Tooth loss

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Tooth loss is a process in which one or more teeth come loose and fall out. Tooth loss is normal for deciduous teeth (baby teeth), when they are replaced by a person's adult teeth. Otherwise, losing teeth is undesirable and is the result of injury or disease, such as dental avulsion, tooth decay, and gum disease. The condition of being toothless or missing one or more teeth is called edentulism . Tooth loss has been shown to causally reduce overall health and wellbeing as it increases the probability of depression.

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Tooth exfoliation in children

A young boy after losing two baby teeth, exfoliated in response to the permanent teeth beneath, which will erupt through the gums to take their place. Gebitswissel.jpg
A young boy after losing two baby teeth, exfoliated in response to the permanent teeth beneath, which will erupt through the gums to take their place.

Normal loss of primary teeth typically begins around age six and continues until age twelve. The upper and lower central incisors are shed at age six to seven years. The upper and lower lateral incisors are shed at seven to eight years. The upper canines are shed at ten to twelve years. The lower canines are shed at nine to twelve years. The upper and lower first molars are shed at nine to eleven years. The upper and lower second molars are shed at ten to twelve years. [1]

Pathological tooth loss

Causes and prevention

As a person ages, their permanent teeth have been exposed to normal mechanical forces, such as chewing, and also more abnormal mechanical forces, such as bruxism and traumatic injury. Permanent teeth may also be affected by oral disease. [2] There are many ways in which a person may protect their permanent teeth from loss.

The main method of preventing tooth loss is prevention of oral diseases. Tooth loss can be due to tooth decay and gum disease. Tooth decay is caused by increased plaque retention. Bacteria can then invade the plaque and cause dental caries (cavities). If cavities persist untreated for an extended period of time, tooth breakdown occurs. [3] Plaque retention and bacterial presence also affect the gums and bone and their ability to hold the teeth in place. Disease of the gums, known as periodontitis, leads to detachment of the supporting structures from the teeth and their eventual loss. Tooth loss due to tooth decay and gum disease may be prevented by practicing good oral hygiene, and regular check-ups at a dentist's office. Good oral hygiene consists of brushing two times a day with a fluoridated toothpaste and flossing. Dental check-ups should occur every six months. Children or adults who are incapable of caring for their own teeth should be assisted with oral hygiene in order to prevent tooth loss. [4]

In contact sports, risk of mouth trauma and tooth injury is reduced by wearing mouthguards and helmets with a facemask (e.g., a football helmet, a goalie mask).

Nightguards may also be implemented in the case of teeth grinding (bruxism) during sleep. These guards function in limiting the wear and force applied to the teeth. In turn, this minimizes the chance of loss.

In countries such as the United States, Japan, Germany, and Italy, there is a strong relationship between cigarette smoking and tooth loss. Studies have shown that an increase in exposure to cigarette smoking can increase the risk of tooth loss. In addition, studies have also found that when people stop smoking, there is a decrease in tooth loss. [5]

Proper nutrition has been shown to prevent tooth loss by providing the nutrients necessary to maintain enamel strength. [6]

Tooth loss occurs more often in people from the lower end of the socioeconomic scale. [7] [8]

Secondary to disease

Tooth loss can occur secondary or concomitantly to many diseases. Diseases may cause periodontal disease or bone loss to prompt tooth loss. Consequently, periodontal disease may cause increased infection, which may predispose a person to other diseases. Diseases commonly related to tooth loss include, but are not limited to: cardiovascular disease, [9] cancer, [10] osteoporosis [11] and diabetes mellitus. [12] Therefore, it is important to not only maintain good oral hygiene, but also overall good health.

Missing tooth replacement

Maximum preservation and protection of natural teeth is best for eating and chewing; however, there are three basic ways to replace a missing tooth or teeth, including a fixed dental bridge, dentures, and dental implants. Each alternative has its own benefits and drawbacks. It is important to consider a patient's medical, financial, and emotional situation. It is recommended that a patient experiencing tooth loss visits a dentist to discuss which replacement method is best suited for their situation. It has been shown that a non-removable replacement, such as a bridge or implant appears to provide patients with the best sense of security and well-being. [13]

In some cases, small missing areas can be restored by using techniques such as resin boded bridge (acid etch bridge) and maryland bridge.

