Q: I see so many ads for “all on four”, “teeth in a day” and many other confusing ads. I need to replace all my upper teeth and eventually the lowers. What is better; fixed or removable teeth after implants?
A: I had a fight with a doctor acquaintance of mine a few years ago. Verbal; not a fist fight. (Honestly, I never really liked him anyway, but that’s besides the point. He’s a big winer an I hate complainers who have it better than 99% of the world; So, there you have it.)
He made a statement to me which falls into the category of “professional stupidity”, a term coined by a longtime patient of mine who is a top foot surgeon. He and I both defined this as: “One who uses all their education and experience only to make a poor judgment choice or take on in illogical philosophy going against the part of the Hippocratic oath which states: “do no harm.”
A local medical specialist referred his son to me to evaluate a missing front tooth that was missing since birth, right in the front of his smile. After my exam and radiographic evaluation, I offered three options and explained the pro’s and cons of each. I then expressed that if my own son had this problem, what option would I choose.
I never heard back from him, and reached out to touch base. His comment, in his annoying wining voice: “I know you gave us three options,….. but you know “Mitch”……. only one is the right option!”
I call BS!
As in many healthcare specialties, many times there are more than one treatment option. ESPECIALLY in dentistry, as there are not only different procedures, but different material options, costs, time of treatment and degrees of invasiveness. We holistically take into account the needs of the patient, lifestyle medical condition, age and their expectations.
Replacing all the teeth in one arch, upper or lower, can be done by placing four implants and attaching a removable set of teeth that clip to the implants nice and tight, limiting movement of the prosthesis. (Sometimes referred to as “All on Four”.
Option two, which is more than double the cost is to place 6 to eight implants and attach a non-removable set of teeth. However, the down side: Necessity to remove a significant amount of bone, lack of ability to have adequate oral hygiene leading to possible bone loss, bad smells and failure of the case, facial collapse and extreme difficulties in repairing the prosthesis.
Option three, cost limitations and/or serious medical conditions may warrant a set of dentures without implants. However, the denture will rely on Polygrip or Fixodent to attempt to limit movement of the teeth, plus every 5 years they will need to be re-lined or re-made.
If your doctor gives you more than one option, it is not a lack of confidence he/she is only thinking of your best interest.