Dr. Josh Muir and Dr. Tanner Townsend discuss the pros and cons of fixed versus removable dental implants on their podcast. They highlight that removable snap-in dentures are easier to clean and can be cheaper, especially for lower jaw implants, but offer only 60-70% of normal chewing force. Fixed dentures, like All-on-4 or All-on-X, feel more natural, allow for stronger chewing (up to 90%), and are aesthetically pleasing but are costlier. They emphasize the importance of patient preference and lifestyle, noting that some patients may require removable options for hygiene or lifestyle reasons. Both hosts stress the importance of a free consultation to determine the best option for each patient.

Dr. Josh Muir 0:05 Welcome back. Everyone to the Smile Reconstruction Dental Implant Podcast, the podcast where we talk and learn about everything dental implant related. My name is Josh Muir and Tanner Townsend is right here. We are your hosts for the day, and so thanks for joining us. We have a really cool topic today. This is one that we’ve talked about before, but we’re going to talk about it with a little bit of a twist today, and that is finding the right option with replacing your teeth, whether it’s fixed or removable. Fixed stays in all the time, removable that comes in and out. Would you rather have dentures or teeth that come in and out, or would you rather have teeth that stay in all the time? That’s our question. Dr Townsend, what are your thoughts there? What can you start us off with?

Dr. Tanner Townsend 0:53 Well, I think this is an excellent topic. So the snap indentures of the removable versus the screwed indentures of the fixed and I think there are pros and cons to both, and I think we just need to weigh out what pros and cons weigh better for that specific patient. So some of the pros for a snap indenture are that it is removable. It’s something that can be cleaned. You could use an existing denture, if the denture is in good condition, so it can help cut on cost.

Dr. Josh Muir 1:24 Would you go over? What do you mean by it can be cleaned?

Dr. Tanner Townsend 1:27 Yeah, great question. So when you have a snap in denture, the snap in denture can be taken out, and we recommend that you take off the denture or pop it off at night and let your gums rest, which gives you access to the little gold pieces where that are screwed into the implant.

Dr. Josh Muir 1:49 Okay, that snaps the part that snaps onto your implant

Dr. Tanner Townsend 1:52 Correct exactly right. And with the screwed in, or the fixed kind, those the teeth stay on all the time, and you have to flush out underneath, and usually do that with a water pick. And that is one thing that is a little bit tricky. The cleaning part of that fixed case is a little bit tricky, and you have to go to the dentist every six months to clean around it.

Dr. Josh Muir 2:14 Okay. So you would say the removable one, or the snap in and out option is easier to clean.

Dr. Tanner Townsend 2:21 Agreed.

Dr. Josh Muir 2:21 Okay.

Dr. Tanner Townsend 2:22 What are some other pros and cons that you see with the snap in kind?

Dr. Josh Muir 2:26 In particular the snap in especially on the lower we can do that with as little as two implants. And so when we’re looking at a cost perspective, it’s definitely cheaper to do the snap in option. And then, of course, there’s always some caveats where that may not be true, but in most cases, it’s it’s a little bit less to do the snap in option. So finances are a factor. The time of treatment is a factor, depending on the situation. Sometimes we can snap them in the day we put the implants in, and there’s still you have to be gentle during the healing period, but it’s a pretty quick procedure that way. And you know, some people just like the ability to breathe a little bit more. So I have had patients that feel claustrophobic when they can’t take their teeth out. So if they’ve had dentures for a long time, they they get a little claustrophobic when we fix those dentures into their implants and they can’t remove it anymore. So those are some of the things that would be, some of the some of the pros for removable. So what are the downsides to removable?

Dr. Tanner Townsend 3:37 Some of the downsides are, I think the biggest one that comes to mind is that you don’t have the chewing force that you otherwise would with the screwed in kind and so typically, there’s a study out there that says you’re only able to choose 60 to 70% of what normal chewing function would be if you had your full normal set of teeth with a snap indenture, with a screwed indenture, you can have up to 90% of what you previously could chew, which is almost identical. And so for me, that’s the biggest one. The second con of the removable is like the profile and the bulkiness, because it’s still a denture, yeah. And in a lot of cases, on the upper we’re able to remove the part of the denture that covers the roof of the mouth, but some cases, you can’t, and you want it there for support. And so you’re still dealing with this bulky denture with the snap in, even though it’s not moving around as much as it previously was.

