The trouble with tooth loss – Mr. Matthieu Dupui Biomedical engineer TBRFeatured Products Promotional Features
Posted by: The Probe 5th November 2019
Losing a tooth is an exciting prospect for most children, as it means the Tooth Fairy will be paying them a visit when they sleep to leave some cash under their pillow. For adults, the loss of one or several teeth is a much more worrying problem – one that does not discriminate based on age or gender. As you know, tooth loss can affect anyone and it can be a particularly distressing issue with long-lasting effects on a patient’s physical and mental wellbeing.
Although the prevalence and incidence of tooth loss continues to decline, it is estimated that 158 million people worldwide still suffer from edentulism.[i] Having a comprehensive understanding of why tooth loss occurs in the first place and how it can impact an individual is key to helping patients effectively prevent or manage the condition. Some studies have already shown that a person’s risk of losing a tooth increases with age, but there are a variety of other factors that can contribute to tooth loss.[ii], [iii]
It is ironic that some oral diseases are entirely preventable, yet remain a leading cause of tooth loss. They can occur due to poor oral hygiene, an unhealthy diet high in free sugars, excess alcohol consumption or tobacco use. This can lead to the development of dental caries and periodontal disease, which – if left untreated – can result in teeth becoming loose and eventually falling out, or requiring an extraction. At least one study has concluded that caries is the main cause of tooth extractions in 20- to 30-year-old patients, while periodontal disease accounts for the majority of extractions in patients over the age of 40.[iv]
Tooth loss can result from systemic conditions that interfere with the protective function of saliva, or detrimentally affect the periodontal tissues that support the teeth. The current literature emphasises a two-way relationship between diabetes and periodontitis, for instance, with research demonstrating that the two diseases can exacerbate one another.[v] One study has found a statistically significant correlation between tooth mobility, tooth loss, the prevalence and severity of periodontal disease, and the glycaemic status of diabetic patients.[vi]
Osteoporosis – in which bone becomes porous and more susceptible to fracture – is another systemic condition that can contribute to tooth loss. It affects an estimated one in three post-menopausal women and one in five men over the age of 50. Accumulating evidence suggests that osteoporosis independently influences alveolar bone loss, which can ultimately result in tooth mobility and the eventual loss of teeth.[vii] Women with osteoporosis are three times more likely to suffer from missing teeth than those without the disease.[viii]
Teeth can also be lost due to dental trauma, with falling down being the most common cause of this, followed by traffic accidents, violence, and sporting activities.[ix] Dental trauma occurs more frequently in permanent than in primary dentition, and these injuries predominantly involve the upper anterior teeth. Predisposing factors of dental trauma could be related to an individual’s anatomic features, including an increased overjet or inadequate lip coverage of the teeth. It is estimated that males experience dental trauma at least twice as often as females do.[x]
The effects of tooth loss
Tooth loss can have significant physical, psychological and emotional effects on a person, particularly if the teeth in the anterior region are involved. Not only can tooth loss deprive patients of their ability to eat, speak or smile properly, but it can also be hugely concerning with regard to aesthetics. An unsightly gap can be distressing enough but over time, the loss of one or several teeth can lead to bone resorption in the jaw, resulting in an older appearance. Some patients with missing teeth may even avoid social situations due to feeling self-conscious about their smile, which can detrimentally impact their overall quality of life.
Thankfully, dental practitioners can offer a wide range of treatments to restore dental function and aesthetics following tooth loss. Dental implant treatment is particularly popular for this purpose, but the key to success is choosing a high quality solution that will be indistinguishable from a natural tooth. TBR’s Z1® implant combines a titanium body with a unique zirconia collar in one seamless component. The zirconia collar acts as an antibacterial shield to minimise the risk of infection, helping to protect the crestal bone and the gingiva from iatrogenic inflammation. This encourages the soft tissue to heal around the implant in a manner that closely resembles natural gingival growth, thereby achieving a truly aesthetic and functional result.
Tooth loss is preventable, but clinicians can offer reliable restorative solutions to help patients that do lose part or all of their dentition. The most effective of these solutions are able to boost a patient’s self-image and self-confidence for the benefit of them living a happier, healthier life. In this day and age, tooth loss doesn’t have to be permanent.
For more information on the Z1® implant, visit tbr.dental, email email@example.com or call 0800 707 6212
[i] Kassebaum, N. J., Bernabé, E., Dahiya, M., Bhandari, B., Murray, C. J. and Marcenes, W. (2014). Global Burden of Severe Tooth Loss: A Systematic Review and Meta-analysis. Journal of Dental Research. 93(7 Suppl): 20S–28S. doi:10.1177/0022034514537828. Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4293725/. [Last accessed: 05.07.19].
[ii] Tonetti, M. S., et al. (2017) Dental caries and periodontal diseases in the aging population: call to action to protect and enhance oral health and well-being as an essential component of healthy ageing – consensus report of group 4 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal disease. Journal of Clinical Periodontology. 44: 135-144. Link: https://onlinelibrary.wiley.com/doi/full/10.1111/jcpe.12681. [Last accessed: 05.07.19].
[iii] Broadbent, J. M., Thomson, W. M. and Poulton, R. (2006) Progression of dental caries and tooth loss between the third and fourth decades of life: a birth cohort study. Caries Research. 40(6): 459–465. doi:10.1159/000095643. Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2253678/. [Last accessed: 05.07.19].
[iv] Nuvvula, S., Chava, V. K. and Nuvvula, S. (2016) Primary culprit for tooth loss!!. Journal of Indian Society of Periodontology. 20(2): 222–224. doi:10.4103/0972-124X.170852. Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4847475/. [Last accessed: 05.07.19].
[v] Llambés, F., Arias-Herrera, S. and Caffesse, R. (2015) Relationship between diabetes and periodontal infection. World Journal of Diabetes. 6(7): 927–935. doi:10.4239/wjd.v6.i7.927. Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4499526/. [05.07.19].
[vi] Rajhans, N. S., Kohad, R. M., Chaudhari, V. G. and Mhaske, N. H. (2011) A clinical study of the relationship between diabetes mellitus and periodontal disease. Journal of Indian Society of Periodontology. 15(4): 388-392. doi: 10.4103/0972-124X.92576. Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3283938/. [05.07.19].
[vii] Karayianni-Nicopoulou, K. and Tzoutzoukos, P. (2009) Tooth loss and osteoporosis: the OSTEODENT study. Journal of Clinical Periodontology. 36(3): 190-197. doi: 10.1111/j.1600-051X.2008.01365.x. Link: https://www.researchgate.net/publication/24034258_Tooth_loss_and_osteoporosis_the_OSTEODENT_study. [05.07.19].
[viii] NIH Osteoporosis and Related Bone Diseases – National Resource Centre. (2018) Oral Health and Bone Disease. Link: https://www.bones.nih.gov/health-info/bone/bone-health/oral-health/oral-health-and-bone-disease. [Last accessed: 05.07.19].
[ix] Wilson, A. (2011) Dental and Oral Trauma. Berman’s Paediatric Decision Making. 452-453. doi:10.1016/b978-0-323-05405-8.00111-x.
[x] Zaleckiene, V., Peciuliene, V., Brukiene, V. and Drukteinis, S. (2014) Traumatic dental injuries: etiology, prevalence and possible outcomes. Baltic Dental and Maxillofacial Journal. 16: 7-14. Link: http://sbdmj.lsmuni.lt/141/141-02.pdf. [Last accessed: 05.07.19].