Edentulism (Toothlessness): Causes, Treatment, Prevention

Edentulism, or tooth loss, is when someone lacks some or all of their teeth. Missing teeth can be detrimental to your health as it makes it hard to chew food and digest it properly.

The condition is most common in the United States among adults and people 60 years or older. According to the American College of Prosthodontics, more than 36 million Americans suffer from the condition.

There are isolated cases of edentulism among young children—especially those who fail to practice proper dental hygiene. In addition to its role in digestion, teeth also contribute to an individual’s facial appearance.

Types of Edentulism

There are two types of edentulism that can affect someone—partial and complete.

1. Partial edentulism: With partial toothlessness, individuals will have some of their natural teeth missing. Partial tooth loss occurs more on the upper jaw than on the lower jaw.
2. Complete Edentulism: People with complete edentulism have all their teeth missing. It has a further classification into four classes, based on diagnostic findings. Class I represents an uncomplicated clinical situation, while Class IV signifies a complex clinical case.

Prevalence of Edentulism

Although it has decreased in the past decade, edentulism is still fairly common. According to the Centers for Disease Control and Prevention, between 2011 and 2016, one in six adults 60 years and older lost one or more teeth. Adults 65 and older are most affected with tooth loss than younger adults.

Causes

Tooth loss is usually associated with bacteria that cause oral infections. Besides that, the following can cause edentulism:

Risk Factors

These are the factors that can increase your chances of getting tooth loss:

• Age: As you get older, the tooth enamel starts to wear out. Further, the gums holding your teeth begin to recede, and you also experience a reduction in saliva production. All these factors put you at a greater risk of contracting edentulism.
• Smoking: Tooth loss is higher in smoking individuals than non-smokers. According to the CDC, smoking causes gum disease. If the disease progresses, it can damage the bones that hold your teeth in place.
• Gender: Women undergo hormonal changes which affect their oral health making them more susceptible to tooth loss than men. During menopause some hormones, such as estrogen, decrease, causing loss of the jaw bone placing women at a greater risk of getting osteoporosis.

Impact on Oral and General Health

Having inadequate dentition can have undesirable effects on one’s oral and general health. It can impact a person’s oral health in the following ways:

• Impaired mastication: Lack of teeth makes it difficult for someone to chew or bite their food. It will affect your diet because you will have to select foods that are easy to break down.
• Modifies the physiology of the mouth: Edentulism weakens the bones that form the mouth’s upper and lower jaw. It also leads to residual ridge resorption, which is the breakdown of the jaw bone that remains after teeth removal. It reduces the size of the jaw containing sockets of teeth (alveolar ridge).
• Determinant of oral health: The decline in salivary glands function compromises the protective role of saliva in the mouth, which is associated with tooth loss.

Other Issues with Tooth Loss

Just when you thought you knew all the problems that can follow tooth loss, here are more:

• Reduced intake of healthy foods such as fruits and vegetables
• Increases the chances of pancreatic cancer and ulcers
• It may lead to noninsulin-dependent diabetes
• Causes sleep apnea, a breathing disorder experienced during sleep

Furthermore, people with edentulism prefer eating fast foods that are easy to chew. These foods contain high cholesterol levels, which can cause obesity and heart disease.

Prevention

Preventing tooth loss may not always be possible. But you can use the following measures to avoid gum diseases, which will help prevent edentulism in the long run:

• Brush your teeth at least twice a day.
• Floss your teeth at least once a day.
• Use dental sealants to prevent tooth decay.
• Avoid smoking as this leads to gum disease.
• Incorporate calcium and vitamin D into your diet to form strong bones.
• Visit the dentist every six months.

Treatment

Dentists use different approaches to treat edentulism, depending on the severity of tooth loss. In persons with partial edentulism, physicians replace teeth lost with partial dentures. They can also use implant-supported prosthetics—artificial tooth roots screwed onto the jaw bone. These contain a single false tooth attached to them.

However, if one has complete tooth loss, dentists will present two option, dentures or a bridge:

• Dentures: These are false teeth used to replace missing ones. You can fix them permanently or make them removable. In case of complete edentulism, the dentist will use full dentures.
• Tooth bridge: It is made up of artificial teeth attached to a metallic frame. The dentist will fix the bridge to the mouth where the teeth used to be.

Facial Support and Aesthetics

Teeth have many functions. One is contributing to facial support which improves an individual’s facial appearance. For example, the front teeth help support the lips.

In edentulous patients, the cheeks have a sunken appearance affecting one’s looks. Additionally, without teeth, the tongue muscles tend to broaden out, filling the mouth. The tongue can make it difficult for one to use dentures.

You can correct it through aesthetic reconstruction. It involves using a facial scanner to predict the normal facial appearance of a person.

References

Facts and figures. (December 2021). American College of Prosthodontists.

Classification system for complete edentulism. The American College of Prosthodontics. (March 1999). Journal of Prosthodontics.

Partial Edentulism and its Correlation to Age, Gender, Socio-economic Status and Incidence of Various Kennedy’s Classes– A Literature Review. (June 2015). National Center for Biotechnology Information.

Edentulism and Tooth Retention. (December 2021). Centers for Disease Control and Prevention.

Epidemiology of Edentulism and Associated Factors. (April 2020). National Center for Biotechnology Information.

Periodontal Gum Disease. (August 2021). National Institute of Dental and Craniofacial Research.

What is osteoporosis and why does it occur? (August 2015). New York State Department of Health.

Impact of smoking on tooth loss in adults. (September 2016). Evidence-Based Dentistry.

Smoking, Gum Disease, and Tooth Loss. (February 2021). Centers for Disease Control and Prevention.

Hormones and Oral Health. (June 2018). Cleveland Clinic. 

Impact of Edentulism On Oral and General Health. (May 2013). National Center for Biotechnology Information. 

Implant treatment of patients with edentulous jaws: a 20-year follow-up. (December 2008). Clinical Implant Dentistry and Related Research.

Edentulism as part of the general health problems of elderly adults. (June 2010). International Dental Journal.

Classification system for partial edentulism. (September 2002). Journal of Prosthodontics.