Research

Researchers in Japan have successfully regrown fully functional teeth in mice. Epithelial and mesenchymal cells were extracted from the mice, cultured to produce a tooth "germ", and the germ was then implanted into the bone at the space of a missing tooth. A tooth of the correct external and internal structure, hardness, strength, and sensitivity later erupted in the space, eventually meeting the opposing tooth in a manner similar to an original natural tooth. This technique may be a possible future treatment for replacement of missing teeth. [14]

See also

Related Research Articles

<span class="mw-page-title-main">Human tooth</span> Calcified whitish structure in humans mouths used to break down food

Human teeth function to mechanically break down items of food by cutting and crushing them in preparation for swallowing and digesting. As such, they are considered part of the human digestive system. Humans have four types of teeth: incisors, canines, premolars, and molars, which each have a specific function. The incisors cut the food, the canines tear the food and the molars and premolars crush the food. The roots of teeth are embedded in the maxilla or the mandible and are covered by gums. Teeth are made of multiple tissues of varying density and hardness.

<span class="mw-page-title-main">Periodontal disease</span> Medical condition

Periodontal disease, also known as gum disease, is a set of inflammatory conditions affecting the tissues surrounding the teeth. In its early stage, called gingivitis, the gums become swollen and red and may bleed. It is considered the main cause of tooth loss for adults worldwide. In its more serious form, called periodontitis, the gums can pull away from the tooth, bone can be lost, and the teeth may loosen or fall out. Bad breath may also occur.

<span class="mw-page-title-main">Tooth decay</span> Deformation of teeth due to acids produced by bacteria

Tooth decay, also known as cavities or caries, is the breakdown of teeth due to acids produced by bacteria. The cavities may be a number of different colors from yellow to black. Symptoms may include pain and difficulty with eating. Complications may include inflammation of the tissue around the tooth, tooth loss and infection or abscess formation.

<span class="mw-page-title-main">Bridge (dentistry)</span> Dental restoration for missing teeth

A bridge is a fixed dental restoration used to replace one or more missing teeth by joining an artificial tooth definitively to adjacent teeth or dental implants.

Periodontology or periodontics is the specialty of dentistry that studies supporting structures of teeth, as well as diseases and conditions that affect them. The supporting tissues are known as the periodontium, which includes the gingiva (gums), alveolar bone, cementum, and the periodontal ligament. A periodontist is a dentist that specializes in the prevention, diagnosis and treatment of periodontal disease and in the placement of dental implants.

Dental plaque is a biofilm of microorganisms that grows on surfaces within the mouth. It is a sticky colorless deposit at first, but when it forms tartar, it is often brown or pale yellow. It is commonly found between the teeth, on the front of teeth, behind teeth, on chewing surfaces, along the gumline (supragingival), or below the gumline cervical margins (subgingival). Dental plaque is also known as microbial plaque, oral biofilm, dental biofilm, dental plaque biofilm or bacterial plaque biofilm. Bacterial plaque is one of the major causes for dental decay and gum disease.

<span class="mw-page-title-main">Alveolar process</span> Bulge on jaws holding teeth

The alveolar process or alveolar bone is the thickened ridge of bone that contains the tooth sockets on the jaw bones. The structures are covered by gums as part of the oral cavity.

<span class="mw-page-title-main">Oral irrigator</span> Dental care device

An oral irrigator is a home dental care device which uses a stream of high-pressure pulsating water intended to remove dental plaque and food debris between teeth and below the gum line. Regular use of an oral irrigator is believed to improve gingival health. The devices may also provide easier cleaning for braces and dental implants. However, more research is needed to confirm plaque biofilm removal and effectiveness when used by patients with special oral or systemic health needs.

<span class="mw-page-title-main">Toothlessness</span> Lacking teeth

Toothlessness, or edentulism, is the condition of having no teeth. In organisms that naturally have teeth, it is the result of tooth loss.

