Tooth Loss is a condition in which one or more teeth become loose and then fall out. A tooth may be lost because of disease or injury.
To learn about tooth loss and the treatment options, it helps to understand the normal anatomy of the tooth.
Normal Tooth Anatomy
A tooth has two main parts: a crown portion and a root portion.
- Crown is the part of the tooth which is seen in the mouth.
- Root is the part of the tooth which is inside the jaw bone.
The different parts of a tooth consist of:
- Enamel: Enamel is the highly mineralized and hard outer substance of the tooth. Its color varies from light yellow to greyish white.
- Dentin: Dentin is that part of the tooth which is present between enamel or cementum and pulp chamber. It is softer than enamel and therefore decays more rapidly.
- Cementum: Cementum is a bony substance covering the root of the tooth. Its color is yellowish and is softer than dentin or enamel. The main function of cementum is to serve as a medium for periodontal ligaments to attach to the tooth for stability.
- Pulp: The dental pulp is the center portion of the tooth. It is filled with soft connective tissue which contains blood vessels and nerves. It is commonly called the “nerve of the tooth”.
Causes of Tooth Loss
- Injury: Trauma to the face and mouth can loosen teeth and make them fall out. Badly fractured teeth due to injury cannot be saved.
- Gum Disease: Gum disease, an infection of the gum tissues, can lead to bone loss in the advanced stages, gradually causing the tooth to lose its support.
- Dental decay: If dental decay is not treated timely, it can spread down deep in the gum tissues and weaken the tooth requiring tooth extraction.
Consequences of Tooth Loss
- When the back teeth (molars, premolars) are lost, biting down on food becomes difficult.
- When front teeth are lost, the person’s appearance, speech, as well as smile is affected.
Why to replace lost teeth?
- Teeth will normally move into spaces created by adjacent lost teeth making tooth replacement later more difficult.
- When teeth are lost, the jawbone holding your teeth starts dissolving over time. You may lose enough bone that your dentist may have to place a bone graft to build up the bone and then place an implant or make a denture for you.
- With missing teeth, you cannot chew upon many food types. This can affect your overall health due to poor nutrition.
- You may not be to speak clearly and understandably.
- Missing teeth leads to changes in the way you bite which can cause problems in the jaw joint.
There are 2 types of options for replacing missing teeth. These include a removable option and a fixed option.
Removable Type includes:
- Removable partial denture: Removable partial dentures are given when only a few teeth are missing and other teeth are sound enough to support the denture.
- Removable complete dentures: Removable complete dentures are given when there are no teeth present in the mouth.
Partial or complete dentures must be removed and cleaned every time after eating. Also, before going to bed, dentures must be removed and stored in a bowl of water.
Fixed Type includes:
- Fixed partial denture (dental bridges): In this procedure, the teeth on either side of the missing tooth are prepared to receive caps and the artificial tooth is attached to the adjoining caps to form one unit. This entire unit is cemented onto the prepared teeth.
- Dental implants: This is the best method known to replace a missing tooth. It does not require support from the neighboring teeth therefore sound tooth structure need not be cut.
Dental Implant Surgery
Dental implants are screw-like materials which replace the root portion of a natural tooth. They are placed inside your jawbone by a dental surgeon. Implants support the crowns, dentures or bridges that will be fixed on to them in a separate procedure.
Types of Dental Implants:
- Root form
- Trans osseous
- Ramus frame
- Blade form
The root form type of implant is the most commonly used. It looks like a screw or a cylinder. After this is placed in the jawbone, a metal base (abutment) is attached which holds the crown.
Treatment steps include the following:
- Placing titanium implants: The implant screw is placed into the jaw bone and will remain covered inside the gums for about 3-6 months to enable the bone to anchor to the implant, a process called Osseo integration.
- Attaching abutments: Abutments are small metal posts that are placed over the implant once Osseo integration has occurred. The abutment provides a foundation for the artificial tooth to be fixed.
- Placement of new tooth: The last step of an implant is placing the replacement tooth or crown.
Advantages of Dental Implants:
- A dental implant will look almost like your same old natural tooth.
- It does not require altering your other teeth.
- You can chew food better with implants.
- The implants are placed within the bone, thus can preserve bone structure.
Prevention of Tooth loss
- Oral hygiene measures: Brush your teeth twice daily and flossing once a day should be done to remove debris from between the teeth. These measures help to prevent gum disease and dental decay.
- Regular dental health check-up: Visit your dentist at least every 6 months for a check-up and tooth cleaning. This helps the dentist to assess for any problems in the initial stages and treat them before complications develop.
- Fluoride application: Use toothpastes and mouthwashes containing fluoride as this helps to prevent dental decay.
- Dental sealants: Dental sealants are preventive filling materials. The dentist applies them on the chewing surface of the back teeth. This prevents dental decay by not allowing food to get stuck onto the chewing surface.