Reviewed by Dr Izbel Aksit.
Bone loss in teeth elicits fear in many people. However, the truth is that it’s normal for our bones to lose and gain mass constantly. It is only when certain conditions make bone loss the predominant process that you have something to worry about.
For that, you need to understand why it happens and what you can do to treat or prevent it entirely.
What is Bone Loss in Teeth?
Here, it’s important to specify the bones that we’re talking about. First, there’s the mandible, mostly known as the (lower) jawbone. It’s the only moveable bone in the skull. Then there’s the maxilla, which sits above the mandible, also known as the upper jaw.
Alveolar bone is a part of both the mandible and maxilla, containing the ridges that anchor the tooth into the upper and lower jawbone. Now, when we’re talking about bone loss in teeth, one or more of these bones are going to be affected. So, “bone” loss refers to any of these.
The alveolar bone is constantly being remodelled by two types of cells:
- Osteoblasts (including osteocytes and bone-lining cells) – the bone-forming cells
- Osteoclasts – the bone-resorbing cells
The formation and resorption processes are balanced so that when the bone is lost, it’s replaced by osteoblasts. However, when bone loss occurs, the activity of osteoclasts dominates that of osteoblasts. This process can vary with age and the location where the bone loss is taking place (either the mandible or the maxilla).
How Bone Loss in Teeth Occurs?
Back in 1881, Wilhelm Roux gave the idea that the reason why bone loss occurs after tooth loss is that the bone is simply not being used as much as before. He called it “disuse atrophy.”
It’s similar to muscle atrophy, where the lack of their use leads to their deterioration. As to why the atrophy occurs, it’s because the forces on the bone are reduced, which gives it the signal of not being in use anymore.
According to a study published in the Journal of Dental Biomechanics, to maintain the bone, it needs a “strain stimulus” daily. When there’s not enough strain on the bone, the bone mass is lost.
Depending on the cause of bone loss, other factors can also play into the deterioration process. For instance, if you’re suffering from an infection, the inflammatory cells will produce substances aimed at eliminating the microorganisms. However, these can also disrupt the bone formation process, leading to a loss of bone.
What Are the Causes of Bone Loss?
You can experience bone loss in teeth as a result of one or more of the following reasons.
A gum infection damages not only the underlying jawbone but also the ligaments that attach the teeth to the jawbone. There’s another way it will result in bone loss:
Left untreated, you could end up losing your tooth entirely. As the height of the alveolar bone continues to decrease, the root of the tooth gets exposed. It’s also not anchored as firmly in place anymore, which easily knocks the tooth out. This further exacerbates the bone loss in teeth.
Since gum disease will also affect your ability to consume food normally, it can result in nutritional deficiencies. If it is that of calcium, it can also end up causing tooth loss, which can result in bone loss.
Research shows that as much as two-thirds of the hard and soft tissue is resorbed after extraction. Not just that, but you also continue losing 0.5-1% of the bone every year for the rest of your life (unless you get treatment for it). Overall, you can end up losing 40-60% of the alveolar bone (both in width and height) in just 2-3 years.
It is a health condition in which the new bone is not being formed as quickly as the old one is being reabsorbed. This can leave the bones porous and brittle. Ageing and low calcium intake (usually goes hand in hand) can result in this.
While this condition is commonly known to affect the bones in the body, it can also affect the jawbone. As the bones get weaker, they’re unable to support the teeth, which results in their loss, further causing bone loss in teeth.
Poor Tooth Alignment
As mentioned above, your jawbone needs a mechanical stimulus to function normally. However, this isn’t always possible if a person has misaligned teeth.
Some of the teeth won’t be receiving as much stimulus, which can cause the bone underneath to get the signal that it’s not used/needed. This can also result in its dissolution.
According to Johns Hopkins Medicine, you can end up with a jawbone infection (osteomyelitis) or a dental abscess if you haven’t had your cavity treated.
The infection spreads into the jawbone if there’s a lack of early intervention. This can even be life-threatening. Therefore, if you have pain, redness, swelling or drainage in the mouth, get in touch with your doctor.
Smoking doesn’t directly result in bone loss; it gives rise to numerous health problems which end up causing the problem at hand. It does so in the following ways:
- Increases the risk of gum disease
- Results in an imbalance in the hormones, which play a role in the maintenance of bone mass
- Increases the risk of osteoporosis
- Decreases the absorption of calcium
Therefore, the best plan of action here is to quit smoking altogether.
