Research Study Guide: Dental Implants vs Dentures Adoption Trends in the U.S. with Coastal North Carolina Insights

Dental implants (titanium posts anchoring replacement teeth) and traditional removable dentures (full or partial prostheses resting on gums) are the two leading tooth-replacement therapies.

Over the past decade, implants have grown from a niche to a major option in dentistry. Implants require surgery and cost more, but they preserve jawbone and often provide better function.

Dentures are less expensive and widely covered (e.g. by Medicaid in many states), but can be uncomfortable, less stable, and lead to bone loss.

This report compares recent U.S. adoption patterns for dental implants vs dentures statistics (especially over 2018–2023), examines the demographics of users of each, and focuses specifically on the Coastal North Carolina region (Wilmington/New Bern/Jacksonville). It also reviews cost differences, patient satisfaction, and clinical outcomes for implants versus dentures, based on peer-reviewed and official sources.

National Adoption Trends

• Implant usage has surged. Analysis of US health surveys (NHANES) shows implant prevalence among adults with missing teeth jumped dramatically. A study reports that only 0.7% of missing-tooth adults had any implant in 1999–2000, rising to 5.7% by 2015–2016. This corresponds to an average growth of ~14% per year in implant prevalence. The fastest growth was in middle-aged adults: e.g. implant use among 65–74 year-olds climbed by 12.9 percentage points (from 1.3% to 14.2% prevalence). Projections suggest that if trends continue, by 2026 up to ~23% of adults with missing teeth could have implants. According to the American Dental Association, around 5 million dental implants are annually implanted in the U.S. Overall, implant dentistry is a rapidly expanding segment of dental practice.
• Denture use remains widespread but relatively stable. Nearly half of Americans have lost at least one permanent tooth. One industry analysis notes ~120 million Americans missing ≥1 tooth. By contrast, the share who are completely edentulous has been steadily declining with better dental care and fluoride use. CDC data (2015–2018) show about 13% of seniors (65+) had lost all natural teeth – down from much higher rates in past decades. Thus, the potential pool of denture candidates is large but aging. According to a market report, the U.S. dentures market was about $703 million in 2022 and is expected to grow modestly (~6.5% CAGR) with the elderly population. Recent trends include increased use of digital/fabricated dentures, but overall denture prevalence largely follows the size and oral health of the senior population. As tooth retention improves, new denture demand rises slowly.

Explore your options for a healthier smile in Wilmington NC. Book an appointment now to compare dental implants and dentures.

Demographic Profiles of Users

• Age: Implant patients skew older but not extremely so. Use rises sharply after middle age. In 2015–16, implant prevalence was highest in ages 65–74 (≈14.2% of those missing teeth) and still high in 75+. (Younger adults rarely get implants unless for congenital or trauma reasons.) By contrast, denture users are overwhelmingly seniors: complete dentures are mainly for those 65+, with edentulism rates ~17.8% at age 75+. In short, both treatments target older patients, but dentures remain most common among the very old and frail, whereas implants increasingly serve healthy retirees.
• Income and Education: Implants tend to be chosen by higher-income, better-educated patients. National survey analysis shows private (vs. no) insurance and college education each roughly doubled the odds of having an implant. In a multivariable model, having a bachelor’s degree (vs. high school only) had OR ≈1.9 for implant use, and private insurance had OR ≈2.0. By comparison, lower-income or uninsured adults almost never receive implants. Denture use skews opposite: lower-education and lower-income groups have much higher rates of tooth loss. For example, among U.S. adults 65+, complete edentulism was 31.9% in those without a high school diploma vs. only 9.5% in those with more education. Minority and lower-income seniors thus form the bulk of denture wearers. (In NC’s Medicaid program, adults get denture coverage, which also directs dentures toward low-income patients.)
• Insurance Coverage: Most dental insurance (including Medicare) does not fully cover implants. Almost all implant costs are out-of-pocket, so private-pay patients dominate. Conversely, dentures are often covered by public programs for seniors and disabled. In North Carolina (and many states), Medicaid’s adult dental benefit is “extensive” and explicitly covers dentures with no annual cap. As a result, low-income seniors can obtain dentures via Medicaid, whereas implants generally require self-pay or high-end plans. This insurance gap contributes to demographic differences: implant recipients are disproportionately those with supplemental dental benefits or wealth.
• Summary of User Profiles: In summary, dental implant patients tend to be middle-aged to senior adults who are more affluent, better educated, and privately insured. Denture patients tend to be older seniors, often with lower incomes or relying on Medicaid, and with lower formal education. Implants have not penetrated disadvantaged or very elderly groups to the same extent, so disparities persist.

Not sure whether to choose dental implants or dentures? Schedule your consultation today and get personalized advice for your smile.

