Dentures vs dental implants vs doing nothing: How to choose what’s right for you

Dentures vs implants vs do nothing – which to choose? No wonder you’re anxious – on the one hand, you are spoiled by so many choices, on the other hand, the sheer number of them can be overwhelming. Replacing missing teeth is more than simply restoring function. Choosing the best replacement for you involves complex decisions based on emotional, financial, and medical factors. There is no universal ‘best’ option. Rather, the solution for your missing teeth will depend on various considerations unique to your situation. While you may think dental implants are automatically better than dentures, the reality is more nuanced.

However, don’t despair, this guide will help you work through the issues offering a practical comparison of the three options, addressing comfort, function, maintenance, costs, timelines and suitability so you can make an informed decision that’s right for you.

The three main options when you’re missing teeth

It’s important to understand each option has many variations. This guide provides general information, but your prosthetist will tailor recommendations to your specific needs.

Option 1 – Doing nothing or delaying treatment

Perhaps you are managing without dentures and question any benefit they might offer. Or maybe you’re happy to limp along with an old denture for fear of change or the financial cost of replacement. Both understandable scenarios.

But even the choice to do nothing comes with consequences. An old, worn denture stops supporting your facial structure properly. This leads to sagging cheeks and a shortened distance between your lip and nose, potentially making you look older. Gaps from missing teeth allow remaining teeth to drift into the spaces and accelerate bone loss, changing your bite pattern. This may cause chewing difficulties, so enjoyment of your food decreases and you risk becoming undernourished. Even one of these consequences can affect your quality of life and self-confidence.

Option 2 – Conventional dentures

Conventional dentures are removable prosthetic devices that replace missing teeth and restore both function and appearance. Common types include removable full dentures, partial dentures, and immediate dentures. Conventional dentures rely on your gums, mouth structure, and facial muscles for support – no surgery required. Conventional partial dentures rely on clasps to secure them to remaining natural teeth.

Option 3 – Dental implants and implant-retained dentures

Before we go any further, it helps to understand the terminology – because this is where things can get genuinely confusing, even for people who’ve done their research. A dental implant, strictly speaking, refers to a single titanium post placed in the jaw that can be topped with a crown: often one artificial tooth to replace one missing tooth. Implant dentures are a different thing entirely. They use those same titanium posts as anchors for a full or partial denture – rather than replacing individual teeth one by one. This article focuses on implant dentures. If you are missing only one or a few teeth, it’s worth asking your dental specialist about single-tooth implant options separately.

There are two types of implant denture, and the difference matters more than you might think. In this article, we use the terms “implant-retained” to refer to a removable denture that clips onto implants, and “implant-supported” to refer to a fixed denture that is attached to implants and removed only by a dentist.

An implant-retained denture snaps onto a small number of anchor posts and can be removed by the patient for cleaning. The denture still rests largely on the gum, which means – just like a conventional denture – it may need relining over time as the jaw gradually changes shape.

An implant-supported denture is fixed to the posts and cannot be removed by the patient (only by a dental professional). Because it does not rely on the gum in the same way for support, it typically does not need the same kind of routine relining as a conventional denture, although it still requires regular maintenance and review. Implant-supported dentures are most commonly suitable for full arch replacements.

Image credit: aestheticsmilereconstruction.com

How dentures compare in real everyday life

Adjustment and comfort

Adjusting to conventional dentures typically takes 2-4 weeks, depending on whether you’ve had teeth removed or are replacing an old denture. If you have had teeth extracted, additional time is needed for your gums to heal.

During this adjustment period, you may experience sore spots, changes in speech, and excessive saliva, but these issues generally resolve quickly. During the settling in phase, you will be monitored by your prosthetist who may perform minor adjustments to ensure your comfort. This is normal and not an indication of a poorly made denture. Lower dentures are often more difficult to stabilise than upper dentures and may take longer to adjust to. Using denture adhesive can help until you adjust.

Eating and speaking

You will need to modify your normal eating patterns while you are adjusting to your new denture. Softer foods that require less rigorous chewing are easier on healing gums. Because dentures don’t chew quite as efficiently as natural teeth, you may need to change the way you prepare your favourite foods. For example, cut apples into small, bite-sized pieces instead of eating them whole. As your muscles and tongue become accustomed to accommodating your denture, and you practise talking, your speech will become clearer and less clumsy.

