What are the options when many teeth are missing?
When most or all of the teeth in a jaw are missing, there are essentially four routes:
- Removable full denture: used when no teeth are left in the jaw. According to Cleveland Clinic, an upper full denture rests on the palate and a lower one on the ridge of the jaw.
- Removable partial denture: used when some teeth remain; it holds on to them with clasps.
- Removable denture on implants (overdenture): looks much like a conventional denture but clips on to attachments fixed to implants in the jawbone. You take it out yourself.
- Fixed teeth on implants: a bridge or a whole arch of teeth is screwed or cemented on to several implants. You remove nothing; only a dentist can take the teeth off. At our clinic a toothless jaw is restored on four or six implants; our full-arch implants page explains how.
For a single gap, see our guide dental implant or bridge.
How do dentures, implant-retained dentures and fixed teeth compare?
| Topic | Removable denture | Denture on implants | Fixed teeth on implants |
|---|---|---|---|
| Surgery | None | Yes | Yes |
| Stability | Relies on gums, palate and remaining teeth; can loosen | Held by attachments, much more stable | Screwed or cemented in place |
| Palate (upper jaw) | Covered by a full denture | Reduced, depending on design | Free |
| Cleaning | Outside the mouth | Outside the mouth, plus brushing the implants | In the mouth, including under the teeth |
| Maintenance | Relining over time | Replacement of worn attachment parts | Check-ups and, if needed, screw servicing |
| Trips to Türkiye | Usually one, with several appointments | Usually two, months apart | Usually two, months apart |
What changes in stability and chewing?
The most common complaint about conventional dentures is that they move. Cleveland Clinic notes that conventional dentures can slip while you speak or chew. The lower full denture in particular is moved by the tongue and cheeks.
The York Consensus Statement of 2009, a statement by a British expert group based on a large body of high-quality research, concluded that a lower denture on two implants brings clearly higher satisfaction and quality of life than a conventional denture. Patients report better retention and stability, and measured chewing performance improves too. The authors therefore describe the two-implant overdenture as the minimum standard that should be offered to people with a toothless lower jaw as first choice.
Between fixed and removable teeth on implants the difference is smaller. The systematic review by Yao and colleagues (2018, 13 studies) found no meaningful overall difference in patient-reported outcomes, only a slight tendency in favour of fixed teeth. In 8 of 11 studies on chewing there was no difference.
How do the jawbone and the fit of a denture change over time?
After teeth are lost, the jawbone gradually becomes narrower and lower. The NHS points out that dentures can become loose as the gums and bone shrink or change shape. According to Cleveland Clinic, a reline, in which the inner surface of the denture is refitted, is usually needed every one to two years or whenever the fit changes, and conventional dentures last seven to ten years on average.
Implants can slow this process. In the study by Kordatzis and colleagues (2003), people with a conventional lower denture lost an average of 1.63 mm of bone height at the back of the jaw over five years, compared with 0.69 mm in people with a denture on two implants. Bone loss did not stop, but it was clearly smaller. Implants do, however, need enough bone; if the ridge is too narrow or too low, a bone graft may be an option.
This matters if you are travelling for treatment: people who have worn a denture for many years often have less bone. Whether implants are possible with or without grafting is shown by the three-dimensional cone-beam CT (CBCT) scan at the examination, not by a photo.
Can an implant-retained denture be made without a palate plate?
An upper full denture covers most of the palate to gain suction. If you find that uncomfortable, there are implant-based alternatives:
- Fixed teeth on implants leave the palate free; the teeth follow the dental arch only.
- A denture on implants can, depending on its design, cover less of the palate. According to the systematic review by Sadowsky and Zitzmann (2016), palate-free designs were used successfully in some studies on four to six implants spread well around the jaw. The same review stresses that an upper implant overdenture improves satisfaction and quality of life, but that all designs need long-term maintenance.
Bone at the back of the upper jaw is often limited by the sinus. A sinus lift may then be needed.
How do cleaning, appointments and maintenance differ?
Appointments and trips: According to the NHS, making a conventional denture usually takes a few weeks, followed by a fitting appointment; Cleveland Clinic describes several adjustment appointments during the settling-in period. With implant-based options, surgery comes first, then several months of healing; for international patients that usually means two trips. What happens on each is explained in our guide how many days in Türkiye for dental implants. How many days to plan for a removable denture is set after the examination.
Cleaning: The NHS recommends cleaning removable dentures morning and night and removing them at night. Cleveland Clinic points out that fixed teeth on implants need more thorough daily care, including flossing under the teeth. In the review by Yao and colleagues, five studies agreed that the removable implant denture is easier to clean.
Maintenance: With removable dentures on implants, parts of the attachments wear and are replaced. According to Sadowsky and Zitzmann, maintenance needs were higher with single attachments, while gum inflammation was more frequent under bars. For international patients this means: agree before treatment who takes on this routine maintenance, your dentist at home or we at a later visit.
Which option suits whom?
- Removable denture: for people who do not want surgery or for whom it is not advisable for health reasons, and for anyone looking for a solution in one trip.
- Denture on implants: for people whose lower denture rocks, who have enough bone for two or more implants and who want to take their denture out for cleaning. It is also an option for anyone who finds detailed cleaning inside the mouth difficult.
- Fixed teeth on implants: for people who want nothing removable, have enough bone and implants for a fixed restoration and can keep up thorough oral hygiene. What matters in later life is covered in our guide full-arch implants in later life.
Poorly controlled diabetes, smoking, untreated gum disease and certain medicines can affect implant planning; see our guides on dental implants with diabetes and smoking and dental implants. The options can also be combined, for example a conventional full denture in the upper jaw and an implant-retained denture in the lower jaw.
What does this mean for treatment in Türkiye?
For a preliminary assessment, you can send photos and any existing X-rays on WhatsApp to +90 532 363 49 54; we reply in English and German. The plan becomes final only after the examination at our clinic in Serdivan, where the bone is assessed with a CBCT scan. We carry out bone grafting and sinus lifts at our clinic, and treatment under general anaesthetic is possible if needed. Depending on your case, a temporary tooth or denture can be fitted during the healing months.
Dentures and crowns are made by CAD/CAM in the dental laboratory we work with. Before treatment starts, you receive a written treatment and cost plan with the cost of each tooth and the total. Transfer from Istanbul and accommodation in Sapanca are included in the treatment price. On departure you receive copies of your treatment summary and X-rays, and an implant card if you have implants; after you return home you can still reach us on WhatsApp (see aftercare and follow-up).
You can read more about each treatment on our pages dentures, implant-supported dentures and dental implants.