The human society favors looks. A smile with white teeth and a harmonious teeth-set (dentition) is pivotal. However, it may lose its sheen with tooth loss.

Total loss of teeth is the ultimate endpoint of full-blown gum disease (periodontitis).¹ Severe periodontitis is the 11th most prevalent condition globally, per the Global Burden of Disease Study (2016).²

With the loss of teeth, there lies a need for replacement, with multiple options available. The most sought-after options are dentures and dental implants.

Is it better to have dentures or implants?

Dentures can be over implants and even stand-alone (without implants). They may replace all teeth or only a few lost teeth.

For simplicity, let’s consider dentures as a replacement of all teeth without dental implant support as ‘complete dentures.’

An alternative option is teeth-supported or retained dentures using ‘dental implants.’

What conditions prompt a patient to choose one over the other?

Conditions that prompt a patient for dentures

Patients generally opt for dentures based on subjective, socioeconomic and cultural factors, including personal views, previous experiences, attitudes and beliefs. For a few, it can be purely an individual decision.

Other factors can be easy access to the treatment of dentures.

It is worth noting that cost, attitudes toward the cost of treatment, and insurance coverage are crucial barriers, as well as the motivation for using dental treatments such as dentures.³

Patients commonly prefer conventional complete dentures in replacement of lost upper teeth. Most patients may opt for low-stress and low-cost treatments like complete dentures. They may even display lesser dissatisfaction levels with the same.

Conditions that prompt a patient for dental implants

With increased public awareness comes the rise in the acceptance of dental implants.

Other factors that prompt patients for dental implants:

• Dental implants have become routine in dental practice, and in the long term, patients benefit from their convenience and cost reduction compared to complete dentures. 
• Dentures retained with two implants show better patient-based outcomes than complete dentures.

And with favorable payment options, patients may opt for it.

Advantages of Dentures

• Complete dentures are relatively economical
• They are easy to fabricate
• They are easy to repair
• The level of function and aesthetics are commonly acceptable to many patients.
• Dentures help maintain the jaw relation in the upper and lower teeth set. 
• The denture teeth may also serve as interim teeth for permanent treatment with dental implants.

Disadvantages of Dentures

• Conventional denture wearers frequently report problems caused by a lack of retention of the lower teeth set.
• Patients often complain of instability with dentures of lower teeth.
• An unstable lower denture can result in the reduction of the lower ridge height.
• Chewing with dentures is worse than with natural teeth.
• On average, denture wearers require 4-8 times more chewing strokes than those with natural teeth.
• There is a reduction in the bite force.
• With poor chewing ability, dentures even require longer chewing duration and swallowing of relatively coarse food.

Advantages of Dental Implants

• Implant-retained mandibular overdentures are a reliable alternative and are considered a standard of care, especially for those who have difficulties adapting to conventional dentures.
• A success rate exceeding 97% over a 10-year period.
• Reduced likelihood of cavities and endodontic issues in neighboring teeth.
• Enhanced preservation of bone in the edentulous area.
• Decrease in sensitivity for adjacent teeth.
• Teeth with dental implants show better aesthetics and good chewing function.⁴

Disadvantages of Dental Implants

• The primary disadvantages of dental implants are associated with the cost.
• Poor oral health maintenance can cause implant-related diseases like peri-implantitis.

Factors considered when comparing the two

Surgical risks

Patients encounter minimal to no surgical risks in the case of complete dentures. However, there is a need for considerable surgical procedures in dental implant placements. Sometimes, even there lies a need to gain the lost bone by placing bone graft materials.  

Cost of Dentures vs Implants

Dentures are economical in the beginning. However, dental implants are cost-effective and better in the long run.

Durability

Factors such as complexity of treatment and longevity, i.e., any need for early replacements after treatment completion, may matter when considering a treatment option.

Conclusion 

It is safe to conclude that the choice of treatment is always a patient’s preference, dependent on his or her social and financial background.

Complete dentures are generally associated with lower expected outcomes by patients. Even when the need for more complex surgeries arises, the patients may choose dentures as a treatment option.

References

1. Guillaume, B. (2016). Dental implants: A review. Morphologie, 100(331), 189-198. https://doi.org/10.1016/j.morpho.2016.02.002
2. Nazir M, Al-Ansari A, Al-Khalifa K, Alhareky M, Gaffar B, Almas K. Global Prevalence of Periodontal Disease and Lack of Its Surveillance. ScientificWorldJournal. 2020 May 28;2020:2146160. doi: 10.1155/2020/2146160. PMID: 32549797; PMCID: PMC7275199.
3. LELES, C. R., FERREIRA, N. P., VIEIRA, A. H., V. CAMPOS, A. C., & SILVA, E. T. (2011). Factors influencing edentulous patients’ preferences for prosthodontic treatment. Journal of Oral Rehabilitation, 38(5), 333-339. https://doi.org/10.1111/j.1365-2842.2010.02158.x
4. Gupta R, Gupta N, Weber, DDS KK. Dental Implants. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470448/
5. Prithviraj, DR; Madan, Vibhor; Harshamayi, P; Kumar, C Gyan; Vashisht, Richa. A comparison of masticatory efficiency in conventional dentures, implant retained or supported overdentures and implant supported fixed prostheses: A literature review. Journal of Dental Implants 4(2):p 153-157, Jul–Dec 2014. | DOI: 10.4103/0974-6781.140882 

About the Author

Dr. Shashank Vijapure – Assistant Professor, Periodontics & Oral Implantology, Affiliate Associate fellow American Academy of Implant Dentistry. Dental Content Creator.