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Is it worth it to save my last two upper teeth, or should I replace them?

I have just two teeth left on top, my upper front teeth, and I currently wear an upper partial denture to replace the rest of the teeth whenever I go out or need to chew tougher foods like steak. Otherwise, I can manage most foods just fine with my two upper teeth and remaining lower teeth.

Here’s the issue I’m facing: my last two upper teeth are perfectly healthy, but a couple of dentists I’ve seen have suggested that I get them pulled anyway and replace them with a full upper denture. They say that a denture will probably look and feel better than my current partial, which is rather cheap and bulky.

I’m inclined to go with the dentists’ recommendation to replace my last two upper teeth, but I’m a little hesitant to make the commitment because I know that once those teeth are gone, they’re gone for good and there’s no going back.

What is the best decision in this situation? Should I try to hold on to my natural teeth for as long as possible, or should I just get it over with and replace them with a full denture?

Thanks in advance for any advice you can offer.

— Erin from Iowa

Hi, Erin

First, we’d like to remind you that we cannot give you a definitive treatment recommendation without examining your mouth and seeing X-rays of your teeth. But we can supply you with a list of key principles that we hope will help guide you in making the best decision.

Principle #1: It’s almost always ideal to save natural teeth whenever possible.

You already said that you know how important natural teeth are and you are correct: it’s best to hold on to healthy teeth and only extract them when absolutely necessary.

But “healthy” is a subjective term, as we’ll clarify in a moment. Just because your individual teeth are in good shape doesn’t guarantee that your bite will remain functional indefinitely.

This brings us to the second principle.

Principle #2: Teeth can only take so much stress.

Your remaining two upper teeth may be healthy at present, but they likely will not stay that way for much longer.

Eventually, they will need to be replaced to avoid painful complications. This is because teeth are meant to share the forces of biting and chewing. If you have just two upper teeth to chew against, then they can quickly wear down or shift out of functional alignment due to the unusual amount of stress.

Additionally, when those two upper teeth are the only ones supplying bite force from the upper part of your mouth, then they will cause the teeth directly below them to wear down much sooner than the other lower teeth which have no opposing neighbors to bite against.

So if you’re presently doing most of your chewing with those two upper teeth, then it’s only a matter of time before they will need to be replaced, anyway.

Principle #3: A well-made upper denture can be a comfortable, functional, and affordable option.

Upper dentures are usually much more stable and comfortable than lower dentures because they stay in place by suctioning to the roof of your mouth. An upper denture would also be much gentler against all of your lower teeth when you chew.

It’s highly likely that a complete upper denture could be worth sacrificing your upper front teeth for.

The dentists you’ve seen have evaluated the health and function of your smile and concluded that the pros of replacing your last two teeth with an upper denture outweigh the cons of extracting healthy teeth. While we cannot confirm this is the best treatment course for you, your dentists’ rationale for suggesting it shows that they carefully weighed the two principles we listed above.

Principle #4: Dental implants are the next best thing after natural teeth.

Lastly, it’s important to know that you have other treatment options besides getting a full upper denture. For example, you could get dental implants to replace some of your missing upper teeth. You could even extract your remaining two teeth and get implants to support a full-arch implant bridge or to retain an implant-supported complete upper denture.

Dental implants are an excellent treatment choice to consider because they are the closest you can come to having your natural teeth back. If implants are out of your budget or if you have a health condition that disqualifies you from getting implants, however, you can still have a beautiful and comfortable smile with a traditional upper denture.

Ultimately, it’s up to you to decide whether it’s worth it to extract your remaining upper teeth and replace them. Ask a trusted dentist who is familiar with your case to help you understand the advantages and disadvantages of all the treatment options available to you before you make a decision.

This post has been published on behalf of Owasso dentist Dr. Heng Lim.