Missing Teeth / Edentulism
An overview of Missing Teeth
The term edentulism refers to permanent teeth which are lost from a place that once had them. An edentulous site is a position in the mouth previously occupied by a tooth. An edentulous area is a region from which multiple teeth have been lost. Total edentulism is the loss of all teeth.
Edentulism is contrasted with anodontia, which is a term for congenital absence of all of the teeth (i.e. the patient never gets teeth); and hypodontia, which is a term for congenital absence of some of the teeth. Hypodontia is also called partial anodontia, which is something of a misnomer. While hypodontia is common, anodontia is rare, and is usually associated with a condition called hypohydrotic ectodermal dysplasia.
Reasons for replacing missing teeth include: to prevent the remaining teeth from moving; to prevent the remaining teeth from becoming overloaded; to preserve the ability to chew normally and maintain proper nutrition; to preserve the tooth bearing (alveolar) bone; to support the cheeks and lips; to restore the appearance of the smile.
How does the dentist diagnose Missing Teeth?
Note: ToothIQ.com contains general information. Only a dentist can properly diagnose your specific condition.
It is easy to diagnose missing teeth. The challenge is determining the best way to replace the missing teeth with teeth that function normally and look beautiful and natural. It is important to understand the factors leading to loss of the natural teeth, so that the likelihood of long-term success with the replacement teeth is greater.
The most common cause of missing teeth in adults is periodontal disease. Other common causes include tooth decay (caries) and bite stress. These factors need to be controlled or eliminated, or the replacement teeth are unlikely to be successful. If all of the teeth are lost, caries and periodontal disease are no longer a factor; however bite stress can be. Forceful avulsion of teeth (i.e. trauma knocks them out) is another mechanism by which teeth are commonly lost.
What are options for replacing Missing Teeth?
There are several options for replacing missing teeth. The best solution depends on which teeth are lost, and how many teeth are lost. Options generally include removable dentures, fixed bridges, and dental implants. Combinations of these procedures are common. Bone grafting procedures may be recommended for patients who have lost significant bone along with the loss of their teeth.
Although it can be performed at the time implants are placed, re-establishing adequate bone is usually done before bridges, dentures or implant-supported restorations are finalized. No treatment is an option, and may not be a bad one if the missing tooth is a second or third molar, at the end of the dental arch, and the patient still has healthy teeth in front of it.
Wisdom teeth (third molars) are almost never replaced when they are removed. Second molars are sometimes replaced, depending on the presence and condition of the remaining teeth, the patient’s oral hygiene, how the patient uses their teeth, among other factors.
Loss of a tooth from between other teeth is generally more serious, because the teeth on either side tend to tip into the space created by the extracted tooth; and the tooth which previously closed against the missing tooth (from the opposite dental arch), tends to extrude into the space.
The problem then becomes that the bite relationship between the upper and lower dental arches has changed, and the biting forces may not be evenly distributed between the teeth. This can lead to wearing (attrition), chipping and cracking of the remaining teeth, and potentially other problems with the jaw joints and jaw muscles.
The treatment options available to you depend on which tooth or teeth are missing; how many teeth you are missing; where in the mouth they are missing from; and whether or not you have any dental conditions such as tooth decay (caries), periodontal disease, or tooth grinding habits (bruxism). It also depends on the quantity and density of bone that remains, and several factors related to your health history (including use of certain medications, whether or not you’ve ever undergone radiation treatment affecting the jaws, and other factors).
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