CAUSes of Jaw Bone Loss and Deterioration
The following are the most common causes for jaw bone deterioration and loss that may require a bone grafting procedure.
When an adult tooth is removed and not replaced jaw bone deterioration may occur. Natural teeth are embedded in the jaw bone and stimulate the jaw bone through activities such as chewing and biting. When teeth are missing, the alveolar bone, or the portion of the jaw bone 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 jaw bone, so it deteriorates and goes away.
The rate that 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 will continue gradually throughout your life.
Dental plaque is a sticky colorless film, composed primarily of food particles and various types of bacteria, that adheres 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. This condition is called gingivitis. If daily brushing and flossing is neglected, plaque can harden into a rough, porous substance known as calculus (or tartar). This can occur both above and below the gum line. Calculus is calcified plaque that can only be removed by your dentist or hygienist at a dental cleaning appointment.
If irritation of the gums by the bacteria in plaque and/or calculus is prolonged, the gums will separate from the teeth causing pockets (spaces) to form. This condition is called periodontal disease. This is due to the destruction of the supporting tissue around your teeth: alveolar bone, periodontal ligament, cementum, and gums. As the supporting gum tissue and alveolar bone that hold teeth in place deteriorates, the teeth become loose and subsequently need to be removed.
Unanchored (conventional) dentures are placed on top of the gum line, but they 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 with eating and speaking. Eventually, bone loss may become so severe that the dentures cannot be held in place with strong adhesives, and a new set of dentures may be required. Proper denture care, repair, and refitting are essential to maintaining oral health.
With bridgework, in the area of the missing teeth there is no direct stimulation to the bone. Thus, bone loss can occur in this area which results in a space opening up between the gums and the bridge.
Trauma to the teeth and bone can cause tooth loss and jaw bone fracture, which may result in bone loss and deterioration.
A tooth infection is a common reason for bone deterioration around a tooth. In this situation, a bone graft is almost always required if a patient wants to replace the tooth with a dental implant.
Tumors and CYsts
Benign facial tumors and cysts, though generally non-threatening, may grow large and require the removal of a portion of the jaw. Reconstructive bone grafting is usually required to help restore normal function to the jaw.
When molar teeth are removed from the upper jaw, the maxillary sinus above these teeth can gradually enlarge and cause deterioration of the alveolar bone. As the sinus enlarges, the thickness of the alveolar bone shrinks. This condition is called hyperpneumatized sinus.
This condition usually develops over several years and may result in insufficient bone for the placement of dental implants. A “sinus lift” surgery can be performed by placing a bone graft in the sinus to regrow the bone back.