I am thrilled to share with you some very exciting information regarding certain advancements that have changed dentistry for the better forever. In the past there were certain dental conditions that left the patient and the dentist with very little desirable choices for treatment. That has all changed now.

The problem we face is tooth loss and how to deal with the consequences. It is estimated that 20 million people in the United States have no teeth at all. An additional 10 million people have no teeth at all in the upper jaw but some teeth in the lower jaw. It is also estimated that one of five people in the United States are missing at least one tooth. Once a tooth is lost the jaw bone in that area shrinks. Everyone is familiar with Osteoporosis which is a condition where the density of bone is decreased over time. With tooth loss not only is the quality of bone decreased but the quantity of bone is decreased as well. This condition only worsens with time as it continues through life.

Facial appearance with healthy teeth and bones

Appearance after tooth and bone loss

Appearance after continued bone loss


The consequences of tooth loss include loss of function. As soon as one tooth is lost the remaining neighboring teeth are compromised. They are now at a higher risk for tooth decay and gum disease. This leads to premature loss of those teeth as well. As this snowball effect continues the patient finds that they can no longer chew certain foods. An average denture wearer can only exert 3% of the normal bite force after wearing dentures for 15 years. 17% of people wearing dentures actually report that they eat better without their denture.

The appearance of the face is affected due to the loss of bone and the loss of muscle attachment to the bone and the relationship of the upper and lower jaws. This leads to the appearance of jowls and witch's chin. Dentures are merely "oral wigs" that simply mask the problem and actually contribute to accelerated bone loss.

Patients wearing dentures often isolate themselves from certain social settings due to their fear that the dentures will fall out. Some patients wear their dentures all day and night in fear that their spouse would find out they have no teeth.

In the past dentists and patients had no choice but to live with these consequences. However, today with the use of dental implants we can stop the bone loss. The implant can maintain the bone sometimes even better than a natural tooth. Implants can be used to replace one tooth or all the teeth. They can be used to support a denture that is removable or to support crowns and bridges that are not removable and the patient can brush and floss just like their natural teeth. Chewing efficiency is restored and patients find that they can eat anything with comfort. Since the bone is maintained we can maintain the appearance of the face.

Even if bone has previously been lost, bone graft procedures can rebuild the bone to allow for the use of dental implants.

Cross-section of a jaw that has lost volume following tooth loss. There is not enough bone to safely place a dental implant. The patient's cells migrate into the graft and remodel it into new bone. Over time host bone will completely replace the allograft material. Restored jaw now has adequate room for placement of a dental implant to replace the missing tooth.

I cannot emphasize enough how serious the problem of tooth loss and bone loss can be and how it effects every aspect of the patient's life. This is why I have never been more excited about any other dental procedure. Dental implants can recover normal function, esthetics, comfort, and speech while preserving bone in the area and maintaining the health of the neighboring teeth.

The photos were provided courtesy of BioHorizons. http://www.biohorizons.com/patient_education.aspx

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