Preserve my last few upper teeth or go with a full denture?

I have a tough choice to make and I need some advice. I don’t know anyone personally who I can ask about this, other than dentists I’ve seen, and I want an unbiased opinion.

Most of my lower teeth are okay, but I only have three upper teeth left: two in the front and one molar in the back. The top teeth I have left are in really good shape. I take care of them and get regular cleanings.

I wear an upper partial denture that I really don’t like. It’s hard to talk with it in. I’m overly aware of it, and that makes me uncomfortable when I’m spending time with friends. I can mostly eat without the upper partial in, but for some foods, like nuts or steak, I need the upper to really chew. It also looks a bit cheap and unnatural.

Here’s my question: Should I keep my remaining top teeth and continue wearing this partial denture, or should I have them pulled and get a full upper denture?

I’ve seen some local dentists about this over the years and got differing opinions. Some say I should get rid of my upper teeth and go with a full denture; it will be more comfortable and attractive. Other dentists don’t think it makes a difference, other than my personal preference. If I regret pulling the last three top teeth afterwards, it will be too late.

I can’t spend much on this, certainly less than 10k, and I know that won’t get me very far.

Derek in Tempe

Hi Derek,

Without having seen you, I can only give you some broad advice about your situation. To do more, I’d need to examine your teeth and look at your x-rays.

In general, it’s best to keep your natural teeth. Quality dentures are a good alternative to having no teeth, but they are less comfortable and can’t chew as efficiently as natural teeth or dental implants.

I understand what you are saying about your remaining top teeth feeling good. However, I’m a bit worried about them. Biting and chewing put stress on teeth, and the best thing is for that stress to be spread out evenly. Right now, your three upper teeth are bearing a disproportionate amount of stress, even with the top partial denture in place.

I’m also concerned about stress on your bottom teeth, particularly where they come in contact with your three remaining upper teeth.

The best treatment, from a clinical standpoint, would be to place some affordable dental implants in your upper jaw to support nonremovable teeth, such as a permanent denture. Two implants might be enough, but the cost will likely exceed your budget. The next best thing for you is likely a full upper denture. If you have these remaining three teeth extracted, a skilled dentist or denturist should be able to give you a comfortable, secure upper denture. You deserve to feel confident when you spend time with your friends, and the full denture will give you that.

Upper dentures are stabilized by the suction created by the roof of your mouth. Lower dentures are different; to keep them in place, you have to deliberately stabilize them with your tongue and cheeks. So, preserving those lower teeth is a good priority for your long-term comfort. A well-made upper denture will reduce stress on your lower teeth and support that goal.

The reason implants are the preferred treatment for tooth loss is that when you lose teeth, your body begins to resorb the jawbone that had been supporting them. Due to this process, tooth loss causes the jawbone to atrophy over time. Now, it’s rare for a patient to have enough bone loss in the upper jaw to have a problem tolerating implants or a denture. The lower jaw is different; over time, the mandible can wear down so much that all that remains is an angular sliver of bone that is so sensitive to pain that it can’t support a removable lower denture at all. That’s all the more reason to protect your lower teeth.

Again, I’m giving you this advice without examining you or your x-rays. For that reason, I want you to ultimately go with the advice of a local dentist you like. Feel free to share my opinion with them.

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