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 the bone deteriorates, as well as the amount of bone loss that occurs, varies greatly among individuals and tooth location in the mouth. However, most loss occurs within the first eighteen months following the extraction, and continues throughout life.
Periodontal diseases are ongoing infections of the gums and bone that gradually destroy the support of your natural teeth. 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 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 deep pockets to form. If daily brushing and flossing are 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, can lead to loosening and subsequent loss of teeth.
Unanchored dentures are placed on top of the gums, 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 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 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.
If the dental infection reaches the nerve space inside the tooth, the nerve can die and cause infection in the bone around the tooth.
When a tooth is knocked out or broken damage to surrounding jawbone can occur. This injury can result in jawbone loss and infection.
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 structure. 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.
Some conditions or syndromes known as birth defects are characterized by missing portions of the teeth, facial bones, jaw or skull. Dr. Filippi may be able to perform a bone graft procedure to restore bone function and growth where it may be absent.
When molars are removed from the upper jaw, air pressure from the air cavity in the maxilla (maxillary sinus), causes resorption of the bone that formerly helped the teeth in place. As a result, the sinuses become enlarged, a condition called hyperneumatized sinus.
This condition usually develops over several years, and may result in insufficient bone for the placement of dental implants. Dr. Filippi can perform a procedure called a “sinus lift” that can treat enlarged sinuses.