In my last article the importance of bone, suction and seal with regards to denture retention/fit were discussed. This time I promised to help you with the decision of when (if needed), to remove your compromised teeth and replace them with implants and dentures. When teeth are removed the bone around the necks of those removed teeth shrinks with healing. This process occurs over four to six months. Almost always a denture is placed immediately after the teeth are removed. Then in 4-6 months the denture is relined to fit the then healed ridge. If a person has periodontal (gum) disease throughout their mouth, tooth loss is inevitable. Generalized severe periodontal disease is if you have many 7milimeter or greater pocket depths, (the depth a small probe can be place alongside a tooth and down beneath the gum line until the attachment of the gums to the tooth root occurs), with greater than 50% bone loss. If tooth removal is postponed, the bone loss continues due to inflammation. Usually your dentist will tell you if this is your situation. For various reasons which can be financial, psychological, time, fear, etc. patients put off the removal of the diseased teeth then more bone loss occurs. When the inevitable occurs and teeth are replaced with dentures there is very little bone left and even less after healing to hold a denture in place. There may not be enough bone to hold implants in to retain the denture if the bone loss is great enough. The bottom line is to keep your teeth and gums healthy. If things are bad, do something now and don’t procrastinate or you can wind up in a terribly difficult situation. Grafting is done if you want to use a rib or the crest of your pelvis or cadaver bone. It’s expensive and painful.