Reasons for 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:

Tooth Extractions

When an adult tooth is removed and not replaced, jaw bone deterioration will 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 (tooth socket), 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.

Periodontal Disease

Periodontal disease is an infection of the gums that gradually destroy the support of your natural teeth. Periodontal disease affects the periodontal tissues: alveolar (jaw) bone, periodontal ligament, and gingiva (gums).  Periodontal disease (plaque-induced inflammation) is divided into two categories: gingivitis (inflammation of just the gums) and periodontitis (inflammation that has also caused bone loss). While gingivitis, the less serious of the diseases, may never progress into periodontitis, it always precedes 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, 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 produces toxins, or poisons, that irritate the gums. Gums may become inflamed, red, swollen, and bleed easily. If this irritation is prolonged, the gums will separate from the teeth causing pockets (spaces) to form. If daily brushing and flossing is neglected, plaque can develop into a rough, hard substance known as calculus (or tartar). This can occur both above and below the gum line.

If gingivitis progresses into periodontitis, the supporting gum tissue and bone that hold teeth in place deteriorates. The progressive loss of bone can lead to the loosening and subsequent loss of teeth.

Dentures/Bridgework

Unanchored dentures are placed on top of the gums, 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 eating and speaking. Eventually, bone loss may become so severe that dentures cannot be held in place with adhesives, and a new set of dentures may be required. Proper denture care, repair, and refitting are essential to maintaining oral health.  Some dentures are supported by implants, which do help adequately stimulate and therefore preserve bone.

With bridgework, the teeth on either side of the bridge provide sufficient stimulation to the bone, but the portion under the bridge that spans the gap, where the teeth are missing, receives no direct stimulation. Bone loss will occur in this area.

Trauma

Some common forms of tooth and jaw trauma include: teeth knocked out from injury or accident, jaw fractures, or teeth with a history of trauma that may die and lead to bone loss years after the initial trauma.

A bone grafting procedure would be necessary to reverse the effects of bone deterioration, restoring function and promoting new bone growth in traumatized areas.

Osteomyelitis

Osteomyelitis is a type of bacterial infection in the bone and bone marrow of the jaw. This infection leads to inflammation, which can cause loss of the bone. Treatment for osteomyelitis generally requires antibiotics and the removal of the affected bone.

Tumors

Benign facial tumors, though generally non-threatening, may grow large and require the removal of a portion of the jaw. Malignant mouth tumors almost always spread into the jaw, requiring the removal of the affected section of the jaw. In both cases, reconstructive bone grafting is usually required to help restore normal function to the jaw. Grafting in patients with malignant tumors may be more challenging because treatment of the cancerous tumor generally requires removal of the surrounding soft tissues as well.

Developmental Deformities

Some conditions or syndromes are characterized by missing teeth or portions of the jaws.

Sinus Deficiencies

When molars are removed from the upper jaw, air pressure from the maxillary sinus causes resorption of the bone that formerly helped keep the teeth in place. As a result, the sinuses become enlarged, a condition called pneumatized sinus.

This condition usually develops over several years and may result in insufficient bone from the placement of dental implants. Dr. Parmer and Dr. Macholl can perform a procedure called a “sinus lift” that can treat enlarged sinuses.