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Jaw Bone Loss and Deterioration


There are a variety of causes for jaw bone loss and deterioration, and these issues will likely require bone grafting in order to correct the problem:

Tooth Extractions

After an adult tooth has been removed, deterioration of the jaw bone could occur. When natural teeth are situated in the jaw bone, they work to stimulate the bone when engaged in biting and chewing. When the teeth are removed, the portion of the bone that anchors the teeth into the mouth, known as the alveolar bone, will no longer receive the stimulation it needs. The bone will then start to break down since the body no longer "needs" it.

The amount of bone that deteriorates and how quickly it occurs will vary depending on your individual situation. Most bone loss will occur in the first 18 months after the extraction, however, it will continue throughout your life unless preventative measures are taken.

Gum Disease

Gum or periodontal disease is an ongoing infection of the gums, and it will slowly destroy the supporting structures of your teeth. Gum disease will affect the periodontal tissues, including the gingiva, cementum, periodontal ligament, and alveolar bone. While there are numerous diseases that could affect the structures that support the teeth, inflammatory lesions caused by plaque buildup make up most periodontal issues, and they are divided into two main categories: gingivitis and periodontitis. Gingivitis is the less serious of the two and can be reversed, but left untreated, it can result in periodontitis.

Gingivitis is typically caused by dental plaque, which is a colorless and sticky film that is composed of bacteria and food particles. This film will adhere to the teeth at and below the gum line, and it will start forming even minutes after you brush. Toxins are caused by bacteria found in the plaque, and they irritate the gums, causing them to become red and inflamed. If this irritation is allowed to progress, the gums can begin to pull away from the teeth to form pockets. Further neglecting your oral hygiene can cause the plaque to harden into a substance known as tartar, which can only be removed with the specialized tools found in your dentist's office.

The more serious form of gum disease, periodontitis, will be affected by the bacteria that stick to the surface of the teeth along with an aggressive immune system response to the bacteria. If gingivitis is allowed to progress into periodontitis, you will experience deterioration of both the gum tissue and the jaw bone that works to hold the teeth in their proper place. If this bone loss continues, the teeth can begin to loosen and fall out.

Dentures and Bridgework

Dentures that are unanchored will be placed onto the top of the gum line, so they aren't going to provide any stimulation to the underlying jaw bone. With time, this lack of stimulation will lead to deterioration of that bone. Because this form of denture will rely on the bone to hold the dentures in place, people typically experience loosening of the dentures and problems with speaking and eating. Eventually, the loss of bone could become so severe that the dentures can't be held in place even with extremely strong adhesives, and a new set of dentures could be required. Proper care, refitting, and repair of your dentures will also be needed to maintain your positive oral health.

Some types of dentures will be supported by implants or anchors, and they are able to adequately stimulate the bone, allowing more of the bone to be preserved than with traditional dentures.

With bridges, the teeth on each side of the appliance will be used to provide stimulation to the jaw bone. However, the portion of the dental bridge that crosses the gap of missing teeth won't receive direct stimulation, so bone loss could occur in that area. Bone grafting will be able to restore the growth and function of the bone, halting the negative and damaging effects of poor denture care.

Trauma and Injury

If a tooth is broken or knocked out to the point where it is completely removed from the mouth, bone stimulation will stop. Again, this can lead to bone loss. The most common types of trauma that result in this devastating effect include accidents, jaw fractures, and teeth that have a history of trauma that could die later on.

Bone grafting may be needed to reverse the negative effects of bone deterioration, resulting in restored function and the promotion of new bone growth at the traumatized area.

Misalignment

Misalignment of teeth can lead to a situation where some of the teeth are crooked or improperly aligned with the rest of the arch. If a tooth over-erupts, deterioration of the underlying bone could result. Other issues like TMJ problems and normal wear and tear can also result in abnormal physical forces that can affect the teeth’s ability to chew properly and grind together, and over time, deterioration may result if the bone has lost stimulation.

Osteomyelitis

A bacterial infection known as osteomyelitis can sometimes affect the bone and marrow of the jaw. This infection will result in inflammation that can reduce the blood supply of the bone. Treatment for this infection will generally require the use of antibiotics, and in many cases, the affected bone will need to be removed. In the most serious of cases, a bone graft could be required in order to fully restore the growth and function of the bone that was lost during removal.

Tumors

Although benign facial tumors are not usually threatening, they can sometimes grow large enough that they might require removal of some of the jaw. Malignant tumors of the mouth will typically always spread into the jaw, which can also require removal of a portion. In either case, reconstructive bone grafting will usually be needed in order to restore the jaw function. It can be more difficult to perform a grafting procedure if malignant tumors are present because treating a cancerous tumor will usually involve removing all of the soft tissue surrounding the area as well.

Developmental Deformities

Certain birth defects may be characterized by missing portions of the facial bones, skull, jaw, or teeth. Our surgeons can perform the bone grafts needed to restore the bone’s original function, and this can promote growth where it may have otherwise been absent.

Sinus Deficiencies

When the molars are extracted from the upper jaw it may result in air pressure from the maxilla air cavity that can cause re-absorption of the bone that previously held the teeth in place. This can result in hyperpneumatized sinuses, or an enlargement of the sinus cavity. The condition will likely develop over the course of several years and can lead to insufficient bone for placing dental implants. Our oral surgeons can perform a sinus lift procedure that will treat your enlarged sinuses.

Scott M. Redlinger, DMD, MD

(775) 430-5355