Jawbone Loss and Deterioration

Tooth Extractions: When an adult tooth is removed and not replaced, the jawbone may begin to deteriorate. Natural teeth are embedded in the jawbone and stimulate it through chewing and biting. Without teeth, the alveolar bone, which anchors the teeth, lacks stimulation and begins to resorb. This process leads to jawbone loss.

The rate and extent of bone loss can vary among individuals. However, most bone loss occurs within the first 18 months after tooth extraction and can continue throughout life.

Periodontal Disease: Periodontal diseases are ongoing infections of the gums that gradually destroy the support of natural teeth. These diseases affect one or more periodontal tissues, such as alveolar bone, periodontal ligament, cementum, or gingiva. Plaque-induced inflammatory lesions make up the majority of periodontal issues and are divided into two categories: gingivitis and periodontitis. Gingivitis, a less serious condition, can precede 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 bacteria that adhere to the teeth at and below the gum line. If left untreated, plaque hardens into tartar and can lead to periodontitis.

Periodontitis involves the loss of supporting gum tissue and bone that holds teeth in place. The progressive loss of alveolar bone can lead to loosening and eventual loss of teeth.

Dentures/Bridgework: Unanchored dentures placed on top of the gum line do not provide stimulation to the alveolar bone. Over time, this lack of stimulation causes bone resorption and deterioration. This can result in loose dentures, difficulty eating and speaking, and eventually an inability to secure dentures.

Trauma: Trauma can result from a knocked-out tooth, jaw fractures, or previous injuries. Without a biting surface below the gum line, bone stimulation stops, leading to jawbone loss.

Misalignment: Misalignment issues can cause certain teeth to lose their opposing tooth structure, leading to over-eruption and underlying bone deterioration.

Osteomyelitis: Osteomyelitis is a bacterial infection in the bone and bone marrow of the jaw. It causes inflammation and reduced blood supply to the bone, requiring antibiotics and potentially bone removal.

Tumors: Benign or malignant tumors in the mouth can grow large and may require removal of a portion of the jaw, potentially necessitating bone grafting.

Developmental Deformities: Birth defects characterized by missing teeth, facial bones, or jaw may require bone grafting to restore function.

Sinus Deficiencies: When upper molars are removed, air pressure from the maxillary sinus may cause bone resorption, leading to hyperneumatized sinus.

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