Category Archives: Dentures

Could I Get Dental Implants and Not Dentures?

I have advanced periodontal disease and have lost seven teeth as a result. My dentist is starting to suggest dentures but I want to know if I can get dental implants instead?


Dear Avery,

illustration of a dental implant in three stages

Dental implants are always the best option in tooth replacements. In most cases, if you are in good general health you will be a candidate for dental implants. Your case is a little more complicated with your gum disease, so you will need one extra procedure.

As you can see from the image above, it is important that there is enough bone structure there for the dental implants to integrate with. This is what helps keep them stable and attached to your jawbone. Your periodontal disease has led to a loss of that bone, which is why your teeth are falling out. In order to have a successful outcome with your dental implants you will want to get your gum disease under control and then have some bone grafting to build back up the missing tooth structure.

As tooth replacement options go, dental implants are far superior to dentures. Even the best fitting dentures reduce your chewing capacity by 50%. On top of that, when your teeth are removed your body recognizes that and begins to resorb the minerals in your jawbone to use elsewhere in your body. After ten years or so, you will no longer have enough jawbone to even retain your dentures. This is known in dental circles as facial collapse.

Implant Overdentures

Implant Overdentures
Implant Overdentures

It is way too expensive to do a one-to-one ratio of teeth to dental implant when you are talking about replacing all of your teeth. In those cases, implant overdentures are recommended. This uses between four to eight dental implants on each arch, depending on your budget, and then anchors a pair of dentures to them. This still gives you all the advantages, protection, and security of dental implants, at a fraction of the cost.

This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.

Why Does My Partial Denture Rock When I Chew?

I went directly through the lab my dentist uses to get my new partial denture. My old partial lasted eight years until I broke it. I bypassed my dentist for the new partial because the lab does a good job, and I knew it could save the lab and me some money if we cut out the middleman. Well, the partial has too much plastic backing that it is uncomfortable, and the plate is too short, so the partial rocks when I chew. The lab tried several times to fix this issue, but they told me that I needed to go through my dentist if I wanted anything different. Why would they agree to do my partial denture if they don’t want to get it right? – Thanks. Dennis W. from Indiana


Thank you for your question.

It is illegal for a lab to make a partial denture, complete denture, or any restoration without a prescription from your dentist. Although you asked the lab to make the partial denture for you to save money, they should have refused. But the lab knows the legal requirements, so they are primarily at fault.

What Causes a Partial Denture to Rock?

Partial denture for lower front teeth
A cosmetic dentist can take accurate impressions of your mouth for a denture that fits well

If the framework of a partial denture is distorted, the appliance can rock. A dentist takes an impression of your mouth, makes an accurate model of your teeth, and transmits the information to the lab to make your partial denture. Lab techs do not receive training to take impressions, so they cannot make a precisely fitting appliance without your dentist’s help.

If you want a refund, you can tell the lab that you will report the issue to the state dental board. They will probably agree to refund you. Afterward, please return to your dentist or the dentist of your choice to make a new partial denture that will fit well, be as comfortable as possible, and not rock when you chew.

Burba Dental Partners of Salem, Massachusetts, sponsors this post.

Will Facial Sagging from Missing Teeth Improve with New Dentures?

Will facial sagging from missing teeth improve with new dentures? I am 52 years old and missing all my teeth. I wore dentures for four years, but after a mishap, I could not afford new ones. I already can tell that my bone is shrinking and wonder if getting new dentures will improve the sagging. Hopefully, I will get some good news from you. Thank you. L. Sellers

Hello, L. Sellers,

Thank you for your question.

Will Dentures Improve Facial Sagging from Missing Teeth?

Dentures will improve facial sagging from missing teeth if you receive implant dentures. Also, if you have experienced a lot of bone shrinkage, you may need grafting to build up the bone to support your facial muscles and dental implants.

What Causes Facial Sagging When Teeth Are Missing?

When all your teeth are missing, your face will sag as your jawbone shrinks. Why does your jawbone shrink? Consider the facts:

  • Tooth roots stimulate and preserve the jawbone.
  • When your teeth are missing, jawbone stimulation stops.
  • Your body begins to resorb the bone and use the minerals from it elsewhere.
  • With less jawbone to support your facial muscles, your face starts to sag.

How Can You Prevent Facial Sagging?

You can prevent facial sagging when all your teeth are missing by supporting your dentures with dental implants. Implants are artificial tooth roots that stimulate the bone and limit shrinkage. Two to six dental implants can support a denture. A denture can snap onto two implants or screw onto four or more implants.

Snap on Dentures
Snap-on denture

So, rather than new dentures preventing facial sagging, bone grafting and implant overdentures are the solutions. But please do not shop around for the lowest cost. Cheap implants can loosen, get infected, and fail. Look for a dentist with advanced training who will use a three-dimensional CT scan to plan for and place your implants precisely.

