Most people, if you ask them, will tell you the big threats to health in the UK are smoking, drinking, inactivity and poor diet.
It’s an interesting point of comparison that there are nearly the same number of partial and full denture wearers as smokers; 11 million.
As denture wearers know, these accessories – unlike cigarettes – are chosen by default; they are the least bad option, usually because they’re the least expensive counter-stroke to missing teeth. Or they are the only choice they have been given.
The problem is, there is another cost. It is well hidden, and very big. And, crucially, no one really talks about it.
It is the cost of not being able to taste food, of losing the confidence to eat out; even to go out at all. Dentures are profoundly inconsistent with personal wellbeing.
Take, for example, the acrylic plate of an upper denture. It inhibits the wearer’s sense of taste by blocking sensations in that part of the mouth.
Taste buds in the tongue are in regular contact with the denture and nerve receptors relay messages to the brain about the acrylic.
As a result, denture wearers who lose the taste sensation can overcompensate by applying too much salt to their food to enhance the taste. Beyond the obvious loss of pleasure from eating, this could be harmful to their health by putting them at increased risk of high blood pressure.
Denture wearers can expect anywhere up to 10 times less chewing efficiency and a loss in bite force of up to 80 per cent. What this really means is 11 million people – 17 per cent of the population – can’t eat what they want, where they want, with who they want.
To put this into context, eating disorders including bulimia and anorexia affected 0.04 per cent of the population in 2009.
Denture wearers swallow larger pieces of food and are more susceptible to digestive complications including indigestion, constipation and nutrition deficiencies.
When teeth are lost the underlying bone shrinks, changing the shape of the jaw and gums. Most of the change takes place in the first six months after an extraction. The bone continues to shrink and change shape at a slower rate throughout life. The height of the face is inevitably affected, with a shallower jaw having a stark ageing effect.
Once the denture becomes even slightly loose, it is liable to pop out in a very embarrassing manner mid-conversation. Lower dentures are more likely to move in function and patients have to learn how to control dentures with their tongue and cheeks.
Some denture wearers may have been told all this before going down this route, but it is unlikely they will have anticipated the level of disruption to their daily life.
The upshot is that dentures can only ever be regarded as a form of palliative care. They are a solution that, while better than missing teeth, don’t return the patient to a full standard of life. And life with dentures only gets worse.
Years of denture wearing tends to leave the jaw out of position and overdevelop the cheek muscles. So patients giving imprints for new dentures can often bite too hard, creating inaccurate molds.
When the best kind of dentures – BPS (Biofunctional Prosthetic System) – are ready to wear, the patient must learn to put their jaw back in its correct position, which can be so unfamiliar it is upsetting. It is difficult to get used to and takes effort and time – at least two and half months.
There is another solution to missing teeth that sidesteps this long list of problems: implants. Implants can give people who had all but given up on normality another chance. Implants feel natural so there’s no retraining of the jaw necessary and, if performed to a high standard, with allow the patient to forget they ever thought about joining those 11 million suffering in silence.