Dentures and partials

The right choice depends on how many healthy teeth you have left, the shape of your gums and jaw, and how much stability matters to you. A quick way to think about it:

• No teeth left on an arch, or none worth saving: a full denture, or an implant denture if you want it to stay put.
• Some healthy teeth left: a partial denture that clips to them. Keeping good teeth gives the partial something solid to hold and helps the jaw keep its shape.
• A lower denture that never stays down: implants. Lower dentures have far less to hold onto than uppers, so even a couple of implants under one can change daily life.
• Teeth that need to come out soon: we plan the extractions and the denture together, so you know how you'll look and eat in between.
• A tight budget right now: a traditional denture today, planned so implants can be added underneath later if you want them.

A full denture is a set of teeth on a gum-colored base that rests on your gums. An upper denture covers the roof of your mouth, which gives it a large surface and good suction. A lower denture sits on a narrow ridge with your tongue moving right beside it, which is why lowers are harder to keep in place.

A well made full denture looks natural, lets you smile without thinking about it, and handles most foods once you're used to it. It won't bite as hard as natural teeth, and tough or sticky foods take practice. Some people use a little adhesive for extra confidence. You shouldn't need a lot; if you do, the fit probably needs attention.

A partial replaces a few missing teeth and holds onto your natural teeth with small clasps. It fills the gaps so the remaining teeth don't drift or tip into the empty spaces, and it spreads your bite across more teeth, which takes pressure off the ones doing all the work.

Partials come in a few builds that differ in strength, comfort and price. In general, a partial with a thin metal framework is stronger and lasts longer, while an all-acrylic partial is simpler and usually costs less. We'll explain which suits your teeth, and whether any of them need a filling or crown first so they can support the partial well.

An implant denture is held by dental implants placed in the jawbone. It solves the two biggest complaints about regular dentures: slipping and sore spots. And because implants stand in for tooth roots, they help slow the bone shrinkage that makes dentures loosen over the years.

We plan implant dentures on our i-CAT 3D scan, which shows how much bone you have and where implants can safely go. The implants heal for several months before the final denture is attached, and you usually wear a denture in the meantime.

There are two main kinds:

• Snap-on (removable). The denture clips onto a few implants, often two to four. You take it out at night and to clean it. It costs less than a fixed option and works especially well on the lower jaw.
• Fixed (permanent). The teeth are attached to four or more implants and only the dentist removes them. It feels closer to having your own teeth and leaves the roof of your mouth uncovered, but it needs more bone and costs more.

Getting dentures right takes a few visits. Rushing it is how people end up with a set that lives in a drawer. Dentures are made and fitted in our office, and every adjustment happens right here, so you're not sent somewhere else when something rubs.

The usual path:

• Exam and x-rays, plus a 3D scan if implants are an option. We check your gums and any remaining teeth, and ask what bothers you most today.
• Any extractions or gum treatment that has to happen first, with a plan for what you'll wear while you heal.
• Impressions and bite records, so the lab knows the shape of your mouth and exactly how your jaws meet.
• A try-in when the case allows, so you can see the tooth shape and color before the final set is made.
• Delivery and adjustments. Sore spots in the first weeks are normal, and short adjustment visits take care of them.

Prices vary widely, and it helps to understand why before you compare. A denture is made for one mouth, and the cost follows the work involved. You get a written estimate before anything is made.

A very cheap denture can end up costing more if it doesn't fit and you stop wearing it. We'd rather show you a couple of options at different prices, with what you get for each, and let you decide.

What moves the number:

• Type: a partial usually costs less than a full denture, and either one costs less than an implant version.
• Materials: the teeth and base affect how natural it looks and how long it holds up.
• What comes first: extractions, gum treatment or bone grafting add to the total.
• Implants: for implant dentures, the number of implants is the biggest factor.
• Reline or replace: sometimes a reline makes an older denture fit again for much less than a new set.

Most dental plans treat dentures as major care. A common setup pays around half after the deductible, up to the plan's yearly maximum. Many plans also limit how often they'll pay for a new denture, often once every five years or so, and some have a waiting period for major work. Coverage for implant dentures varies much more.

We're in network with plans including Aetna, Blue Cross Blue Shield, Cigna, Delta Dental, Guardian, Humana, MetLife and UnitedHealthcare. We check your benefits first and write down what the plan should pay. If you have adult Medicaid, call with your plan details and we'll check what applies.

No insurance, or coverage that doesn't go far enough? The Sunshine Membership is a $110 one-time fee that takes 30 to 40% off dental treatment, with no monthly fees. Sunbit and Cherry let you split the rest into monthly payments.

Expect an adjustment period. Your mouth has to learn to hold something new, and that takes a little patience.

• Eating: start with soft foods cut small, and chew on both sides at once so the denture stays balanced. Work up to firmer foods over a few weeks. Bite into sandwiches and fruit with your side teeth, not your front ones.
• Speaking: some words sound off at first. Reading out loud for a few minutes a day helps your tongue and lips adjust faster.
• Sore spots: common early on. Don't file or bend the denture at home. Call us and we'll adjust it, usually in a short visit.
• Extra saliva: normal for the first days, and it settles on its own.

Take your dentures out at night. Your gums need the break, and soaking the denture overnight keeps it clean. Brush it daily with a soft brush and a denture cleaner rather than regular toothpaste, which can scratch it. Brush your gums, tongue and any natural teeth too.

Your jaw keeps changing after teeth are gone, so even a great denture slowly loosens. Most need a reline every year or two and a new set every several years. Come in once a year even with no natural teeth left: we check the fit, look for sore spots, and do an oral cancer screening, which is part of every regular exam here.

Signs it's time to come in: the denture clicks, rocks or drops, you need more and more adhesive, food gets trapped underneath, your gums stay sore, or your face looks more sunken than it used to. Sometimes an adjustment fixes it, sometimes a reline does, and sometimes it's time for a new set or implants underneath. You'll see each option with its price.