Ongoing maintenance

Dental hygiene is important whether you have natural teeth or some form of replacement. Dentures are no different in this respect. Looking after dentures means having a regular cleaning regime and scheduled reviews with your prosthetist. Dentures often need relines, repairs or replacement over time as the mouth changes.

Pros and cons of dentures

Pros:

• No surgery needed
• Faster treatment
• Lower initial cost
• Suitable for patients unable to have dental implants

Cons:

• Less stable than dental implants
• Less chewing efficiency and bite pressure
• Ongoing bone shrinkage may require denture adhesives or relines to regain a snug fit

How implant dentures compare in real everyday life

What the treatment journey involves

The assessment, preparation, and treatment for implant dentures is lengthy compared to conventional dentures – typically 6–12 months. The treatment process may involve several dental specialists: a general dentist, periodontist, oral surgeon, and dental prosthetist. Not everyone is a suitable candidate for implant dentures.

Your procedure will include a thorough assessment, scans/X-rays, and development of a treatment plan to determine your suitability. In some cases, a bone graft will be necessary to provide a secure anchorage for the implants. Your dental professional will then surgically implant posts into your jawbone in a minor operation. A waiting period of about 3–6 months is necessary for your bone to grow around the implant. This is the process known as osseointegration, where the implanted titanium post fuses with the jawbone, creating a permanent, secure foundation.ⁱ While the implant site is healing, the denture component is made in a dental laboratory, after which it is then attached to the posts.

Implant-retained vs implant-supported: What's the difference?

Both types of implant denture offer superior stability compared to conventional dentures – but they work differently in practice, and it's useful to know which one you're talking about before you walk into any consultation.

An implant-retained denture clicks onto posts and is removed daily for cleaning. It still rests on the gum, so it behaves a little like a conventional denture in that respect – it may need relining over time as the jaw gradually changes shape. That said, even two to four anchor posts make a remarkable difference to stability, particularly for the lower jaw.

An implant-supported denture is fixed permanently to the posts and cannot be removed by you at home. Because it doesn't rely on the gum for support in the same way, it is less affected by jaw changes over time and typically doesn't require the same routine relining as a conventional denture — though it still needs periodic review and maintenance. It generally requires more posts and a greater upfront investment, but delivers the most stable, fixed result available.

Stability, function and feel

One of the superior features of implant dentures is their similarity to natural teeth. This is largely due to the stability they offer, especially for the lower jaw where even a small number of implanted posts can make a major difference to anchoring the lower denture firmly. Because of this, implant dentures eliminate the discomfort of loose dentures, allowing patients to eat, speak, and smile confidently. Implant dentures also stimulate the jawbone helping to prevent bone loss. There are some sensory differences due to the absence of attached natural nerves and ligaments – less perception of bite pressure and no sense of hot and cold through the artificial teeth.ⁱⁱ Most patients adjust easily.ⁱⁱⁱ

Long-term maintenance

Implant dentures are valued for their longevity. The titanium posts, if well maintained and your health remains good, can last for many years and often a lifetime, while the prosthetic component will eventually need replacing, typically after 10–20 years. Note that implant-retained dentures may need relining over time, just as conventional dentures do, whereas implant-supported dentures typically do not require the same kind of routine relining because they are not primarily supported by the gums, although they still need periodic review and maintenance. Both types require careful daily hygiene and regular professional oversight.

Pros and cons of implant dentures

Pros:

• Firmer anchorage
• Stronger bite and chewing capacity
• Bone preservation benefits
• Superior patient comfort
• Enhanced patient confidence

Cons:

• Lengthy timeline
• Usual risk of infection with any surgery
• Higher upfront costs
• Must be a suitable candidate
• Some sensory changes

Dentures vs implant dentures: Side-by-side comparison

So, to answer the question: are implant dentures better than dentures? – the answer is: it's complicated and highly dependent on individual circumstances. We provide the following comparison table as a general guide, followed by the most common concerns for those contemplating a choice between options.

Which option is better for comfort?

Implant dentures offer superior stability because posts anchor them securely into your jaw. Less movement in the mouth when eating or talking makes them more comfortable. However, millions worldwide successfully wear conventional dentures. Many people do equally well with properly made and well-fitting dentures.

Which option is better for eating?

Because of the superior anchoring of implant dentures, biting and chewing force is better than that of conventional dentures. Food choices for implant denture wearers are much less constrained. While food choices may be more restricted with conventional dentures and bite force isn't as great, they can still restore significant chewing function in those with missing teeth.

Which option looks more natural?

