All restorative options have pros and cons. When reviewing the flexible partial denture for tooth replacement, we look at some key points to consider regarding case selection.
Flexible partial dentures are a versatile and affordable option for tooth replacement. Like all the restorative options, they have their pros and cons. We look at both and what you should consider regarding case selection.
Dental implants are an excellent restorative option for patients with missing teeth. However, not every patient can tolerate or afford dental implants. Therefore, every dental practice must have other, more affordable alternatives to restore missing teeth.
Partial dentures are an affordable way to replace a missing tooth or teeth. Traditionally, these are made with a plastic or metal base with clasps that attach to surrounding teeth to hold the replacement tooth in place.1
By contrast, flexible partial dentures have a non-rigid base. Many patients find them more comfortable to wear than a traditional partial denture.2 Made of thin thermoplastic, such as nylon or a vinyl composite, flexible partials bend to fit the patients' oral cavity. Flexible dentures are an excellent option for patients that have:
The Materials Used for Flexible Partial Dentures
Many flexible partial dentures, including the early ones from the 1950s, were made of nylon-based materials, like Valplast. A couple of decades later, flexible partial dentures were made from a range of materials, including:
Today's denture materials have continued to evolve. There are super flexible crystalline nylons and polyolefins. Choosing the material depends on the patient's needs. For example, crystalline nylon might be the better choice for patients with allergies.4
These materials have many patient benefits. They are biocompatible and don't have BPAs. They are also stain and odor-resistant. Plus, they are comfortable to wear and eat with because the bases are thin, much thinner than traditional dentures. The flexibility means they are also less likely to irritate the oral cavity.4
Pros of Flexible Partial Dentures
Partial dentures are great for patients with three or more missing teeth next to each other. They can also be helpful after extractions from trauma or disease, holding the surrounding teeth in place until the patient gets a more permanent option.5
Flexible dentures retain better (no adhesive necessary) and are more difficult to break than traditional partials. Many think they are more comfortable than conventional partial dentures, too. Also, they are affordable, ranging from $700 to $3000, depending upon the case, and some insurance policies cover them up to 50 percent.3
In addition, flexible partial dentures are more straightforward to custom design. The whole process requires less time for custom design than other restorative options and is far less invasive than dental implants. Moreover, flexible partials tend to fit appropriately with less fuss than other modalities.6
Cons of Flexible Partial Dentures
While partial dentures are esthetic and affordable and help patients eat, smile, and talk, patients cannot always wear them. Also, flexible partial dentures need maintenance more than other permanent solutions. Patients often need replacements at five years, although some estimates put that at 8 years.5-6 Plus, the color can degrade as the patient wears them. Additionally, they are more expensive than traditional partial dentures, which might be a stumbling block for some patients.3
Some patients want a low-maintenance and natural-feeling solution for their missing teeth. In those cases, flexible partial dentures, with their less-than-permanent feel, will not deliver the proper patient experience. Also, even though they don't break the same way traditional partials do, flexible partials are challenging to fix and often require a complete replacement if something breaks.6
Sometimes, flexible partials aren't compatible with the case. When a patient is missing several teeth or has fused teeth, flexible partial dentures might not have enough support to provide an adequate replacement.6
Choosing the Right Flexible Partial Denture Candidates
Case selection has much to do with a partial denture's success. If dental implants are off the table for treating the patient's edentulism, then consider the following:
Of course, clinicians should also include the patient's concerns in the case selection. When deciding whether a flexible partial denture is suitable for your patient, consider the following three patient preferences:
Patient expectations: Discover your patient's understanding of the materials used, how easy they are to maintain, and their goals for the prosthesis. You might uncover a misunderstanding that needs clarification or a better option that meets the patient's desired experience.
Patient esthetic objectives: Maybe the patient wants a better smile. Perhaps they are concerned with how the replacement will work and the comfort level of wearing it. Whatever they want from the appliance, ensure you know what that is before proceeding with any restorative solution.
Patient budget: Even patients with insurance coverage might not have the finances to cover their out-of-pocket treatment expenses. It can be helpful to know those limitations before presenting options patients want but can't afford.7
Also, flexible partial dentures have some preferences, too. For example, these replacement teeth are excellent for patients who have gum recession, titled teeth, irregular bony structures in the oral cavity, or a cleft palate. Flexible partials are also ideal for patients with acrylic or metal allergies. In addition, these prosthetics are suitable for patients new to replacement teeth or those likely to break their dentures.8
What You Cannot Forget to Discuss With Patient Who Gets Flexible Partial Dentures
Maintaining excellent oral hygiene with a flexible partial denture is essential. Plaque can build up around it without proper cleaning and contribute to gum disease. Therefore, clinicians should explain how to clean the denture properly, as well as how to clean the remaining natural teeth and gums. Tell them what foods they should avoid in the first two weeks and foods that always require extra caution when eating, like chewy, sticky foods or foods that are hard to bite, like an apple. Also, dental professionals should ensure patients understand they cannot wear the dentures around the clock and that the patient should soak them in water or denture solution when not wearing them.9
In addition to hygiene concerns, clinicians should explain when they should return to the practice for further help with their flexible partial dentures. Give patients scenarios of regular side effects of wearing a new type of denture that needs time to get used to and what is a fit or function concern that needs professional help. For example, some symptoms that indicate a patient needs to return are inflamed gums, the persistent appearance of blisters or sores, and frequent cuts in the oral tissue. The patient should also come in if they are experiencing headaches or ear pain.9
Flexible partial dentures are not for everyone, but they are an excellent and affordable solutions for many edentulous cases. These prosthetics have their pros and cons, but as the materials evolve and improve, so too might the advantages and drawbacks. By having a discussion with your patients and ensuring that everyone understands what the benefits and challenges are, as well as the expectations for the outcome, flexible partial dentures can deliver excellent patient outcomes.