Denture technology is evolving rapidly, and that’s great news for patients missing all or some of their teeth because more options are becoming available.  In addition, scanning techniques have dramatically improved diagnostic abilities, meaning quantity and quality of bone can be determined prior to surgical intervention.

Tooth loss can be a traumatizing event.  When teeth are gone, the bone immediately begins to dissolve and shrink, both horizontally and vertically. This causes loss of support and stability for a prosthetic device (denture), meaning dentures loosen and cease to fit well, and must be relined or new ones made.  But even worse, as bone loss increases, support for the mouth and face is compromised, and the negative effect on facial esthetics, speech, self-esteem, and even nutrition and overall health cannot be overstated.  That is why the gold standard now in alternatives to removable dentures is dental implants, because they provide the ridge of bone that holds your teeth with continued stimulation, just like natural tooth roots, keeping the bone healthy and whole, and thus preventing features from sagging and shifting, causing that old-age sunken look.

An overwhelming majority of patients with implants are extremely well satisfied with their restored dental health and function.  Studies have shown that around 75% of denture wearers would have chosen implants if they had known about the bone loss they would experience.  However they may not be ideal in every case, due to:

  • Higher cost – this may be a significant barrier, particularly for seniors on fixed incomes.
  • A lack of adequate bone to support an implant, if teeth have been missing for a long time, necessitating bone grafting treatment, adding more expense and recovery time
  • Seniors may be concerned with time (months for implants to osseointegrate) and quality of life, plus the pain associated with the procedure.
  • A history of uncontrolled diabetes, bisphosphonate use, or certain blood dyscrasias

There are many alternatives to dentures, starting with implant options:

IMPLANTS:  All-on-4, 5, 6, or 8, signifying the number of implants that support a fixed bridge that can only be removed by a dentist.  Unlike a removable denture, a bridge doesn’t need to be taken out for cleaning every night and can be brushed and flossed like natural teeth.  During conversations and eating, it doesn’t get loose or shift.  It eliminates the acrylic covering over the palate of removable upper dentures, which can cause a gagging sensation and a reduced sense of taste.  Implants prevent further bone loss, and vastly improve bite force and chewing ability.  In addition, it feels very natural and most patients forget that they are not real teeth, not to mention that with proper maintenance they can last a lifetime.

Other types of permanently fixed implant systems are:

Titanium Hybrid Bridge:   Titanium framework permanently fixed to implants that have nano-resin teeth set in denture acrylic over it.  The term “hybrid” refers to the acrylic that, like a denture, fills in the space of missing gum and bones to the proper position where teeth should be placed.   The hybrid is only removed periodically at professional dental cleanings.

Prettau Hybrid Bridge:  Zirconia framework and Zirconia crowns permanently fixed to implants.  Tissue colored porcelain is then applied over the soft tissue area of the gums if needed.  Zirconia, being very strong, is the material recommended for crowns on severe tooth grinders.

Zurick Bridge:  Zirconia framework permanently fixed to implants, mimics individual crown preparations with beautiful EMax porcelain crowns.  If needed, tissue-colored EMax porcelain can be artistically designed to mimic healthy gums.

Mini Implants:  An alternative for patients for whom regular implants are not suitable.   A pilot drill is used to create entry points for four implants, meaning a full osteotomy is not necessary.  This allows the denture to be tissue supported and implant retained, giving it immediate loading capability.  Usually chosen for people who have worn removable dentures for a time, to provide a boost in confidence and stability.  Some of the benefits are:

  • Greater ease of placement
  • Minimally invasive
  • Lower costs
  • High levels of patient satisfaction
  • The small diameter works in bone that is inadequate for traditional implants
  • No flap surgery required
  • Immediate loading, allows same-day completion (implant placement and crown)
  • Existing denture can be retrofitted to snap on

OVERDENTURES:  Also called Snap On, these are removable appliances that include prosthetic teeth, and attach to two or more dental implants, either with locator connections or a bar.  When Snapped On, this denture rests over your gums, meaning it will not move or wiggle, avoiding any gum sores.  Like fixed bridges, the implants stimulate the bone and keep it healthy, and they are more comfortable than dentures without implants.  They can be implant retained or assisted (soft tissue and bone help support the prosthesis), or implant supported (retention and support come from the implants or bars attached to the implants).  Some of the benefits are:

  • Dramatically improves stability and chewing ability compared to standard complete denture
  • Inexpensive replacement for tooth and gum structures
  • They require fewer implants,
  • There is less surgery,
  • There is less technical demand for the dentists,
  • Provides lip support,
  • Existing dentures can be modified and used instead of a new prosthesis,
  • Esthetics may be easier to achieve,
  • The patient can receive the prosthesis faster,
  • Removable – easy to clean outside of mouth,
  • A good interim solution while saving up towards a fixed implant bridge.

Montreal Bar:  This bar-supported over-denture has a titanium bar affixed over several implants.  The removable denture snaps over the bar.

BOIL-AND-BITE DENTURES:  Developed by a retired California dentist, using technology in use for many years to make inexpensive mouth guards for sports, this helps people for whom even the cost of dentures is out of reach.  Low-income people are more likely to need dentures.  The statistics are grim:  In the 65-74 age bracket, more than a third of people at or below the poverty level had no teeth (above the poverty level it’s 13%).  Charities have distributed many of these cheap alternatives.  Not having teeth leads to problems of malnutrition and other diet-related difficulties, besides mental issues like depression.

Making these prefabricated dentures takes just a few minutes and can be completed in a single visit.  They come in five sizes with a tray of thermoplastic in the back.  The dentures are put into boiling water, softening the thermoplastic polymer material. The patient bites down into the softened polymer, creating an impression of their jawbone where the denture will rest.  A small amount of additional customization can be performed, but it’s minor compared to fitting traditional dentures.  It’s not ideal, of course:  there can be poor fit, sore spots, bone loss, lack of longevity, etc., but still better than going without teeth… and sitting home, totally embarrassed at an unsightly toothless smile or unable to eat hard foods, or both.

If you are interested in denture alternatives in Costa Rica, fill out the “Find a Dentist” form on this page.  One of our patient advocates will reply to your needs.