Patients visit my office every day asking how they can improve the fit of their lower denture, or if they have to use denture adhesive for life. Many patients believe that their denture will fit great for the rest of their life and not heed Dentists recommendations for dental implants thinking "my denture fits good now, why should I spend 5,000 or more?
There is a point almost every patient will reach when a stable fitting denture is not possible. This occurs when the ridge of the jaw bone reabsorbs overtime.
Teeth or implants create stresses with in the bone that leads to bone turnover - this is a natural occurring process that occurs and results in the jaw bone staying the same size. With out teeth or implants the jaw bone reabsorbs over time. The lower jawbone reabsorbs 4x faster then the top!
This is why I stress to all of my denture patients that they all need to be in implants, eventually. The best time to have implants placed is when the teeth are being extracted, therefore you only need one surgery. If it is not financially feasible, then implants should be placed within the next 3 years. The photo below shows the re absorption process over time. Notice all of the bone that is lost! Implants need bone to be held in, patients also need bone to support dentures!
Here is a cross-section of different aged cadavers. After the teeth are removed the bone begins to atrophy and absorb. As you can see there is plenty of room for implants for all of these examples except for the last one. This is why getting implants close to the time of extraction is best.
Who needs dental implants? Everyone. I think that lack of jaw bone to hold a denture is an oral health concern. Patients are able to have more oral function, longer more satisfying lives by being proactive and maintaining jaw bone for your entire life. Bone loss is inevitable.
If you are a patient who has lost your teeth at an early age (there are many of you out there) you need to begin getting implants as soon as you can. I see patients who are in their 20's and 30's with mouths full of rotten and too completely damaged teeth to save. If you are 20-30 you need to be working toward having a 4 implants in each jaw. Two up in the front and two in the back so you can maintain your bone throughout your life. Below is a proof that implants retain jaw bone around them, however this patient did not have any implants placed in the posterior of the mandible (back of jaw). This is where severe resorption still occurred.
For patients who may be 60-70 years of age, typically two implants placed in the anterior mandible will be sufficient. If you don't think you have enough bone for implants, a simple CT Scan can allow us to see in three diminsions, surgically plan your virtural reality before any incision is made!
Photos were taken from Carl Misch 3rd ed. Implantology Text Book.