Coastal North Carolina Context

Coastal North Carolina (including Wilmington/New Hanover, New Bern/Craven, Jacksonville/Onslow and nearby counties) has unique demographics. Many coastal areas have a large retiree population and relatively higher incomes, but also pockets of poverty in rural towns.

For example, New Hanover County (Wilmington) has median age ~39.2 and high per-capita income (~$47.9k), indicating an older, affluent community. Neighboring Brunswick County is even older (median age ~57.6) and relatively well-off (median household ~$76k). In contrast, Onslow County (Jacksonville) has a very young median age (≈27) and lower per-capita income (~$31k) due to the military bases. Educational attainment is high in Wilmington (≈47% bachelor’s degree) and moderate in Brunswick (≈35% BA), but only ~26% in Onslow.

These demographics suggest that Coastal NC likely follows national patterns: the older, more affluent subregions (Wilmington, Brunswick) would have relatively high demand for implants, while younger/poorer areas (Jacksonville, rural outskirts) might rely more on traditional dentures.

Local dental practices report seeing many retirees and “snowbirds” requesting implants and implant-supported dentures. At the same time, public clinics in poorer towns likely serve dentures to Medicaid-eligible seniors.

Precise regional statistics are scarce, but the combination of an aging beachfront population and available Medicaid benefits (NC covers dentures fully) means Coastal NC should exhibit both a robust implant market and a significant denture-using population. In practice, one would expect higher implant uptake in New Hanover/Brunswick than in Onslow/Pender.

Cost Comparison

Cost is a major factor in treatment choice.

 

• Implants: The out-of-pocket cost is high. A single tooth implant (surgery + crown) typically costs $3,000–$7,000 or more. Multi-tooth or full-arch implant restorations multiply that cost. For example, an implant-supported bridge or all-on-four denture can easily exceed $15,000–$20,000 per arch. Even partial implant overdentures (with two implants) often run into the $10,000+ Because implants are elective and often not covered, most patients must finance these large costs.
• Dentures: Traditional dentures are far less expensive. Entry-level acrylic dentures can cost only $300–$500 per arch (i.e. $600–$1,000 for a full upper+lower set). A reasonable mid-range complete denture is around $1,000–$3,000 for a full set. Premium or precision dentures can exceed $4,000–$8,000 per arch, but many providers and insurance plans offer mid-range dentures in the $1–3k range. Importantly, dentures are often covered (or partially covered) by insurance: Medicare Advantage and Medicaid programs typically include at least a portion of denture cost, and private dental plans often include dentures with annual limits. In North Carolina, Medicaid covers dentures without an annual cap.
• Comparison: In short, a standard full denture set typically costs under $1,000 out-of-pocket for a budget patient, whereas a single implant starts at ~$3,000. Thus, implants can be an order of magnitude more expensive than dentures. Even implant-supported dentures (which use multiple implants) are usually much costlier than a conventional denture. This cost gap is the chief barrier to implants for many patients. Dentures, by contrast, remain the economical solution for patients on limited incomes or with generous dental coverage.

Patient Satisfaction & Clinical Outcomes

• Patient Satisfaction: Almost all studies show higher satisfaction with implants than with conventional dentures. In trials comparing implant-supported overdentures to regular dentures, implant patients report far better outcomes in comfort, stability, and chewing ability. For example, one cohort study found significantly higher satisfaction scores for implant overdentures versus conventional dentures, with patients rating comfort and chewing efficiency much higher under implants. A systematic review similarly concluded that implant-retained removable prostheses “significantly improved patients’ overall quality of life and satisfaction” compared to conventional dentures. In practical terms, a much larger proportion of implant patients say they are “very satisfied” with their prosthesis than denture wearers. (By contrast, many conventional-denture wearers report issues: poor fit, sore spots, and difficulty eating.) Thus, dental implants – especially implant-supported dentures – consistently yield superior patient-reported outcomes.
• Oral Function: Implants also restore chewing function closer to natural teeth. Conventional dentures only allow 20-40% of normal bite force, whereas implants (even implant dentures) can double or triple that force. Patients can eat a wider diet (nuts, steak, etc.) with implants. Many studies use masticatory performance tests to confirm that implant patients chew hard foods more effectively. Improved nutrition and speech clarity often result.
• Clinical Outcomes and Longevity: Dental implants have high survival rates. Modern implants placed under good conditions show roughly 90–95% survival at 5–10 years. For example, a large retrospective series reported cumulative implant survival of 98.4% at 1 year, 95.7% at 3 years, and 91.8% at 5 years. Well-treated implants can last decades if maintained. By contrast, dentures are not measured by “implant survival” but by how long the prosthesis remains serviceable. A recent clinic study found about 92% of complete dentures remained in use at 5 years without needing replacement. (“Immediate” dentures placed same-day after extractions fared worse, with higher remake rates.) In practice, dentures typically require periodic relines or remakes as jawbones resorb and wear accumulates, often every 5–8 years.
• Bone and Tissue Health: Implants tend to preserve jawbone. Because implants transmit bite forces to the bone, they help maintain bone volume under the prosthesis. Dentures, however, bear on the gums and accelerate alveolar ridge resorption, especially in the posterior jaw. Research shows that mandibular overdentures supported by four implants cause significantly less posterior bone loss than conventional dentures. (Even two-implant overdentures are better than no implants, but four or more implants preserve bone best.) Dentures without implants offer no bone stimulation, so residual ridges shrink over time – leading to poorer fit and the need for relining.
• Complications: Both treatments have potential downsides. Implant complications include infection (peri-implantitis), prosthetic screw loosening, and surgical risks. Implant-supported dentures also require maintenance (e.g. replacing attachment clips). Conventional dentures cause pressure sores, sore gums, and difficulty chewing if ill-fitting. Many denture wearers use adhesives or avoid hard foods. Overall, implant complications are less common than the chronic issues faced by denture wearers, but implants require surgical expertise and patient commitment to hygiene and follow-up.