Dr. Josh Muir 4:39 And I would say the same thing. The biggest con is it’s bulky, and you have something that covers at least part of the roof of your mouth and down along your tongue, and it wraps around behind, behind where your teeth would be. It goes along your cheek, and it even goes along here, right underneath your lip. So it’s something that you feel it’s something that you. What you know you have to put up with. And I would say most people can wrap their mind around that, and they do pretty well with it. There is always a little bit of wiggle to it.

Dr. Tanner Townsend 5:12 Yeah

Dr. Josh Muir 5:12 And that’s one thing some people don’t realize, is it can still move. And depending on how you chew, it can flip up one way it can un snap on this part when they’re chewing. So, you know, those are some of the downsides. But all in all, it’s a great treatment option.

Dr. Tanner Townsend 5:30 Yeah, it’s a great treatment option, and it’s way better than a denture.

Dr. Josh Muir 5:34 Right. So you mentioned chewing force with the snap in kind with a fixed kind. What about someone that just has regular dentures? Just to give that comparison

Dr. Tanner Townsend 5:45 Yeah, you can only chew about 20% of what you typically chew, and that’s a huge difference.

Dr. Josh Muir 5:50 Yeah, and kind of put that into perspective, why? Why is that? Why does our body limit how forcefully we can chew with regular dentures?

Dr. Tanner Townsend 6:02 So with with regular dentures, there’s their plastic essentially. And so you are trying to chew, and you can’t really feel how much you’re chewing. Is one with teeth, you’ve got sensation, and you know when you’re biting down certain forces. But also you’re chewing different. With a denture, you have to chew on both sides at the same time, like mashing your food, where, with teeth, you can move in all different directions and grind that food up into sharper shreds. Anything I missed with that?

Dr. Josh Muir 6:36 Just that, you know, the dentures, I would say, Sit on your gums, and your body is going to limit the force that you can compress any tissue, kind of like standing on a on a rock with your bare foot, like your your body is going to try to pull back and so you can try to bite harder with your dentures, but your jaw pulls back your body doesn’t want you to pinch and smash your gums, and so you limit yourself, even without trying. So that’s, that’s another part of it. But, I mean, I just think it’s, it’s amazing, the pros and the cons. And for some people, those pros outweigh the cons. And for some people, it doesn’t, you know we’re all so different.

Dr. Tanner Townsend 7:22 Yeah. So we’ve kind of covered some of the pros and cons. Are ready for a screwed in denture? What are there any additional ones that we haven’t covered that you think are worth mentioning?

Dr. Josh Muir 7:33 Yeah, so and again, when we talk about the screwed in kind, there are different names for it. It can be a fixed denture screwed in, All-on-4 or All-on-X. The thing that most people feel like is the nicest about that is it just feels like natural teeth, and it it doesn’t really take up much more space than the natural teeth did, so with your tongue, with your lip, it it feels about the same. There’s nothing that goes up under your lip here. There’s nothing that covers the roof of your mouth. And so that’s a huge plus, or a huge pro. It’s just not as bulky. The next one that everybody talks about is you can chew harder with it, just like you were saying. So those are the two main things. The other thing is just how it looks. It’s a different material. You know, often those are made out of type of porcelain or zirconium. And so there are some esthetic factors that you can get with that that are a little bit harder to get with dentures.

Dr. Tanner Townsend 8:36 100% agree. And I think really the only drawback to this option of the screwed in dentures are the cost. It can be somewhat cost prohibitive, but one of the things that we’ve really tried to do in our office is to make it more obtainable, to make it so more people can enjoy their food more and have a higher quality of life because of it.

Dr. Josh Muir 9:00 I was talking to a patient today, and I was just telling him some of the things that we’ve been able to do to help get that cost down as much as we’d like to charge, you know, as much as we can for it. You know, it gets to a point where it’s, it’s unattainable for a lot of people, yeah, and so, you know, with our in house lab equipment, with going fully digital, I mean, those are some huge things, but, I mean, we’ve focused so much on increasing technology in our office so that we can provide certain treatments for a lower cost. And would you say that’s been successful at helping people move forward with that treatment.

Dr. Tanner Townsend 9:42 Oh, 100%

Dr. Josh Muir 9:43 Yeah, every day.