Burba Dental Partners of Salem, Massachusetts, sponsors this post. Please read why our patients think we provide some of the best dental care in the Boston area.

The front teeth in my snap-on denture are too big

Concerned senior woman, perhaps because her snap-on denture teeth are too big

For more than a year, I saved for implant dentures. Snap-on dentures were the most affordable, so I found who I thought was a good dentist. The implant placement went well, and I wore temporary dentures until the healing was complete.

Twice, I told my dentist that I was concerned that the front teeth in the denture were too big, and I wanted to be sure that the permanent denture would not look the same. My dentist said that the teeth looked fine, but we could get the permanent denture the way I liked it.

After a lot of discussion about the permanent denture and a try-in, I am convinced that somehow my dentist switched back to the denture with the buck teeth. I paid too much money for a snap-on denture with buck teeth. If my dentist will not cooperate, can I ask for a refund? Thank you. Janice from New Haven CT


Thank you for your question. We are sorry that you invested your time and money into a new smile that does not complement your face. Yes, your dentist is responsible.

We suggest that you make a list of what you do and do not like about your snap-on denture. Schedule an appointment with your dentist to discuss your concerns. Ask him if he is either willing to correct what you do not like or issue a refund. And you are entitled to a refund because the denture you received does not match the agreement you had with your dentist.

Preventing Denture Teeth from Being Too Big

A cosmetic dentist will ensure your denture teeth are not too big but complement your face. The wax try-in allows your dentist to check these factors:

  • Your facial appearance and profile
  • Lip fullness
  • Your bite
  • Your speech

Although you mention that your dentist did the try-in, it seems that he was not attentive to your concerns. If you think that your dentist will not cooperate, it is best to see a cosmetic dentist for a second opinion?

Will You Need a New Denture to Replace the Teeth?

A dentist can remove your snap-on denture, drill out the teeth, and reprocess the denture. The revision will improve your smile and help your snap-on denture feel comfortable.

Even if you decide to stay with your current dentist, consider getting a second opinion and documentation of the work that a dentist must complete to correct the denture teeth. You can take the information back to your dentist to support your discussion about the issues you want him to fix.

Best wishes for a stress-free resolution.

Burba Dental Partners of Salem, Massachusetts, sponsors this post. Read about how we strive to give our patients some of the best dental care in the Boston area.

How do I know which denture implants to choose?

I’ve worn full upper and lower dentures since 2003. My jawbone is shrinking, and my dentist recommends implants. But my dentist would refer me to a periodontist for the implants. I thought about implants in the past, but now that my facial appearance is changing, I am considering them more seriously. I plan to finance the work and complete payments within two years. After researching all the options for denture implants like the snap-on denture, all on 4, all on 6, or implants with bone grafts, I am confused. Then I looked at prices online and found some dental tourism practices in Mexico (not my preference), Portugal, and Costa Rica that charge 40-50% less than the U.S. for denture implants. What can help me decide with denture implants to choose? – Thank you. Karson


Thank you for choosing our office for your question. Knowing which implant denture option to choose begins with a 3-D x-ray and exam. An implant dentist, oral surgeon, or periodontist would need diagnostic studies before recommending options for stabilizing your dentures. Only then can you decide on a type of implant dentures.

How Do Implant Dentures Work?

Implant dentures work by support a full arch of teeth with dental implants. You will need at least two implants to keep a denture in place. But four to six implants will increase the stability. You can get implants for an upper or a lower denture—or both.

What Determines Your Choice of Implant Denture?

Several factors can determine your choice of implant denture, including:

  • The level of stability you want
  • Your jawbone quality and volume
  • Your oral and overall health
  • Your implant dentist’s skill, experience, and offerings
  • Your budget

Your implant dentist will explain the differences between types of implant dentures including:

  • Snap-on denture
  • Mini implants
  • All-on-4 dental implants
  • Fixed implant dentures
  • Removable implant dentures

What About Dental Tourism for Implants?

Before signing up for dental tourism for implants consider a few factors:

Implant denture - available in Salem, MA from Burba Dental
  • Dental implant standards vary among countries throughout the world
  • Think about how you could verify the credentials and experience of an implant dentist in another country
  • How does the foreign dental practice handle follow-up care?
  • What will you do if you experience complications?
  • Who will restore the implants with your final denture?
  • Have you considered all the financial costs involved with dental tourism?
  • How can you verify the reputation of a dental practice in another country?

The Academy of General Dentistry published an article on dental tourism that includes Center for Disease Control (CDC) reminders about what to research before seeking dental care outside of the United States. For each country and facility that you are considering for dental care, research the following:

  • Medications
  • Infection control
  • Antibiotic-resistant bacteria
  • Standards by which facilities are measure

Schedule Implant Denture Consultations

Before you choose a provider or a type of implant denture, schedule consultations with at least two skilled implants dentists with post-graduate implant training. Talk openly with the dentists about your options, concerns, and thoughts about dental tourism.

