What happened to dentures?

It’s not uncommon these days to hear stories of people being quoted five figure sums to have their 'failing’ dentition removed and replaced; from the prices quoted, I assume with implant supported prostheses.

This is not just in the capital cities, this can be in small rural towns. My daughter related such a tale the other day. Someone from her workplace had been quoted more than $30,000 to have their teeth removed and replaced with implant dentures. She lives in a town of 3000 people. They had not been quoted an alternatice price for full on full dentures.

That’s why she was ringing me to get a ball park figure for them.

This popped up a couple of days later:

I’m note sure its lack of knowledge of periodontal treatment that is the sole problem, I think it's a combination of factors; the growing influence of the dental industry over clinical education, and belief systems of the dental profession. We might be back to the whole hammer and nail scenario I previously wrote about here.

Don’t get me wrong, I think implants are one of the great advances in dentistry. And it’s fantastic that they are readily available to a large part of the population.

It’s great that training is available in a range of situations and flexible delivery assists dentists with access to training.

There’s a few things that worry me:

Without global treatment planning of the entire mouth there is a risk that a single tooth implant is placed that later complicates restoring a worn dentition that had not previously been properly identified, diagnosed and managed. And to make matters worse, the patient’s dental budget has been spent on the implant rather than contributing to delivery of a more holistic treatment plan.

With implant retained dentures something that I struggle to understand is placing implants in people that have suffered from severe dental disease, often at a young age. Obviously people’s lives change and progress and their ability to maintain good oral hygiene and motivation does too. However, after the intial excitement and the 'after’ photos, is there not a temptation for the patient to forego regular maintenance if they are not already in a life long habit? What happens in the long term if the implants fail?

How well does a denture work on the edentulous ridges following implant failure?

I also have issues with patients accessing their superannuation savings to fund such work, but that’s a personal thing. Yes, it can be life changing, but for how long and can there be buyer’s remorse in the future and the benefits of compounding interest gone.

For a large proportion of the population, dentures are still a viable option but I feel that at present they aren’t fashionable and implants are ubiquitous. Patients are perhaps being led to believe they are a second tier treatment. Or that they are offering substandard treatment.

For the more recently graduated dentist, dentures can be challenging and it certainly takes practice and a helpful technician to become confident and competent in providing this service.

Becoming proficient at fabricating dentures, whether partial or complete, can be a useful service to provide your patients. Taking time to get it right is what matters most. Alternativley, find a prosthetist who can provide an excellent service for your patients and work closely with them, we’re a team after all.

If you’re looking for inspiration to become better at dentures and how they can help people, then follow someone like Finlay Sutton.

Yes, dentures can be hard, and I’ve certainly had cases that did not go well, but overall they are a vital service and treatment that can help patients just as much as implants.

On another note my podcast recommendation this week is a conversation betweeen Mark Bouris and Ben Crowe, who was famously the mindset coach for Ash Barty. As dentists, we perform everyday and there are valuable tools and lessons to be had that we can take away from this podcast.

Have a great week, don’t forget to share with a friend

Rosi”