How Many Dental Implants Do I Need Under My Denture?

In this post I am specifically talking about overdentures, not fixed implant bridges.

Most commonly, a lower denture is supported with two to four implants underneath it.  The more implants you have the more stable the denture is.

If I gave you a stool with two legs, could your sit on it?  Yes you could!  It would take some balance on your part, but you could sit on it.  An overdenture with two implants, works like that.  The denture is held in very strongly, but it can still move in the back.

In a two-implant overdenture, the implants are purposely placed in the front part of the jaw.

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If you added a third leg to the stool, would that make it more stable? 


Of course! Especially if the three legs were equally spaced away form each other.

The average denture has fourteen teeth on it.  So the more implants, the better.  Four implants are the best option for stability.  It is a four-legged stool.  The implants make the overdenture even more stable when a bar connects all the implants.  This “splints” them together and creates strength in numbers.

Implant attachment mechanisms IMG_8216

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Even two or three implants and be splinted together with a bar for added stability.

Image16 IMG_1505

Five or more implants in the lower jaw is usually strong enough to replace the denture all together!  Meaning the teeth would no longer come out.  They can be fixed in place.

The upper jaw generally requires six implants to have a non-removable fixed bridge.

The basic theme is: the more stability you want, then the more implants are needed.  Also, the more bone you have missing, requires more implants to be stable over time.

This concept is sometimes confusing.  Please comment below if you have a question!

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Burbank, California
http://www.burbankdentalimplants.com

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35 Responses to How Many Dental Implants Do I Need Under My Denture?

  1. Maria Carpenter says:

    Dear Sir, which option do you consider the best to fix to four implants on the top jaw.
    A full denture
    or a front bridge with dentures afixed to the back?
    Please can you let me know of any pro’s and con’s to each option.
    Thank you

  2. Bryant says:

    What about using very powerful magnets to hold the dentures in place? Either located in the abutments or in the denture material or both if polarity is in proper alignment?

  3. Hi Bryant,
    Magnets were used many years ago as attachments for implants and dentures. They do not hold as well as the current line of attachments.
    Also, If you needed to take an MRI, the magnets can cause a problem. MRI stands for Magnetic Resonance Imaging.
    My preference is the locator or a bar attachment. I have been doing this procedure for the last 11 years with great success.
    Does this help?
    Dr. Ramsey Amin

  4. Hi Maria,
    It depends on what your goals are. Do you have a problem with your dentures staying in? If so, the full overdenture may be a better option.
    The front implants with a fixed bridge will always allow you to have your front teeth in place even when you sleep. You could transition to implants in the back and have a separate bridge in the back left and back right to supplement the front fixed bridge at a later date. The bone preservation of fixed dental implants is ideal.
    Can you send your x-rays and photographs to me?
    Dr. Ramsey Amin

  5. Bob L. says:

    Hello Doctor, my question pertains to two implants that I have in my lower jaw. I have had the denture for about three months now and have had use of the denture for the last two weeks and it doesn’t fit right yet. I have been back to the dentist that made the denture and put in the posts and caps more than seven times. The denture still rocks back to front. The last visit was Tues. the 15th.Also, my lower gums are jammed up into the cap holes and leaves me with aching gums at the end of the day. Is there something wrong here?
    Should I go to another dentist? I don’t find any prosthodontists in the area I live. How do I go about finding a dentist that can examine the implants and denture and recommend a proper procedure. The work has already been paid for. Bob L

  6. Hi Bob,
    I think you should follow up with your dentist. Have them carefully adjust the bite. That is often the source of pain.
    An overdenture with only two implants will generally still rock. The denture is held in, but it can still move in the back. Consider adding 1 -2 more implants.
    A prosthodontist may or may not be the answer. Just be sure to see any dentist highly experienced to troubleshoot this if you have to go elsewhere.

  7. Diane Romano says:

    Dear Doctor Amin, I am soeaking to a periodontist about a ‘permanent denture’- my dentist who is a Prothodontist will do my teeth. My problem is my two sides of my mouth are thin. I want a non-removable denture on the bottom as I am in the beauty business. My Periodontish says he can do 5 or 6 implants around my front to my first molar. This is not a cheap procedure at all. Will this secure this denture?? I have read above what you said. Bone grafts would be a hardship for me. Thank You so much!

  8. Hi Diane,
    Usually extensive bone grafting is not required for the lower jaw to have a non-removable option. The upper jaw usually does.
    Err on the side of more than less implants, especially if you choose to “upgrade” your implants to fixed at a later date.
    Are you local enough to come in for me to look at you?
    Dr. Amin

  9. bill dowden says:

    I simply couldn’t leave your web site prior to suggesting that I really enjoyed the expertise. Is going to be back often to read new posts?

    • Hi Bill,
      Yes, I post on a very regular basis and try to help people around the world by providing solid answers for dental implant questions.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

    • RamseyAminDDS says:

      Yes. Thank you. :)

  10. Norma says:

    Hi. In processes of getting an over denture w/implants. I have had bone grafts and 4 implants. In the process of having the removable over denture made. What is the parts called that are inserted into the over denture that clicks on to the locator/implant.

