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Tooth loss can occur for a variety of reasons – congenital absence, trauma, dental disease (e.g. caries or periodontal disease), as well as mechanical failure.
It is not uncommon for a tooth or teeth to be congenitally absent. Most commonly, the primary (baby) tooth is present but there is no successor (permanent tooth) to replace it. Frequently, this will be apparent when the baby tooth exfoliates, or falls out (usually during adolescence). Often however, the baby tooth will remain in place and will function until it fails due to the loss of root support or other dental disease. At this point, it will need to be removed.
Trauma can cause loss of teeth in a variety of ways. Teeth can be “knocked out” from trauma, such as a child falling off her bicycle and onto her face. Frequently however, trauma can affect the teeth in ways that do not manifest until months or years later. Root fracture may not be apparent until some time later when infection develops. Sometimes, after teeth have been traumatized, they can be treated and appear to be doing well until many years later when root resorption becomes apparent. This occurs when the body turns against itself and causes cells to eat away at the root surface, often allowing bone to grow into the defect that has been created.
Trauma of a more pernicious order can also affect the dentition. Significant defects of the jaw bone, in addition to teeth, can occur as a result of trauma. This may be following surgery to remove a tumor from the mouth and/or jaws, or secondary to external trauma such as an automobile accident, other forms of blunt trauma or ballistic wounds. These types of trauma can often be compounded by significant loss of jaw bone volume, or even continuity, and could require other forms of surgery to reconstruct the jaw anatomy as well as provide for prosthetic tooth replacement.
The most common reason for tooth loss is gum (periodontal) disease. This is essentially a localized infection in the gums and supporting structures of the teeth leading to loss of bone. This can progress to the point that teeth fall out on their own or are deemed beyond repair or are too compromised to be useful and must be extracted. Dental caries (decay) can also progress to the extent that teeth are beyond the ability to be restored in function. Decay can also lead to significant infection in the bone around the ends of the root(s) leading to necessary tooth extraction to prevent further infectious complications.
Lastly, teeth may crack or fracture in such a way that they cannot be maintained and must be removed. This can happen as the result of clenching and grinding habits (bruxing), or for mechanical reasons related to the lack of sufficient support from other teeth which causes extreme stress to the teeth that remain in function.
Pyorrhea called Periodontitis and periodontal diseases involve inflammation of tissues and are caused by bacteria. Depending on the degree of damage are called:
Old people lose teeth due to several factors. The most common causes involve poor oral hygiene and wrong eating habits. In the absence of proper brushing and flossing plaque begins to build up on and between the teeth over a period of several years. The dentists recommend brushing teeth twice a day right from the childhood and flossing teeth at least once a day.
In the absence of proper oral hygiene, the bacteria begin to build up in the mouth and gradually eat away the enamel, the protective layer of teeth, to expose the sensitive parts of teeth. This further develops into cavities in the mouth. Over a period of several years, many cavities develop in the mouth and gums may also get inflamed and infected. Thus, tooth decay and gum inflammation together make the tissues supporting teeth weak and fragile. Eventually this causes tooth decay in elderly people.
Wrong eating habits also put a great stress on teeth. Some people eat lots of sweets, candies and other sweet things quite frequently. Sugar causes tooth decay and when too much sugar consumption is combined with poor oral hygiene habits then it becomes a sure shot way to lose teeth early.
In order to retain teeth for your entire life time, make sure to brush and floss regularly, eat a calcium, protein and nutrients rich diet and visit your dentist regularly for check-ups.
Replacing a single tooth can be achieved with a conventional bridge or an implant retained crown. The conventional fixed partial denture (fixed bridge) requires that your dentist drills down two or more adjacent teeth to create space for the crowns of the prosthetic teeth. Placing a bridge on natural teeth increases the functional forces that are placed upon them and makes the use of floss between the teeth more difficult. Conventional bridges may need to be replaced if the supporting teeth develop cavities or periodontal disease. In a certain percentage of instances while preparing the adjacent teeth for crowns (i.e. drilling down a tooth), the preparatory procedure will cause the nerve of the tooth to die and require root canal treatment to eliminate infection of the nerve.
An implant single-tooth restoration avoids the need to restore the adjacent teeth and also replaces the support that is lost with the missing tooth. This allows normal flossing as if the replacement implant were a natural tooth. An implant is placed in the position of the missing tooth. When the implant is stable and ready for loading, an abutment can be attached to the implant that will connect the final crown to the implant. An impression is made to record the contours of the abutment or the position of the implant top. The crown is then fabricated and fixed in place using cement or screws. An implant crown is not susceptible to cavities but may develop complications if oral hygiene is not maintained. The implant restoration should be routinely evaluated in time intervals that are determined by the conditions of the remaining natural teeth and the implant.