Edentulism, or tooth loss, can rob you of much more than the ability to chew and properly digest food. It has serious social, psychological and emotional consequences, impacting your quality of life, self-image and self-esteem.
Edentulism results when one or more teeth are missing, or need removing due to injury or disease. With full edentulism, all teeth are missing; with partial edentulism, one or more teeth are missing.
Causes of tooth loss
Losing a tooth as a child was a glorious event — it meant The Tooth Fairy was on her way to put money under your pillow. But losing teeth as an adult? Not so fun (and sadly, no Tooth Fairy comes to your house).
As adults, we typically have about 25 permanent teeth, so even losing one tooth can have an effect on how you eat, your health and even your confidence.
Lifestyle has a huge impact on adult tooth loss
Brushing your teeth twice a day can help you maintain healthy teeth, but brushing only once a day — or not at all — give bacteria the chance to set up shop on your teeth. This bacteria can eventually lead to decay, cavities and, eventually, periodontal diseases like gingivitis.
Foods and beverages high in sugar, carbohydrates and acid may cause irreversible tooth and gum damage.
Smoking and chewing tobacco
Two bad habits that are known to increase your risk for cancer and tooth loss. The large-scale Study also found that smokers are twice as likely to lose their teeth as non-smokers.
Systemic conditions such as heart disease, respiratory disease, diabetes, HIV infection, malnutrition and immunosuppression are all associated with forms of periodontitis that often result in tooth loss.
Certain treatments, such as chemotherapy, head radiation therapy and immunosuppresive medications, weaken the immune system. These treatments may increase the risk of tooth infections and, consequently, the need for tooth extraction.
Gum disease, also known as periodontal disease, is the number one cause of tooth loss among adults—accounting for 70 percent of missing teeth.
It begins with bacteria and inflammation in the gums. As it progresses, it destroys the gum tissues and can destroy the jawbone underneath the gums, resulting in no support for the teeth.
Cavities are holes in teeth caused by a bacterial infection that turns into tooth decay. If untreated, a cavity can destroy the pulp in the center of the tooth, which will likely result in a root canal or even removal of the tooth.
Prevent cavities by practicing good oral health habits, choosing healthy foods and drinks, and making regular trips to the dentist for early detection. Early treatment can save your tooth.
Physical injury or trauma
Accidents happen, especially during sports, which is why mouth guards are important. Falls, car accidents and more can also cause tooth loss. However, you can be vigilant to avoid some common causes of tooth loss or damage through accidents. Don’t use your teeth to remove caps, tops or lids, to loosen knots, tear off tags or cut thread. Nor should you use your teeth to chew ice, open nut shells or chew on popcorn kernels if you want to make sure your teeth stay intact.
Osteoporosis is a disease that causes the bones to weaken and become porous. As a result, even minor bumps and impacts can lead to broken bones.
While osteoporosis commonly affects the spine, hips, and wrists, it can also damage the bones in the jaw that support the teeth.
If the jaw bones become less dense, the teeth may loosen and fall out. Certain medications used to treat osteoporosis can cause dental health problems, though this is uncommon. In rare cases, drugs called bisphosphonates, which help to treat bone loss, can lead to loose teeth. This is known as osteonecrosis of the jaw.
Authors of one study suggest that osteonecrosis rarely occurs in people who are taking bisphosphonates in pill form, but that the condition may develop in people who receive the medication intravenously.
Trauma and surgical procedures, such as tooth extraction, can also cause osteonecrosis.
Raised levels of estrogen and progesterone during pregnancy can affect the bones and tissues in the mouth. Having more of these hormones can alter the periodontium, which is the collection of bones and ligaments that support the teeth and keep them in place. When the periodontium is affected, one or more teeth may feel loose.
The changes to this part of the body will resolve after pregnancy, and they are not a cause for concern. However, anyone experiencing pain or loose teeth during pregnancy should see a dentist to rule out gum disease and other oral health problems.
It is safe for pregnant people to have dental checkups, cleanings, and X-rays. In fact, because of a possible link between gum disease and premature birth, pregnant people are encouraged to see dentists regularly.
Lack of education
A lack of education about the causes and consequences of tooth loss prevents people from taking the proper preventative lifestyle and oral health care measures, or from getting periodic dental maintenance or necessary restorative treatment.
Fear and embarrassment
Many people suffer from dental phobia, or anxiety/fear of going to the dentist, and do not seek dental treatment, even if they know they have a problem or are in pain. Others are embarrassed or ashamed to seek dental treatment because they feel they will be blamed or judged negatively for the condition of their teeth. Ignoring tooth decay or other serious dental problems can prolong and aggravate the condition.
Some people have to postpone or forgo dental visits and treatments, including regular check-ups and cleanings, due to high dental care costs and/or lack of insurance coverage. Unfortunately, prolonging or eliminating dental care increases the chances of developing serious problems and, subsequently, greater expense for repairs.
