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Should I have my teeth taken out and have dental implants?



We all want to have a beautiful smile. I’m frequently told by patients that they hate their teeth, they tell me “if I had the money, I’d have them all out and have implants”. It’s always sad when a patient has lost so much confidence in their teeth and themselves that they feel this is the only way to improve things.


And it can be truly life changing having a full set of teeth back that allow you to laugh and eat with confidence, not worrying about teeth falling out or an unsightly appearance and we can do this with dental implants.


So, is replacing all your teeth with dental implants a good idea?


Short answer: In most cases, no.


Implants are a wonderful option to have as a replacement for teeth once you’ve lost them (or if you know a tooth has to come out), but as good as our modern implants are, they’re not as good as natural teeth.


Teeth vs Implants


There are many reasons for this, the main one in my mind is to do with how implants and teeth are attached to the jaw bone. Our natural teeth are not actually fused into the bone, but held in by thousands of collagen fibres called the periodontal ligament. These are tiny string-like structures that fuse to the root of the tooth at one end and into the surrounding bone at the other. Not only do these ligaments hold our teeth in, but they act like a sort of suspension for our teeth.


You may notice that when you bite very lightly together, only a few of your teeth touch, when you clamp down hard, most or all of your teeth are brought into action. If this didn’t happen, you would struggle to eat and chew effectively as you’d have to do all the chewing on the small number of teeth that actually touched. It’s the compression of the ligaments around the teeth that mean you can chew effectively using a lot of teeth rather than just a few.


These ligaments also help to provide tactile feedback so we know when something is too hard to chew and to prevent us breaking teeth all the time.


Dental implants are different however. Implants are fused directly into the bone, with no ligaments and so no suspension. When you bite on an implant, there’s next to no flex and very little tactile feedback. Many studies have shown that people can function well with full sets of dental implants, but they’re never going to be quite as good as the real thing.



How long to teeth and implants last?


A patient who asked to have all his teeth out but we restored his teeth with crowns and veneers instead

Then consider that nothing lasts forever. As much as I’d love to promise all my patients that when we put an implant in for them, it will be there forevermore, it’s simply not true. Natural teeth should in theory last us our whole life and yet we know, all too often through personal experience, that this isn’t the case. Teeth can get tooth decay, gum disease or general wear and tear, needing treatment and sometimes removal. Implants are exactly the same (except for the tooth decay bit, by definition, that has to happen to a tooth). Gum disease in particular catches a lot of people out, if you’ve had gum disease around your teeth, you’re at a higher risk of getting gum disease around dental implants too.


We need to have bone available to put a new dental implant into. When you lose a tooth, you lose some bone. If you were to lose a dental implant, you’d lose some more bone. Unfortunately, there’s not an infinite supply of bone and once it’s gone, it’s very difficult to rebuild and put it back. This means that we can’t go on putting new implants in indefinitely. This is particularly important for younger patients who will need and want their teeth and implants to last much longer.


Finally, most of the things that cause problems with teeth, cause problems with dental implants. 99% of dental problems are caused by either not cleaning enough or effectively, eating too much sugar, or smoking. If we replace your teeth with implants, we’re likely to simply replace tooth problems with implant problems unless we can identify and rectify the cause of the problems in the first place.



So, should I definitely not have implants instead of teeth?


If you’re young and still have a lot of teeth, even if they don’t look great, maybe you’ve neglected them, they’ve got some holes or they’ve been causing you pain, the chances are that underneath, there’s a lot of healthy tooth that can last you many years, if we can identify and remedy the cause of the problems. A full set of dental implants is probably not for you, though maybe one or two implants could fill some smaller gaps to help support your other teeth.



A patient who's had implants to replace all his teeth at Smiles in Tandem

Of course, it all depends on the specifics of your situation. If you have very few remaining good teeth, then it’s possible that replacing them all with implants is a better option. It’s often more difficult, expensive and with worse potential outcomes to fill large spaces around a small number of healthy teeth, than it would be to more simply replace them all and this treatment truly can be life changing. Without having a full examination with a dentist though, it really is impossible to say either way.



Most of the time, when a patient comes to me asking to replace all their teeth with implants, I find they’ve got lots of really good healthy teeth that just need a little TLC. If cared for well, even teeth with large fillings in can last many, many more years and will offer a much better appearance and function than any dental implant could achieve.


Having all your teeth taken out is an irreversible step. You’ll never be able to eat and chew as if you had a perfect set of natural teeth. With a bit of TLC, it is possible to help someone with a lot of dental problems with conventional dental treatment that will offer a much better solution in terms of function and the long term options. Remember, if you have your teeth rebuilt and ultimately you do need to have them taken out in 10 years time, you’ve still got the option of having dental implants in the future. If you replace them with implants now and have problems with the implants in 10 years time, your options may be much more limited.



Replacing all the teeth with dental implants can be a life changing treatment and it’s something I’ve been privileged to provide at Smiles in Tandem for patients when it is genuinely their best option, usually, when it’s the only alternative to dentures. It’s equally life changing and even better though to have your own teeth restored to their former glory, giving you that same confidence back and giving you the best possible smile in the short and the long term.




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