Short answer: A dental prosthesis is the general name for artificial structures that replace lost teeth or tooth tissue to restore chewing, speech and aesthetics. They fall into three groups: fixed prostheses bonded to natural teeth (crowns, bridges), removable prostheses the person can take in and out (complete, partial dentures), and implant-supported prostheses that rely on implants. The suitable option is determined after an examination.
Artificial teeth that replace missing or severely damaged teeth are commonly referred to simply as “dentures” or “prosthetics.” Yet this concept covers a very wide range of treatments, from a cap placed over a single tooth to false teeth that restore an entire jaw. To make the right choice among dental prosthetic options, it helps to know what each type does and its advantages and limitations. In this guide we look at fixed, removable and implant-supported prostheses together, explaining which prosthesis may be suitable for whom and how to care for them so they last.
What is a prosthesis?
In dentistry, a prosthesis is the general name for artificial structures made to replace lost teeth or tooth tissue in order to restore chewing, speech and aesthetic function. Prostheses are grouped into three main categories according to how they are held in the mouth:
- Fixed prostheses: Bonded to natural teeth; they cannot be removed by the person.
- Removable prostheses: Can be put in and taken out by the person; they are supported by the gums, the remaining teeth or both.
- Implant-supported prostheses: Supported by implants placed in the jawbone; they can be fixed or removable.
The choice of prosthesis depends on the number and position of missing teeth, the condition of the remaining teeth and gums, the amount of jawbone, the person's general health and their expectations. Leaving a missing tooth unreplaced for a long time can cause neighboring teeth to tilt into the gap and the opposing tooth to over-erupt, which can also make it harder to make a prosthesis.
Fixed prostheses: what are crowns and bridges?
Fixed prostheses are restorations permanently bonded to natural teeth or implants that the person cannot remove; a crown (cap) covering a single tooth and a bridge that replaces missing teeth by using the neighboring teeth for support are the most common examples of this group.
Crown (dental cap)
A crown is a cover that encases the entire outside of a tooth that is badly broken down, fractured, heavily filled or weakened after root canal treatment. The tooth is reduced by a certain amount, an impression or digital scan is taken, and the crown made in the laboratory is bonded to the tooth. It can be made from different materials such as zirconia, all-ceramic or porcelain fused to metal; the choice of material depends on the position of the tooth, the chewing load and aesthetic expectations.
Bridge
A bridge replaces one or more missing teeth with a fixed structure supported by the teeth on either side of the gap. The supporting teeth are reduced for crowns, and the missing tooth in between is replaced by an artificial tooth attached to these crowns. A bridge offers a fixed, comfortable solution; however, it requires reducing the supporting teeth. If the supporting teeth are healthy and have no fillings, this can be considered a disadvantage. In the front of the mouth, in suitable cases, resin-bonded bridges, which are bonded to the back surfaces of the neighboring teeth and require less removal of tooth tissue, can also be an option.
What are removable prostheses?
Removable prostheses are prostheses that the person can put in and take out themselves and that are used when many teeth are missing or all teeth have been lost; there are two main types: complete (full) dentures and partial dentures.
- Complete denture: Used when no teeth remain in a jaw. It consists of a pink acrylic base with artificial teeth arranged on it. In the upper jaw it covers the palate and is held by suction; in the lower jaw, retention is usually more limited because of the movement of the tongue and cheeks.
- Partial denture: Used to replace missing teeth when natural teeth are still present in the mouth. It is held to the remaining teeth with metal clasps or more aesthetic precision attachments. There are types with a metal framework or a flexible base material.
- Temporary dentures: Prostheses used for a short time during the healing period after extraction or while waiting for permanent treatment.
Getting used to removable dentures usually takes a few weeks. In the first days, speech may feel different, saliva may increase and some spots may rub; these sore spots are relieved by adjusting the denture at follow-up appointments. Because the shape of the jawbone changes over time, the fit of removable dentures can deteriorate, and the inner surface may need to be relined or the denture remade.
How are implant-supported prostheses applied?
Implant-supported prostheses are prostheses supported by implants placed in the jawbone that replace missing teeth without touching the natural teeth; they can take different forms, from a single-tooth crown to fixed bridges covering the whole jaw or removable dentures attached to implants.
- Implant crown: For a single missing tooth, an abutment and crown are placed on the implant. The neighboring teeth are not reduced.