<span class="mw-page-title-main">Tooth brushing</span> Act of scrubbing teeth with a toothbrush

Tooth brushing is the act of scrubbing teeth with a toothbrush, usually equipped with toothpaste. Interdental cleaning can be useful with tooth brushing, and together these two activities are the primary means of cleaning teeth, one of the main aspects of oral hygiene.

<span class="mw-page-title-main">Gingival and periodontal pocket</span>

Gingival and periodontal pockets are dental terms indicating the presence of an abnormal depth of the gingival sulcus near the point at which the gingival tissue contacts the tooth.

<span class="mw-page-title-main">Oral microbiology</span>

Oral microbiology is the study of the microorganisms (microbiota) of the oral cavity and their interactions between oral microorganisms or with the host. The environment present in the human mouth is suited to the growth of characteristic microorganisms found there. It provides a source of water and nutrients, as well as a moderate temperature. Resident microbes of the mouth adhere to the teeth and gums to resist mechanical flushing from the mouth to stomach where acid-sensitive microbes are destroyed by hydrochloric acid.

<span class="mw-page-title-main">Oral hygiene</span> Cleaning the mouth by brushing the teeth and cleaning in between the teeth.

Oral hygiene is the practice of keeping one's oral cavity clean and free of disease and other problems by regular brushing of the teeth and adopting good hygiene habits. It is important that oral hygiene be carried out on a regular basis to enable prevention of dental disease and bad breath. The most common types of dental disease are tooth decay and gum diseases, including gingivitis, and periodontitis.

<span class="mw-page-title-main">Gingivitis</span> Inflammation of the gums

Gingivitis is a non-destructive disease that causes inflammation of the gums. The most common form of gingivitis, and the most common form of periodontal disease overall, is in response to bacterial biofilms that is attached to tooth surfaces, termed plaque-induced gingivitis. Most forms of gingivitis are plaque-induced.

Chronic periodontitis is one of the seven categories of periodontitis as defined by the American Academy of Periodontology 1999 classification system. Chronic periodontitis is a common disease of the oral cavity consisting of chronic inflammation of the periodontal tissues that is caused by the accumulation of profuse amounts of dental plaque. Periodontitis initially begins as gingivitis and can progress onto chronic and subsequent aggressive periodontitis according to the 1999 classification.

<span class="mw-page-title-main">Tooth mobility</span> Medical condition

Tooth mobility is the horizontal or vertical displacement of a tooth beyond its normal physiological boundaries around the gingival area, i.e. the medical term for a loose tooth.

<span class="mw-page-title-main">Overdenture</span> Removable dental prosthesis

Overdenture is any removable dental prosthesis that covers and rests on one or more remaining natural teeth, the roots of natural teeth, and/or dental implants. It is one of the most practical measures used in preventive dentistry. Overdentures can be either tooth supported or implant supported. It is found to help in the preservation of alveolar bone and delay the process of complete edentulism.

Interdental cleaning or interproximal cleaning is part of oral hygiene where the aim is to clean the areas in between the teeth, otherwise known as the proximal surfaces of teeth. This is to remove the dental plaque in areas a toothbrush cannot reach. The ultimate goal of interproximal cleaning is to prevent the development of interproximal caries and periodontal disease. The combined use of tooth brushing, and mechanical and manual interdental cleaning devices has been proven to reduce the prevalence of caries and periodontal diseases.

Periodontal surgery is a form of dental surgery that prevents or corrects anatomical, traumatic, developmental, or plaque-induced defects in the bone, gingiva, or alveolar mucosa. The objectives of this surgery include accessibility of instruments to root surface, elimination of inflammation, creation of an oral environment for plaque control, periodontal diseases control, oral hygiene maintenance, maintain proper embrasure space, address gingiva-alveolar mucosa problems, and esthetic improvement. The surgical procedures include crown lengthening, frenectomy, and mucogingival flap surgery.

