Loss of a tooth is not a pleasant phenomenon and it is frequently and rightly associated with a disability by the human psyche. However, as for many people the loss of a tooth by extraction is a matter of major importance, there are also categories of people for whom it is only a missing tooth in the arcade and as long as they can carry out their social or alimentary activities without this phenomenon to be visible, I’m overwhelmingly overlooked. For either of these two categories it is very important to know the short and long term effects of the extraction of an irrecoverable tooth.
Statistics show that the average age of loss of the first definitive tooth among the Romanian population is somewhere around the age of 18, which is not encouraging.
The most common indication of a tooth extraction is in cases of advanced periodontal disease or complicated caries with significant destruction of hard and even bony dental tissues.
Loss of one or more teeth on a dental arcade does not just create dents in the dental arcade they break, also known as bumps or edentuous spaces. Depending on the place, extent and size of these spaces, mastication (chewing food), physiognomy (physical and aesthetic appearance), swallowing (swallowing) and phonation (speech) can be affected in varying degrees.
The main change associated with the loss of a tooth is the resorption (melting) of the alveolar bone that sustained it in the jaw, a continuous and irreversible process. Bone resorption is maximal in the first year after extraction and especially in the first three months (50% in the first month). The female / male ratio is 4/1 and the resorption rate increases in women by 3% after menopause. If the loss of the tooth has also contrasted with a bone infection, resorption is even greater and large defects sometimes occur.
This is of particular importance in prosthetic reconstruction of the edentation either by implant or by dental bridge, preventing the insertion of an implant without bone addition and even more complicated interventions or the application of a bridge capable of restoring the resonance ridge physiognomy it can mimic the gums at the level of the added teeth added).
Also, the loss of one tooth results in the tilting of the neighboring teeth in their search for restoring the contact point and the continuity of the arcade, along with the “lowering” or “climbing” (depending on the jaw) of the tooth on the opposite arch that establishes contact with the lost tooth. Practically the teeth are erupting continuously throughout life to compensate for any change in occlusal contacts (from the bite).
These changes are not benign for the oral cavity. The inclination of the neighboring teeth is often accompanied by the damage to the support tissues of these teeth and the appearance of the periodontal pockets (pus in the gum). At the same time, they no longer receive the demands of mastication on their long axis, as they are created, and this even affects their supporting tissues and even the dental pulp (the nerve). These teeth can be lost in time by periodontal disease.
Use as pillars for a future dental bridge (fixed work), pillars that need to be parallel, these teeth require additional dental supplement sacrifice and often prosthetic removal (nerve removal).
The opposing teeth (on the opposite arch) of the lost teeth, which erupt further to look for occlusal contact during chewing, are interposed as obstructions in the lateral or back – front movements of the mandible that we normally do when chewing or bite the food, which traumatizes them extra and can even lead to spasms and muscle and joint pains.
And these teeth require adjustments before inserting an implant or applying a bridge, and this may sometimes mean high dental implants and even extractions (nerve removal).
Lowering or climbing they lose their initial contact with their neighbors and this leads to food retention, caries and even periodontal disease.
At the same time, due to these dental migrations, unequal wear on teeth (uneven bending) occurs.
Depending on the adaptability of the body, it is possible or not to install a cranio-mandibular dysfunction with associated suffering of the temporomandibular joint (the one supporting the mandible on the skull). These conditions are complicated and difficult to treat, so their prevention is the most appropriate attitude.
As we have already mentioned, the current solutions for restoring an editorial consist of one of the following: application of orthodontic appliances, insertion of implants or application of dental bridges or combination of these solutions.