Dear Dr. H,
 
My dentist told me I need dentures. Needless to say, I am devastated. I knew this was coming, but I am only 51 years old! I asked him if I could do implants and he said I could not because I am diabetic and I ” don’t have good bone”. Is this true? What are my options? Do I have to do this?
 
Soon to beToothless
Dear Soon to be,
 
I am sorry to hear you are devastated and I understand the fear you are expressing. And, please understand, you will never be toothless. Your new teeth will just be artifical, much like a new hip or a new knee. (We don’t refer to people as “kneeless”!)
 
I do hear your question about implants, and I will answer it, but I want to address your biggest fears first:
 
1. This will be a transition for you, just like getting a new hip or a new knee is a transition. There will be things you cannot do that you could do when you had a full functioning set of natural teeth. However, you will be able to smile and eat in a way that a partial set of natural teeth has not allowed you to do in a long time. Just like getting a new hip, you will have to follow your dentist’s recommendations after surgery and give yourself some time to heal and adjust. There will be a new normal after all the work is done and
it will be ok.
 
2. Be upfront and honest about your concerns with your dentist. Are you afraid of your teeth looking fake? There are things that can be done to make your denture look more natural. For example, teeth should not be white (like a lab coat white) and they should not be perfectly straight and all the same length. Bring a picture of yourself with natural teeth to help guide your dentist. Are you afraid they will fall out? Talk about how that concern can be relieved.
 
3. You would be surprised at how many people are in full dentures. If they are made well, you cannot tell. Most people think of their grandfather’s dentures, but technology in dentures has come a long way since your grandpa got his dentures.
 
4. Wearing dentures does not reflect a defect in your character or a failure of any sort. It is simply a medical condition that needs to be addressed. Again, much like a new hip does not reflect a defect in someone’s character. Yes, if any of us could go back in time, we would most likely take better care of ourselves. But that is a lesson learned from having lived life. You cannot tell a young person this truth and have them listen!
 
Now about implants: they are a wonderful option and the technology has made them very stable and strong. However, your body must be able to accept a foreign body to be implanted. Many patients with chronic illness, such as uncontrolled diabetes, cannot have a foreign object implanted without serious consequences. I highly recommend you talk to a specialist ( a periodontist or an oral surgeon) to see if controlling your diabetes could change the prognosis for implants.
 
I hope this information helps you. And I hope you will be able to smile a big toothy smile for your next family picture.
 
Best,
 
Dr. H

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