Dr. Tanner Townsend 9:44 Every single day. So what are some cases that you’ve seen just with different patients that you’ve been like, this is like, fixed was the right option for them? Or maybe they started with a snap in and they switched. Or vice versa. You have an example of that?

Dr. Josh Muir 10:02 So it really there are two things we look at. Number one, is a patient a candidate for this treatment or that treatment? A lot of times, a patient’s a candidate for both treatments, and then it just becomes Okay, patient, what makes sense to you? So I’ve had one patient, for example, that we did the All-on-X on the top. And she said, No, I’m not going to worry about it on the bottom. And then after she got it on the top, she came back a week later and she said, guys, I don’t care what it takes. I’m going to figure out a way to do this, because it is so much nicer than having something removable. Wow. But like I was telling you earlier, we’ve also had patients that we do the fixed and they were in a denture for a while. We placed implants. We made it fixed or All-on-X so it stays in all the time, and they just felt like they needed something that they could remove. In fact, she she ended up hating it because she was so used to taking her denture out that she just, she just felt very troubled with it, I guess is the way to say it. Another part of it was, how can you clean it if it’s stuck in your mouth so well? I mean, same with your natural teeth. Now, her thing was, she, she wasn’t one that took care of her natural teeth, and so she always struggled with that. So knowing that she was so much more comfortable. So even after we finished this All-on-X treatment, she said, Guys, I’m so sorry, but we’ve got to make a change. Can you turn it into something that comes in and out Now, fortunately, we have the technology to do that, and it wasn’t a big deal. But you know, that was a surprise. So what have you found with some of your patients?

Dr. Tanner Townsend 11:54 Very similar things. We had a case recently where we had planned on doing a snap in upper denture, and we had a screwed in on the bottom, and the patient came back and was like, Hey, I love this lower. Is there any way that we could potentially do this on the top?

Dr. Josh Muir 12:12 And implants were already in, you were already moving down the road. We were removable.

Dr. Tanner Townsend 12:17 Yeah. We were like, at the last appointment, and she’s like, You know what? It’s worth the money to me to to upgrade to the next thing, and I want the screwed in kind. And we’re like, Okay, sounds good. Is what we can do.

Dr. Josh Muir 12:32 Wow. It’s so it really, it’s up to the patient. It’s a personal choice, yeah, and that’s probably the most important thing to realize. So our job isn’t to sell someone an idea of treatment. It’s to educate the patient with the pros and cons and let them decide what makes the most sense for them, exactly as long as they’re a good candidate for it.

Dr. Tanner Townsend 12:56 Yeah, and I think knowing having patients know that they have options is a really powerful thing, and I that’s why we encourage people to come to that free consultation so bad, because then they can see, okay, what are my options? And then what is going to work within my budget to make the most sense?

Dr. Josh Muir 13:14 Yep. And you know, prospective patients can listen to a podcast like this, and they can say, Okay, I probably fit into this category, but really, until we take a look at the CT scan, look at their bone quality, we really don’t know what they’re to candidate for. And so we would invite anyone to come in for a free consult. We get a CT scan for you. We take a look at everything, and we give you your options. You know, as we’ve been saying this, I also remembered a couple of things. I have had some patients that are singers and or musicians. One of them was, I believe it was a trumpet player, and the singer and the trumpet player, they both needed something fixed. And so there are some lifestyle things that would be pros with, one versus another, because we’ve also had an outdoor guide that he said, Guys, I can’t I can’t have something that stays in all the time, because I may be out in the wilderness for two weeks at a time. I’m not going to be brushing or doing anything with it, at least if I have something removable, I can rinse it in the river and put it back in and so, you know, lifestyle plays a factor, and I think that’s why it’s so important for each patient to decide. But any closing thoughts with any of that.

Dr. Tanner Townsend 14:35 No, I think just the power of knowing that patients have options and then helping in that consult determine what’s going to fit best with their lifestyle and their goals. And so that’s why we just encourage everyone to come to that free consult and to get a gage of what’s going to be best for you.

Dr. Josh Muir 14:53 Yeah, well, thanks for those comments, guys. Thank you so much for joining us. If you have questions, give us a call. Let’s get you in, and we’ll figure out some options for you, and let you make the best decision that’s right for you. Again. My name is Josh Muir, and this is Tanner Townsend. We’re your hosts for the Smile Reconstruction Dental Implant Podcast.

Dr. Tanner Townsend 15:16 Have a great day.