Burba Dental Partners of Salem, MA sponsors this post.

Should My Dentist Refund My Money after Not Providing on Time?

I told my dentist I was moving to another state, but needed to replace my snap-on denture. In deciding whether or not to replace them now or wait until I move, I asked him how long it would take if I did it through him. He told me three weeks. That was do-able so I went forward with it. On week NINE it finally came in! But, it didn’t fit with the snap fixutres. He sort of forced it on. By the next day, I was in agony. I couldn’t even eat bread without pain. I was able to take it off, but it was not easy. I called to schedule to come in they told me my dentist was on vacation but I can see another one. I agreed. He told me the ‘holes’ were not properly done and the whole thing would need to be re-done. At this point, I am out of time. Is it unreasonable to just ask for a refund and do it at the new office? I can’t really drive back and forth for this?


Dear Lance,

Snap on Dentures

Your dentist entered into a contractual agreement with you when he said the denture would be ready in three weeks. When they weren’t, he broke that agreement. He did not just barely miss the deadline, either. He was a full six weeks late and even then it was not a usuable denture. So, yes, he should definitely return your money without any fuss. I would not let them “fix” it. You will be better served moving onto the other dentist.

Now, I say he should return your money without any fuss, but we all know that humans are sometimes unreasonable. I would start by just asking politely. If he doesn’t respond as he should, you have a few options.

First, tell him you will have to leave a review letting others know about the poor service and result you received from his care. Marketing research shows that a majority of patients check online reviews before deciding whether or not to see a specific care giver. In that same vein, you could offer to let patients know how accomodating he was when it didn’t work out the way you both hoped as a means of making him look better if he does cooperate.

Second, threaten to go to the dental board. I don’t know any dentist who is excited about the prospect of their name and practice being brought before the board.

Thirdly, if you paid through any dental insurance, you can contact the insurance company and see if they’ll help resolve it.

I am sorry this happened to you. Most people get Snap-on Dentures as a means of having more affordable dental implant options. When this is the result, it can be very discouraging. Make sure after you move, the dentist you choose to re-do these has advanced (post-doctoral) training in dental implants. These procedures are not adequately taught in dental school.

This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.

Do Dental Implants Look Better Than Dentures?

I had dentures made a few weeks ago and they look awful. My dentist insists they’re fine, but I think my old messed up teeth even looked better. I did dentures to save money. Now I’m thinking maybe if I got the dental implants instead, they’d look better. Is that true or would it just be more money for the same ugly teeth?


Dear Monica,

Implant Overdentures

I’m glad you wrote. While I think dental implants are a good change. It is not for the reasons you would think. Whether or not your new smile looks beautiful or even just natural does not depend on whether you had dentures versus dental implants. The thing that makes the biggest difference is the cosmetic skills of the dentist doing your procedure. You could have a stunning smile with dentures and an ugly one with implants or vice-versa.

What you need is to find a skilled cosmetic dentist. The best cosmetic dentists are AACD accredited. I would start there. While you could just have dentures re-made more beautifully if you can at all afford dental implants I am going to highly suggest you get them. There are serious long-term consequences to dentures that I hope your dentist warned you about.

The Danger of Dentures

When your teeth were removed, you body recognized that you no longer had any tooth roots in your jawbone. In an effort to be as efficient as possible with your body’s resources, it immediately began to resorb the minerals in your jawbone in order to use them elsewhere in your body where it perceived they would be more useful. While an excellent method of resource conservation it will result in your jawbone shrinking.

After about ten years, your jawbone will shrink so much that your appearance will be aged by decades. Even worse, you will no longer have enough jawbone left to retain your dentures, leaving you without a way to chew your food.

The way to prevent this is by getting implant overdentures. This takes between four to eight dental implants and anchors a denture to them. The dental implants serve as prosthetic tooth roots and signal to your body that you have teeth and need the minerals in order to retain your jaw.

This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.

Does She Deserve a Refund?

I had four mini implants done to support a denture. It was time for the denture to be done, but I knew I’d be relocating. I asked my dentist how long it would take for the overdenture to be made and he told me three weeks. Nine and a half weeks later (and a week before I have to move), I finally get the denture and it doesn’t fit. Knowing I have to leave, he sort of forces it in. I thought I could make it work, but I could even eat soft food. I called back to see what we could do about it, but he wasn’t in. I ended up calling another dentist for an “emergency” second opinion. He said there are two problems. First, the holes around the attachment were not drilled out properly. Second, the denture teeth themselves are slanted the wrong way. He doesn’t think there is any way it can be fixed in the time I have left in this state. Is it appropriate for me to ask for a refund or will I have to travel back and forth to get this finished here?


