Short answer: Jawbone loss is the loss of volume and density in the bone that holds the teeth. Its most common causes are thinning of the bone in an area left empty after tooth loss and untreated gum disease. Loose teeth, gum recession and a loosening denture are among the symptoms. Treatment is planned according to the cause, with options such as periodontal treatment, bone grafting and implants.
Jawbone loss is the loss of volume and density in the jawbone that holds the teeth; in dentistry it is usually called "bone loss" or "bone resorption," and it is also commonly referred to as dental bone loss. Its two most common causes are the gradual thinning of the bone in an area left empty after tooth loss, and untreated gum disease destroying the supporting bone around the teeth. In this article we explain why bone is lost, its symptoms, its effect on denture and implant treatment, and the options for treatment and prevention.
Why does the jawbone shrink?
The jawbone shrinks mainly because of tooth loss and advanced gum disease, either because the stimulation the bone needs disappears or because inflammation destroys the bone tissue. Bone is a living tissue and is constantly being reshaped; bone that is not used or is exposed to inflammation loses volume over time.
Tooth loss
The force placed on the teeth during chewing is transmitted through the roots to the jawbone and creates a stimulus that keeps the bone healthy. When a tooth is extracted, this stimulus disappears, and the bone in the gap begins to thin in both width and height. Bone loss is faster especially in the first months after extraction and continues at a slower pace over the years.
Gum disease (periodontitis)
When gum inflammation is left untreated, the inflammation can spread to the supporting tissues beneath the gum. Bacterial plaque and tartar, together with the body's defense response, lead to the destruction of the bone surrounding the teeth. As a result, teeth may start to loosen and, if left untreated, may be lost. Smoking, uncontrolled diabetes and genetic predisposition can speed up this process.
Other causes
- Ill-fitting removable dentures: Dentures that put uneven pressure on the gums can contribute to faster loss of the bone underneath.
- Tooth root infections: Long-standing inflammation at the root tip leads to bone loss in that area.
- Trauma: Blows that cause tooth loss can also affect the surrounding bone.
- Cysts and tumors: Rarely, lesions growing inside the jawbone can cause bone destruction.
- Systemic conditions and medications: General bone diseases such as osteoporosis and certain bone medications can affect the jawbone. In particular, people taking certain osteoporosis and cancer medications need to inform their dentist before procedures such as tooth extractions; this is a different condition and is evaluated separately.
Symptoms
Jawbone loss usually progresses silently at first; symptoms such as loose teeth, gum recession, gaps forming between the teeth and a removable denture that no longer fits are often noticed only once the bone loss has reached a certain level.
- Bleeding, redness and swelling of the gums
- Gum recession and teeth that look longer
- Loose or shifting teeth, new gaps between the front teeth
- Persistent bad breath
- Discomfort when chewing or a change in the way your teeth bite together
- A removable denture that loosens and starts to rub frequently
- In people who have been without teeth for a long time, a sunken lower face and deepening wrinkles around the lips
The presence and amount of bone loss can only be determined by an examination and X-rays. The depth of the gum pockets is measured with a periodontal probe; a panoramic X-ray and, when needed, cone beam CT show the level and volume of the bone.
Effect on dentures and implants
Jawbone loss reduces the retention of removable dentures and can limit the bone volume needed for implant treatment; it is therefore a decisive factor in treatment planning.
Removable dentures
Complete dentures get their support and retention from the bony ridge they rest on. As the bone is lost, this ridge flattens; the denture starts to move, rub and come loose during chewing. It is important to have the denture checked at regular intervals and to have its inner surface relined when needed. Using an ill-fitting denture for a long time can speed up bone loss even further.
Implant treatment
For an implant to be placed safely, there must be sufficient height and width in the jawbone. If a long time has passed since tooth loss, the bone may be insufficient for an implant. In that case, bone augmentation procedures are planned before the implant or in the same session. In the back of the upper jaw, bone height can decrease even further as the sinus cavity expands.
On the other hand, implants can help preserve bone by transmitting chewing forces to it. That is why implant treatment carried out at the right time after tooth loss can also be considered as a way of limiting bone loss.
Treatment: grafts, implants, periodontal treatment
Treatment of jawbone loss is determined by the cause; with loss due to gum disease, the first step is stopping the inflammation, while with loss due to missing teeth, reconstructive procedures such as bone grafts and implants come into consideration.
Periodontal treatment
In gum disease, the first step is deep cleaning, in which tartar and bacterial plaque are removed from the tooth surfaces and inside the gum pockets. The aim is to stop the inflammation and prevent bone loss from progressing. In suitable cases, regenerative surgical methods aimed at regaining some of the lost bone can be used. The success of periodontal treatment is directly linked to the patient's regular oral care at home and regular checkups.
Bone graft procedures
- Socket preservation: Graft material is placed in the socket when the tooth is extracted, with the aim of limiting bone loss.
- Guided bone regeneration: Graft material is placed in the area with a bone deficiency and covered with a membrane to support bone formation.
- Sinus floor elevation: If bone height in the upper back area is insufficient, the sinus membrane is lifted and graft material is placed underneath.
- Block grafts: For larger bone deficiencies, bone blocks taken from the patient's own bone or from other sources can be used.
The type of graft material is chosen according to the case from among the patient's own bone, processed materials of natural origin or synthetic products. A waiting period of several months is usually needed for the graft to mature; this time varies with the area and the scope of the procedure.
Implants
If the bone volume is sufficient, or has been made sufficient through bone augmentation, missing teeth can be replaced with implants. In some cases, shorter or narrower implants can be chosen so that no additional bone procedure is needed; the suitable option is determined based on the CT findings.
Prevention
The basis for preventing jawbone loss is treating gum disease early, not leaving the gaps of lost teeth empty for a long time and keeping up regular dental checkups.
- Brushing twice a day and using floss or an interdental brush every day
- Taking gum bleeding seriously and seeing a dentist without delay
- Checkups and professional cleaning every six months or at the intervals your dentist recommends
- Quitting smoking
- Keeping chronic diseases such as diabetes under control
- When an extraction is needed, planning in advance how and when the gap will be filled
- Regular denture checkups for people who wear removable dentures
For other topics you may be curious about, you can take a look at our frequently asked questions page.
Bone loss assessment in Ankara
If you notice gum recession, loose teeth or a loosening denture, or if you have had a missing tooth for a long time, an assessment of your bone condition directly affects the treatment options that may be available to you in the future. At our polyclinic in Park Oran Ofis next to Panora Mall in Çankaya, the roadmap that suits you is explained after the examination and imaging. To make an appointment, you can use our contact page.
Frequently asked questions
Can jawbone loss be reversed?
Lost bone does not grow back on its own. However, in suitable cases, bone volume can be increased with bone grafts and regenerative methods. In gum disease, the primary aim of treatment is to stop the loss from progressing.
Can people with bone loss get implants?
In most cases, yes. If bone volume is insufficient, bone augmentation procedures can be planned before the implant or in the same session. Suitability is determined by evaluating the height and width of the bone with a CT scan.
How quickly is bone lost after a tooth is extracted?
Bone loss is faster in the first months after extraction and continues at a slower pace over the years. That is why it is recommended to plan early how the gap will be filled after an extraction.
What is the first sign of bone loss?
Bone loss often causes no symptoms at first. Gum bleeding and persistent bad breath can be early signs of underlying gum disease; a definitive assessment is made with an examination and X-rays.
