When teeth are lost due to extensive decay, gum disease, trauma, or developmental anomalies, there are a number of options available to replace them. Common ways that teeth can be replaced include a permanent bridge (a series of joined caps or crowns), implant(s), and a removable partial denture. Some people may opt not to have missing teeth replaced at all. A recent study revealed that a removable partial denture might actually be detrimental to the teeth that help support it.

Over the years, I have listened to patients who felt that their removable partial denture might have damaged their teeth. A removable partial denture consists of a metal base that has acrylic teeth attached to it. Metal clasps are the hook-like structures that help hold it in place. Now, a new study confirms that the supporting teeth of a partial denture are at a substantially greater risk of being lost than if the patient had a permanent bridge or had never had the teeth replaced. This ten-year study evaluated 317 patients who had a permanent bridge, no tooth replacement, or a removable partial denture. At the end of the study, 92% of the adjacent teeth restored with a permanent bridge were intact, 81% of the adjacent teeth with no tooth replacement were intact, and only 56% of adjacent teeth with a removable partial denture were intact. I would speculate that the metal clasps and the fact that removable partial dentures tend to trap food, plaque, and debris are the primary reasons why tooth damage and loss occurs.

In most cases, a permanent bridge or implants can replace missing teeth, but this is not always possible. Weakness or lack of teeth, inadequate bone support, and economic considerations are all reasons that may rule out both a permanent bridge and implants. In these situations, no treatment or a removable partial denture may still be the best option available.