Although you might think that the wearing of dentures would provide enough mechanical stimulation to the underlying jawbone, this isn’t the case.
If you continue wearing dentures for a long time (without having dental implants to anchor them), you’re not applying the pressure on the jawbone that it needs for formation. As the bone loss in teeth continues, you’ll feel your dentures becoming loose.
This is the kind of bone loss that affects the maxilla (upper jawbone). After the extraction of the tooth, air pressure from the sinus cavity can reabsorb the bone, resulting in the expansion of the sinus cavities.
Other Conditions Causing Bone Loss in Teeth
There are some other conditions that can also result in the loss of bone in the jaw. These are as follows:
- Shattering of the bone due to physical trauma
- Removal of the bone due to a tumour
- Reduced blood supply to the jawbone due to radiotherapy (osteonecrosis)
- Excessive release of calcium into the blood due to hormonal disturbance caused by hyperparathyroidism
- Having vitamin D-resistant rickets, which commonly results in the formation of dental abscesses (without having any cavities or trauma)
If you’re suffering from any of these and are having bone loss issues, it’s possible that the two are related. However, you need to speak with your dentist for an accurate diagnosis.
Is Jawbone Loss Reversible?
Unfortunately, you cannot reverse it on your own. Bone loss in teeth is permanent and life-long. However, it is possible to get the bone restored for improved functioning.
If you leave it untreated, though, the process will continue affecting more and more of your teeth and your overall oral health. If you notice any of the following signs, you should get in touch with the dentist for stopping further bone loss:
- Loose, moving teeth (and consequent appearance of gaps between them)
- Swollen, bleeding, recessed gums
- Facial collapse (mouth moves inward, chin points out, and wrinkles form around the mouth)
Some people also want to know “how to slow down bone loss in teeth?” To answer this, first, you need to find out the cause of your bone loss, which only your dentist can help with. Certain habits can worsen the problem, such as smoking and poor diet. Therefore, quitting the former and bettering the latter can help you with bone loss.
What Are the Treatment Options for Bone Loss in Teeth?
You may get the following treatments for treating jawbone loss. These can help stop it and restore bone mass.
Dental Bone Grafting & Implants
Since you may lose the width and height of the alveolar bone, one way to restore it is to get dental bone graft surgery.
This surgery is especially needed if you plan to get dental implants because you need to have enough bone to anchor the metal post. One of the biggest benefits of implants is that not only will it prevent further bone loss in teeth but also stimulate the regrowth of the bone.
Scaling & Root Planning or Flap Surgery
All these aim to clean the teeth by removing the plaque or tartar which surrounds the bottom of the teeth or extends deep down. If the problem isn’t as severe, deep scaling and root planning would do the job.
However, if you have periodontal pockets that go deep down into the gums, you will need flap surgery for the proper removal of bacteria to stop the bone loss. It is possible to get flap surgery with a bone graft.
In order to restore bone in the upper jawbone, right below the sinus cavity, the doctor may recommend a sinus lift, where the sinus membrane is pushed back, and the thickness of the bone around it is increased with a graft. This also helps with the insertion of an implant.
Can You Prevent Jawbone Loss?
Maintaining your oral health is the first step in the prevention of bone loss in teeth. That means brushing and flossing the right way every day and going to a dental clinic for regular checkups. You need to be proactive.
If you have lost your tooth or are suffering from an oral health problem, do not delay getting treatment for it. The longer you wait, the more bone you will lose, and you’ll end up needing more extensive repairs.
Other than that, you need to consume foods that ensure good bone health. Bone Health and Osteoporosis Foundation (BHOF) recommends the following foods:
- Fish – Sardines, salmon, mackerel, tuna
- Fruits & vegetables – Collared/leafy greens, tomatoes, potatoes, raisins, papaya, oranges, banana, prunes, pineapples, etc.
- Fortified foods – Cereals, soy milk, rice milk, bread, etc.
Having these in your diet will also help you improve your overall health.
Bone loss in teeth is something that’s normal as long as it’s balanced by the gaining of bone mass. Our bones are constantly remodelled.
However, sometimes, this doesn’t happen, and the bone loss ends up outpacing bone formation. This can result in serious functional and aesthetic problems.
Although you cannot reverse bone loss, it is possible to stop it through different dental treatments. The earlier you get yourself checked, the better it will be.