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Bad Teeth: Bone Loss Tooth Failure

Too Much Bone Loss Poll (New)

Untreated - Excessive Extractions

Bone loss is commonly associated with gum disease. Younger patients tend not to think too much about bone loss as does the older adult population.. given that over 70% of them have some degree of gingivitis or periodontal disease.

Many patients who have a tendency to "choose" extraction versus, say, a root canal or retreatment of a large filling that has failed discover years later they have bone loss issues caused by old extractions.

Declining treatment for wisdom teeth extractions is normal. When removed in a fashion that doesn't disturb occlusal relationhips (opposing pair or both opposing pairs), the failure to treat those tooth sites is generally a nonevent. Bone loss does occur but rarely affects adjacent molars for most patients.

Extractions throughout key areas of either the upper or lower jaws that go untreated for too long potentially cause adjacent teeth to move, rotate or tilt and can affect underlying bone for those teeth.

Socket grafts, consisting of injectable bone matric or a pre-formed plug that entirely fills the extraction socket are popular treatments.... especially for those patients preparing for bridgework or implants.

The pictures below are examples of dentition that has been adversely affected by too many extractions or spans of missing teeth.

An extreme example of what the overuse of extraction dentistry ("an affordable pretend treatment") can do to the upper arch of a young adult. What makes this example unique is the amount of bone loss.... which is quite severe. Eating habits, food preferences, smoking, medication programs and basic oral hygiene habits can accelerate the loss of critical tissue.

Recreating a natural smile for this patient could include the use of dental implants, bridgework or a partial. The use of implant technology however would require significant bone grafting / augmentation in the affected area.

Upper arch bone loss
Disappearing Bone - Excessive Extractions
Dr. Richward Winter, Milwaukee WI

One of the worst bone loss events due, not to poor oral health or gum disease issues that lead to tooth loss, but rather the common assumption held by many patients that extracting a tooth can be smarter than treating it.

Notice how ALL of the bone mass to the left and right of the anterior (front) block of teeth (most dense bone in upper and lower jaws) no longer exists.

Excellent testimony to how opposing teeth keep bone healthy while the absense of teeth can make bone disappear.

Other than using a grossly oversized partial, bone block grafting would be required to create a suitable foundation for replacing the missing teeth. With bone height and width rebuilt, implants would enable the use of custom bridgework.

Zero mandibular bone
Mandibular Bone Loss - Excessive Extractions
Dr. Richward Winter, Milwaukee WI

Poor oral health habits and eventual gum disease, coupled with the patient's preference for extractions rather than restorative treatments caused significant bone loss in the mandible. Untreated long term effects of untreated conditions and poor focus on oral health habits have disastrous effects on jaw structures.

Treatment may include bone grafts (chin block graft, ramus, cadaver based, etc) along with tissue grafting. Choices or combinations of implants, fixed bridge, cantilevered implants, overdenture or a full implant supported denture could be available.

Zero mandibular bone
Perio Disease - Excessive Extractions
Dr. Ara Nazarian, Troy, Michigan

Long history of an extraction here.... and extraction there. Piecemeal treatments over the span of several years reduced the level of mandibular bone extensively in some areas. Bone in the anterior (front most) area of the mandible is practically nonexistant

Treatment may include bone grafts (synthetic, chin block graft, ramus, cadaver based, etc) along with tissue grafting. Choices or combinations of implants, fixed bridge, overdenture or a full implant supported denture could be available.

Mandibular Bone Loss
Dr. Corinne Scalzitti, Austin, Texas

This is actually a picture of "meth mouth," a condition that describes long term devastation caused by drug abuse. Note the excessive extractions on the upper jaw and the loss of bone height in the posterior area. As each tooth failed, the patient's preferred treatment was extraction. Bone loss has also occurred due to xerostomia (dry mouth, cotton mouth) conditions.

Treatment may include selective bone grafting, (synthetic, chin block graft, ramus, cadaver based, etc) along with tissue grafting, dental implants, bridge work, total extractions, overdenture, full dentures.

Methamphetamine dental bone teeth loss
Meth Mouth Bone Loss
Dr. Corinne Scalzitti, Austin, Texas

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