    • RamseyAminDDS says:

      Hi Norma,

      The piece that connects the dental implant abutment to the denture is called an attachment. They are made of plastic and will need to replaced about every one to two years on average.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, California

  11. gail says:

    Dr. I got a full set of dentures about a year and a 2 years ago and my tops are wonderful! My bottoms have been a constant source of sadness for me! I have a very small mouth (my bottom only have 12 teeth) I just cant seem to get comfortable with them no matter what I do! I have been thinking of getting the implants for my bottoms but I am so scared to spend the amount of money it will cost and It NIOT work either! I live on disability because I have crippling arthritis (RA) which is another concern about the implants. I just want someone to tell me that if I get them that I wont have to wear paste anymore and I WONT be getting things stuck under my dentures? Is this possible?? Should I have 4 post put in? 2 in front and 2 in back? I’m so confused I just want to be me again!

    • gail says:

      I’m sorry my typing is bad arthritis does that…i meant two years ago

    • Ramsey Amin DDS says:

      Hi Gail,

      Four implants will be far more stable than two. A stool with four legs is more stable than a stool with 2-3 legs. It is definitely worth the money. Keep in mind that if you have the denture over implants you will always get food underneath them. You won’t need paste, but unless you get a fixed implant bridge, you will get food under them. You are ok with the RA too, just see someone very skilled in this procedure that understands your medical condition too.

      Good Luck!

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      • gail says:

        thank you! do you have a recombination for anyone in the memphis tn area?

        • Ramsey Amin DDS says:

          Hi Gail,

          I don’t know anyone personally in that area.

          Ramsey A. Amin, D.D.S.
          Diplomate of the American Board of Oral Implantology /Implant Dentistry
          Fellow-American Academy of Implant Dentistry

  12. Dawn says:

    Hi Dr. Amin
    I have a question about whether it is possible to wear a full upper denture(traditional removable) with an implant retained denture on the lower mouth. The prothodontist that is working with my periodontist right now is telling us that the constant pressure of an upper traditional denture against a fixed lower implant denture will more then likely cause the implants to fail within 5, 10 or 15 years. He so far has been very resistant to wanting to do anything apart from a removable overdenture with a four implant base . Right now I only have four remaining teeth, three in the front and one in the back and I’d like to keep them if possible, My periodontist has suggested that if I had the remaining teeth pulled that it might be easier to do a full fixed bridge. In your opinion, is there a significant risk of damaging the implants that retain a fixed denture with an upper denture? I don’t want to invest a lot of money in implants and a fixed denture if it will fail in a short period of time. I also don’t want to have to lose viable teeth unless it is absolutely necessary.

    Thanks
    Dawn

    • Ramsey Amin DDS says:

      Hi Dawn,

      This sounds strange. The opposite can be true. The stronger jaw, in your case the lower, could damage the bone in the upper that has no implants…not the reverse. A fixed bridge is a much better option for both your upper and lower. See this link:

      http://www.burbankdentalimplants.com/prettau-dental-implant-full-mouth-bridge/

      Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      • dawn says:

        This was very helpful…thank you for the link and for the explanation. The whole process of trying to understand implants and overdentures at first was pretty overwhelming so your answer helped me to know what questions to ask when I spoke with my new prothodontist.

        Thanks
        dawn

  13. Hi, I have had four implants inserted in my lower jaw and an overdenture fitted. I had this done quite some time ago and they have never held firm appart from a couple of days of when the dentist replaced the o-ring with the strongest hold. I went to a dental technician the other day and he told the reason that the overdenture is not holding firm is because the implants have not been implanted straight up and down, they are facing slightly inwards (on a lean). Is it possible that the implants can move slightly in the bone or that once the implants have been implanted they would never move over time? The implants are still holding very firmly into the bone. I really look forward to your comments as I spent heaps of $$$’s on having this done, and had no real success. Thank you

    • Ramsey Amin DDS says:

      Hi Jenny,

      The implants had to be placed at the trajectory of your bone if it is really small. O-rings are a really old design. Try changing to “locator abutments” or change to a fixed porcelain bridge.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  14. Don says:

    My Dentists wants me to get six implants on the top. I don’t see why 4 wouldn’t work just as good. I don’t have a lot of money to throw around and that would save me some money. Why wouldn’t 4 be plenty?

    • Ramsey Amin DDS says:

      Hi Don,

      Four implants on the upper is really under-engineered **IF** it is fixed bridge. If you have a problem with just one of them, you will lose the all of the teeth. Is this for an overdenture? If it is, four can work, but you will still need to keep most of the palate.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  15. Eduardo Prieto says:

    I need a full lower denture, and I want to get two implants, because my doctor say I have very little bone, but he say I haved to doing right away, because if I way long time don’t going to have any bone for the implant, is this true?, if I way long time don’t going to be any bone. Thank you

    • Ramsey Amin DDS says:

      Hi Eduardo,

      The sooner the better in general. The longer you wait, the more bone you will lose. Keep in mind that only having to lower implants will only help to retain your lower denture from falling out but doesn’t provide a whole lot of stability.