Dear Rebekah,

dental implants anchoring dentures
Implant supported dentures

You definitely have the right to ask for a refund. When he told you he could do it in 3 weeks, that was the equivalent of a contract. He broke that contract by a large margin. Then, when he did provide your denture it didn’t fit. From a legal standpoint, you are in good shape.

There’s the dental standpoint as well. Dental implants aren’t a recognized specialty. Because of that, many dentists are doing a procedure they are not qualified to do. It is one of the leading areas of dental malpractice.

Three weeks was a right and reasonable time to get your dentures done. Because he couldn’t, nor could he get them done correctly in a much longer period of time, I have a high suspicion he is in over his head.

Getting Your Refund

You are in a good place here with the leverage you have. He’s messed up from a legal and dental standpoint. You’ve already done this. For those who haven’t, it is always helpful to make sure it is a blind second opinion. This means you don’t let the second dentist know who the first dentist is. Simply let him look at the work which was done and give his thoughts.

Once you have secured the second opinion, then you go to the dentist and simply ask for a refund. Hopefully, your dentist will recognize the flaw in his technique and have the integrity to make things right. But what if he doesn’t?

If he doesn’t, use your leverage.

Tell him you will write a bad review for him. Research shows that somewhere between 60 -65% of people rely on reviews to determine where to go to the dentist. He should care about the type of reviews he is getting. You could even tell him you’d be willing to do a good review about his willingness to cooperate with you when your denture didn’t work out.

If that doesn’t work, you could tell him you will have to speak with the dental board about the situation. I’m sure the second opinion dentist can help you show the level of incompetence that went into your case. That should sober him up a bit.

This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.

Should I Save My Last Two Upper Teeth?

I have all of my bottom teeth and they are still healthy. My upper teeth, on the other hand, are a complete disaster. I only have my two front teeth left of those. Currently, I’m wearing two upper partials, but they’re uncomfortable and make it hard to speak. Because I don’t like them, I am only wearing them when I have to chew things that require grinding, such as meat and nuts, etc. Recently my dentist mentioned he thought I’d be happier with a full upper denture. I’d always thought it was better to save your natural teeth, but I’m all for being happier. Which is the way to go? One other piece of information that may be helpful is I have an underbite.


Dear Danny,

completely removable dentures

First, my disclaimer: I have not examined your bite and therefore can only give general guidelines. As you mentioned earlier, under most circumstances, saving your natural teeth is the ideal. However, you are using those last two teeth for most of your eating. Combining that with your underbite means those two teeth are under a lot of stress and not likely to last much longer, even if they are healthy now.

The idea solution, in that case, is to remove those last two upper teeth and get implant-supported dentures. These place dental implants into the arch which mimic the roots of your teeth and help prevent facial collapse.

However, having implants isn’t nearly as important on your upper arch as it is your lower arch. Upper dentures are held in by suction and don’t have a lot of movement.

Lower dentures just rest on the ridge of your jawbone. The longer you are in dentures, the more your jawbone shrinks, hence the facial collapse I mentioned above. Eventually, there isn’t enough jawbone to retain your dentures.

In my mind, the priority would be to keep the lower teeth as healthy as possible. Having dentures on the upper arch will actually create less wear on the lower arch and will help preserve those lower teeth, so long as you are keeping up with adequate oral health habits.

This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.

Dentist or Oral Surgeon for denture Extractions


I have avoided the dentist my entire life. As a result, my mouth is a wreck and I need to get my teeth extracted for dentures. Is a dentist able to do the extractions or should I see an oral surgeon? I want to go to someone qualified, though I’m thinking an oral surgeon can knock me out to deal with my anxiety. What do you think?


Dear Patrick,

You can go to a dentist to have the extractions done, which will save you quite a bit of money over an oral surgeon. Denture extraction surgery should be in the wheelhouse of most dentists. One caution though, I would only have a dentist do it who is able to do both the extraction and the denture placement. Ask them what they normally do in this type of situation. You don’t want a dentist doing this if they normally send someone to an oral surgeon.

Dealing with Dental Anxiety

Woman giving thumbs up in a dental chair

One word about your dental anxiety. You should not have to pay the extra money to an oral surgeon in order to have a stress-free/ anxiety-free procedure. Instead, I would like to recommend in addition to the other issue I mentioned, you also look for a dentist who offers dental sedation options.

In your situation, I believe you would do better with something such as oral conscious sedation. This is administered with a pill and will completely relax you.

You should be aware, however, you will so relaxed that you will need someone to drive you to and from your appointment. You will be too loopy to drive. They will also need to stay with you for a few hours until you are both lucid and steady on your feet again.

This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.