Debra, If you're a gagger, the key for you is going to be a design that leaves the roof of your mouth uncovered. There are a few ways of doing this, some removable and some fixed. Removable:-Implants with "snaps" on them and a denture without a palate that can snap in and out. These are very sturdy, excellent restorations, and I recommend having a metal framework included in the denture to make it strong enough and also thin enough to last a long time but also minimize material in your mouth. Depending on the size and position of the implants, you will likely need 4-6 implants to accomplish this. The snap in design uses the implants to keep the denture very stable and it helps increase your biting forces dramatically. -Mini implants will be the cheapest, but also probably the plan with the shortest life span prognosis. You will need at least 6 mini implants to support this design.-Standard size implants will likely last longer and be a safer design, so go this route if possible. 4-6 implants are required, but when going palate-less I always prefer 5 or 6. -CONUS abutment dentures. This is very similar to the "snap" or "Locator" denture mentioned above, but it's a little higher end. The CONUS abutments are quite new, but they are metal cylinders that stick out of the gums, instead of the snaps, that the denture will slide over to secure in place. Because these are such a precise fit, the force of biting that you achieve with this design is much more like a "fixed" option such as having crowns and bridges or a hybrid denture that screws into place and cannot be removed from the mouth. The CONUS abutments can be pricey (probably around $1000/abutment, and you'll need one per implant (~$2000/implant) and you'll still need at least 4 implants. Again, this would be a metal sub-structure design with no palate to help avoid the gag issue and add strength to the design.-Fixed options will include: -Implants placed at positions where natural teeth used to be and restoring you with bridges to essentially give you a natural arch of teeth again. This will require at least 6 implants, as implant bridges shouldn't replace more than about 3-4 teeth for every 2 implants. This is generally the most costly option, as it requires the most implants, the most custom abutments, and individual crowns everywhere.-Hybrid denture: this can be done with as few as 4 implants, but again, I always recommend 5 or 6 if possible, as if you ever lose an implant for any reason in the future, the hybrid denture usually cannot work with only 3 implants. This option replaces the full arch of teeth with one piece that looks like teeth and gums and screws into the implants. As the patient, you cannot remove it, but your dentist can. This is a very popular option that can have a range of costs depending on procedures required: removal of bone, how many implants, and the material of the final prosthesis. Cheapest is acrylic (which should only be used as a temporary in my opinion, acrylic over Titanium substructure (very common, but acrylic breakages are a frequent complication), and full contour zirconia which cannot chip or stain and is my personal recommendation. What's really nice about a hybrid restoration is that you can often have the implants placed and a provisional restoration (full arch of teeth) attached the very same day which makes for a dramatic and wonderful improvement in one sitting. Depending on where you are geographically and what level of practice you go to, I'd expect the above restorations to range anywhere from 10K-35K.Best of luck, and if you can do anything to avoid the mini-implant option, I would recommend it. A few dollars saved in the front end may cost you dearly in the long run if you have to replace those implants down the road.
