Reasons for Jawbone Loss and Deterioration
The following are the most common causes for jawbone deterioration and loss that may require a bone grafting procedure:
When an adult tooth is removed and not replaced, jawbone deterioration may occur. Natural teeth are embedded in the jawbone and stimulate the jawbone through activities such as chewing and biting. When teeth are missing, the alveolar bone, or the portion of the jawbone that anchors the teeth in the mouth, no longer receives the necessary stimulation and begins to break down, or resorb. The body no longer uses or “needs” the jawbone, so it deteriorates and goes away.
The rate at which the bone deteriorates, as well as the amount of bone loss that occurs, varies greatly among individuals. However, most loss occurs within the first eighteen months following the extraction, and continues throughout life.
Periodontal diseases are ongoing infections of the gums that gradually destroy the support around your natural teeth. Periodontal disease affects one or more of the periodontal tissues: alveolar bone, periodontal ligament, cementum, or gingiva. While there are many diseases which affect the tooth-supporting structures, plaque-induced inflammatory lesions make up the majority of periodontal issues and are divided into two categories: gingivitis and periodontitis. While gingivitis, the less serious of the diseases, may never progress into periodontitis, it always precedes periodontitis.
Dental plaque is the primary cause of gingivitis in genetically-susceptible individuals. Plaque is a sticky, colorless film, composed primarily of food particles and various types of bacteria, which adhere to your teeth at and below the gum line. Plaque constantly forms on your teeth, even minutes after cleaning. Bacteria found in plaque produce toxins or poisons that irritate the gums. Gums may become inflamed, red, swollen, and bleed easily. If this irritation is prolonged, the gums separate from the teeth causing pockets (spaces) to form. If daily brushing and flossing is neglected, plaque can also harden into a rough, porous substance known as calculus (or tartar). This can occur both above and below the gum line.
Periodontitis is affected by bacteria that adhere to the tooth’s surface, along with an overly aggressive immune response to these bacteria. If gingivitis progresses into periodontitis, the supporting gum tissue and bone that holds teeth in place deteriorates. The progressive loss of this bone, the alveolar bone, can lead to loosening and subsequent loss of teeth.
Unanchored dentures are placed on top of the gum tissue and therefore do not provide any direct positive stimulation to the underlying alveolar bone. Over time, the lack of stimulation and potentially negative force associated with dentures causes the bone to resorb and deteriorate. Because this type of denture relies on the bone to hold them in place, people often experience loosening of their dentures and problems eating and speaking. Eventually, bone loss may become so severe that dentures cannot be held in place even with strong adhesives, and a new set may be required. Proper denture care, repair, and refitting are essential to maintaining oral health.
Some dentures are supported by anchors, such as dental implants, which do help adequately stimulate, and therefore preserve bone.
With bridgework, the teeth on either side of the appliance provide sufficient stimulation to the bone, but the portion of the bridge that spans the gap where the teeth are missing receives no direct stimulation. Bone loss can occur in this area.
When a tooth is knocked out or severely broken, bone stimulation stops, resulting in jaw bone loss. Some common forms of tooth and jaw trauma include: teeth knocked out from injury or accident, jaw fractures, or teeth with a history of trauma that may die and lead to bone loss years after the initial trauma.
A bone grafting procedure would be necessary to reverse the effects of bone deterioration, restoring function and promoting new bone growth in traumatized areas.
Misalignment issues can create a situation in the mouth where some teeth no longer have an opposing tooth. The unopposed tooth can over-erupt, causing deterioration of the underlying bone.
Issues such as TMJ problems, normal wear-and-tear, and lack of treatment can also create abnormal physical forces that interfere with the teeth’s ability to grind and chew properly. Over time, bone deterioration can occur where bone is losing stimulation.
When molar teeth are removed from the upper jaw, the sinus can expand into the space where the tooth used to be, causing resorption of the bone that formerly held the teeth in place. As a result, the sinuses become enlarged, or pneumatized.
This condition usually develops over several years, and may result in insufficient bone for the placement of dental implants. Drs. Hyde, Greising and Tzanos can perform a procedure called a “sinus lift” that can treat enlarged sinuses.