References

  1. ↑ "Tooth Eruption: The primary teeth". Mouth healthy.org. American Dental Association. Retrieved 2 June 2014.
  2. ↑ Baelum V, Luan W-M, Chen X, Fejerskov O (1997). "Predictors of tooth loss over 10 years in adult and elderly Chinese". Community Dent Oral Epidemiol. 25 (3): 204–10. doi:10.1111/j.1600-0528.1997.tb00927.x. PMID   9192148.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  3. ↑ Burt BA, Ismail AI, Morrison EC, Beltran ED (May 1990). "Risk factors for tooth loss over a 28-year period". J Dent Res. 69 (5): 1126–30. CiteSeerX   10.1.1.534.1547 . doi:10.1177/00220345900690050201. PMID   2335645. S2CID   1904543.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  4. ↑ Li; et al. (2011). "Age, period and cohort analysis of regular dental care behavior and edentulism: a marginal approach". BMC Oral Health. 11 (9): 9. doi:10.1186/1472-6831-11-9. PMC   3073963 . PMID   21410991.
  5. ↑ Hanioka, T., Ojima, M., Tanaka, K., Matsuo, K., Sato, F., and Tanaka H. (2011). "Causal assessment of smoking and tooth loss:a systematic review of observational studies". BMC Public Health. 11: 221. doi:10.1186/1471-2458-11-221. PMC   3087682 . PMID   21477320.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  6. ↑ Ioannidou, E; et al. (Nov 11, 2013). "Tooth Loss Strongly Associates with Malnutrition in Chronic Kidney Disease". J Periodontol. 85 (7): 899–907. doi:10.1902/jop.2013.130347. PMC   4469954 . PMID   24215204.
  7. ↑ Sacker, Amanda; Bartley, Mel (2015). Social inequalities in oral health: from evidence to action (PDF). p. 9. ISBN   9780952737766.
  8. ↑ Matsuyama Y, Jürges H, Listl S (2019). "The Causal Effect of Education on Tooth Loss: Evidence from UK Schooling Reforms". American Journal of Epidemiology. 188 (1): 87–95. doi:10.1093/aje/kwy205. PMID   30203091.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  9. ↑ Desvarieux, M; et al. (Sep 2003). "Oral Infections and Vascular Disease Epidemiology Study (INVEST). Relationship between periodontal disease, tooth loss, and carotid artery plaque". Stroke. 34 (9): 2120–5. doi:10.1161/01.STR.0000085086.50957.22. PMC   2677013 . PMID   12893951.
  10. ↑ Meyer, MS; et al. (Nov 2008). "A review of the relationship between tooth loss, periodontal disease, and cancer". Cancer Causes Control. 19 (9): 895–907. doi:10.1007/s10552-008-9163-4. PMC   2723958 . PMID   18478344.
  11. ↑ Anil, S; et al. (Nov 2013). "Impacto of Osteoporosis and its treatment on oral health". Am J Med Sci. 346 (5): 396–401. doi:10.1097/MAJ.0b013e31828983da. PMID   23588259. S2CID   19709817.
  12. ↑ Sima C, Glogauer M (Jun 2013). "Diabetes mellitus and periodontal diseases". Curr Diab Rep. 13 (3): 445–452. doi:10.1007/s11892-013-0367-y. PMID   23430581. S2CID   33714299.
  13. ↑ Zarb, George A (June 1988). "The Replacement of Missing Teeth". Can Fam Physician. 34 (34): 1435–1440. PMC   2219122 . PMID   21253206.
  14. ↑ Etsuko Ikeda; Ritsuko Morita; Kazuhisa Nakao; Kentaro Ishida; Takashi Nakamura; Teruko Takano-Yamamoto; Miho Ogawa; Mitsumasa Mizuno; Shohei Kasugai & Takashi Tsuji (2009). "Fully functional bioengineered tooth replacement as an organ replacement therapy". Proceedings of the National Academy of Sciences of the United States of America. 106 (32): 13475–80. doi: 10.1073/pnas.0902944106 . PMC   2720406 . PMID   19666587.
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