The question of whether all remaining teeth can be removed to be replaced by a full set of dentures is often asked by individuals facing extensive dental issues. The answer is yes; full mouth extraction followed by the placement of dentures is a viable treatment option in dentistry. This process, often referred to as a full mouth restoration, is typically reserved for cases where saving the natural dentition is no longer practical or possible. The decision requires a careful assessment by a dental professional to ensure it is the appropriate solution for your long-term oral health.
Determining Candidacy for Full Extraction
The decision to recommend a full extraction is made only after a comprehensive evaluation reveals that the existing teeth are non-restorable. Dentists consider this approach when the integrity of the teeth and supporting structures is severely compromised. The most frequent cause necessitating this procedure is advanced, generalized periodontal disease, where chronic bacterial infection has led to significant loss of the alveolar bone, resulting in severe tooth mobility.
Another primary indicator for full extraction is extensive, unmanageable dental decay, especially when damage extends far below the gum line. If the remaining tooth structure is insufficient to support restorative procedures like fillings or crowns, extraction is necessary to eliminate infection. Systemic health factors, such as uncontrolled diabetes, can also complicate efforts to save the teeth by exacerbating decay and periodontal disease.
Economic considerations sometimes factor into the decision, as the cumulative cost of repeated complex restorative treatments may exceed the cost of extraction and denture fabrication. A thorough clinical assessment, including dental X-rays and patient history, guides the dental team in confirming that removing all teeth is the necessary step to restore health and function.
The Surgical Process and Initial Healing
The procedure begins with the administration of anesthesia, which can range from local anesthesia to IV sedation or general anesthesia. The choice is determined by the number and complexity of extractions, and the patient’s anxiety level. Once the patient is comfortable, the dental surgeon removes all the remaining teeth.
Following the extractions, the surgeon often performs a process called alveoloplasty, which involves smoothing and reshaping the underlying jawbone, or alveolar ridge. This step is performed to remove any sharp bone edges and create a smooth, optimal foundation for the immediate placement of the denture. This contouring is particularly important for ensuring the final denture will have maximum stability and a comfortable fit.
The initial healing phase begins immediately, with the first 24 to 48 hours focusing on controlling bleeding and swelling. Patients are instructed to bite down on gauze to facilitate blood clot formation in the sockets. Swelling and discomfort are typical, peaking around days two to three, and are managed with prescribed pain medication and a cold compress.
The soft tissues of the gums typically heal within one to two weeks. However, the underlying bone remodeling takes a minimum of three to six months to complete. This extended healing period is why the first set of dentures placed are generally considered temporary, as the changing bone structure will soon affect their fit.
Understanding Denture Options
After full extraction, patients typically choose between two primary types of conventional full dentures: immediate or conventional (delayed) dentures, with implant-supported options also available. Immediate dentures are fabricated before the extraction appointment and are inserted immediately following the removal of the teeth. A major benefit of this option is that the patient never has to go without teeth, providing continuous function and preserving facial aesthetics during the healing period.
Immediate dentures also act as a protective bandage over the surgical sites, which can help control bleeding and protect the healing tissues. The main drawback, however, is that as the gums and bone heal and shrink over the next several months, the fit of the immediate denture will quickly become loose and unstable. This requires multiple adjustments, known as relines, to maintain a functional fit until the mouth is stable enough for a final prosthesis.
Conventional, or delayed, dentures are custom-made after the gums have fully healed, typically three to six months after the extractions are complete. While this option requires the patient to endure a period of being toothless, the resulting denture offers a stable and long-lasting fit. Since the final impression is taken on fully healed tissues, the conventional denture is precisely molded to the mature contours of the jaw.
For those seeking the highest level of stability and retention, implant-supported dentures, or overdentures, are considered the premium solution. This option involves surgically placing a few dental implants into the jawbone, which then act as anchors to snap the denture securely into place. The implants significantly reduce movement, improve chewing power, and importantly, help to preserve the jawbone, slowing the natural process of bone loss that occurs after tooth removal.
Long-Term Adjustment and Maintenance
Adjusting to life with full dentures is an ongoing process that extends beyond the initial healing period. Patients must learn new muscle movements to control and stabilize the denture during speaking and eating. Initially, it is recommended to start with soft foods, gradually progressing to a more varied diet as confidence improves.
A daily cleaning routine is necessary to maintain both the dentures and the underlying soft tissues. Dentures must be removed and cleaned daily using a non-abrasive cleanser and a soft brush. It is highly recommended that dentures not be worn continuously, particularly at night, to allow the gum tissues to rest and recover from constant pressure.
The most significant long-term challenge is residual ridge resorption (RRR), the gradual shrinkage of the jawbone after teeth are removed. Since the jawbone is no longer stimulated, it diminishes in volume, causing the denture to lose its precise fit over time. To counteract this, periodic relining or rebasing procedures are needed every few years to restore the comfortable fit.
Regular professional checkups are necessary, typically annually, to monitor the denture fit and screen oral tissues for irritation or infection. If the fit becomes noticeably loose, a professional adjustment or reline is immediately needed to prevent chronic sore spots and accelerated bone loss.