Reasons for Jawbone Loss and Deterioration
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, (ie: 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. Also, bone is often lost at the time of tooth removal.
The rate of bone deterioration/bone loss that occurs varies greatly among individuals. Bone loss is most significant six months following the extraction, and continues throughout life.
Unanchored dentures are placed on top of the gum line, and therefore do not provide any direct stimulation to the underlying alveolar bone. Over time, the lack of stimulation causes the bone to resorb and deteriorate because dentures rely 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.
Periodontal disease is a chronic infection of the gums and bone that gradually destroy the support of your natural teeth. Periodontal disease affects one or more of the periodontal tissues: 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. Gingivitis, the less serious of the diseases, may never progress into periodontitis.
Dental plaque is the primary cause of gingivitis. 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 that irritate the gums. The gingiba may become inflamed, red, swollen, and bleed easily. If this irritation is prolonged, bone loss occurs. If daily brushing and flossing is neglected or inadequate, 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 can lead to loosening and subsequent loss of teeth.
In regards to fixed bridges, 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.
Jaw trauma that include teeth that are knocked out and jaw fractures, may lead to bone loss years after the initial trauma as well as bone loss from the actual accident.
Osteomyelitis is a type of bacterial infection in the bone and bone marrow of the jaw. Treatment for osteomyelitis generally requires antibiotics and removal of the affected bone.
Benign facial tumors, may become large and require significant removal of part of the jaw. Malignant mouth tumors almost always spread into the jaw, requiring removal of a section of the jaw.