Smile, as toothless folk bite back

False teeth - nothing but the tooth

The All-On-Four dental implant procedure (above) tilts two of the implants to ensure a secure base for the full denture. A set of complete dentures (below) will replace all your missing teeth.
The All-On-Four dental implant procedure (above) tilts two of the implants to ensure a secure base for the full denture. A set of complete dentures will replace all your missing teeth.PHOTO: NOBEL BIOCARE
The All-On-Four dental implant procedure (above) tilts two of the implants to ensure a secure base for the full denture. A set of complete dentures (below) will replace all your missing teeth.
The All-On-Four dental implant procedure tilts two of the implants to ensure a secure base for the full denture. A set of complete dentures (above) will replace all your missing teeth.PHOTO: SPECIALIST DENTAL GROUP

What nice teeth you have, granny... thanks to dentures, bridges and implants

Apart from dentures and implants, bridges or fixed dentures are other options for replacing teeth. Though none of them is as ideal as natural teeth, each has its pros and cons.

Patients should discuss the options with their dental practitioner before committing to any of them, said Dr Tay Chong Meng, an associate consultant at the University Dental Cluster, National University Hospital.

DENTAL IMPLANTS

These are replacement tooth roots that are usually made of titanium. They are placed in the jaw to support a crown (a replacement tooth made to match your natural teeth) or bridge. They can also be used to support a full set of dentures for those with no teeth.

Implants are long-term solutions for missing teeth. The replacement teeth are not removable, and look and function like normal teeth, said Dr Ho Kok Sen, who specialises in oral and maxillofacial surgery at Specialist Dental Group.

However, they are not suitable for all, he said. Heavy smokers or people with poorly controlled diabetes may have a higher chance of failure because their bone may not fuse properly to the titanium screw.

Dr Tay said those who have tried dentures before getting implants done successfully would agree that implants offer better comfort. However, dental implants require sound bone structure in the mouth for stability surgery is needed, he said. Cost: From $3,000 to $8,000 for a single tooth, or between $25,000 and $40,000 per jaw.

ALL-ON-FOUR

This is a newer dental implant method for those who need full dentures. As few as four implants can be used to support a full set of non-removable replacement teeth on the upper or lower jaw. Fewer implants mean cost savings.

It is a simpler procedure as bone grafting - a procedure needed in other dental implants when there are not enough bones - is not required, said Dr Ho.

"However, it is more difficult to execute. Dental specialists need to be trained to angle the implant correctly."

Dr Tay said: "All-On-Four treatment is a complex dental rehabilitative procedure best handled by a team of prosthodontists, oral and maxillofacial surgeons and peridontists."

Dr Jerry Lim of Orchard Scotts Dental said he does not offer this treatment to younger patients, such as those in their 40s, as the method requires the removal of all teeth on the upper or lower jaw, in order to have four implants to support a full set of dentures. Cost: $20,000 to $30,000 per jaw.

BRIDGES

These false teeth bridge the gap left by one or more missing teeth.

"As the false tooth (or teeth) is fixed to the anchoring teeth, patients typically feel more comfortable with it, compared to using a denture," said Dr Tay.

An older person who has been using bridges to replace his missing teeth would prefer it over dentures, unless he does not have enough remaining teeth to support a bridge, he said.

Dr Lim said he is seeing less demand for bridges. "Every time you do a bridge, you need to file down the two neighbouring teeth to accommodate it," he said. "It's such a waste." Cost: From about $2,000 to $7,000 per bridge.

DENTURES

Full dentures will replace all your missing teeth. Partial dentures will replace some teeth and are retained in the mouth by metal clasps attached to natural teeth.

As dentures can be removed for cleaning, they may be a better option for an older person who has lost the manual dexterity of cleaning his teeth due to medical conditions such as a stroke, said Dr Tay.

Moreover, in terms of work required in the clinic, dentures are the least invasive among the three options and may be the least traumatic for the patient. However, dentures may result in speech alteration or diminished taste sensation and oral comfort, said Dr Valerie Tey Hwee Shinn, a registrar at the prosthodontic unit of the National Dental Centre Singapore's restorative dentistry department.

Dentures need to be replaced every five to 10 years. "At some point in time, it will become loose as the jaw bone undergoes biological changes as one ages," said Dr Ho.

"The dentures can move in the mouth so you may get ulcers, pain or discomfort." Cost: From $400 for subsidised patients at NDCS to as much as $5,000 at private clinics.

A version of this article appeared in the print edition of The Straits Times on November 08, 2016, with the headline 'False teeth - nothing but the tooth'. Print Edition | Subscribe