Although typically associated with the elderly, edentulism also affects children and adults if they do not practice proper oral hygiene.
Toddlers and children run the risk of two types of traumatic tooth loss: premature loss of baby teeth and loss of permanent teeth due to injury or neglect. Dental caries are a major cause of tooth loss in children and teens.
Gum disease (gingivitis or periodontitis) and dental caries are the leading causes of tooth loss among adults. Periodontal disease is a chronic bacterial infection affecting the gums and bone supporting the teeth. As the disease destroys gum tissue and bone, teeth loosen and may require extraction. Smoking, heart disease and diabetes also are associated with tooth loss.
Plaque accumulation and hardening, gum recession, older fillings and dry mouth put the elderly at greater risk for losing their natural teeth.
The incidence of edentulism among certain populations reflects differences in healthy behaviors and attitudes toward oral health and dental care, as well as access to and use of dental services and treatments.
Research indicates that tooth loss caused by gum disease is commonly associated with risk indicators that include age, gender (more common with males), smoking, inadequate personal oral hygiene and professional dental care, diabetes mellitus, hypertension, and rheumatoid arthritis.
What to Do If You Lose a Tooth
You need to see your dentist right away. Sometimes dentists can save a lost tooth by placing it back in the socket, especially if the whole tooth comes out (including the root). If that’s not possible, your dentist can help you fill the space the permanent tooth left behind with either a tooth-colored crown made of metal and porcelain, a dental implant or a bridge.
Just don’t let it go: Losing one tooth makes it more like that you’ll lose even more teeth because the empty space puts pressure on the surrounding teeth, leading to fracture from overuse. You’re also more likely to develop infections and other dental issues, leading to painful — and costly — procedures down the road.
Patients and their dentists should develop a treatment plan that emphasizes prevention and early detection of oral diseases in order to keep the remaining teeth ― especially in cases of partial edentulism. Prevention and detection strategies include patient education about edentulism causes, consequences and treatments, and following preventive oral health practices (e.g., daily oral health care), as well as preventative and therapeutic treatment.
However, if tooth loss is unavoidable, there are several options for restoring your teeth and your smile.
An implant is usually the preferred option for replacing a single tooth. Placing an implant requires careful preparation to assess the amount of bone where the implant will be placed to make sure that there will be adequate support for the implanted tooth.
Your dentist may take CT scans of your teeth to see the amount and shape of bone available for the implant and take impressions of your teeth. If your jawbone is adequate, your dentist may use a computer to make a models of your jaw to simulate the implant before performing the actual procedure. Doing so can improve the accuracy of placement and minimize the amount of tissue disrupted during the implant procedure.
If your jawbone won’t support an implant, your dentist will augment it with bone or a bone-like material in a surgical procedure. You will need to wait several months for the bone to heal before receiving the implant.
The next step is to place a titanium screw—which serves as a replacement for a tooth root—in your jaw. The screw is fitted with a cap that looks like a small stud in your gum. During the next several weeks, your jawbone will grow around the screw to firmly anchor it in place, and your gum will heal.
In the final step, your dentist will make sure the implant is firmly in place. He or she will remove the screw cap and re-place it with a titanium abutment, or post. A porcelain crown that has been designed to match your surrounding teeth will be cemented or screwed onto the abutment.
Dentures are removable replacements for missing teeth and adjoining tissues. Partial dentures fill in the spaces created by missing teeth, keep remaining teeth from shifting and are an option if you have some natural teeth remaining. If you have lost most or all of your teeth, complete or full dentures are recommended. “Immediate” dentures are inserted immediately after removal of the natural teeth; “conventional” dentures are placed in the mouth about three to six months after tooth removal.
A bridge—which consists of artificial teeth fused to a metal frame—is a good option for replacing several teeth. The frame is cemented to supports—either implants or healthy teeth that have been covered by crowns. The more teeth being replaced, the more natural teeth or implants are needed to give the bridge the necessary support.
Getting a bridge is a shorter process than getting an implant, but still requires several visits—one for imaging and impressions, another for preparing the supporting teeth for crowns and fitting a temporary bridge, and another for fitting the permanent bridge.
Loose teeth cannot always be prevented, but a person can take steps to reduce the risk. Tips for tooth and gum health include:
- brushing the teeth thoroughly twice a day
- flossing once a day
- refraining from smoking
- attending dental checkups and cleanings as often as recommended
- wearing a properly fitted mouth guard while playing sports
- wearing a bite splint, when nighttime grinding or clenching is an issue
- asking a doctor about calcium and vitamin D supplementation to help prevent osteoporosis
- keeping diabetes under control, as diabetes is a risk factor for gum disease
- being aware of medications that may affect the teeth