- Implant bridge: For several missing teeth, a fixed bridge is built between a few implants.
- Full-arch fixed implant prosthesis: In a jaw where all teeth have been lost, a fixed prosthesis is screwed or cemented onto a limited number of implants.
- Implant-supported removable denture: Thanks to retentive attachments or a bar system under the complete denture, the denture snaps onto the implants. The person can remove the denture for cleaning; however, retention and chewing comfort are usually noticeably better than with a conventional complete denture. It is an important option especially for those who have retention problems in the lower jaw.
Implant-supported prostheses require sufficient bone and suitable general health. If the bone is insufficient, additional surgical procedures may be needed. If neighboring teeth have tilted into the gap because of a missing tooth, repositioning the teeth orthodontically before the prosthesis can create a more suitable space for it; we discuss this in our article missing teeth and clear aligner treatment.
Which prosthesis is right for whom?
Which prosthesis is suitable depends on the number and location of the missing teeth, the health of the remaining teeth, the amount of jawbone, general health, the person's expectations and budget; there is no single right option, and the decision is made together after an examination.
- One missing tooth, healthy neighboring teeth: An implant crown is often the first option considered; if an implant is not suitable, a bridge or resin-bonded bridge can be considered.
- One missing tooth, neighboring teeth already need crowns: A fixed bridge can be a sensible option.
- Several missing teeth in different areas: A removable partial denture, implant bridges or a combination of these can be considered.
- All teeth missing: Complete dentures, implant-supported removable dentures or a full-arch fixed implant prosthesis are evaluated.
- People who do not want surgery or whose health is not suitable: Fixed bridges or removable dentures may be preferred.
The cost of dental prosthetics is also directly affected by this choice: the type of prosthesis, the material used, the number of implants or supporting teeth needed and any treatments required before the prosthesis determine the cost. At our clinic, treatment options and fee information are provided in writing after the examination and planning.
How should prostheses be cared for?
Although care varies by type, prostheses always require daily cleaning and regular dental check-ups; with fixed prostheses, the areas under bridges and along the gum line in particular, and with removable prostheses, the prosthesis itself and the oral tissues, must be cleaned carefully.
For fixed and implant-supported prostheses
- Brush twice a day with fluoride toothpaste.
- Clean under the bridge every day with special floss, floss threaders or interdental brushes.
- Remember that decay can form at the edges of crowned teeth; do not skip check-ups.
For removable prostheses
- Take the denture out and rinse it after every meal, and clean it at least once a day with a soft brush and denture cleaner.
- Unless your dentist advises otherwise, take the denture out at night to let the tissues rest, and store it so it does not dry out.
- Do not use hot water or abrasive substances such as bleach.
- When cleaning the denture, fill the sink with water or lay a towel underneath in case you drop it.
- Also clean your gums, tongue and palate with a soft brush.
- If you notice sore spots, looseness or a crack, do not try to fix the denture yourself.
When should you see a dentist about prosthetic options?
If missing teeth affect your chewing, speech or smile, or if you are having problems such as looseness, sore spots or cracks with your current denture, it is a good idea to have an evaluation and learn which options suit you. At our polyclinic in Oran, Çankaya, after an intraoral examination and the necessary imaging, the pros and limitations of fixed, removable and implant-supported prosthetic options for you are clearly explained.
Frequently asked questions
Is it hard to eat with removable dentures?
In the first weeks it can take time to get used to chewing with removable dentures. Starting with soft foods and small bites and chewing on both sides makes it easier to adapt. If there are retention problems, adjusting the denture or implant-supported options can be considered.
How long can a prosthesis be used?
The life of a prosthesis varies with its type, material, oral hygiene and regular check-ups. With removable dentures, the fit can deteriorate over time because of changes in the jawbone, and the inner surface may need to be relined. With fixed prostheses, the health of the supporting teeth is decisive.
Should I choose a bridge or an implant?
If the neighboring teeth are healthy, an implant offers the advantage of closing the gap without touching these teeth. If the neighboring teeth already need crowns or conditions are not suitable for an implant, a bridge can be a good option. The decision is made together based on the bone condition and personal preferences.
Should removable dentures be taken out at night?
Unless your dentist advises otherwise, it is recommended to take removable dentures out at night so the gums and palate can rest. The removed denture should be cleaned and stored so that it does not dry out.
