People who have significant pain or problems with their teeth are likely to wonder about full dentures. Getting dentures is usually considered a choice for the elderly, but there are certainly a number of people who’ve needed them at a younger age for a variety of reasons. How does it really work, and what about the pain and the cost? I took the opportunity to interview a thirty-nine year old woman who has been through this. Here you will learn firsthand what it is really like to have all your teeth extracted and what was involved for this individual. Please note that this interview was with the patient and not a doctor or dentist, so please use this information to evaluate the experience from a real person who has been through it, but don’t use it as a substitute for medical advice.
Q. I know that I had only a few visits to the dentist as a child since our family didn’t have insurance and that made it tough for me as a young adult. Can you tell me about your early experiences with dentists and your general dental problems?
A. When I was growing up our family didn’t believe in going to a doctor of any kind unless you were at death’s door, so the only dental care I had during those years was due to front chipped tooth that resulted from a fall. I didn’t go back to the dentist until I had significant pain at age twenty-two. My teeth were quite salvageable, I’m sure, but I did have some genetic issues as well as those related to the years of dental neglect. I’d brushed my teeth regularly and tried to floss, but I had thirteen cavities on that visit and I had in inherited a tendency toward very thin enamel so I had always experienced pain while drinking hot or cold liquids. The dentist understood that repairing such a number of problems at once would be costly and painful, so he did his best to help me though I had no dental insurance. He filled even the larger cavities instead of doing root canals and crowning those teeth. My gums bled very freely and he had to space the visits out, so it took me eight visits over a one-month period to complete that process. It did relieve some of my pain, but overall it was an exhausting and frightening experience that certainly didn’t leave me wanting more. I also couldn’t say that it fixed all my problems, so I wasn’t even sure it was worth the three thousand dollars and multiple visits. One of the teeth that he tried to fill cracked a few days after the filling set, and the dentist said he couldn’t save that tooth. He extracted it and put in what he called a “spider-bridge” which was once false tooth that could be taken out. It was the least expensive option, and even then it was another eight-hundred dollars.
Q. So, from there, tell me a little bit about what leads a relatively young person to consider having every tooth removed and go for a full set of dentures.
A. Well, over the years it seemed that I developed new problems with my teeth faster than I could repair them. I tried to go to the dentist at least once or twice a year after that extended treatment, but those visits seemed to me like trying to put a blazing house fire out by throwing snowballs at it! Each visit they would suggest multiple root canals and crowns, generally at a cost of at least nine-hundred dollars per tooth. I was in college full-time then, so money was tight. I asked them to work on the worst tooth each time, and they did. I’d get a root canal done and then a crown. Afterwards, I would typically still feel pain and sometimes more pain than before the procedure. Dentists often told me that this was due to pain that was coming from other teeth and that I wouldn’t truly feel much better until I could commit to fixing it all. They were often quite condescending about this, telling me that I just needed to make this “commitment” and get it done. I’d ask them what we were really dealing with to just do it, then. It wasn’t like I wanted to be in pain! By the time I was twenty-five, I was told that I really needed to get nine more root canals and crowns and do it as closely-spaced as possible in order to really be pain free afterwards. They recommended doing it all at once under a general anesthetic. Without insurance, the cost was expected to run about thirteen-thousand dollars. I asked about payments. The dentist I went to at the time didn’t take payments of any kind, so he recommended that I take out a personal loan. As a college student planning on graduate school, it felt like they might as well tell me I need a million dollars. I was also honestly terrified of the general anesthetic. It was not a good situation. So, I asked about dentures. The dentist literally laughed at me. He said that there was absolutely no reason for someone as young as I was with fixable teeth to even think about it. And, he was probably right at that point. I didn’t know what to do, though, so I kept on throwing money and effort at the problem by getting another tooth fixed about every six months.
