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Tooth loss is a process in which one or more
teeth A tooth ( : teeth) is a hard, calcified structure found in the jaws (or mouths) of many vertebrates and used to break down food. Some animals, particularly carnivores and omnivores, also use teeth to help with capturing or wounding prey, ...
come loose and fall out. Tooth loss is normal for deciduous teeth (baby teeth), when they are replaced by a person's adult teeth. Otherwise, losing teeth is undesirable and is the result of injury or disease, such as dental avulsion,
tooth decay Tooth decay, also known as cavities or caries, is the breakdown of teeth due to acids produced by bacteria. The cavities may be a number of different colors from yellow to black. Symptoms may include pain and difficulty with eating. Complicatio ...
, and gum disease. The condition of being toothless or missing one or more teeth is called '' edentulism''. Tooth loss has been shown to causally reduce overall health and wellbeing as it increases the probability of depression.


Tooth exfoliation in children

Normal loss of
primary teeth Deciduous teeth or primary teeth, also informally known as baby teeth, milk teeth, or temporary teeth,Illustrated Dental Embryology, Histology, and Anatomy, Bath-Balogh and Fehrenbach, Elsevier, 2011, page 255 are the first set of teeth in the ...
typically begins around age six and continues until age twelve. The upper and lower central incisors are shed at age six to seven years. The upper and lower lateral incisors are shed at seven to eight years. The upper canines are shed at ten to twelve years. The lower canines are shed at nine to twelve years. The upper and lower first molars are shed at nine to eleven years. The upper and lower second molars are shed at ten to twelve years.


Pathological tooth loss


Causes and prevention

As a person ages, their permanent teeth have been exposed to normal mechanical forces, such as chewing, and also more abnormal mechanical forces, such as
bruxism Bruxism is excessive teeth grinding or jaw clenching. It is an oral parafunctional activity; i.e., it is unrelated to normal function such as eating or talking. Bruxism is a common behavior; reports of prevalence range from 8% to 31% in the gen ...
and traumatic injury. Permanent teeth may also be affected by oral disease. There are many ways in which a person may protect their permanent teeth from loss. The main method of preventing tooth loss is prevention of oral diseases. Tooth loss can be due to tooth decay and gum disease. Tooth decay is caused by increased plaque retention. Bacteria can then invade the plaque and cause dental caries (cavities). If cavities persist untreated for an extended period of time, tooth breakdown occurs. Plaque retention and bacterial presence also affect the gums and bone and their ability to hold the teeth in place. Disease of the gums, known as periodontitis, leads to detachment of the supporting structures from the teeth and their eventual loss. Tooth loss due to tooth decay and gum disease may be prevented by practicing good
oral hygiene Oral hygiene is the practice of keeping one's mouth clean and free of disease and other problems (e.g. bad breath) by regular brushing of the teeth (dental hygiene) and cleaning between the teeth. It is important that oral hygiene be carried ou ...
, and regular check-ups at a
dentist A dentist, also known as a dental surgeon, is a health care professional who specializes in dentistry (the diagnosis, prevention, management, and treatment of diseases and conditions of the oral cavity and other aspects of the craniofacial c ...
's office. Good oral hygiene consists of brushing two times a day with a fluoridated toothpaste and flossing. Dental check-ups should occur every six months. Children or adults who are incapable of caring for their own teeth should be assisted with oral hygiene in order to prevent tooth loss. In contact sports, risk of mouth trauma and tooth injury is reduced by wearing
mouthguard A mouthguard is a protective device for the mouth that covers the teeth and gums to prevent and reduce injury to the teeth, arches, lips and gums. An effective mouthguard is like a crash helmet for teeth and jaws. It also prevents the jaws co ...
s and helmets with a facemask (e.g., a
football helmet The football helmet is a piece of protective equipment used mainly in gridiron football, although a structural variation has occasional use in Australian rules football. It consists of a hard plastic shell with thick padding on the inside, a ...
, a
goalie mask A goaltender mask, commonly referred to as a goalie mask, is a mask worn by goaltenders in a variety of sports to protect the head and face from injury from the ball or puck, as they constantly face incoming shots on goal. Some sports requiring th ...
). Nightguards may also be implemented in the case of teeth grinding (bruxism) during sleep. These guards function in limiting the wear and force applied to the teeth. In turn, this minimizes the chance of loss. In countries such as the United States, Japan, Germany, and Italy, there is a strong relationship between cigarette smoking and tooth loss. Studies have shown that an increase in exposure to cigarette smoking can increase the risk of tooth loss. In addition, studies have also found that when people stop smoking, there is a decrease in tooth loss. Proper nutrition has been shown to prevent tooth loss by providing the nutrients necessary to maintain enamel strength. Tooth loss occurs more often in people from the lower end of the socioeconomic scale.