Take the first step toward a confident, lasting smile. Schedule your appointment today and discover if implants or dentures are best for you.

Summary of Key Points

• Trend: Implant use has grown rapidly in the U.S. over the past 20 years, and continues rising. Denture use reflects the large elderly population; the denture market remains sizable ($703 M in 2022) but growing slowly.
• Users: Implant patients are generally older adults with higher income/education and private insurance. Denture patients are mostly seniors (especially the very old) often with lower socioeconomic status; e.g. edentulism is much higher among less-educated, low-income seniors.
• Regional: Coastal NC’s demographics (retiree population and Medicaid coverage) suggest a mixed picture: affluent coastal retirees likely choose implants, while low-income seniors rely on dentures (which NC Medicaid covers).
• Cost: Dentures cost a few hundred to a few thousand dollars (often covered by insurance). Implants cost several thousand per tooth, so full-arch implant solutions cost tens of thousands. High cost and limited coverage are major barriers to implant adoption.
• Satisfaction & Outcomes: Implant-supported prostheses consistently provide higher patient satisfaction, better chewing function, and better oral health outcomes than conventional dentures. Implants show ~90+% 5-year survival and preserve jawbone, whereas dentures require frequent adjustments and cause bone loss over time.

In conclusion, dental implants are increasingly popular in the U.S., especially among well-insured older adults, while traditional dentures remain the standard solution for lower-income seniors. Coastal North Carolina’s aging and mixed-income population likely reflects both trends: a growing implant market alongside continued reliance on dentures supported by public dental benefits. Dental professionals in this region should be aware of these patterns to tailor treatment planning, patient education, and resource allocation.

References:

• Elani HW, Starr JR, Da Silva JD, Gallucci GO. Trends in Dental Implant Use in the U.S., 1999–2016, and Projections to 2026. J Dent Res. 2018;97(13):1466–1471.
• CDC/NCHS. Prevalence of Severe Tooth Loss in Adults: United States, 2015–2018. NCHS Data Brief 368, Feb 2020.
• GoodRx Research. “How Much Do Dental Implants Cost?” 2024 (online article).
• KWC Dental. “Denture Cost Breakdown: Factors to Consider”. KWC Dental Blog, Dec 14 2023.
• Rajput M, Kumar A et al. Patient-Reported Satisfaction and Functional Outcomes with Implant-Supported Overdentures versus Conventional Dentures. J Pharm Pharmacol Sci. 2025;17(5):1205–1214.
• Guéye M, Mbodj EB, Le Guéhennec L. Implant-Supported Removable Partial Dentures vs. Conventional: A Meta-Analysis of QoL and Satisfaction. Clin Exp Dent Res. 2022;8(1):28–36.
• D’Souza NL, Vasconcelos A, et al. Postinsertion Adjustments and 5-Year Survival of Conventional vs. Immediate Complete Dentures. J Prosthet Dent. 2025;134(4):1207.e1–1207.e8.
• Ludwig HC, Neiss A, et al. Bone Changes with Different Prosthetic Treatments in the Edentulous Mandible. Int J Prosthodont. 2023;36(4):330–338.
• S. Dentures Market Size, Share & COVID-19 Impact Analysis (Fortune Business Insights). 2025.
• Medicaid Coverage of Dental Benefits for Adults: Appendix. 2019 (reports North Carolina covers dentures).
• S. Census Bureau, American Community Survey 2023 (county-level demographic data for NC, via Census Reporter).