Q. So, you discarded the idea of getting dentures then. What happened next?
A. The “catch-up” thing just kept being a problem. I’d go for another visit and be told that I needed a second root canal on a tooth they’d already worked on. Due to the enamel problem I had, they also decided that a specialist called an Endodontist should start to do my work. That doubled the cost of each root canal, but I did it anyway. I really wanted to fix this. Another few years went by with me trying to keep up in this same way. The bridge that my first dentist had put in was causing me more pain, in addition, and they explained to me that that type of bridge was no longer approved by the FDA. They wanted to replace it with a permanent bridge. I was out of school then and had a full-time job with insurance, but the insurance company said that was a pre-existing condition. They replacement bridge would run about two-thousand dollars and I still had a queue of other teeth to be worked on. I decided the missing tooth was the least of my problems and the bridge hurt so I just took it out. The missing tooth wasn’t visible while I smiled, so I learned to eat on the other side and just lived with it. Heat, cold, sugar – they all hurt. I drank with a straw and avoided sugary foods. By the time I was thirty, though, a tooth on the opposite side broke while I was eating a tortilla chip and my insurance offered to cover 50% of the fix. I needed another fourteen hundred dollars and I didn’t have it. So, I had the tooth pulled and now I was missing two. I still had a great deal of pain in my mouth and eating was becoming more difficult. I went to three different dentists between the age of thirty and thirty-five and kept asking for help and solutions. They all told me that dentures were not the answer. They all encouraged me to borrow money from family and “fix it all.” By that point, I obviously need more work than ever. I needed two replacement bridges, permanent crowns to replace some of the temporary ones, and several more teeth that needed crowns. I had a job dealing with the public and by now I hated the way my smile looked. It wasn’t horrible, but my teeth were somewhat discolored in the front. I had the best dental insurance my company provided, and all I can tell you about that is that dental insurance is usually a big joke. Each time I filed a claim, they’d fight me on it. They said I went to the dentist too often. They only covered up to a certain amount of money per year, and then the dentists chided me for not coming in more often. My newest dentist did a complete set of panoramic x-rays (at my cost) and gave me an estimate. She wanted to do fourteen root canals, replace two temporary crowns and one permanent crown, add eight new crowns to my remaining teeth, and bridge the gaps where I’d lost teeth. Then, to improve my looks for the least cost, she wanted to try an invisible set of braces and a whitening procedure. She would have preferred veneers in the front, but the cost was astronomical. The quote without the cosmetic part was now twenty-four thousand dollars. The cosmetic work would add another two-thousand. I went home and cried. And, I gave up. I didn’t have any of the work done and I just stopped going to the dentist altogether.
Q. Wow, that sounds like a really rough experience. When did you finally go back?
A. Right after my thirty-ninth birthday I woke up with a bad toothache. I knew it was probably abscessed. I called another new dentist and got an appointment. When I went in, they gave me a really hard time about the temporary crowns I hadn’t replaced, even though those teeth weren’t bothering me. They put me on antibiotics and recommended that I have yet another root canal and new crown. I could just feel the nightmare rolling on. I lied about plans to come back and went home. The antibiotics took care of the pain by stopping the infection, though I certainly knew that this would only hold me for a short time. I was exhausted. I went online and tried to research the issue, but most of the information I found was about much older people getting dentures or about all the bad things. I wanted to know the good and the bad. I found a fair amount of information on some forums where people discussed their experiences. Some of them hated their false teeth and others loved them. I called a friend who had told me about a cousin named Denise who had gotten dentures and was only forty-two. I got a phone number and called Denise. We had a heart-to-heart talk for three hours. Denise told me to go to a place that specialized in nothing but dentures and she recommended one. She told me that it was true that dentures weren’t a lot like real teeth, but she was still happy with hers. She said that dentists are right about most things they tell you about dentures, but they obviously also don’t want you to get them because that is less money in their pockets. A denture specialist would give me straight information. I made an appointment that afternoon.
Q. How did that appointment go?
A. It was much easier than I expected. They did have to do a full new set of x-rays to talk to me about my personal situation, but that ran about a hundred dollars. My insurance did not cover full dentures or related expenses at my age, period, so I paid out-of-pocket. The specialist explained that there were many cons about getting dentures. There is an adjustment period and they won’t ever feel quite like real teeth. You cannot bite with as much pressure when you wear them, so there are some minor limits to what you can chew. The adhesives to hold them in can be an annoyance. They also told me about some of the advantages. With modern technology, dentures can look natural and quite real. Once you get through the first set of appointments, you usually only need a fit adjustment every year. You can sometimes keep a good set of dentures then for many years before having to replace them. Then we got to some of my more intense questions. I asked about the actual process and the cost, and I explained that I had been through some bad experiences with anesthetics and was not thrilled about “going under.”