Secondary to disease

Tooth loss can occur secondary or concomitantly to many diseases. Diseases may cause periodontal disease or bone loss to prompt tooth loss. Consequently, periodontal disease may cause increased infection, which may predispose a person to other diseases. Diseases commonly related to tooth loss include, but are not limited to: cardiovascular disease, cancer, osteoporosis and diabetes mellitus. Therefore, it is important to not only maintain good oral hygiene, but also overall good health.


Missing tooth replacement

Maximum preservation and protection of natural teeth is best for eating and chewing; however, there are three basic ways to replace a missing tooth or teeth, including a fixed dental bridge,
dentures Dentures (also known as false teeth) are prosthetic devices constructed to replace missing teeth, and are supported by the surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable ( removable partial denture o ...
, and
dental implant A dental implant (also known as an endosseous implant or fixture) is a prosthesis that interfaces with the bone of the jaw or skull to support a dental prosthesis such as a crown, bridge, denture, or facial prosthesis or to act as an orthodo ...
s. Each alternative has its own benefits and drawbacks. It is important to consider a patient's medical, financial, and emotional situation. It is recommended that a patient experiencing tooth loss visits a dentist to discuss which replacement method is best suited for their situation. It has been shown that a non-removable replacement, such as a bridge or implant appears to provide patients with the best sense of security and well-being. In some cases, small missing areas can be restored by using techniques such as resin boded bridge (acid etch bridge) and maryland bridge.


Research

Researchers in Japan have successfully regrown fully functional teeth in mice.
Epithelial Epithelium or epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercellu ...
and mesenchymal cells were extracted from the mice, cultured to produce a tooth "germ", and the germ was then implanted into the bone at the space of a missing tooth. A tooth of the correct external and internal structure, hardness, strength, and sensitivity later erupted in the space, eventually meeting the opposing tooth in a manner similar to an original natural tooth. This technique may be a possible future treatment for replacement of missing teeth.
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See also

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Teeth cleaning Teeth cleaning is part of oral hygiene and involves the removal of dental plaque from teeth with the intention of preventing cavities (dental caries), gingivitis, and periodontal disease. People routinely clean their own teeth by brushing and in ...
**
Tooth brushing Tooth brushing is the act of scrubbing teeth with a toothbrush, usually equipped with toothpaste. Interdental cleaning (with floss or an interdental brush) can be useful with tooth brushing, and together these two activities are the primary me ...
**
Flossing Dental floss is a cord of thin filaments used in interdental cleaning to remove food and dental plaque from between teeth or places a toothbrush has difficulty reaching or is unable to reach. Its regular use as part of oral cleaning is design ...
** Tongue cleaning *
Dental surgery Dental surgery is any of a number of medical procedures that involve artificially modifying dentition; in other words, surgery of the teeth, gums and jaw bones. Types Some of the more common are: * Endodontic (surgery involving the pulp or root ...
*
Wisdom tooth A third molar, commonly called wisdom tooth, is one of the three molars per quadrant of the human dentition. It is the most posterior of the three. The age at which wisdom teeth come through ( erupt) is variable, but this generally occurs betw ...
*
Dental implant A dental implant (also known as an endosseous implant or fixture) is a prosthesis that interfaces with the bone of the jaw or skull to support a dental prosthesis such as a crown, bridge, denture, or facial prosthesis or to act as an orthodo ...
*
Periodontist Periodontology or periodontics (from Ancient Greek , – 'around'; and , – 'tooth', genitive , ) is the specialty of dentistry that studies supporting structures of teeth, as well as diseases and conditions that affect them. The supporting ...


References

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External links


Avulsed tooth: What to doTooth injury
Acquired tooth pathology