Getting dental implants is a life-changing choice if you have missing or severely damaged teeth, but what happens if you don’t have the jawbone necessary to support these artificial teeth?
Dental implants are traditionally fused to the jawbone, but if you have struggled with missing teeth for years, your jawbone may have deteriorated.
The good news is that state-of-the-art treatment options are available—even if you might not seem like a good candidate for dental implants.
Causes of Jawbone Loss
Jawbone loss can occur for a variety of reasons. For instance:
Missing teeth. If teeth have fallen out or been extracted, the alveolar bone no longer receives the stimulation that it needs. In other words, the body no longer requires it, and so it breaks down and deteriorates over time. The most significant bone loss occurs within 18 months of losing the tooth, but it can continue for a lifetime.
Gum disease. Periodontal disease doesn’t just deteriorate your teeth. It can affect all types of periodontal tissues, including the periodontal ligament, cementum, gingiva, and the aforementioned alveolar bone. If you have severe untreated periodontitis (advanced-stage gum disease), the bone and gum tissue will start to break down. For many people seeking implants, this is where the problem starts. They lose teeth because the bone can no longer support them.
Dentures. Unanchored dentures rest against the gum line but provide no stimulation to the underlying jaw bone. As a result, the bone may deteriorate over time, especially if most or all of the underlying teeth are missing. If you do wear dentures, it’s a good idea to opt for anchored dentures, which fasten to the jawbone and provide adequate stimulation to prevent bone deterioration.
There are other causes as well, including osteoporosis and blunt impact to the jaw. Your dentist can assess the extent of the damage (if any) and help you to determine the best course of action for preserving or restoring your smile.
Signs of Jawbone Loss
Jawbone loss is sometimes obvious, but other times it can sneak up on you. If you’re considering dental implants, it’s important to recognize the telltale signs of bone loss.
Misaligned, loose, or drifting teeth. If your teeth have gradually started to drift or fall out of alignment, this can be a sign of bone loss. The problem can be especially prominent in denture wearers. For instance, if an upper or lower plate suddenly feels loose or no longer fits the way it once did, you’re probably losing bone density.
Discomfort when chewing. If your teeth are otherwise healthy but you struggle to chew normally, the underlying bone may be compromised. Again, the loss of bone density can alter the alignment of your bite, making it difficult to chew foods as easily as you once did.
Unexplained headaches and jaw pain. A headache can have myriad causes, but when it’s accompanied by jaw- and/or face pain, you may be dealing with the effects of gradual jaw bone loss.
The distortion of facial features. When the jawbone deteriorates, you may experience a change of appearance in facial features. For instance, it’s not uncommon for bone-loss sufferers to notice a collapsed facial profile, wrinkled skin around the mouth, or the visible appearance of a diminishing jawbone.
In addition, the loss of jawbone may be accompanied by signs like sore teeth and difficulty speaking. In other cases, you can just feel it deteriorating. If you notice any signs of bone loss, it’s important to visit your dentist right away—even if you’re not in the market for implants right now.
Can You Get Dental Implants if You Have Jawbone Loss?
The good news is that you may be eligible for dental implants even if you have moderate to significant jawbone loss. This would have been unheard of in previous generations, but state-of-the-art treatments have made it possible for oral surgeons to rely on alternative anchoring surfaces—or to reconstruct lost bone and provide a secure foundation for dental implants.
If bone loss has limited your options, you may be a candidate for a bone graft, a sinus lift, or zygomatic implants.
Bone grafting is the traditional solution for treating bone loss in dental implant candidates. It remains a popular option due to its extremely high success rate. Some types of bone grafts are over 99% successful.
With a bone graft, the existing low-density bone is combined with bone matter from a different part of the body. The two types of bone matter gradually fuse, improving bone density in the jaw to the point where you can support dental implants.
The bone matter may be taken from the hip bone, the tibia, or another part of the jawbone (if the bone loss is localized). In some cases, dentists will use bone matter from other donors or artificial bone. Once applied to the jaw, the bone graft may take 3 months or longer to heal before you can start the implantation procedure.
A sinus lift is similar to a bone graft but is applied to the upper jaw. Like a bone graft, it has an extremely high success rate; one review found sinus lifts to be more than 95% successful after 24 months of evaluation.
For this procedure, an opening is made along the gum tissue near the upper teeth. The sinus membrane is lifted and packed with bone powder. The powder gradually integrates with and reinforces the surrounding bone tissue. As with bone grafts, the sinus lift may take 3 months or longer to integrate to the point where implants can be supported. In some cases, the healing process may take up to 9 months.
Zygomatic implants are a relatively new treatment option. Developed in the 1990s, this treatment is specifically designed for implants along the upper jaw. The procedure can be combined with a traditional implant procedure, or it may be done on its own.
Rather than setting posts into the jawbone (as is the process for traditional implants), zygomatic implants are secured to the zygomatic bone (hence the name), more commonly referred to as the cheekbone. Longer posts are used since the posts have further to travel, but the posts remain secure because the zygomatic bone is much denser than a jawbone, providing a solid anchor point.
Factors That May Make You Ineligible for Dental Implants
A dentist specializing in implants can usually work with a patient experiencing jawbone loss, but bone loss isn’t the only factor that determines your candidacy for dental implants. There are other factors that must also be weighed. For instance:
Autoimmune diseases: Certain autoimmune diseases like rheumatoid arthritis, Graves’ disease, and lupus may make you a poor candidate for dental implants. That’s because autoimmune diseases cause the body to heal at a slower pace. As a result of the slower healing time, you would be at a significantly increased risk of dental implant failure.
Diabetes. Type 1 diabetes is an autoimmune disease, like the kinds highlighted above. Type 2 diabetes may be either a metabolic disease or an autoimmune disease (the issue is being hotly debated as we speak), but regardless, it may make you a poor candidate for implants—not just because it slows your healing times but because diabetes is also closely associated with other oral health problems.
Gum disease. If you have severe periodontal disease (periodontitis), you might be a poor candidate for dental implants—at least right now. The dentist will need to treat the gum disease before starting the implant procedure. Otherwise, you may be at a high risk for implant failure.
Patients With Jawbone Loss Have Options
If you have experienced some degree of jawbone loss but are hoping to receive dental implants, options are available. The first step is to visit your dentist and obtain a consultation. The dentist will take X-rays and gain an overall picture of your oral health. From there, they can determine your candidacy and let you know the best course of action.
Don’t put it off any longer. Dental implants can be life-changing, and bone loss is not an automatic deal breaker. Discover for yourself if you would be a good candidate.