Both replacement options for missing teeth can look natural when well-made and fitted. Much depends on the clinician's skills in tooth set-up, smile design, and facial support, which can have a significant bearing on the aesthetic outcome.^iv

Which option lasts longer?

Implant dentures have a longer life than conventional dentures. The titanium post component of implant dentures can last a lifetime, while the attached teeth may need replacing after 15–20 years. Conventional dentures generally last 5–10 years, during which time regular relines and adjustments will be required due to jawbone changes. The longevity of both options will depend on the wearer's continuing good health, good hygiene practices, and regular oversight by an oral practitioner.

Which option costs less upfront and over time?

Conventional dentures generally cost less upfront. However, since implant dentures have greater longevity, they may offer longer-term value, depending on maintenance. Costs can also change according to your location (rural or a city), and the complexity of the treatment needed. If, for example, a bone graft was needed before the posts could be implanted, this would impose an additional cost.

When dentures may be the better choice

Dentures may be a better choice when:

• You want to avoid surgery or have health conditions that make surgery risky.
• Your budget doesn't allow for the higher upfront cost of implant dentures.
• The speed of treatment matters.
• You are comfortable with removable appliances.

When implant dentures may be the better choice

Implant dentures may be a better choice if:

• You prioritise maximum stability and chewing efficiency.
• You have sufficient healthy bone and acceptable overall health for surgery.
• You are willing to invest more upfront for a feeling closer to natural teeth and for greater stability.

When waiting can cost you more than you think 

While your budget may be a reason for postponing treatment for missing teeth, it can be false economy. It's useful to consider the following:

• Over time, you lose more bone density.
• With decreasing bony scaffolding, your face sags.
• As the alveolar ridges (bony ridges that support dentures) are reabsorbed, fitting a denture becomes more complex.
• Prices rarely go down.

A free, no obligation consultation and assessment with your prosthetist will inform you of the facts as they apply in your situation so that you can plan for the future.

Questions to ask before choosing dentures or implant dentures

Because better decisions are made when one is informed, having accurate information about your specific situation empowers you to make those better decisions. Below are some questions you can take to ask your oral health providers. It's a wise move to take notes so you can reflect and remember the answers.

Questions to ask:

• What are the pros and cons in my mouth specifically?
• Am I a suitable candidate for implant dentures?
• What happens if I wait a year?
• How many adjustment visits are typical?
• What maintenance will I need?
• What are the likely long-term costs, not just the upfront fee?
• How will my appearance change?

Final thoughts

Choosing between dental implants, dentures, or simply doing nothing is not a decision to take lightly. Understandably, the anxiety attached to such a decision can be overwhelming. This makes personal research crucial. Consider your particular health, financial circumstances, and expectations for function and appearance. Even a decision to do nothing must be carefully thought through to avoid adverse consequences. The best option for you will be one that matches all these factors. Choosing dentures over implants because of budgetary considerations doesn't mean you are settling for a lesser option. Dental implants are not for everyone. Most importantly, you can take comfort knowing you don't have to make the decision on your own. Your dental prosthetist can help you find a highly personalised solution.

References

i Parithimarkalaignan S, Padmanabhan TV. Osseointegration: an update. J Indian Prosthodont Soc. 2013 Mar;13(1):2-6. doi: 10.1007/s13191-013-0252-z. Epub 2013 Jan 11. PMID: 24431699; PMCID: PMC3602536.
ii Ananthan S, Patil AG, Jaiswal D, Nasri-Heir C, Heir GM, Benoliel R. Sensory Changes Related to Dental Implant Placement: A Scoping Review. J Oral Facial Pain Headache. 2022 Spring;36(2):165-186. doi: 10.11607/ofph.3027. PMID: 35943327; PMCID: PMC10586583.
iii https://haberfielddentists.com.au/dental-implants-vs-natural-teeth-do-they-feel-the-same/#:~:text=This%20design%20is%20highly%20effective,Sensory%20Feedback
iv https://doi.org/10.1016/S0011-8532(22)01961-9.(https://www.sciencedirect.com/science/article/pii/S0011853222019619)

About Northern Rivers Denture Clinic

Northern Rivers Denture Clinic is a specialist denture practice based in Tweed Heads, NSW. Our team of qualified dental prosthetists has decades of combined clinical experience helping patients navigate their options for missing or failing teeth. We believe good decisions start with good information, and we're happy to talk through your situation with no pressure and no obligation. If you'd like an honest, personalised assessment, we offer a free consultation to get you started.

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