​Dental decay and gum disease are the most common causes of tooth loss in older adults.

When teeth are lost, oral function, such as eating and speaking, or aesthetics may be affected.

Replacement options for lost teeth can include fixed or removable dental prostheses such as bridges and dentures. These prostheses can be supported by the remaining natural teeth or dental implants.

Dental implants are titanium fixtures embedded into the jaw bone via a minor surgical procedure.

Prior to the procedure, a detailed dental examination and consultation with your dentist is required to determine your suitability for dental implant treatment. Diagnostics radiographs or bone scans are also required to determine the feasibility of dental implants, as well as the size and number of implants required to replace your missing teeth.

“Many older patients think that they are not suitable for dental implants due to their age,” shared Dr Phang Zi Ying, Associate Consultant from the Department of Restorative Dentistry – Prosthodontics at National Dental Centre Singapore (NDCS), a member of the SingHealth group.

“However, treatment with dental implants in older patients is an option and can be predictable, as long as health and dental conditions are suitable,” Dr Phang added.

Dentures, on the other hand, are removable and can be fitted for your mouth regardless of how much bone is present. They can be complete sets to replace all teeth or be made to replace a few missing teeth.

Dentures are made by first taking a mould of your gums and teeth. Further moulds and recording of jaw relationship may be necessary in order to develop a preliminary set of dentures, which is then placed in your mouth with adjustments made, before a final set is produced.

Caring for dentures also requires special attention such as keeping them soaked in water or a denture cleanser when not in use, and ensuring that the dentures are not soaked in hot water to avoid warping. Also, when brushing dentures, a denture cleanser should be used instead of regular toothpaste.

Considerations when choosing dental implants or dentures

When choosing between dental implants or dentures, some considerations are:

1) Age

It used to be that older adults tend to shy away from dental implants due to their age and it being an invasive procedure. However, with advancements in medical technologies, more seniors are aging healthily and want to consider implants for better function.

2) Bone density

Dental implants require a certain amount of jawbone material in order to support the posts. If you have lost bone material, either through injury, age, gum disease, or tooth loss, you may not be a suitable candidate for implants. So consult your dentist to discuss your options.

3) Function and feel

In terms of bite and feel, dental implants feel more like natural teeth and may provide a better comfort level and chewing than dentures. Some patients also experience initial pain and discomfort with dentures, more salivation or report reduction in taste sensation. 

4) Hygiene

Both implants and dentures require proper maintenance for success. If not well maintained, dental implants may have gum inflammation or gum disease, also known as peri-implant mucositis and peri-implantitis respectively. These conditions can lead to the loss of bone support around the implant, and eventually the loss of implants.

On the other hand, dentures require less dexterity for maintenance as they can be removed for cleaning. However, food tends to get stuck underneath dentures and it is recommended to remove your dentures for cleaning after each meal.

When to consider dental implants

Dental implants can be considered in a variety of scenarios, from the replacement of a single missing tooth to replacement of multiple teeth using implant supported bridges.

“Fully edentulous patients, for example those who have no teeth remaining, may also consider the use of dental implants to help anchor their removable dentures. This can aid in stabilising their dentures and improve chewing. A consultation with a dentist, and necessary diagnostic records for planning, will be needed to determine an individual’s suitability for dental implant treatment,” Dr Phang explained.

Tips to care for dental implants

Like natural teeth, implants require maintenance care for long term success. Regular dental visits are recommended to check on your implants and related prostheses to ensure that they are healthy and well maintained. Frequency of visits are based on the dentist’s evaluation of your oral condition, and range from 3 months to a year.

Do’s and don’ts when caring for dental implants include:

Do's

Don'ts

Brush your teeth and implants daily to remove food and plaque deposits.

Ignore gum bleeding or gum pain. This can be indicative of inflammation in the gums around the implants.

Use the appropriate interdental cleaning aids to help clean between the teeth and implants. Ask your dentist for recommendations!

Forget to use interdental cleaning aids.

Schedule regular dental visits for maintenance care.

Avoid the dentist after implants are placed.

For the do's and don'ts on the proper use and cleaning of dentures, click here.

Ref: J22

Check out other articles on oral care:

Tips for Clean Teeth

Bad Breath: Causes and How to Keep It Away

Wisdom Tooth: When to Extract

Root Canal Treatment: How Painful is It?

Gum Disease: Causes, Symptoms and Treatment

Am I Too Old for Braces?

Wearing Dentures? What You Need to Know