Dr. Michael Handler

Why Periodontal Disease Causes Bone Loss, and What to Do About It

By Dr. Michael Handler

Dr. Michael Handler

Bone loss can happen for a number of reasons, including misalignment of the jaw, tumours and accidental trauma to the face, but periodontal disease is one of the most common causes. Periodontitis is a chronic inflammatory condition ranging from mild gum inflammation to a serious disorder, which can result in damage to the soft tissues of the mouth and the bone supporting the teeth. Statistics from the University of Ottawa show 21% of Canadian adults have experienced periodontal disease at some point in their lives.

How Periodontal Disease Develops

The first stage of periodontal disease is gingivitis, which is the development of a mild infection that makes the gums feel sensitive and bleed easily. This is caused by accumulation of dental bacteria at the edge of the gum tissue. Plaque then develops and spreads into the gums, causing infection of the tissues. If the infection isn’t treated it causes a breakdown of the gum tissue, forming pockets around the teeth, which can then become loose and either fall out or need to be extracted. This results in bone loss, which can have a severe impact on your overall health.

Why Bone Loss Occurs

Tooth loss happens because the bacteria causing your periodontitis “eats away” at the underlying jawbone and destroys the ligaments connecting your teeth to the bone. If one or more teeth are lost and not replaced, the pressure and stimulation of chewing is gone, causing the bone surrounding and supporting the tooth to become absorbed back into your system through lack of use. This is called alveolar bone resorption.

In the first year after you lose a tooth 25% of the bone is lost, and this continues to happen unless you replace all missing teeth with implants. Eventually, your face changes shape completely because the jawbone has partially disappeared, and the muscles and tissues are no longer supported the way they should be. Dentures don’t help, because they provide less than 10% of the pressure required to prevent bone loss.

Preventing Bone Loss

Prevention is always better than having to try and cure bone loss, and the best way to protect yourself is to avoid getting periodontal disease. Maintain a healthy daily oral regimen, have your teeth cleaned professionally twice a year, and get an annual examination from your dentist. Some factors increase your risk for gum disease, such as smoking, diabetes and other chronic conditions, medications, hormonal changes, and genetic markers.

Replace any teeth you lose immediately with implants, which provide between 70% and 80% of the pressure required to prevent bone loss. If you already have inflammation and deep pockets in your gum tissue that don’t recover after deep cleaning and medication, your dentist may recommend flap surgery. This entails lifting back the gums to remove the tartar and then suturing them around the teeth to fit closely again.

Treating Alveolar Bone Loss

For patients who are too late to prevent bone loss, bone grafting or augmentation may be necessary before implants can be placed. This is because the dentist needs the ridge to be high and wide enough to accommodate the artificial tooth. The process provides a sound structure for the implants and helps stimulate the bone to grow and rebuild itself. Bone grafting can also be used to repair damaged and lost bone around any teeth with deep pockets caused by gum disease.

For more information on how to prevent and treat bone loss caused by gum disease or to schedule an appointment with Dr. Handler, please contact 416-267-4661.

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