The term “permanent dentures” refers to long-term prosthetic solutions used to replace a full arch of missing teeth, including conventional removable full dentures and fixed or removable implant-supported options. While these devices restore function and appearance, they have significant drawbacks that prospective wearers must consider. This article focuses exclusively on the disadvantages and limitations inherent to these solutions, ranging from daily comfort issues to long-term structural changes in the jaw.
Impact on Comfort and Daily Function
Adjusting to any full-arch prosthetic involves an initial period of discomfort and functional challenges. New wearers frequently experience sore spots, gum irritation, and even minor ulcerations as the denture base settles against the delicate soft tissues of the mouth. This friction is particularly common with conventional dentures that rely entirely on the gums and underlying bone ridge for support.
Even after the initial adjustment, chewing efficiency is significantly reduced compared to natural teeth. Traditional full dentures may only provide about 10% to 25% of the biting force of a natural dentition, often requiring a permanent shift to softer foods. This reduced stability can cause the prosthetic to shift or slip during meals, making biting into firmer items like apples or steak difficult or impossible.
Upper complete dentures cover the palate for suction and retention, which can diminish the wearer’s perception of taste. Covering the palate, which contains taste receptor cells, with the acrylic base may dull the flavor of foods. The bulk of the prosthetic material can also interfere with the tongue and cheek muscles, potentially leading to difficulties in speech articulation until the wearer adapts.
Biological and Structural Changes
A primary long-term disadvantage, particularly with conventional dentures, involves the biological response of the jawbone to tooth loss. When the natural tooth root is no longer present to stimulate the bone, the body begins alveolar bone resorption, causing the jawbone to shrink. This structural change occurs because the bone tissue is no longer being used or stressed, causing minerals to be reabsorbed by the body.
The rate of bone loss is most rapid in the first four to six months following tooth extraction, but it continues steadily at 0.2 millimeters per year. The lower jaw often experiences this atrophy at a rate up to four times faster than the upper jaw. This continuous shrinkage means the prosthetic’s fit will gradually worsen over time, leading to instability, chronic irritation, and accelerating bone loss.
As the jaw structure changes, the lower third of the face can take on a sunken or collapsed appearance. To counteract the resulting loose fit, the denture requires periodic professional adjustments known as relines or rebases to conform to the new gum contour.
Implant-supported dentures largely prevent this bone loss by utilizing titanium posts that stimulate the jawbone. However, they introduce other biological risks, such as the potential for surgical complications or the development of peri-implantitis, a serious gum disease affecting the tissue and bone around an implant.
Ongoing Financial and Maintenance Requirements
Conventional dentures are not truly permanent and typically require full replacement every five to ten years due to wear, acrylic fatigue, and changes in the jawbone structure. Even implant-supported dentures, while more durable, may need replacement after 10 to 15 years, and their attachments or clip-in components require frequent replacement.
The initial cost presents a financial barrier, especially for implant-supported options, which can range from $15,000 to over $30,000 per arch. The long-term maintenance expenses add up significantly, making the lower upfront cost of traditional dentures misleading. These recurring costs include professional relines, which are needed every few years, as well as repairs for chips or fractures.
Beyond the monetary expense, daily hygiene requires a time commitment. Dentures must be removed and cleaned multiple times a day using a soft-bristled brush and non-abrasive cleansers to prevent fungal infections and bacterial buildup. Failing to maintain this cleaning schedule can lead to oral health issues like denture-induced stomatitis or an unpleasant taste.