Understanding and Treating Jawbone Loss: Keeping Your Smile Strong

Your bones are constantly undergoing a process of remodeling, where old bone is removed (resorption) and new bone is added (ossification). This natural cycle is crucial for maintaining bone health. However, if resorption outpaces ossification, it can lead to a decrease in bone mass, particularly in your jawbone, increasing your risk of fractures. How Bone Remodeling Works Two types of cells are responsible for bone remodeling: osteoclasts break down old bone and release it into your bloodstream, while osteoblasts build new bone where reinforcement is needed. During childhood, bone creation occurs at a faster rate, slowing down as you age. In your first year of life, nearly 100% of your skeleton is replaced, and as an adult, your bones remodel at about 10% per year. Bone remodeling is vital for various dental procedures. Orthodontic treatments like braces rely on resorption and ossification to reposition and strengthen teeth. For dental implants, new bone growth around the metal post provides stable support comparable to natural teeth. Symptoms of Jawbone Loss Early stages of jawbone loss may go unnoticed. As bone resorption progresses, you might experience: Changes in your bite and facial structure Discomfort while chewing Wrinkles forming around your mouth Shifting or loosening of teeth Lips appearing to sink inward Wrinkled skin around your mouth Headaches, facial pain, and jaw pain Increased difficulty speaking Changes in the fit and comfort of dentures What Causes Jawbone Loss? Jawbone strength is maintained through osseointegration, a process stimulated by the forces exerted through your teeth during chewing and biting. These forces signal osteoblasts to keep the bone strong. When a tooth is lost due to extraction, gum disease, or injury, the jawbone in that area no longer receives these stimuli. Consequently, osteoclasts begin to break down the jawbone, and osteoblasts deprioritize rebuilding the bone structure there. While some new bone may still form, it often occurs at a slower rate than bone destruction. Wearing dentures can also accelerate this deterioration, leading to loose dentures that require refitting. Other common causes of jawbone loss include: Gum disease, especially severe forms like periodontitis. Osteoporosis, a condition that weakens bones throughout the body, including the jawbone. Orthodontic treatment has been shown to temporarily decrease bone density around moved teeth, though it typically recovers in healthy individuals after treatment. Effects of Jawbone Loss Beyond the physical symptoms, jawbone loss can lead to tooth loss and make it challenging or impossible to get replacement teeth (implants, bridges, or dentures) without a bone graft. Severe jawbone loss can also result in facial collapse, where the mouth appears to recede into the face, the chin becomes more pointed, and facial muscles weaken. These changes can lead to premature wrinkling around the mouth and thinning lips, often making individuals appear older. Treatment Options for Jawbone Loss Treatment for jawbone loss depends on its underlying cause. Your dental professional can help determine the source of abnormal resorption. If you have missing teeth and sufficient bone density, dental implants may be recommended. Implants not only replace teeth but also stimulate the bone, restoring the natural balance of osseointegration and resorption. For significant bone loss, a bone graft may be necessary before an implant can be placed. Bone grafting can also stimulate new bone growth. If bone loss is linked to conditions like osteoporosis, your healthcare and dental professionals may collaborate on a treatment plan, which could involve medications or hormone therapies. While jawbone loss can be concerning, your dental professional can work with you to develop an effective treatment approach, helping you maintain a healthy, smiling future.