Q. Were they willing to work with you?
A. Yes, they were really compassionate. They said that if I preferred to do the whole thing awake, it was quite possible and many people do it. They recommend that you take a stout sedative before you begin and you may need more before it is over. Of course, they use local anesthetic to numb you during the surgery. They told me that most people can do the entire thing in one day including the insertion of the first set of temporary dentures. Most people can go back to work within three days.
Q. Did they try to talk you out of it at all?
A. Yes, to some degree. They said that I still had at least ten decent teeth and that I might consider having them leave in a certain number of teeth and attach bridges between those real teeth. A lot of people are happier with that alternative since the bridges are more fixed and usually feel more like real teeth. They did admit that the natural teeth will still need a fair amount of care and changes in the mouth can mean more work over the years. I was personally concerned that I might have pain from those teeth as well. It was also more expensive. I could see the good part about it, too, and truthfully I could see it as a good alternative for many people.
Q. So, what did they tell you the cost would be to do all the work?
A. One of their best packages was for extraction of all teeth, a set of temporary dentures, follow-up visits over the first year, and then a high-quality set of permanent teeth. The cost for that package was about thirty-five hundred dollars. I had already paid more than ten-thousand dollars on dental care since the age of twenty-two. That’s not counting what the insurance paid – those were just my costs. I couldn’t imagine being pain-free and having a nice smile again for less than four-thousand dollars. I made the appointment to do it the next day, which I especially wanted to do since I was still on antibiotics.
Q. It must have been really scary to know it was really going to happen.
A. Yes and no. I’d been through so much that it honestly didn’t seem like it was going to be that much bigger. I’d been through a couple of extensive procedures that had taken four hours apiece, and they said this would probably take about 5 hours. I was more afraid of what it would be like right afterwards. Still, as the time got closer to the actual appointment time, I can’t say that I didn’t have some second thoughts. I considered backing out once or twice. Somehow I knew that it was what I really wanted, though, and the rest was just nerves. I took one of those sedatives about two hours before the procedure started and it calmed me down. When I arrived for the appointment, the nurse told me to take another dose of the sedative so it would have time to start working while I signed the paperwork. They required payment in advance, which I kind of understood given that I didn’t expect to be feeling great at the end. I had a friend along who had bravely offered to come right in with me, and they were okay with that as long as she stayed out of the way. They said they would try to finish it that day if all went well, but I would come back the next day either way. I had a hotel room booked just a block away, since I didn’t want to have to go very far.
Q. You signed the paperwork and paid, then, and then they took you into the operating room?
A. Basically. It wasn’t really like an operating room at a hospital. It was more like a regular dentist office except that there were more people and more tools. I saw an IV stand in the corner and it scared me too, but they said it was only there in case I changed my mind. I had all the control. That relieved me. I tried to relax and the doctor came in and asked how I was doing. He was very businesslike and brisk, and I appreciated that. My friend was there to hold my hand and feel sorry for me, but I needed the doctor to act like this was no big deal. He did. He pulled over an instrument tray and he told me that there would be a little pain and some pressure, but he would go as quickly as he was able. They had encouraged me to bring music and headphones to help distract me from the sounds. My anxiety levels were high, I guess, but I mostly just wanted it to be over.
Q. If it doesn’t bother you, can you tell me a little bit about the kind of tools they used and what went on? I know this part might be a little graphic, but you can say whatever you feel comfortable with.
A. I tried not to look to closely, to tell you the truth. [laugher.] I know they had some small kind of power saws, but those really weren’t any scarier to me than regular dentist drills. They worst thing was a device that looked to me like a kind of big set of pliers. It was to pull when necessary, and though I’d had that done before, it was incredible to me that they were going to take out all of my teeth in just a few hours.