      3 or 4 dental implants are going to be more stable if you are considering having a denture on top of implants.

      Even if you wait, it will still likely be okay. Just yesterday I treated an 87-year-old woman who has been missing teeth for 50 years. I placed for implants in her lower jaw.

      Dr. Amin

  16. Tina says:

    Hi Dr. Ramsey,

    Quick question. I have had the o-ring and abutment changed on my implant after only two days of use on the right side of lower denture. Now again, two days later I need them changed on the left side. I have only two implants retaining it. Is this common? It just wont snap securely into place and I can pop it out with my tongue. Once the right side was changed it’s been fine…..so far.

    Thanks for your help!
    Tina

    • Ramsey Amin DDS says:

      Hello Tina,

      The Dental implant abutment attachments should last 1-2 years on average. Have you found a solution to the problem yet?

      Ramsey Amin DDS

  17. Barb says:

    I am getting ready to have 2 implants my dentist said it takes 4 to 6 months to heal then I have to go back so they can be laser what us the purpose for this and I’m wondering if I should do more I don’t want them coming up while out in a restraunt eating

    • Ramsey Amin DDS says:

      Hello Barb,

      I am guessing that you are missing all the teeth on your lower jaw. A two implant over denture will definitely give your lower denture a more secure hold. Yes, the more dental implants you have, the more stable your overdenture on dental implants will be.

      You can also consider replacing all of your teeth to a fixed bridge if you desire.

      It sounds like your dentist is using a traditional, two-stage surgical approach. This means that here she is going to put the implants under the gums for 4-6 months. At the 4-6 month mark, the dentist will expose the implants and connect the abutments. Sometimes it is better to bury the implants under the gum line for healing and sometimes it is okay to leave them exposed in the mouth during the healing process. They can be exposed by traditional surgery, laser and/or other dental instrumentation.

      If the implants are in your lower jaw, typically I would let them heal for 2-3 months and then provide you with the lower over denture. 4-6 months is utilized more in the upper jaw than in the lower jaw.

      Good luck with everything. Let me know if you need any more help.

      Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, California

  18. Mona Edwards says:

    Hello Dr,
    I have a perm. Fixed denture on lower. It’s great! My problem is the top.
    I only had enough bone to put 4 implants in , two on each back side .
    After a couple months they had to change the connector ring? It only works for about 6 weeks and then my over denture falls out again.
    Is there a way to have a fixed upper? I want it like the lower. It feels real.
    I’m very disappointed with my upper. I’m in Dallas.

    • Ramsey Amin DDS says:

      Hi Mona,

      Four dental implants to support and upper overdenture or fixed bridge is unfortunately under engineered. 4 dental implants on the lower jaw can work very well…. The difference is in the bone. The upper jaw is very soft, while the lower jaw is very hard. This allows me to use less implants in the lower jaw than in the upper.

      From what it sounds like, I am guessing you have locator custom abutments. If these abutments were placed in a divergent manner, your dentist needs to correct the attachment by using the divergent attachments rather than the ones that are intended for straight (axial) implants. If you only have 4 implants on your upper jaw, I would suggest connecting them together with a bar to stabilize the bone so that you don’t lose your implants within 3-7 years.

      Keep in mind that bone can be rebuilt anywhere in your mouth. It is most common to do lateral window sinus bone graft in the upper jaw in order to build bone to have 6 or 8 implants. With proper implant position and location, your teeth will never fall out. Ideally, you can convert your current situation to a fixed monolithic zirconia, Prettau bridge or a porcelain fused to metal fixed restoration that never comes out. You will need some bone grafting in order to do this to add more implants.

      attached are some links that I would like you to review:




      I hope this helps

      Very respectfully

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, California

  19. Greg Gregory says:

    In your proffessional opinion is The Baylor School of Dentistry in Dallas, Texas a good place for a patient to go to and have a full set of dentures made. (Posts Included). Are 3M MDI better than Sendax MDI, in your opinion.

    • Ramsey Amin DDS says:

      Hello Greg,

      The two companies you mention I believe are now fused as one. The manufacturing giant, 3M, purchased IMTEC/Sendax.
      What you are speaking of arm mini dental implants. Mini dental implants are not real traditional implants. They are small, bend and break very easily. I would consider them temporary dental implants. Many inexperienced dentists use exclusively mini dental implants as a way to avoid opening your gums to place normal dental implants.

      I would suggest you have traditional diameter dental implants which will last you so many years. I just removed four more many dental implants just last week!

      Typically a dental school University can be a good place to have procedures if you have more time than money. Often what would take 1 hour and a traditional dental office may take 5-7 hours in a dental school. Total cost reduction is approximately 25% so it is really not that much cheaper. You can definitely have excellent work in a dental school with proper oversight by the instructor dentist. I speak from first-hand experience because I taught in a dental school for many years. Some students are definitely way better than others. Good luck, I’m sure it’ll all work out for you just do your due diligence.

      Very respectfully

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

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