Dental implants are one of the best ways to replace one or more missing teeth and they can also help support bone structure. Bone loss can be detrimental to your dental health and can lead to tooth mobility and even tooth loss. Dental implants act as an artificial tooth root and can help support bone structure and prevent further deterioration of the jawbone. Dental implants use bone structure to sit securely in the patient's mouth and if the patient does not have enough bone structure, they may need to have a bone graft.
There are a number of reasons that a patient may begin to lose bone mass including underlying medical conditions such as osteoporosis but the most common cause of bone loss in the jaw is periodontal disease. When the jaw bone begins to deteriorate, not only can the patient's teeth become loose and fall out, it can also result in changes to the patient’s facial structure. A bone graft can help restore the jaw to a healthy state and prevent further damage.
Periodontal Disease and Bone Loss
Gum disease develops in stages, the first of which is gingivitis. Caught early, gingivitis is easily treated and any damage is likely reversible. Left untreated, gingivitis can progress into advanced periodontitis which is a chronic bacterial infection in the gum pockets. Each of our teeth have pockets between the tooth structure and gum tissue and when these pockets become infected due to a build-up of tartar and bacteria, the gum tissue begins to pull away from the root surface causing tooth sensitivity and bone loss.
The number one cause of gum disease is poor oral hygiene, though it can also be a symptom of an underlying medical condition or even a side effect of certain medications. Some patients may even be genetically predisposed to periodontal disease and can benefit from more frequent professional cleanings with their dental hygienist than the standard twice-a-year.
Some symptoms of gum disease include:
- Tender, puffy gums that bleed with oral hygiene
- Tooth sensitivity to hot or cold foods and beverages
- Chronic bad breath that does not go away after oral hygiene
- Tooth mobility
- Pain and difficulty chewing
When gum disease leads to gum recession, it can cause a lot of pain and sensitivity. Severe cases of gum recession can be treated with a gum graft which can help prevent bone loss and tooth mobility. Without treatment, gum recession will eventually lead to bone deterioration causing otherwise healthy teeth to become mobile and possibly fall out. If you notice signs of gingivitis, it is important to have it treated before it can progress further and cause additional damage. Patients that do experience bone loss still have a few options available. A periodontist can provide treatment to restore bone structure to any affected areas.
Types of Bone Graft
There are a few different types of bone grafts. Your doctor will be able to determine which type is best for your individual case.
Types of bone grafts include:
- Alloplast: A synthetic material containing calcium, phosphorus, and hydroxylapatite, a natural mineral chemically similar to hard tissue.
- Allograft: A piece of bone is harvested from a human cadaver donor.
- Xenograft: Donor bone is harvested from an animal, usually a cow.
- Autograft: Harvested from the patient’s hip or the back of their jaw.
Bone Loss and Dental Implants
Healthy bone structure is vital to the success of a dental implant. Patients that do not have enough bone structure may need to have a bone graft before an implant can be placed. Sometimes, a bone graft can be placed at the same time as the implant! The procedure for a bone graft is performed under local anesthetic, administered via injection directly to the site being worked on.
Once the area receiving the bone graft is numb, the doctor will make a small incision in the gum tissue to access the infected bone. Any infected bone will be removed before the graft is placed. The graft site is then stitched up and left to heal for a few months during which the new bone will fuse with the remaining healthy bone to restore the jaw and provide a stable foundation for any remaining natural teeth or future implants.
Preventing Bone Loss
Since gum disease is most often a result of poor oral hygiene, the best way to prevent bone loss is with good dental care and regular visits to your dentist. Your dental hygienist will be able to identify any symptoms of gingivitis at which point they can immediately provide treatment to prevent progression and begin the healing process which may reverse any damage that has occurred.
Patients who are more susceptible to periodontal disease may be advised to have professional cleanings more often than twice a year. The "industry standard" of twice per year is set by insurance companies and most patients are better served with three or four preventative cleanings per year. Even if your dental insurance does not cover more than two cleanings, the out-of-pocket cost for one more cleaning each year is much less than treatment for periodontal disease and bone loss. Dental insurance typically only covers $1500 to $2000 per patient per year, regardless of the treatment needed.
Gum disease is a common problem for adult patients and it is not always just because of bad oral hygiene. Patients can be genetically predisposed to periodontal issues, including gum disease, so it is important to understand your health history and maintain a good home care routine in order to give yourself the best chance of preventing periodontal disease and possibly bone loss.
A patient can develop gingivitis without even realizing it so if you notice any symptoms of gingivitis, it is important to see your dentist as soon as possible for a routine cleaning and an exam to assess the area and any damage that may have been done. When caught early, gum disease is easily treated and further damage prevented. Gum disease can quickly lead to gum recession and bone loss but your periodontist can provide a gum or bone graft to restore any affected areas and keep your smile looking and feeling great.