Q. What did they do for your pain, since you wanted to stay awake?
A. They had advised me to take ibuprofen before we even started, along with the sedative. I had told them that I sometimes had a hard time with the epinephrine that is used in Novocain; it makes my heart beat fast. They said they would still use Novocain since the sedative should counteract that and the epinephrine helps the numbness to stay with you longer. I should tell them if I did start to feel badly due to the epinephrine and they would switch to a similar local anesthetic that had less epinephrine in it. They rubbed some numbing gel on my gums on the left side and then they gave me small shots along that whole side to numb it all. They warned me to take care to keep my numbed tongue out of the way of my teeth until they could fix my jaw open. I was also afraid of choking, but they assured me that someone would be constantly monitoring the liquid in my mouth and using suction constantly to keep everything clear and clean. I could take short breaks, too.
Q. How did the numbing shots work for you?
A. There was still some pain, but I was so used to pain in my mouth that it probably wasn’t as bad for me as it would be if you weren’t used to that. It was actually as painful as I thought it would be. They gave me more shots if I needed them, and they stopped for me to take more sedatives if I asked. The first hour seemed to go by in a blur, actually, but then the pain got a little worse. I guess there is a kind of shock that sets in right when they start and it seems to carry you for awhile. Then your brain starts yelling at you to say that you really are hurting and that someone is taking your damn teeth out. Sorry. It was scary at that point.
Q. How did you handle it when the pain and anxiety got worse for you?
A. I thought about stopping for a minute. I had lost several teeth already, but I thought about just telling them to shut it down. I must have looked upset because my friend started to squeeze my hand and ask if I was okay. I couldn’t answer, of course, but I think tears were coming out of my eyes. It was more from fear than from pain. My friend asked them to stop for a moment and she got me a notepad and pencil. I wrote that I was afraid. She was reassuring and patted me and told me that if we had to, they could stop and we could take more appointments to do it. That got me. It was the perfect thing to say, even though she probably didn’t mean it how I took it. I just thought, “Oh my god, if I stop now I will have to come back and do this again. I can’t stay like I am now.” I wrote that I wanted to keep going and that I was okay. The doctor had stepped out for a moment, probably using the break to rest a little. He came back in and started right back without giving me more time to think. Then I was okay. After that, it sort of reminded me of how I had felt when I got a tattoo. After awhile you just kind of go somewhere else in your head. You don’t really have a choice.
Q. It sounds like that was a really bad part. Did it stay like that for you for hours, then?
A. No, not at all. For me, it was just maybe ten minutes of panic and then I was better. The pain was better too. I think panic makes pain worse, or makes you think the pain is worse. I know that maybe two more hours went by before I had another hard time.
Q. What happened then?
A. I had sort of halfway passed out, is kind of how it felt. I mean, I was conscious but just kind of drifting. The pain would come and go. They sometimes gave me more numbing shots and asked if I was okay and I was able to nod a little. I barely paid attention when they finished one half of my mouth and numbed the right side. It didn’t occur to me that much at that moment that half my teeth were really gone. They worked on the right side for a little while. Then all of a sudden I just got very aware again and my mouth hurt. I realized they were having a hard time with one tooth that was not coming out easily. My friend patted me and told me that the doctor had said it was a stubborn tooth and that they would get it out shortly. I was nervous, but then they did and they gave me another numbing shot. The nurse leaned down and said she could put a sedative under my tongue and let it dissolve. It would taste terrible, she told me and she laughed and said she wouldn’t lie about that and that she had done it herself before. She said it would go to work faster, though, and that it was easier than trying to swallow a pill with my whole mouth numbed. I nodded that it was okay. She was very kind. She opened the bottle and took one out and slid it under my tongue. Then she took some kind of thing that sprays water and spritzed some water under my tongue to help it dissolve. I couldn’t really feel it and the numbing stuff also took away some of my ability to taste so it wasn’t terrible. After a few minutes she put more water in my mouth and promised me that it was clean water and that I could swallow it. I did, and it was okay. Then I settled down and things were all right again for awhile.
