have significantly poorer functionality compared to fixed dentures, and there are many different types available.
If you are open to it, I recommend considering a flexible partial denture, which would allow you to avoid grinding down healthy teeth and would also be more aesthetically pleasing.
Additionally, this would not hinder any future plans for a fixed bridge or implants.
I suggest you seek a second opinion to determine whether the existing abutment teeth can be preserved after the removal of the crowns through periodontal treatment or root canal therapy.
If you can retain those four abutment teeth, it would simplify the process considerably.
Wishing you peace and health.
Sincerely,
Dr.
Chih-Cheng Huang
Director, Dental Department
Taoyuan Hospital, Ministry of Health and Welfare

Reply Date: 2008/09/15

More Info

When considering the best option between fixed and removable dentures, several factors must be taken into account, particularly your age, dental health, and personal preferences. Given your situation, where you have an existing fixed denture that has been in place for over ten years and is now causing issues such as looseness and bleeding gums, it’s essential to evaluate the options carefully.

1. Fixed Dentures: Necessity and Alternatives
Your dentist has suggested replacing your current fixed denture with a new one, which may involve creating a bridge that includes not only the four teeth currently involved but also the adjacent teeth. This could mean that you would need to modify or reduce the size of healthy teeth, which is understandably concerning.
While it is common for fixed dentures to require the alteration of adjacent teeth, there are alternatives. One option could be to consider a partial denture that does not require altering healthy teeth. This could be a more conservative approach, preserving your natural teeth while still providing functional and aesthetic benefits.

2. Removable Dentures: Impact on Healthy Teeth
Removable dentures, often referred to as partial dentures when they replace only a few teeth, can be designed to minimize the impact on surrounding healthy teeth. They typically attach to existing teeth using clasps or other retention methods, which means that they do not require the alteration of adjacent healthy teeth. However, it’s important to ensure that the design is appropriate to avoid putting undue stress on these teeth.

3. Types of Removable Dentures and Their Functionality
Removable dentures come in several forms, including:
- Partial Dentures: Used when some natural teeth remain. They can be made from acrylic or metal frameworks.

- Complete Dentures: Used when all teeth are missing in the upper or lower jaw.

The lifespan of removable dentures can vary, but they typically last between 5 to 10 years with proper care. In terms of functionality, while removable dentures can be less stable than fixed options, many patients adapt well and can eat a variety of foods. However, they may not provide the same level of chewing efficiency as fixed dentures or implants.

4. Transitioning Between Denture Types
If you choose to start with removable dentures, you can later transition to fixed dentures or implants if desired. However, it’s essential to maintain good oral hygiene and regular dental check-ups to ensure that your remaining teeth and gums remain healthy during this time.

Conclusion and Recommendations
Given your concerns about altering healthy teeth and the potential for future issues with fixed dentures, it may be worthwhile to discuss the following with your dentist:
- The possibility of a partial denture that does not require altering adjacent teeth.

- The pros and cons of starting with removable dentures and the potential for transitioning to fixed options later.

- A thorough examination of your gum health and the condition of your remaining teeth to determine the best course of action.

Ultimately, the decision should be based on a balance of functionality, aesthetics, and the preservation of your natural teeth. Consulting with a trusted dentist who can provide a comprehensive evaluation and discuss all available options will be crucial in making the best decision for your dental health.

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