When missing most of the teeth in one or both of our jaws, there are a couple of ways to use implants in order to replace them.
The two most common ways are “snap-on” dentures and “All-on-Four” bridges.
What are the differences between these two treatments, and which one is right for you?
Snap-on dentures are removable dentures with clips that snap onto the implants placed in the jaw bone. This means that the patients can take the teeth in and out of their mouth. Since they are still full dentures, they have all the acrylic extensions of a normal denture (covering the gums and palate). Therefore, teeth must be taken out at night to sleep. These extensions cover the gums, and can cause sores and decreased taste. Many patients say that these extensions feel bulky in their mouth.
For snap-on dentures, we place four implants in the upper jaw, and either two or four implants in the lower jaw. These implants will help hold the dentures in place without adhesive (denture glue). This is especially helpful with the lower denture, since the tongue pushes the dentures out of the mouth when speaking.
On the other hand, the All-on-Four is a permanent set of teeth. They cannot be removed by the patient at home. We use four implants across the arch and a bridge of teeth, which are screwed to the implants. The implants hold and support the teeth inside the mouth. This means that the extensions of acrylic that dentures have are not required, as the bridge sits on top of the gums rather than around them. This makes the bridges less bulky, and creates a more natural feeling in the mouth.
Advantages and Disadvantages
- Price: The main advantage of snap-on dentures is the price. They are about 25% cheaper than an All-on-Four bridge.
- Extension: Snap-on dentures are very bulky, just like a regular denture. This can affect the speech, taste, and comfort of the patient. The All-on-Four is slimmer, and more closely resembles our natural teeth.
- Maintenance: Because snap-on dentures are still full dentures, they have to be relined (readapted to the gums) after a few years. In addition, the clips that snap onto the implants wear down with time, and depending on the patient they will need to be replaced every 3-6 months– this adds to the cost of treatment in the long run. For the All-on-Four it is recommended to have a cleaning at the dental office, just like natural teeth, once or twice a year depending on home hygiene.
- Function: Snap-on dentures will allow the patient to bite into most foods and chew more comfortably than a complete denture. However, as the clips wear over time, the dentures will have more movement while eating. This will result in sore spots, and the dislodging of the dentures. Also, because of its extension, food will get under the teeth. The All-on-Four restores chewing capacity for the patients allowing them to bite into any food, chew hard things, and not have any movement of the bridge. This is the closest replacement to natural teeth function.
- Cleaning at home: Snap-on dentures are easy to clean. Since they are removable, patients will have to take them out of their mouth to rinse them in the sink. A toothbrush will need to be used to clean the implants inside the mouth. Just like natural teeth, the All-on-Four teeth will need to be brushed inside the mouth. In addition, a water flosser, such as a Waterpik, will need to be used to clean the gums under the bridge. This will have to be done at least twice a day.
- Implant failure: There is evidence that there is a higher risk of failure of implants on the upper jaw with snap-on dentures compared to a permanent bridge of teeth, like the All-on-Four. This is because the implants work alone with snap ons and carry the chewing load individually. With the All-on-Four, the bridge splints the implants together, and distributes the load of chewing across the four implants.
Overall, the All-on-Four bridges are a superior solution to replace natural teeth compared to snap-ons. They feel and function much more like natural teeth. They are also more predictable in the long run. For both options, there is an investment to be made, and the 25% savings in the price of snap-ons may not compensate for the functional advantages of an All-on-Four.
Dr. Carolina Cespedes, DDS, MS, FACP