Q. So, how much time had passed by then?
A. I guess about three and a half hours or so. I’m not positive. I know quite a bit of time went by after that and it seemed like they were going slower. I felt like it would never end. I got restless and my back was hurting. They stopped again and gave me the notepad and I wrote that it seemed to be taking a long time. The doctor told me that he was tired and it was taking a little longer, but that another doctor was going to take over temporarily and give him a break. I tried to relax. The second doctor was not as gentle and didn’t seem as experienced. He did not have an easy time for the next little while and neither did I, but it was bearable. Then the first doctor came back and took over again and he said they were on another stubborn one that did not want to come out. He worked at it for awhile and this is kind of yucky, but I could hear a cracking sound in my head. Sorry about that, I know it’s awful.
Q. Hey, we’re here to know what it was like for you. What happened next?
A. The doctor had sweat on his forehead and I was kind of scared. I’m sure he could see it in my eyes. He told me that he could probably finish in an hour but that if I couldn’t do it, we could stop and finish another day. I thought about leaving and having all but a few teeth gone. I shook my head no and tried to beg him to finish with my eyes. He went back to work and he got the tough one out. Things quieted down and they continued and I lost track of time again.
Q. Were you able to finish it?
A. Yes, they finished it that day, though I guess it wasn’t one of their easiest jobs. I know several nurses had switched out. My friend later told me that we were actually in there about six hours, which was much longer than she had thought it would be. When they were done, even they seemed relieved. I didn’t feel that bad, either, just very groggy and tired. A lady came in and told me that she was going to put the temporary teeth in. They had explained how it would work, but it was a weird feeling that I must truly now be toothless.
Q. They were able to put new teeth in that fast?
A. Oh, yes. It’s kind of neat what they do. They make impressions of your original teeth before you even start, and that lets them model a kind of similar set of dentures. They won’t have a perfect fit, but they aren’t bad at all. They actually put them in right after the extractions are finished because they want you to start to heal underneath those teeth. The temporaries act as an actual bandage. In most cases, you come back the next morning and they see if they need to be adjusted in any way so you can go home for few days and just heal up. You don’t take the temporaries out at all for awhile.
Q. Wow, that is amazing. How did it feel?
A. It was awful, but only for a few minutes. I was raw and very sore, of course, though still very numb. She put the teeth in and made sure my tongue was not in the way and had me bite down to make them settle. That was pretty painful even with numbness. It helped that I was tired and still sedated. She told me that there wasn’t much to do now but to rinse with plain water once in awhile. The swelling should be minimal and would go down soon. They would give me prescription pain killers to take for a week or so. Then she got a mirror and showed me. I was absolutely shocked.
Q. Really, it was that incredible right off?
A. Yeah. They actually looked really good for temporary teeth. My face was a little swollen, but I already had a pretty good smile. I couldn’t move my mouth very well, but it was still all good. They had explained that I’d need soft foods for awhile, but that technically I could eat whatever I felt up to. You can’t glue your teeth in for awhile, so you do have to take some care not to loosen them. They stay in pretty well in those early stages, though.
Q. I’ve heard of denture adhesives but I never thought about it like gluing them in. How do they stay in without it?
A. I guess adhesive is a good marketing term, but to me it’s just glue. Those first few days the teeth stay in pretty well since you aren’t chewing much anyway. The top ones kind of suction against the roof of your mouth very naturally, so they are even easier to keep in there. It feels weird at first, since the roof of your mouth is now covered by part of the upper plate. You have to get used to the feeling that you now have a kind of hard plastic mouth roof! And the same for the places where you used to feel gums, of course. It’s odd. Oh, you can also get things called mini-implants later on if you want them. They put like four little screws in your mouth and your dentures fix onto those. I haven’t really considered it seriously.
Q. Does it feel like you have a foreign object in your mouth?
A. At first, yes. You forget about it, though, and you get used to it mostly. It was weird, too, since parts of my mouth were more sore than others, so to me it felt like I had a toothache here and there. I told my friend I had a toothache and she laughed and said more like a teethache.
