Reasons for Jaw Bone Loss and Deterioration

The following are the most common causes for jawbone deterioration and loss that may require a bone grafting procedure:

Tooth Extractions

When an adult tooth is removed and not replaced, the jawbone may deteriorate. 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 at which the bone deteriorates and the amount of bone loss vary greatly among individuals. However, most of the loss occurs within the first 18 months following extraction and continues throughout life.

Periodontal Disease

Periodontal diseases are ongoing infections of the gums that gradually destroy the support of your natural teeth. Periodontal disease affects one or more of the periodontal tissues: alveolar bone, periodontal ligament, cementum, or gingiva. While many diseases affect the tooth-supporting structures, plaque-induced inflammatory lesions account for 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 always 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 that adhere to your teeth at and below the gum line. Plaque constantly forms on your teeth, even minutes after cleaning. Bacteria in plaque produce toxins 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 pockets (spaces) 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 hold teeth in place deteriorate. The progressive loss of this bone, the alveolar, can lead to loosening and subsequent loss of teeth.

Dentures/Bridgework

Unanchored 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 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 anchors, 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.
By performing a bone graft procedure, Dr. Barack or Dr. Gupta can restore bone function and growth, thereby halting the effects of poor denture care.

Facial Trauma

When a tooth is knocked out or broken to the extent that no biting surface is left below the gum line, bone stimulation stops, which results in jawbone loss. 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 bone deterioration, restore function, and promote new bone growth in traumatized areas.

Misalignment

Misalignment issues can create a situation in the mouth in which some teeth no longer have opposing teeth. 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 when it is no longer stimulated.

Osteomyelitis

Osteomyelitis is a bacterial infection of the jawbone and bone marrow. The infection leads to inflammation, which can reduce the blood supply to the bone. Treatment for osteomyelitis generally requires antibiotics and removal of the affected bone. A bone graft procedure may then be required to restore bone function and growth lost during removal.

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 a section of the jaw. In both cases, reconstructive bone grafting is usually required to restore jaw function. Grafting in patients with malignant tumors may be more challenging because treatment of the cancerous tumor generally requires removal of the surrounding soft tissue as well.

Developmental Deformities

Some conditions, known as birth defects, are characterized by missing portions of the teeth, facial bones, jaw, or skull. Drs. Barack or Gupta may be able to perform a bone graft to restore bone function and growth where it is absent.

Sinus Deficiencies

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 held the teeth in place. As a result, the sinuses become enlarged, a condition called hyperpneumatized sinus.

This condition usually develops over several years and may result in insufficient bone for dental implant placement. Drs. Barack or Gupta can perform a procedure called a “sinus lift” that can treat enlarged sinuses.

Schedule Your Consultation

Request your visit with Dr. Barack or Dr. Gupta by calling our office at (847) 750-3373 or by completing our online appointment request form.