Q. And you went back the following day?
A. In my case, it didn’t work out like that. I went to the hotel with my friend that night, and I feel more sorry for my friend than I do for myself! I was knocked out by the medications and I went to sleep pretty fast. She must have been bored at first. Then in the night I woke up really hurting and frightened. I was confused and I think I scared my friend half to death. I was bleeding a little bit around the edges of the teeth which is pretty normal that early, but that also scared me. I panicked and that must have kind of made my blood pressure go up which made the pain and the bleeding worse. The surgeon had given us an emergency number for the night, but he said that if we had real trouble (which is very rare) that we should go to the emergency room at the nearby hospital. My friend wanted to take me there. My pillow had blood on it. I got a towel and laid down on my side with my face on it so I didn’t feel like I was choking and I tried to calm down. I was lucky, though, because a close friend of mine is a doctor in another city. We called her and told her what was happening. She said that it was mostly just panic and that it didn’t sound like I was losing enough blood to be a big danger, though I needed to get the anxiety under control. She said that I should try to drink some cola or something to make sure my blood sugar wasn’t too low, and to try my best to eat something soft. Then I could take pain medication without messing up my stomach, and I could take sedatives again to get through the night. She was right. I drank some soda and swallowed some applesauce that we had brought along. I’d forgotten that I hadn’t eaten in many hours. Then I took the recommended medication and went back to sleep. My poor friend, though, and I felt bad about messing up the hotel pillow and maybe leaving the maid with a scare!
Q. I hope you left a good tip!
A. Yes, I did, and I was leaving a note but the hotel maid came in and I was trying to apologize to her. I was hard to understand early that morning since my mouth was so sore. The maid just laughed and said that they were quite used to it because they were so near the clinic. They kept plastic under the sheets and pillowcases and they had lots of bleach. It was funny and the laugher helped.
Q. So, then you went back to the clinic?
A. No, they had told us to call before coming over and my friend told them about what had happened the night before. The nurse said that they wouldn’t want to take the temporary dentures out to adjust them since I’d had a little more bleeding than anticipated, but that I should worry. It was a Friday and she said to go home and then come back on Monday morning for an adjustment. By Monday I was doing much better and they adjusted them then.
Q. What was the first adjustment like?
A. That one was painful, but I’ll tell you why it was worth it. We went to the clinic and they took them out and rinsed my mouth with antibiotic stuff and checked the fit of the teeth. They heated them or something and made them fit a little better and put them back in. They told me that I could put some adhesive only on the upper ones and only in the very center since that part would stick to the roof of my mouth which wasn’t cut. Otherwise, I needed to wait four weeks for adhesive and I’d come back to the clinic twice within those four weeks for checkups. They gave me some rinse and told me to take them out and rinse with it several times a day at first, but otherwise leave them in. Once you heal more, most people leave their teeth out at night. Anyway, putting those teeth back in that morning hurt so when we left, my friend suggested that we go to Sonic for some ice cream. I started to tell her that I didn’t eat ice cream. Then I realized that I hadn’t like ice cream since I was a child because it hurt my teeth. I hadn’t been able to enjoy very cold foods for years. What would it be like now? So, we went to Sonic and I had a chocolate cream pie milkshake. It was so good! After I finished it, I ordered a small dish of vanilla ice cream which numbed my gums right through the dentures and felt so very good. I’ve had my dentures for over a year now and to this day, ice cream is such a treat. I love it now.
Q. So, do you have any regrets?
A. Oh, once in awhile I wish that I’d had the money to do something different. Once in awhile I wonder if I’d rather have had it done partially instead of the whole thing. Overall, though, I have no regrets. Nowadays I have no pain in my mouth at all. I rarely even get sore from the dentures, but I do go back to a clinic once or twice a year to get them adjusted. That runs about forty dollars each time. I try to take really good care of them so they last a long time. I can eat most things I want. Chewing ice is another treat. I didn’t even know that I was missing!
Q. Wow. Thank you so much for sharing your experience. I know some of it was pretty rough. Maybe we can do another interview later on and talk about what it is like to live with dentures on a day-to-day basic? How to get the most out of it and take good care of them?
A. Sure, I’d be glad to do that. I really don’t mind talking about it. It was so hard for me not to have more people to talk to about it, especially since I am younger than many people who have them. At the clinic, though, I run into people my age pretty often. It just isn’t talked about so much, and maybe it should be for those of us that have to do this for one reason or another. It’s just not such a big deal.
Note from Interviewer/Writer:
You may also want to check out: “Dentures – Are They Right for You?” by Dr. David Leader.
